|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$380.21 |
| Max. Negotiated Rate |
$1,389.75 |
| Rate for Payer: Aetna Commercial |
$788.94
|
| Rate for Payer: Aetna Medicare |
$612.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$847.81
|
| Rate for Payer: BCBS Complete |
$399.22
|
| Rate for Payer: BCBS MAPPO |
$588.76
|
| Rate for Payer: BCN Commercial |
$934.21
|
| Rate for Payer: BCN Medicare Advantage |
$588.76
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$847.81
|
| Rate for Payer: Cofinity Commercial |
$788.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.76
|
| Rate for Payer: Healthscope Commercial |
$942.02
|
| Rate for Payer: Healthscope Commercial |
$1,089.21
|
| Rate for Payer: Mclaren Medicaid |
$380.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.20
|
| Rate for Payer: Meridian Medicaid |
$399.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$647.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,101.80
|
| Rate for Payer: Nomi Health Commercial |
$706.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,389.75
|
| Rate for Payer: PACE SWMI |
$588.76
|
| Rate for Payer: PHP Medicare Advantage |
$588.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,138.28
|
| Rate for Payer: Priority Health Medicare |
$588.76
|
| Rate for Payer: Priority Health SBD |
$1,138.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,138.28
|
| Rate for Payer: Railroad Medicare Medicare |
$588.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.71
|
| Rate for Payer: UHC Core |
$1,089.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$588.76
|
| Rate for Payer: UHC Exchange |
$1,089.71
|
| Rate for Payer: UHC Medicaid |
$380.21
|
| Rate for Payer: UHCCP Medicaid |
$380.21
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,559.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$1,169.25 |
| Rate for Payer: Aetna Commercial |
$527.95
|
| Rate for Payer: Aetna Medicare |
$409.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.35
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCBS MAPPO |
$393.99
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: BCN Medicare Advantage |
$393.99
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cofinity Commercial |
$567.35
|
| Rate for Payer: Cofinity Commercial |
$527.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.99
|
| Rate for Payer: Healthscope Commercial |
$728.88
|
| Rate for Payer: Healthscope Commercial |
$630.38
|
| Rate for Payer: Mclaren Medicaid |
$254.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.69
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.85
|
| Rate for Payer: Nomi Health Commercial |
$472.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,169.25
|
| Rate for Payer: PACE SWMI |
$393.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$757.23
|
| Rate for Payer: Priority Health Medicare |
$393.99
|
| Rate for Payer: Priority Health SBD |
$757.23
|
| Rate for Payer: Priority Health Tiered Network |
$757.23
|
| Rate for Payer: Railroad Medicare Medicare |
$393.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.19
|
| Rate for Payer: UHC Core |
$724.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.99
|
| Rate for Payer: UHC Exchange |
$724.19
|
| Rate for Payer: UHC Medicaid |
$254.75
|
| Rate for Payer: UHCCP Medicaid |
$254.75
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$1,765.06 |
| Rate for Payer: Aetna Commercial |
$1,212.18
|
| Rate for Payer: Aetna Medicare |
$940.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.64
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCBS MAPPO |
$904.61
|
| Rate for Payer: BCN Commercial |
$1,448.62
|
| Rate for Payer: BCN Medicare Advantage |
$904.61
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cofinity Commercial |
$1,302.64
|
| Rate for Payer: Cofinity Commercial |
$1,212.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.61
|
| Rate for Payer: Healthscope Commercial |
$1,673.53
|
| Rate for Payer: Healthscope Commercial |
$1,447.38
|
| Rate for Payer: Mclaren Medicaid |
$581.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.84
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$995.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,720.30
|
| Rate for Payer: Nomi Health Commercial |
$1,085.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,467.00
|
| Rate for Payer: PACE SWMI |
$904.61
|
| Rate for Payer: PHP Medicare Advantage |
$904.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,765.06
|
| Rate for Payer: Priority Health Medicare |
$904.61
|
| Rate for Payer: Priority Health SBD |
$1,765.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,765.06
|
| Rate for Payer: Railroad Medicare Medicare |
$904.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,706.96
|
| Rate for Payer: UHC Core |
$1,706.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$904.61
|
| Rate for Payer: UHC Exchange |
$1,706.96
|
| Rate for Payer: UHC Medicaid |
$581.06
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,470.78 |
| Rate for Payer: Aetna Commercial |
$1,013.64
|
| Rate for Payer: Aetna Medicare |
$786.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.29
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$756.45
|
| Rate for Payer: BCN Commercial |
$1,207.10
|
| Rate for Payer: BCN Medicare Advantage |
$756.45
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,089.29
|
| Rate for Payer: Cofinity Commercial |
$1,013.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.45
|
| Rate for Payer: Healthscope Commercial |
$1,399.43
|
| Rate for Payer: Healthscope Commercial |
$1,210.32
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.27
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$832.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,431.14
|
| Rate for Payer: Nomi Health Commercial |
$907.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$756.45
|
| Rate for Payer: PHP Medicare Advantage |
$756.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,470.78
|
| Rate for Payer: Priority Health Medicare |
$756.45
|
| Rate for Payer: Priority Health SBD |
$1,470.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,470.78
|
| Rate for Payer: Railroad Medicare Medicare |
$756.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.05
|
| Rate for Payer: UHC Core |
$1,416.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.45
|
| Rate for Payer: UHC Exchange |
$1,416.05
|
| Rate for Payer: UHC Medicaid |
$487.13
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$1,005.75 |
| Rate for Payer: Aetna Commercial |
$461.13
|
| Rate for Payer: Aetna Medicare |
$357.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.55
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$344.13
|
| Rate for Payer: BCN Commercial |
$575.17
|
| Rate for Payer: BCN Medicare Advantage |
$344.13
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cofinity Commercial |
$495.55
|
| Rate for Payer: Cofinity Commercial |
$461.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.13
|
| Rate for Payer: Healthscope Commercial |
$636.64
|
| Rate for Payer: Healthscope Commercial |
$550.61
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.34
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.40
|
| Rate for Payer: Nomi Health Commercial |
$412.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.75
|
| Rate for Payer: PACE SWMI |
$344.13
|
| Rate for Payer: PHP Medicare Advantage |
$344.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$618.52
|
| Rate for Payer: Priority Health Medicare |
$344.13
|
| Rate for Payer: Priority Health SBD |
$618.52
|
| Rate for Payer: Priority Health Tiered Network |
$618.52
|
| Rate for Payer: Railroad Medicare Medicare |
$344.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.30
|
| Rate for Payer: UHC Core |
$681.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.13
|
| Rate for Payer: UHC Exchange |
$681.30
|
| Rate for Payer: UHC Medicaid |
$222.16
|
| Rate for Payer: UHCCP Medicaid |
$222.16
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$217.69 |
| Max. Negotiated Rate |
$1,029.00 |
| Rate for Payer: Aetna Commercial |
$453.16
|
| Rate for Payer: Aetna Medicare |
$351.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.98
|
| Rate for Payer: BCBS Complete |
$228.57
|
| Rate for Payer: BCBS MAPPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$563.22
|
| Rate for Payer: BCN Medicare Advantage |
$338.18
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cofinity Commercial |
$486.98
|
| Rate for Payer: Cofinity Commercial |
$453.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.18
|
| Rate for Payer: Healthscope Commercial |
$625.63
|
| Rate for Payer: Healthscope Commercial |
$541.09
|
| Rate for Payer: Mclaren Medicaid |
$217.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.09
|
| Rate for Payer: Meridian Medicaid |
$228.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$372.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.34
|
| Rate for Payer: Nomi Health Commercial |
$405.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.00
|
| Rate for Payer: PACE SWMI |
$338.18
|
| Rate for Payer: PHP Medicare Advantage |
$338.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$605.67
|
| Rate for Payer: Priority Health Medicare |
$338.18
|
| Rate for Payer: Priority Health SBD |
$605.67
|
| Rate for Payer: Priority Health Tiered Network |
$605.67
|
| Rate for Payer: Railroad Medicare Medicare |
$338.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.32
|
| Rate for Payer: UHC Core |
$665.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$338.18
|
| Rate for Payer: UHC Exchange |
$665.32
|
| Rate for Payer: UHC Medicaid |
$217.69
|
| Rate for Payer: UHCCP Medicaid |
$217.69
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,875.39 |
| Rate for Payer: Aetna Commercial |
$1,262.40
|
| Rate for Payer: Aetna Medicare |
$979.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.61
|
| Rate for Payer: BCBS Complete |
$627.11
|
| Rate for Payer: BCBS MAPPO |
$942.09
|
| Rate for Payer: BCN Commercial |
$1,537.77
|
| Rate for Payer: BCN Medicare Advantage |
$942.09
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.61
|
| Rate for Payer: Cofinity Commercial |
$1,262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$942.09
|
| Rate for Payer: Healthscope Commercial |
$1,742.87
|
| Rate for Payer: Healthscope Commercial |
$1,507.34
|
| Rate for Payer: Mclaren Medicaid |
$597.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.19
|
| Rate for Payer: Meridian Medicaid |
$627.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,840.57
|
| Rate for Payer: Nomi Health Commercial |
$1,130.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.00
|
| Rate for Payer: PACE SWMI |
$942.09
|
| Rate for Payer: PHP Medicare Advantage |
$942.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,873.67
|
| Rate for Payer: Priority Health Medicare |
$942.09
|
| Rate for Payer: Priority Health SBD |
$1,873.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,873.67
|
| Rate for Payer: Railroad Medicare Medicare |
$942.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,875.39
|
| Rate for Payer: UHC Core |
$1,875.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$942.09
|
| Rate for Payer: UHC Exchange |
$1,875.39
|
| Rate for Payer: UHC Medicaid |
$597.25
|
| Rate for Payer: UHCCP Medicaid |
$597.25
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$449.22 |
| Max. Negotiated Rate |
$1,411.78 |
| Rate for Payer: Aetna Commercial |
$948.28
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.28
|
| Rate for Payer: BCBS Complete |
$471.68
|
| Rate for Payer: BCBS MAPPO |
$707.67
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: BCN Medicare Advantage |
$707.67
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$948.28
|
| Rate for Payer: Cofinity Commercial |
$1,019.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.67
|
| Rate for Payer: Healthscope Commercial |
$1,309.19
|
| Rate for Payer: Healthscope Commercial |
$1,132.27
|
| Rate for Payer: Mclaren Medicaid |
$449.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.05
|
| Rate for Payer: Meridian Medicaid |
$471.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,385.59
|
| Rate for Payer: Nomi Health Commercial |
$849.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$707.67
|
| Rate for Payer: PHP Medicare Advantage |
$707.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,411.32
|
| Rate for Payer: Priority Health Medicare |
$707.67
|
| Rate for Payer: Priority Health SBD |
$1,411.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,411.32
|
| Rate for Payer: Railroad Medicare Medicare |
$707.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,411.78
|
| Rate for Payer: UHC Core |
$1,411.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.67
|
| Rate for Payer: UHC Exchange |
$1,411.78
|
| Rate for Payer: UHC Medicaid |
$449.22
|
| Rate for Payer: UHCCP Medicaid |
$449.22
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,203.93 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,884.25
|
| Rate for Payer: BCN Commercial |
$2,884.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Advantage |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Mclaren Medicaid |
$3,150.44
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,203.93 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Advantage |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$919.28
|
| Rate for Payer: Aetna Medicare |
$713.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.88
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$686.03
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: BCN Medicare Advantage |
$686.03
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$987.88
|
| Rate for Payer: Cofinity Commercial |
$919.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.03
|
| Rate for Payer: Healthscope Commercial |
$1,269.16
|
| Rate for Payer: Healthscope Commercial |
$1,097.65
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.33
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.58
|
| Rate for Payer: Nomi Health Commercial |
$823.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE SWMI |
$686.03
|
| Rate for Payer: PHP Medicare Advantage |
$686.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,361.57
|
| Rate for Payer: Priority Health Medicare |
$686.03
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,361.57
|
| Rate for Payer: Railroad Medicare Medicare |
$686.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.64
|
| Rate for Payer: UHC Core |
$1,367.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.03
|
| Rate for Payer: UHC Exchange |
$1,367.64
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$919.28
|
| Rate for Payer: Aetna Medicare |
$713.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.88
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$686.03
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: BCN Medicare Advantage |
$686.03
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$987.88
|
| Rate for Payer: Cofinity Commercial |
$919.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.03
|
| Rate for Payer: Healthscope Commercial |
$1,269.16
|
| Rate for Payer: Healthscope Commercial |
$1,097.65
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.33
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.58
|
| Rate for Payer: Nomi Health Commercial |
$823.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE SWMI |
$686.03
|
| Rate for Payer: PHP Medicare Advantage |
$686.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,361.57
|
| Rate for Payer: Priority Health Medicare |
$686.03
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,361.57
|
| Rate for Payer: Railroad Medicare Medicare |
$686.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.64
|
| Rate for Payer: UHC Core |
$1,367.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.03
|
| Rate for Payer: UHC Exchange |
$1,367.64
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 49593
|
| Min. Negotiated Rate |
$334.84 |
| Max. Negotiated Rate |
$1,099.50 |
| Rate for Payer: Aetna Commercial |
$706.54
|
| Rate for Payer: Aetna Medicare |
$548.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.27
|
| Rate for Payer: BCBS Complete |
$351.58
|
| Rate for Payer: BCBS MAPPO |
$527.27
|
| Rate for Payer: BCN Commercial |
$859.02
|
| Rate for Payer: BCN Medicare Advantage |
$527.27
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cofinity Commercial |
$759.27
|
| Rate for Payer: Cofinity Commercial |
$706.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.27
|
| Rate for Payer: Healthscope Commercial |
$975.45
|
| Rate for Payer: Healthscope Commercial |
$843.63
|
| Rate for Payer: Mclaren Medicaid |
$334.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.63
|
| Rate for Payer: Meridian Medicaid |
$351.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.32
|
| Rate for Payer: Nomi Health Commercial |
$632.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,099.50
|
| Rate for Payer: PACE SWMI |
$527.27
|
| Rate for Payer: PHP Medicare Advantage |
$527.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,046.66
|
| Rate for Payer: Priority Health Medicare |
$527.27
|
| Rate for Payer: Priority Health SBD |
$1,046.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,046.66
|
| Rate for Payer: Railroad Medicare Medicare |
$527.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.81
|
| Rate for Payer: UHC Core |
$1,049.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.27
|
| Rate for Payer: UHC Exchange |
$1,049.81
|
| Rate for Payer: UHC Medicaid |
$334.84
|
| Rate for Payer: UHCCP Medicaid |
$334.84
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 49592
|
| Min. Negotiated Rate |
$278.60 |
| Max. Negotiated Rate |
$912.75 |
| Rate for Payer: Aetna Commercial |
$587.50
|
| Rate for Payer: Aetna Medicare |
$455.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.34
|
| Rate for Payer: BCBS Complete |
$292.53
|
| Rate for Payer: BCBS MAPPO |
$438.43
|
| Rate for Payer: BCN Commercial |
$714.11
|
| Rate for Payer: BCN Medicare Advantage |
$438.43
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$631.34
|
| Rate for Payer: Cofinity Commercial |
$587.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.43
|
| Rate for Payer: Healthscope Commercial |
$811.10
|
| Rate for Payer: Healthscope Commercial |
$701.49
|
| Rate for Payer: Mclaren Medicaid |
$278.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.35
|
| Rate for Payer: Meridian Medicaid |
$292.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$482.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$855.38
|
| Rate for Payer: Nomi Health Commercial |
$526.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.75
|
| Rate for Payer: PACE SWMI |
$438.43
|
| Rate for Payer: PHP Medicare Advantage |
$438.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$870.09
|
| Rate for Payer: Priority Health Medicare |
$438.43
|
| Rate for Payer: Priority Health SBD |
$870.09
|
| Rate for Payer: Priority Health Tiered Network |
$870.09
|
| Rate for Payer: Railroad Medicare Medicare |
$438.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.46
|
| Rate for Payer: UHC Core |
$871.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.43
|
| Rate for Payer: UHC Exchange |
$871.46
|
| Rate for Payer: UHC Medicaid |
$278.60
|
| Rate for Payer: UHCCP Medicaid |
$278.60
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$895.00
|
|
|
Service Code
|
HCPCS 49591
|
| Min. Negotiated Rate |
$201.29 |
| Max. Negotiated Rate |
$671.25 |
| Rate for Payer: Aetna Commercial |
$423.19
|
| Rate for Payer: Aetna Medicare |
$328.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.77
|
| Rate for Payer: BCBS Complete |
$211.35
|
| Rate for Payer: BCBS MAPPO |
$315.81
|
| Rate for Payer: BCN Commercial |
$513.42
|
| Rate for Payer: BCN Medicare Advantage |
$315.81
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cofinity Commercial |
$454.77
|
| Rate for Payer: Cofinity Commercial |
$423.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.81
|
| Rate for Payer: Healthscope Commercial |
$584.25
|
| Rate for Payer: Healthscope Commercial |
$505.30
|
| Rate for Payer: Mclaren Medicaid |
$201.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.60
|
| Rate for Payer: Meridian Medicaid |
$211.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.75
|
| Rate for Payer: Nomi Health Commercial |
$378.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.25
|
| Rate for Payer: PACE SWMI |
$315.81
|
| Rate for Payer: PHP Medicare Advantage |
$315.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$625.56
|
| Rate for Payer: Priority Health Medicare |
$315.81
|
| Rate for Payer: Priority Health SBD |
$625.56
|
| Rate for Payer: Priority Health Tiered Network |
$625.56
|
| Rate for Payer: Railroad Medicare Medicare |
$315.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.53
|
| Rate for Payer: UHC Core |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.81
|
| Rate for Payer: UHC Exchange |
$625.53
|
| Rate for Payer: UHC Medicaid |
$201.29
|
| Rate for Payer: UHCCP Medicaid |
$201.29
|
|
|
PR RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,256.00
|
|
|
Service Code
|
HCPCS 49618
|
| Min. Negotiated Rate |
$721.64 |
| Max. Negotiated Rate |
$2,442.00 |
| Rate for Payer: Aetna Commercial |
$1,525.51
|
| Rate for Payer: Aetna Medicare |
$1,183.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,525.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.35
|
| Rate for Payer: BCBS Complete |
$757.72
|
| Rate for Payer: BCBS MAPPO |
$1,138.44
|
| Rate for Payer: BCN Commercial |
$1,863.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.44
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cofinity Commercial |
$1,639.35
|
| Rate for Payer: Cofinity Commercial |
$1,525.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.44
|
| Rate for Payer: Healthscope Commercial |
$2,106.11
|
| Rate for Payer: Healthscope Commercial |
$1,821.50
|
| Rate for Payer: Mclaren Medicaid |
$721.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,195.36
|
| Rate for Payer: Meridian Medicaid |
$757.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,252.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,231.12
|
| Rate for Payer: Nomi Health Commercial |
$1,366.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.00
|
| Rate for Payer: PACE SWMI |
$1,138.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,271.09
|
| Rate for Payer: Priority Health Medicare |
$1,138.44
|
| Rate for Payer: Priority Health SBD |
$2,271.09
|
| Rate for Payer: Priority Health Tiered Network |
$2,271.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.10
|
| Rate for Payer: UHC Core |
$2,273.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,138.44
|
| Rate for Payer: UHC Exchange |
$2,273.10
|
| Rate for Payer: UHC Medicaid |
$721.64
|
| Rate for Payer: UHCCP Medicaid |
$721.64
|
|
|
PR RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 49617
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,621.26 |
| Rate for Payer: Aetna Commercial |
$1,088.43
|
| Rate for Payer: Aetna Medicare |
$844.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.65
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$812.26
|
| Rate for Payer: BCN Commercial |
$1,330.61
|
| Rate for Payer: BCN Medicare Advantage |
$812.26
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,169.65
|
| Rate for Payer: Cofinity Commercial |
$1,088.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.26
|
| Rate for Payer: Healthscope Commercial |
$1,502.68
|
| Rate for Payer: Healthscope Commercial |
$1,299.62
|
| Rate for Payer: Mclaren Medicaid |
$515.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$852.87
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$893.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,590.95
|
| Rate for Payer: Nomi Health Commercial |
$974.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.25
|
| Rate for Payer: PACE SWMI |
$812.26
|
| Rate for Payer: PHP Medicare Advantage |
$812.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,621.26
|
| Rate for Payer: Priority Health Medicare |
$812.26
|
| Rate for Payer: Priority Health SBD |
$1,621.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,621.26
|
| Rate for Payer: Railroad Medicare Medicare |
$812.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,621.25
|
| Rate for Payer: UHC Core |
$1,621.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.26
|
| Rate for Payer: UHC Exchange |
$1,621.25
|
| Rate for Payer: UHC Medicaid |
$515.46
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,804.00
|
|
|
Service Code
|
HCPCS 49616
|
| Min. Negotiated Rate |
$499.49 |
| Max. Negotiated Rate |
$1,574.44 |
| Rate for Payer: Aetna Commercial |
$1,055.46
|
| Rate for Payer: Aetna Medicare |
$819.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.23
|
| Rate for Payer: BCBS Complete |
$524.46
|
| Rate for Payer: BCBS MAPPO |
$787.66
|
| Rate for Payer: BCN Commercial |
$1,285.78
|
| Rate for Payer: BCN Medicare Advantage |
$787.66
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cofinity Commercial |
$1,134.23
|
| Rate for Payer: Cofinity Commercial |
$1,055.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.66
|
| Rate for Payer: Healthscope Commercial |
$1,457.17
|
| Rate for Payer: Healthscope Commercial |
$1,260.26
|
| Rate for Payer: Mclaren Medicaid |
$499.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.04
|
| Rate for Payer: Meridian Medicaid |
$524.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,545.57
|
| Rate for Payer: Nomi Health Commercial |
$945.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.00
|
| Rate for Payer: PACE SWMI |
$787.66
|
| Rate for Payer: PHP Medicare Advantage |
$787.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,566.65
|
| Rate for Payer: Priority Health Medicare |
$787.66
|
| Rate for Payer: Priority Health SBD |
$1,566.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,566.65
|
| Rate for Payer: Railroad Medicare Medicare |
$787.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.44
|
| Rate for Payer: UHC Core |
$1,574.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.66
|
| Rate for Payer: UHC Exchange |
$1,574.44
|
| Rate for Payer: UHC Medicaid |
$499.49
|
| Rate for Payer: UHCCP Medicaid |
$499.49
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 49615
|
| Min. Negotiated Rate |
$372.32 |
| Max. Negotiated Rate |
$1,227.75 |
| Rate for Payer: Aetna Commercial |
$785.92
|
| Rate for Payer: Aetna Medicare |
$609.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.57
|
| Rate for Payer: BCBS Complete |
$390.94
|
| Rate for Payer: BCBS MAPPO |
$586.51
|
| Rate for Payer: BCN Commercial |
$957.62
|
| Rate for Payer: BCN Medicare Advantage |
$586.51
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$844.57
|
| Rate for Payer: Cofinity Commercial |
$785.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.51
|
| Rate for Payer: Healthscope Commercial |
$938.42
|
| Rate for Payer: Healthscope Commercial |
$1,085.04
|
| Rate for Payer: Mclaren Medicaid |
$372.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.84
|
| Rate for Payer: Meridian Medicaid |
$390.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,149.79
|
| Rate for Payer: Nomi Health Commercial |
$703.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.75
|
| Rate for Payer: PACE SWMI |
$586.51
|
| Rate for Payer: PHP Medicare Advantage |
$586.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,166.79
|
| Rate for Payer: Priority Health Medicare |
$586.51
|
| Rate for Payer: Priority Health SBD |
$1,166.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,166.79
|
| Rate for Payer: Railroad Medicare Medicare |
$586.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.51
|
| Rate for Payer: UHC Core |
$1,171.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$586.51
|
| Rate for Payer: UHC Exchange |
$1,171.51
|
| Rate for Payer: UHC Medicaid |
$372.32
|
| Rate for Payer: UHCCP Medicaid |
$372.32
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 49614
|
| Min. Negotiated Rate |
$334.20 |
| Max. Negotiated Rate |
$1,047.46 |
| Rate for Payer: Aetna Commercial |
$705.28
|
| Rate for Payer: Aetna Medicare |
$547.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.92
|
| Rate for Payer: BCBS Complete |
$350.91
|
| Rate for Payer: BCBS MAPPO |
$526.33
|
| Rate for Payer: BCN Commercial |
$856.53
|
| Rate for Payer: BCN Medicare Advantage |
$526.33
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cofinity Commercial |
$757.92
|
| Rate for Payer: Cofinity Commercial |
$705.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.33
|
| Rate for Payer: Healthscope Commercial |
$973.71
|
| Rate for Payer: Healthscope Commercial |
$842.13
|
| Rate for Payer: Mclaren Medicaid |
$334.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.65
|
| Rate for Payer: Meridian Medicaid |
$350.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.03
|
| Rate for Payer: Nomi Health Commercial |
$631.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.00
|
| Rate for Payer: PACE SWMI |
$526.33
|
| Rate for Payer: PHP Medicare Advantage |
$526.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,043.62
|
| Rate for Payer: Priority Health Medicare |
$526.33
|
| Rate for Payer: Priority Health SBD |
$1,043.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,043.62
|
| Rate for Payer: Railroad Medicare Medicare |
$526.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.46
|
| Rate for Payer: UHC Core |
$1,047.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$526.33
|
| Rate for Payer: UHC Exchange |
$1,047.46
|
| Rate for Payer: UHC Medicaid |
$334.20
|
| Rate for Payer: UHCCP Medicaid |
$334.20
|
|
|
PR RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 49613
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$771.19 |
| Rate for Payer: Priority Health SBD |
$769.36
|
| Rate for Payer: Aetna Commercial |
$519.75
|
| Rate for Payer: Aetna Medicare |
$403.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.53
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$387.87
|
| Rate for Payer: BCN Commercial |
$631.44
|
| Rate for Payer: BCN Medicare Advantage |
$387.87
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$558.53
|
| Rate for Payer: Cofinity Commercial |
$519.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.87
|
| Rate for Payer: Healthscope Commercial |
$717.56
|
| Rate for Payer: Healthscope Commercial |
$620.59
|
| Rate for Payer: Mclaren Medicaid |
$246.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.26
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.59
|
| Rate for Payer: Nomi Health Commercial |
$465.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$662.25
|
| Rate for Payer: PACE SWMI |
$387.87
|
| Rate for Payer: PHP Medicare Advantage |
$387.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$769.36
|
| Rate for Payer: Priority Health Medicare |
$387.87
|
| Rate for Payer: Priority Health Tiered Network |
$769.36
|
| Rate for Payer: Railroad Medicare Medicare |
$387.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.19
|
| Rate for Payer: UHC Core |
$771.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.87
|
| Rate for Payer: UHC Exchange |
$771.19
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 35190
|
| Min. Negotiated Rate |
$437.50 |
| Max. Negotiated Rate |
$1,360.42 |
| Rate for Payer: Aetna Commercial |
$922.55
|
| Rate for Payer: Aetna Medicare |
$716.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.40
|
| Rate for Payer: BCBS Complete |
$459.38
|
| Rate for Payer: BCBS MAPPO |
$688.47
|
| Rate for Payer: BCN Commercial |
$1,108.51
|
| Rate for Payer: BCN Medicare Advantage |
$688.47
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$991.40
|
| Rate for Payer: Cofinity Commercial |
$922.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.47
|
| Rate for Payer: Healthscope Commercial |
$1,273.67
|
| Rate for Payer: Healthscope Commercial |
$1,101.55
|
| Rate for Payer: Mclaren Medicaid |
$437.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.89
|
| Rate for Payer: Meridian Medicaid |
$459.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.85
|
| Rate for Payer: Nomi Health Commercial |
$826.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.25
|
| Rate for Payer: PACE SWMI |
$688.47
|
| Rate for Payer: PHP Medicare Advantage |
$688.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,192.05
|
| Rate for Payer: Priority Health Medicare |
$688.47
|
| Rate for Payer: Priority Health SBD |
$1,192.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,192.05
|
| Rate for Payer: Railroad Medicare Medicare |
$688.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.42
|
| Rate for Payer: UHC Core |
$1,360.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.47
|
| Rate for Payer: UHC Exchange |
$1,360.42
|
| Rate for Payer: UHC Medicaid |
$437.50
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 35188
|
| Min. Negotiated Rate |
$805.57 |
| Max. Negotiated Rate |
$3,275.25 |
| Rate for Payer: Aetna Commercial |
$1,685.43
|
| Rate for Payer: Aetna Medicare |
$1,308.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.20
|
| Rate for Payer: BCBS Complete |
$845.85
|
| Rate for Payer: BCBS MAPPO |
$1,257.78
|
| Rate for Payer: BCN Commercial |
$1,956.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.78
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,811.20
|
| Rate for Payer: Cofinity Commercial |
$1,685.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.78
|
| Rate for Payer: Healthscope Commercial |
$2,326.89
|
| Rate for Payer: Healthscope Commercial |
$2,012.45
|
| Rate for Payer: Mclaren Medicaid |
$805.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.67
|
| Rate for Payer: Meridian Medicaid |
$845.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,323.69
|
| Rate for Payer: Nomi Health Commercial |
$1,509.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,275.25
|
| Rate for Payer: PACE SWMI |
$1,257.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,104.03
|
| Rate for Payer: Priority Health Medicare |
$1,257.78
|
| Rate for Payer: Priority Health SBD |
$2,104.03
|
| Rate for Payer: Priority Health Tiered Network |
$2,104.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,255.91
|
| Rate for Payer: UHC Core |
$2,255.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,257.78
|
| Rate for Payer: UHC Exchange |
$2,255.91
|
| Rate for Payer: UHC Medicaid |
$805.57
|
| Rate for Payer: UHCCP Medicaid |
$805.57
|
|
|
PR RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26350
|
| Min. Negotiated Rate |
$471.16 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$938.96
|
| Rate for Payer: Aetna Medicare |
$728.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.96
|
| Rate for Payer: BCBS Complete |
$494.72
|
| Rate for Payer: BCBS MAPPO |
$700.72
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$700.72
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$938.96
|
| Rate for Payer: Cofinity Commercial |
$1,009.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.72
|
| Rate for Payer: Healthscope Commercial |
$1,296.33
|
| Rate for Payer: Healthscope Commercial |
$1,121.15
|
| Rate for Payer: Mclaren Medicaid |
$471.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.76
|
| Rate for Payer: Meridian Medicaid |
$494.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$770.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,308.91
|
| Rate for Payer: Nomi Health Commercial |
$840.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$700.72
|
| Rate for Payer: PHP Medicare Advantage |
$700.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.53
|
| Rate for Payer: Priority Health Medicare |
$700.72
|
| Rate for Payer: Priority Health SBD |
$1,202.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,202.53
|
| Rate for Payer: Railroad Medicare Medicare |
$700.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,234.86
|
| Rate for Payer: UHC Core |
$1,234.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$700.72
|
| Rate for Payer: UHC Exchange |
$1,234.86
|
| Rate for Payer: UHC Medicaid |
$471.16
|
| Rate for Payer: UHCCP Medicaid |
$471.16
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$595.12 |
| Max. Negotiated Rate |
$2,092.50 |
| Rate for Payer: Aetna Commercial |
$1,214.80
|
| Rate for Payer: Aetna Medicare |
$942.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.46
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$906.57
|
| Rate for Payer: BCN Commercial |
$1,499.42
|
| Rate for Payer: BCN Medicare Advantage |
$906.57
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,305.46
|
| Rate for Payer: Cofinity Commercial |
$1,214.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.57
|
| Rate for Payer: Healthscope Commercial |
$1,677.15
|
| Rate for Payer: Healthscope Commercial |
$1,450.51
|
| Rate for Payer: Mclaren Medicaid |
$595.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.90
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.02
|
| Rate for Payer: Nomi Health Commercial |
$1,087.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,092.50
|
| Rate for Payer: PACE SWMI |
$906.57
|
| Rate for Payer: PHP Medicare Advantage |
$906.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,602.83
|
| Rate for Payer: Priority Health Medicare |
$906.57
|
| Rate for Payer: Priority Health SBD |
$1,602.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,602.83
|
| Rate for Payer: Railroad Medicare Medicare |
$906.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.95
|
| Rate for Payer: UHC Core |
$1,709.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$906.57
|
| Rate for Payer: UHC Exchange |
$1,709.95
|
| Rate for Payer: UHC Medicaid |
$595.12
|
| Rate for Payer: UHCCP Medicaid |
$595.12
|
|
