|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,063.44 |
| Max. Negotiated Rate |
$1,519.20 |
| Rate for Payer: Aetna Commercial |
$1,434.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.20
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,181.60
|
| Rate for Payer: Cofinity Commercial |
$1,451.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,181.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Healthscope Commercial |
$1,519.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: PHP Commercial |
$1,434.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health SBD |
$1,063.44
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$592.06 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$793.36
|
| Rate for Payer: Aetna Medicare |
$615.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.36
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$592.06
|
| Rate for Payer: BCN Medicare Advantage |
$592.06
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Cofinity Commercial |
$793.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.06
|
| Rate for Payer: Healthscope Commercial |
$947.30
|
| Rate for Payer: Healthscope Commercial |
$1,095.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$710.47
|
| Rate for Payer: PACE SWMI |
$592.06
|
| Rate for Payer: PHP Medicare Advantage |
$592.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$592.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$592.06
|
| Rate for Payer: UHC Medicare Advantage |
$592.06
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$404.10 |
| Max. Negotiated Rate |
$885.30 |
| Rate for Payer: Aetna Commercial |
$541.49
|
| Rate for Payer: Aetna Medicare |
$420.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.49
|
| Rate for Payer: BCBS Complete |
$544.80
|
| Rate for Payer: BCBS MAPPO |
$404.10
|
| Rate for Payer: BCN Medicare Advantage |
$404.10
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$581.90
|
| Rate for Payer: Cofinity Commercial |
$541.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.10
|
| Rate for Payer: Healthscope Commercial |
$646.56
|
| Rate for Payer: Healthscope Commercial |
$747.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.30
|
| Rate for Payer: Nomi Health Commercial |
$484.92
|
| Rate for Payer: PACE SWMI |
$404.10
|
| Rate for Payer: PHP Medicare Advantage |
$404.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.30
|
| Rate for Payer: Priority Health Medicare |
$404.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.10
|
| Rate for Payer: UHC Medicare Advantage |
$404.10
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,799.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$600.19 |
| Max. Negotiated Rate |
$1,169.35 |
| Rate for Payer: Aetna Commercial |
$804.25
|
| Rate for Payer: Aetna Medicare |
$624.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.25
|
| Rate for Payer: BCBS Complete |
$719.60
|
| Rate for Payer: BCBS MAPPO |
$600.19
|
| Rate for Payer: BCN Medicare Advantage |
$600.19
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cofinity Commercial |
$864.27
|
| Rate for Payer: Cofinity Commercial |
$804.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.19
|
| Rate for Payer: Healthscope Commercial |
$960.30
|
| Rate for Payer: Healthscope Commercial |
$1,110.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.35
|
| Rate for Payer: Nomi Health Commercial |
$720.23
|
| Rate for Payer: PACE SWMI |
$600.19
|
| Rate for Payer: PHP Medicare Advantage |
$600.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.35
|
| Rate for Payer: Priority Health Medicare |
$600.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.19
|
| Rate for Payer: UHC Medicare Advantage |
$600.19
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,514.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$984.10 |
| Rate for Payer: Aetna Commercial |
$534.66
|
| Rate for Payer: Aetna Medicare |
$414.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.66
|
| Rate for Payer: BCBS Complete |
$605.60
|
| Rate for Payer: BCBS MAPPO |
$399.00
|
| Rate for Payer: BCN Medicare Advantage |
$399.00
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cofinity Commercial |
$574.56
|
| Rate for Payer: Cofinity Commercial |
$534.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.00
|
| Rate for Payer: Healthscope Commercial |
$638.40
|
| Rate for Payer: Healthscope Commercial |
$738.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.10
|
| Rate for Payer: Nomi Health Commercial |
$478.80
|
| Rate for Payer: PACE SWMI |
$399.00
|
| Rate for Payer: PHP Medicare Advantage |
$399.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.10
|
| Rate for Payer: Priority Health Medicare |
$399.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.00
|
| Rate for Payer: UHC Medicare Advantage |
$399.00
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$759.60 |
| Max. Negotiated Rate |
$1,729.49 |
| Rate for Payer: Aetna Commercial |
$1,252.71
|
| Rate for Payer: Aetna Medicare |
$972.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.71
|
| Rate for Payer: BCBS Complete |
$759.60
|
| Rate for Payer: BCBS MAPPO |
$934.86
|
| Rate for Payer: BCN Medicare Advantage |
$934.86
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cofinity Commercial |
$1,346.20
|
| Rate for Payer: Cofinity Commercial |
$1,252.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.86
|
| Rate for Payer: Healthscope Commercial |
$1,729.49
|
| Rate for Payer: Healthscope Commercial |
$1,495.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,234.35
|
| Rate for Payer: Nomi Health Commercial |
$1,121.83
|
| Rate for Payer: PACE SWMI |
$934.86
|
| Rate for Payer: PHP Medicare Advantage |
$934.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.35
|
| Rate for Payer: Priority Health Medicare |
$934.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.86
|
| Rate for Payer: UHC Medicare Advantage |
$934.86
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$666.00 |
| Max. Negotiated Rate |
$1,438.04 |
| Rate for Payer: Aetna Commercial |
$1,041.61
|
| Rate for Payer: Aetna Medicare |
$808.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,041.61
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$777.32
|
| Rate for Payer: BCN Medicare Advantage |
$777.32
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,119.34
|
| Rate for Payer: Cofinity Commercial |
$1,041.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.32
|
| Rate for Payer: Healthscope Commercial |
$1,243.71
|
| Rate for Payer: Healthscope Commercial |
$1,438.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.25
|
| Rate for Payer: Nomi Health Commercial |
$932.78
|
| Rate for Payer: PACE SWMI |
$777.32
|
| Rate for Payer: PHP Medicare Advantage |
$777.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$777.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.32
|
| Rate for Payer: UHC Medicare Advantage |
$777.32
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,302.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$368.12 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$493.28
|
| Rate for Payer: Aetna Medicare |
$382.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.28
|
| Rate for Payer: BCBS Complete |
$520.80
|
| Rate for Payer: BCBS MAPPO |
$368.12
|
| Rate for Payer: BCN Medicare Advantage |
$368.12
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cofinity Commercial |
$530.09
|
| Rate for Payer: Cofinity Commercial |
$493.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.12
|
| Rate for Payer: Healthscope Commercial |
$681.02
|
| Rate for Payer: Healthscope Commercial |
$588.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.30
|
| Rate for Payer: Nomi Health Commercial |
$441.74
|
| Rate for Payer: PACE SWMI |
$368.12
|
| Rate for Payer: PHP Medicare Advantage |
$368.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health Medicare |
$368.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.12
|
| Rate for Payer: UHC Medicare Advantage |
$368.12
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$361.79 |
| Max. Negotiated Rate |
$865.80 |
| Rate for Payer: Aetna Commercial |
$484.80
|
| Rate for Payer: Aetna Medicare |
$376.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.80
|
| Rate for Payer: BCBS Complete |
$532.80
|
| Rate for Payer: BCBS MAPPO |
$361.79
|
| Rate for Payer: BCN Medicare Advantage |
$361.79
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$520.98
|
| Rate for Payer: Cofinity Commercial |
$484.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.79
|
| Rate for Payer: Healthscope Commercial |
$578.86
|
| Rate for Payer: Healthscope Commercial |
$669.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.80
|
| Rate for Payer: Nomi Health Commercial |
$434.15
|
| Rate for Payer: PACE SWMI |
$361.79
|
| Rate for Payer: PHP Medicare Advantage |
$361.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.80
|
| Rate for Payer: Priority Health Medicare |
$361.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.79
|
| Rate for Payer: UHC Medicare Advantage |
$361.79
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$626.00 |
| Max. Negotiated Rate |
$1,855.14 |
| Rate for Payer: Aetna Commercial |
$1,343.73
|
| Rate for Payer: Aetna Medicare |
$1,042.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,343.73
|
| Rate for Payer: BCBS Complete |
$626.00
|
| Rate for Payer: BCBS MAPPO |
$1,002.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.78
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$1,343.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.78
|
| Rate for Payer: Healthscope Commercial |
$1,855.14
|
| Rate for Payer: Healthscope Commercial |
$1,604.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,052.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.25
|
| Rate for Payer: Nomi Health Commercial |
$1,203.34
|
| Rate for Payer: PACE SWMI |
$1,002.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.25
|
| Rate for Payer: Priority Health Medicare |
$1,002.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,002.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,002.78
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$634.40 |
| Max. Negotiated Rate |
$1,395.88 |
| Rate for Payer: Aetna Commercial |
$1,011.07
|
| Rate for Payer: Aetna Medicare |
$784.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,086.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.07
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$754.53
|
| Rate for Payer: BCN Medicare Advantage |
$754.53
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$1,086.52
|
| Rate for Payer: Cofinity Commercial |
$1,011.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.53
|
| Rate for Payer: Healthscope Commercial |
$1,207.25
|
| Rate for Payer: Healthscope Commercial |
$1,395.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$792.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.90
|
| Rate for Payer: Nomi Health Commercial |
$905.44
|
| Rate for Payer: PACE SWMI |
$754.53
|
| Rate for Payer: PHP Medicare Advantage |
$754.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$754.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$754.53
|
| Rate for Payer: UHC Medicare Advantage |
$754.53
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,855.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,168.65 |
| Max. Negotiated Rate |
$1,669.50 |
| Rate for Payer: Aetna Commercial |
$1,576.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.75
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$1,298.50
|
| Rate for Payer: Cofinity Commercial |
$1,595.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.00
|
| Rate for Payer: Healthscope Commercial |
$1,669.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.75
|
| Rate for Payer: PHP Commercial |
$1,576.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health SBD |
$1,168.65
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$728.48 |
| Max. Negotiated Rate |
$1,347.69 |
| Rate for Payer: Aetna Commercial |
$976.16
|
| Rate for Payer: Aetna Medicare |
$757.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.01
|
| Rate for Payer: BCBS Complete |
$742.00
|
| Rate for Payer: BCBS MAPPO |
$728.48
|
| Rate for Payer: BCN Medicare Advantage |
$728.48
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$976.16
|
| Rate for Payer: Cofinity Commercial |
$1,049.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.48
|
| Rate for Payer: Healthscope Commercial |
$1,347.69
|
| Rate for Payer: Healthscope Commercial |
$1,165.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,205.75
|
| Rate for Payer: Nomi Health Commercial |
$874.18
|
| Rate for Payer: PACE SWMI |
$728.48
|
| Rate for Payer: PHP Medicare Advantage |
$728.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health Medicare |
$728.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.48
|
| Rate for Payer: UHC Medicare Advantage |
$728.48
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$728.48 |
| Max. Negotiated Rate |
$1,347.69 |
| Rate for Payer: Aetna Commercial |
$976.16
|
| Rate for Payer: Aetna Medicare |
$757.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.01
|
| Rate for Payer: BCBS Complete |
$742.00
|
| Rate for Payer: BCBS MAPPO |
$728.48
|
| Rate for Payer: BCN Medicare Advantage |
$728.48
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$976.16
|
| Rate for Payer: Cofinity Commercial |
$1,049.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.48
|
| Rate for Payer: Healthscope Commercial |
$1,165.57
|
| Rate for Payer: Healthscope Commercial |
$1,347.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,205.75
|
| Rate for Payer: Nomi Health Commercial |
$874.18
|
| Rate for Payer: PACE SWMI |
$728.48
|
| Rate for Payer: PHP Medicare Advantage |
$728.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health Medicare |
$728.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.48
|
| Rate for Payer: UHC Medicare Advantage |
$728.48
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,855.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,168.65 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$1,576.75
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$1,595.30
|
| Rate for Payer: Cofinity Commercial |
$1,298.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$1,669.50
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.75
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$1,576.75
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$1,168.65
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,423.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$896.49 |
| Max. Negotiated Rate |
$1,280.70 |
| Rate for Payer: Aetna Commercial |
$1,209.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.95
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,223.78
|
| Rate for Payer: Cofinity Commercial |
$996.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Healthscope Commercial |
$1,280.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: PHP Commercial |
$1,209.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health SBD |
$896.49
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,423.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$896.49 |
| Max. Negotiated Rate |
$17,130.07 |
| Rate for Payer: Aetna Commercial |
$1,209.55
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,223.78
|
| Rate for Payer: Cofinity Commercial |
$996.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$1,280.70
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$1,209.55
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$896.49
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,426.14
|
| Rate for Payer: VA VA |
$6,085.50
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 49593
|
| Min. Negotiated Rate |
$559.46 |
| Max. Negotiated Rate |
$1,035.00 |
| Rate for Payer: Aetna Commercial |
$749.68
|
| Rate for Payer: Aetna Medicare |
$581.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.68
|
| Rate for Payer: BCBS Complete |
$569.20
|
| Rate for Payer: BCBS MAPPO |
$559.46
|
| Rate for Payer: BCN Medicare Advantage |
$559.46
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$805.62
|
| Rate for Payer: Cofinity Commercial |
$749.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.46
|
| Rate for Payer: Healthscope Commercial |
$1,035.00
|
| Rate for Payer: Healthscope Commercial |
$895.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$924.95
|
| Rate for Payer: Nomi Health Commercial |
$671.35
|
| Rate for Payer: PACE SWMI |
$559.46
|
| Rate for Payer: PHP Medicare Advantage |
$559.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health Medicare |
$559.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$559.46
|
| Rate for Payer: UHC Medicare Advantage |
$559.46
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$559.46 |
| Max. Negotiated Rate |
$1,035.00 |
| Rate for Payer: Aetna Commercial |
$749.68
|
| Rate for Payer: Aetna Medicare |
$581.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.68
|
| Rate for Payer: BCBS Complete |
$569.20
|
| Rate for Payer: BCBS MAPPO |
$559.46
|
| Rate for Payer: BCN Medicare Advantage |
$559.46
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$805.62
|
| Rate for Payer: Cofinity Commercial |
$749.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.46
|
| Rate for Payer: Healthscope Commercial |
$895.14
|
| Rate for Payer: Healthscope Commercial |
$1,035.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$924.95
|
| Rate for Payer: Nomi Health Commercial |
$671.35
|
| Rate for Payer: PACE SWMI |
$559.46
|
| Rate for Payer: PHP Medicare Advantage |
$559.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health Medicare |
$559.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$559.46
|
| Rate for Payer: UHC Medicare Advantage |
$559.46
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$744.66 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$1,004.70
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$768.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.52
|
| Rate for Payer: Cofinity Commercial |
$827.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$827.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$1,063.80
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,004.70
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$1,004.70
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$744.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,182.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$744.66 |
| Max. Negotiated Rate |
$1,063.80 |
| Rate for Payer: Aetna Commercial |
$1,004.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$768.30
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.52
|
| Rate for Payer: Cofinity Commercial |
$827.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$827.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Healthscope Commercial |
$1,063.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,004.70
|
| Rate for Payer: PHP Commercial |
$1,004.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health SBD |
$744.66
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$464.97 |
| Max. Negotiated Rate |
$860.19 |
| Rate for Payer: Aetna Commercial |
$623.06
|
| Rate for Payer: Aetna Medicare |
$483.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.56
|
| Rate for Payer: BCBS Complete |
$472.80
|
| Rate for Payer: BCBS MAPPO |
$464.97
|
| Rate for Payer: BCN Medicare Advantage |
$464.97
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$669.56
|
| Rate for Payer: Cofinity Commercial |
$623.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.97
|
| Rate for Payer: Healthscope Commercial |
$743.95
|
| Rate for Payer: Healthscope Commercial |
$860.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.30
|
| Rate for Payer: Nomi Health Commercial |
$557.96
|
| Rate for Payer: PACE SWMI |
$464.97
|
| Rate for Payer: PHP Medicare Advantage |
$464.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health Medicare |
$464.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.97
|
| Rate for Payer: UHC Medicare Advantage |
$464.97
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 49592
|
| Min. Negotiated Rate |
$464.97 |
| Max. Negotiated Rate |
$860.19 |
| Rate for Payer: Aetna Commercial |
$623.06
|
| Rate for Payer: Aetna Medicare |
$483.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.06
|
| Rate for Payer: BCBS Complete |
$472.80
|
| Rate for Payer: BCBS MAPPO |
$464.97
|
| Rate for Payer: BCN Medicare Advantage |
$464.97
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$669.56
|
| Rate for Payer: Cofinity Commercial |
$623.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.97
|
| Rate for Payer: Healthscope Commercial |
$860.19
|
| Rate for Payer: Healthscope Commercial |
$743.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.30
|
| Rate for Payer: Nomi Health Commercial |
$557.96
|
| Rate for Payer: PACE SWMI |
$464.97
|
| Rate for Payer: PHP Medicare Advantage |
$464.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health Medicare |
$464.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.97
|
| Rate for Payer: UHC Medicare Advantage |
$464.97
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$333.43 |
| Max. Negotiated Rate |
$616.85 |
| Rate for Payer: Aetna Commercial |
$446.80
|
| Rate for Payer: Aetna Medicare |
$346.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.14
|
| Rate for Payer: BCBS Complete |
$347.60
|
| Rate for Payer: BCBS MAPPO |
$333.43
|
| Rate for Payer: BCN Medicare Advantage |
$333.43
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$480.14
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.43
|
| Rate for Payer: Healthscope Commercial |
$533.49
|
| Rate for Payer: Healthscope Commercial |
$616.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.85
|
| Rate for Payer: Nomi Health Commercial |
$400.12
|
| Rate for Payer: PACE SWMI |
$333.43
|
| Rate for Payer: PHP Medicare Advantage |
$333.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health Medicare |
$333.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.43
|
| Rate for Payer: UHC Medicare Advantage |
$333.43
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
IP
|
$869.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$547.47 |
| Max. Negotiated Rate |
$782.10 |
| Rate for Payer: Aetna Commercial |
$738.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.85
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$608.30
|
| Rate for Payer: Cofinity Commercial |
$747.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$608.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Healthscope Commercial |
$782.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.65
|
| Rate for Payer: PHP Commercial |
$738.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health SBD |
$547.47
|
|
