|
PR RPR NONUNION SCAPHOID CARPAL B1 W/WO RDL STYLODC
|
Professional
|
Both
|
$1,376.00
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$502.68 |
| Max. Negotiated Rate |
$136,467.00 |
| Rate for Payer: Aetna Commercial |
$996.02
|
| Rate for Payer: Aetna Medicare |
$773.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,070.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$996.02
|
| Rate for Payer: BCBS Complete |
$527.81
|
| Rate for Payer: BCBS MAPPO |
$743.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,264.75
|
| Rate for Payer: BCN Commercial |
$1,131.77
|
| Rate for Payer: BCN Medicare Advantage |
$743.30
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cofinity Commercial |
$996.02
|
| Rate for Payer: Cofinity Commercial |
$1,070.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.30
|
| Rate for Payer: Healthscope Commercial |
$1,375.10
|
| Rate for Payer: Healthscope Commercial |
$1,189.28
|
| Rate for Payer: Mclaren Medicaid |
$502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.46
|
| Rate for Payer: Meridian Medicaid |
$527.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136,467.00
|
| Rate for Payer: Nomi Health Commercial |
$891.96
|
| Rate for Payer: PACE SWMI |
$743.30
|
| Rate for Payer: PHP Medicare Advantage |
$743.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,189.21
|
| Rate for Payer: Priority Health Medicare |
$743.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,189.21
|
| Rate for Payer: Priority Health SBD |
$1,189.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$743.30
|
| Rate for Payer: UHC Exchange |
$980.43
|
| Rate for Payer: UHC Medicare Advantage |
$743.30
|
| Rate for Payer: UHCCP Medicaid |
$502.68
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$29,984.00 |
| Rate for Payer: Aetna Commercial |
$216.33
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.47
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS MAPPO |
$161.44
|
| Rate for Payer: BCBS Trust/PPO |
$627.09
|
| Rate for Payer: BCN Commercial |
$3,788.72
|
| Rate for Payer: BCN Medicare Advantage |
$161.44
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$232.47
|
| Rate for Payer: Cofinity Commercial |
$216.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.44
|
| Rate for Payer: Healthscope Commercial |
$258.30
|
| Rate for Payer: Healthscope Commercial |
$298.66
|
| Rate for Payer: Mclaren Medicaid |
$108.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.51
|
| Rate for Payer: Meridian Medicaid |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,984.00
|
| Rate for Payer: Nomi Health Commercial |
$193.73
|
| Rate for Payer: PACE SWMI |
$161.44
|
| Rate for Payer: PHP Medicare Advantage |
$161.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.51
|
| Rate for Payer: Priority Health Medicare |
$161.44
|
| Rate for Payer: Priority Health Narrow Network |
$234.51
|
| Rate for Payer: Priority Health SBD |
$234.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.44
|
| Rate for Payer: UHC Medicare Advantage |
$161.44
|
| Rate for Payer: UHCCP Medicaid |
$108.42
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$257,360.00 |
| Rate for Payer: Aetna Commercial |
$1,867.17
|
| Rate for Payer: Aetna Medicare |
$1,449.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,867.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,006.51
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS MAPPO |
$1,393.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.04
|
| Rate for Payer: BCN Commercial |
$2,085.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,393.41
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cofinity Commercial |
$2,006.51
|
| Rate for Payer: Cofinity Commercial |
$1,867.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,393.41
|
| Rate for Payer: Healthscope Commercial |
$2,229.46
|
| Rate for Payer: Healthscope Commercial |
$2,577.81
|
| Rate for Payer: Mclaren Medicaid |
$914.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,463.08
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257,360.00
|
| Rate for Payer: Nomi Health Commercial |
$1,672.09
|
| Rate for Payer: PACE SWMI |
$1,393.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,393.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.81
|
| Rate for Payer: Priority Health Medicare |
$1,393.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,555.81
|
| Rate for Payer: Priority Health SBD |
$2,555.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,393.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.41
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,118.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$734.00 |
| Max. Negotiated Rate |
$205,076.00 |
| Rate for Payer: Aetna Commercial |
$1,491.14
|
| Rate for Payer: Aetna Medicare |
$1,157.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,491.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,602.42
|
| Rate for Payer: BCBS Complete |
$770.70
|
| Rate for Payer: BCBS MAPPO |
$1,112.79
|
| Rate for Payer: BCBS Trust/PPO |
$822.56
|
| Rate for Payer: BCN Commercial |
$1,667.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.79
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Cash Price |
$1,694.40
|
| Rate for Payer: Cofinity Commercial |
$1,602.42
|
| Rate for Payer: Cofinity Commercial |
$1,491.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.79
|
| Rate for Payer: Healthscope Commercial |
$1,780.46
|
| Rate for Payer: Healthscope Commercial |
$2,058.66
|
| Rate for Payer: Mclaren Medicaid |
$734.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,168.43
|
| Rate for Payer: Meridian Medicaid |
$770.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205,076.00
|
| Rate for Payer: Nomi Health Commercial |
$1,335.35
|
| Rate for Payer: PACE SWMI |
$1,112.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.49
|
| Rate for Payer: Priority Health Medicare |
$1,112.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,050.49
|
| Rate for Payer: Priority Health SBD |
$2,050.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,112.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,112.79
|
| Rate for Payer: UHCCP Medicaid |
$734.00
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$2,801.00
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$841.78 |
| Max. Negotiated Rate |
$237,026.00 |
| Rate for Payer: Aetna Commercial |
$1,719.53
|
| Rate for Payer: Aetna Medicare |
$1,334.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.85
|
| Rate for Payer: BCBS Complete |
$883.87
|
| Rate for Payer: BCBS MAPPO |
$1,283.23
|
| Rate for Payer: BCBS Trust/PPO |
$871.97
|
| Rate for Payer: BCN Commercial |
$1,919.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.23
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,847.85
|
| Rate for Payer: Cofinity Commercial |
$1,719.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.23
|
| Rate for Payer: Healthscope Commercial |
$2,053.17
|
| Rate for Payer: Healthscope Commercial |
$2,373.98
|
| Rate for Payer: Mclaren Medicaid |
$841.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.39
|
| Rate for Payer: Meridian Medicaid |
$883.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237,026.00
|
| Rate for Payer: Nomi Health Commercial |
$1,539.88
|
| Rate for Payer: PACE SWMI |
$1,283.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,352.97
|
| Rate for Payer: Priority Health Medicare |
$1,283.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,352.97
|
| Rate for Payer: Priority Health SBD |
$2,352.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.23
|
| Rate for Payer: UHCCP Medicaid |
$841.78
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$3,439.00
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$784.48 |
| Max. Negotiated Rate |
$220,813.00 |
| Rate for Payer: Aetna Commercial |
$1,600.72
|
| Rate for Payer: Aetna Medicare |
$1,242.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,600.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,720.18
|
| Rate for Payer: BCBS Complete |
$823.70
|
| Rate for Payer: BCBS MAPPO |
$1,194.57
|
| Rate for Payer: BCBS Trust/PPO |
$940.03
|
| Rate for Payer: BCN Commercial |
$1,789.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,194.57
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Cofinity Commercial |
$1,720.18
|
| Rate for Payer: Cofinity Commercial |
$1,600.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,194.57
|
| Rate for Payer: Healthscope Commercial |
$1,911.31
|
| Rate for Payer: Healthscope Commercial |
$2,209.95
|
| Rate for Payer: Mclaren Medicaid |
$784.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,254.30
|
| Rate for Payer: Meridian Medicaid |
$823.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220,813.00
|
| Rate for Payer: Nomi Health Commercial |
$1,433.48
|
| Rate for Payer: PACE SWMI |
$1,194.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,194.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$784.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,235.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,190.70
|
| Rate for Payer: Priority Health Medicare |
$1,194.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,190.70
|
| Rate for Payer: Priority Health SBD |
$2,190.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,194.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,194.57
|
| Rate for Payer: UHCCP Medicaid |
$784.48
|
|
|
PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 49621
|
| Min. Negotiated Rate |
$482.23 |
| Max. Negotiated Rate |
$133,247.00 |
| Rate for Payer: Aetna Commercial |
$982.72
|
| Rate for Payer: Aetna Medicare |
$762.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.72
|
| Rate for Payer: BCBS Complete |
$506.34
|
| Rate for Payer: BCBS MAPPO |
$733.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,534.33
|
| Rate for Payer: BCN Commercial |
$1,080.46
|
| Rate for Payer: BCN Medicare Advantage |
$733.37
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$982.72
|
| Rate for Payer: Cofinity Commercial |
$1,056.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.37
|
| Rate for Payer: Healthscope Commercial |
$1,173.39
|
| Rate for Payer: Healthscope Commercial |
$1,356.73
|
| Rate for Payer: Mclaren Medicaid |
$482.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.04
|
| Rate for Payer: Meridian Medicaid |
$506.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,247.00
|
| Rate for Payer: Nomi Health Commercial |
$880.04
|
| Rate for Payer: PACE SWMI |
$733.37
|
| Rate for Payer: PHP Medicare Advantage |
$733.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,007.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.84
|
| Rate for Payer: Priority Health Medicare |
$733.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.84
|
| Rate for Payer: Priority Health SBD |
$1,323.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.37
|
| Rate for Payer: UHC Medicare Advantage |
$733.37
|
| Rate for Payer: UHCCP Medicaid |
$482.23
|
|
|
PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49622
|
| Min. Negotiated Rate |
$599.81 |
| Max. Negotiated Rate |
$164,484.00 |
| Rate for Payer: Aetna Commercial |
$1,224.20
|
| Rate for Payer: Aetna Medicare |
$950.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,224.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.56
|
| Rate for Payer: BCBS Complete |
$629.80
|
| Rate for Payer: BCBS MAPPO |
$913.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,705.42
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: BCN Medicare Advantage |
$913.58
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,315.56
|
| Rate for Payer: Cofinity Commercial |
$1,224.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$913.58
|
| Rate for Payer: Healthscope Commercial |
$1,461.73
|
| Rate for Payer: Healthscope Commercial |
$1,690.12
|
| Rate for Payer: Mclaren Medicaid |
$599.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$959.26
|
| Rate for Payer: Meridian Medicaid |
$629.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164,484.00
|
| Rate for Payer: Nomi Health Commercial |
$1,096.30
|
| Rate for Payer: PACE SWMI |
$913.58
|
| Rate for Payer: PHP Medicare Advantage |
$913.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,632.29
|
| Rate for Payer: Priority Health Medicare |
$913.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,632.29
|
| Rate for Payer: Priority Health SBD |
$1,632.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$913.58
|
| Rate for Payer: UHC Medicare Advantage |
$913.58
|
| Rate for Payer: UHCCP Medicaid |
$599.81
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS
|
Professional
|
Both
|
$7,564.00
|
|
|
Service Code
|
HCPCS 33925
|
| Min. Negotiated Rate |
$843.70 |
| Max. Negotiated Rate |
$304,312.00 |
| Rate for Payer: Aetna Commercial |
$2,207.73
|
| Rate for Payer: Aetna Medicare |
$1,713.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,207.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,372.49
|
| Rate for Payer: BCBS Complete |
$1,132.79
|
| Rate for Payer: BCBS MAPPO |
$1,647.56
|
| Rate for Payer: BCBS Trust/PPO |
$843.70
|
| Rate for Payer: BCN Commercial |
$2,460.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,647.56
|
| Rate for Payer: Cash Price |
$6,051.20
|
| Rate for Payer: Cash Price |
$6,051.20
|
| Rate for Payer: Cofinity Commercial |
$2,372.49
|
| Rate for Payer: Cofinity Commercial |
$2,207.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,647.56
|
| Rate for Payer: Healthscope Commercial |
$3,047.99
|
| Rate for Payer: Healthscope Commercial |
$2,636.10
|
| Rate for Payer: Mclaren Medicaid |
$1,078.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,729.94
|
| Rate for Payer: Meridian Medicaid |
$1,132.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304,312.00
|
| Rate for Payer: Nomi Health Commercial |
$1,977.07
|
| Rate for Payer: PACE SWMI |
$1,647.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,647.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,078.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,916.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,686.24
|
| Rate for Payer: Priority Health Medicare |
$1,647.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,686.24
|
| Rate for Payer: Priority Health SBD |
$2,686.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,009.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,647.56
|
| Rate for Payer: UHC Exchange |
$2,009.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,647.56
|
| Rate for Payer: UHCCP Medicaid |
$1,078.85
|
|
|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$5,876.00
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$1,600.75 |
| Max. Negotiated Rate |
$541,856.00 |
| Rate for Payer: Aetna Commercial |
$3,923.69
|
| Rate for Payer: Aetna Medicare |
$3,045.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,923.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,216.51
|
| Rate for Payer: BCBS Complete |
$2,013.74
|
| Rate for Payer: BCBS MAPPO |
$2,928.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.75
|
| Rate for Payer: BCN Commercial |
$4,379.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,928.13
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Cofinity Commercial |
$4,216.51
|
| Rate for Payer: Cofinity Commercial |
$3,923.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,928.13
|
| Rate for Payer: Healthscope Commercial |
$5,417.04
|
| Rate for Payer: Healthscope Commercial |
$4,685.01
|
| Rate for Payer: Mclaren Medicaid |
$1,917.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,074.54
|
| Rate for Payer: Meridian Medicaid |
$2,013.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541,856.00
|
| Rate for Payer: Nomi Health Commercial |
$3,513.76
|
| Rate for Payer: PACE SWMI |
$2,928.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,928.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,917.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,819.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,769.40
|
| Rate for Payer: Priority Health Medicare |
$2,928.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,769.40
|
| Rate for Payer: Priority Health SBD |
$4,769.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,641.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,928.13
|
| Rate for Payer: UHC Exchange |
$3,641.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,928.13
|
| Rate for Payer: UHCCP Medicaid |
$1,917.85
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$1,951.00
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$85,626.00 |
| Rate for Payer: Aetna Commercial |
$626.29
|
| Rate for Payer: Aetna Medicare |
$486.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.03
|
| Rate for Payer: BCBS Complete |
$333.46
|
| Rate for Payer: BCBS MAPPO |
$467.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.31
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: BCN Medicare Advantage |
$467.38
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Cofinity Commercial |
$673.03
|
| Rate for Payer: Cofinity Commercial |
$626.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.38
|
| Rate for Payer: Healthscope Commercial |
$864.65
|
| Rate for Payer: Healthscope Commercial |
$747.81
|
| Rate for Payer: Mclaren Medicaid |
$317.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.75
|
| Rate for Payer: Meridian Medicaid |
$333.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,626.00
|
| Rate for Payer: Nomi Health Commercial |
$560.86
|
| Rate for Payer: PACE SWMI |
$467.38
|
| Rate for Payer: PHP Medicare Advantage |
$467.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,268.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.60
|
| Rate for Payer: Priority Health Medicare |
$467.38
|
| Rate for Payer: Priority Health Narrow Network |
$752.60
|
| Rate for Payer: Priority Health SBD |
$752.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.38
|
| Rate for Payer: UHC Exchange |
$716.51
|
| Rate for Payer: UHC Medicare Advantage |
$467.38
|
| Rate for Payer: UHCCP Medicaid |
$317.58
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$432.82 |
| Max. Negotiated Rate |
$117,418.00 |
| Rate for Payer: Aetna Commercial |
$859.40
|
| Rate for Payer: Aetna Medicare |
$666.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.53
|
| Rate for Payer: BCBS Complete |
$454.46
|
| Rate for Payer: BCBS MAPPO |
$641.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,373.05
|
| Rate for Payer: BCN Commercial |
$969.54
|
| Rate for Payer: BCN Medicare Advantage |
$641.34
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$923.53
|
| Rate for Payer: Cofinity Commercial |
$859.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.34
|
| Rate for Payer: Healthscope Commercial |
$1,186.48
|
| Rate for Payer: Healthscope Commercial |
$1,026.14
|
| Rate for Payer: Mclaren Medicaid |
$432.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.41
|
| Rate for Payer: Meridian Medicaid |
$454.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,418.00
|
| Rate for Payer: Nomi Health Commercial |
$769.61
|
| Rate for Payer: PACE SWMI |
$641.34
|
| Rate for Payer: PHP Medicare Advantage |
$641.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.00
|
| Rate for Payer: Priority Health Medicare |
$641.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.00
|
| Rate for Payer: Priority Health SBD |
$1,034.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.34
|
| Rate for Payer: UHC Exchange |
$1,039.05
|
| Rate for Payer: UHC Medicare Advantage |
$641.34
|
| Rate for Payer: UHCCP Medicaid |
$432.82
|
|
|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$442.19 |
| Max. Negotiated Rate |
$120,080.00 |
| Rate for Payer: Aetna Commercial |
$875.21
|
| Rate for Payer: Aetna Medicare |
$679.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.52
|
| Rate for Payer: BCBS Complete |
$464.30
|
| Rate for Payer: BCBS MAPPO |
$653.14
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$996.90
|
| Rate for Payer: BCN Medicare Advantage |
$653.14
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$940.52
|
| Rate for Payer: Cofinity Commercial |
$875.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.14
|
| Rate for Payer: Healthscope Commercial |
$1,208.31
|
| Rate for Payer: Healthscope Commercial |
$1,045.02
|
| Rate for Payer: Mclaren Medicaid |
$442.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.80
|
| Rate for Payer: Meridian Medicaid |
$464.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,080.00
|
| Rate for Payer: Nomi Health Commercial |
$783.77
|
| Rate for Payer: PACE SWMI |
$653.14
|
| Rate for Payer: PHP Medicare Advantage |
$653.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.77
|
| Rate for Payer: Priority Health Medicare |
$653.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,048.77
|
| Rate for Payer: Priority Health SBD |
$1,048.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.14
|
| Rate for Payer: UHC Exchange |
$957.73
|
| Rate for Payer: UHC Medicare Advantage |
$653.14
|
| Rate for Payer: UHCCP Medicaid |
$442.19
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$356.56 |
| Max. Negotiated Rate |
$97,175.00 |
| Rate for Payer: Aetna Commercial |
$706.60
|
| Rate for Payer: Aetna Medicare |
$548.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.33
|
| Rate for Payer: BCBS Complete |
$374.39
|
| Rate for Payer: BCBS MAPPO |
$527.31
|
| Rate for Payer: BCBS Trust/PPO |
$620.09
|
| Rate for Payer: BCN Commercial |
$803.87
|
| Rate for Payer: BCN Medicare Advantage |
$527.31
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cofinity Commercial |
$759.33
|
| Rate for Payer: Cofinity Commercial |
$706.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.31
|
| Rate for Payer: Healthscope Commercial |
$975.52
|
| Rate for Payer: Healthscope Commercial |
$843.70
|
| Rate for Payer: Mclaren Medicaid |
$356.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.68
|
| Rate for Payer: Meridian Medicaid |
$374.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97,175.00
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PACE SWMI |
$527.31
|
| Rate for Payer: PHP Medicare Advantage |
$527.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.22
|
| Rate for Payer: Priority Health Medicare |
$527.31
|
| Rate for Payer: Priority Health Narrow Network |
$845.22
|
| Rate for Payer: Priority Health SBD |
$845.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.31
|
| Rate for Payer: UHC Exchange |
$785.79
|
| Rate for Payer: UHC Medicare Advantage |
$527.31
|
| Rate for Payer: UHCCP Medicaid |
$356.56
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$141,266.00 |
| Rate for Payer: Aetna Commercial |
$1,008.44
|
| Rate for Payer: Aetna Medicare |
$782.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.70
|
| Rate for Payer: BCBS Complete |
$543.25
|
| Rate for Payer: BCBS MAPPO |
$752.57
|
| Rate for Payer: BCBS Trust/PPO |
$89.28
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$752.57
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$1,083.70
|
| Rate for Payer: Cofinity Commercial |
$1,008.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.57
|
| Rate for Payer: Healthscope Commercial |
$1,392.25
|
| Rate for Payer: Healthscope Commercial |
$1,204.11
|
| Rate for Payer: Mclaren Medicaid |
$517.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.20
|
| Rate for Payer: Meridian Medicaid |
$543.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,266.00
|
| Rate for Payer: Nomi Health Commercial |
$903.08
|
| Rate for Payer: PACE SWMI |
$752.57
|
| Rate for Payer: PHP Medicare Advantage |
$752.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.04
|
| Rate for Payer: Priority Health Medicare |
$752.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,237.04
|
| Rate for Payer: Priority Health SBD |
$1,237.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.57
|
| Rate for Payer: UHC Exchange |
$958.13
|
| Rate for Payer: UHC Medicare Advantage |
$752.57
|
| Rate for Payer: UHCCP Medicaid |
$517.38
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$652.66 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.33
|
| Rate for Payer: BCN Commercial |
$1,516.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.66
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$108,441.00 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$613.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.30
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Healthscope Commercial |
$943.66
|
| Rate for Payer: Healthscope Commercial |
$1,091.11
|
| Rate for Payer: Mclaren Medicaid |
$392.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,441.00
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,090.58
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.58
|
| Rate for Payer: Priority Health SBD |
$1,090.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$638.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Exchange |
$638.50
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$108,441.00 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$613.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.30
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Healthscope Commercial |
$943.66
|
| Rate for Payer: Healthscope Commercial |
$1,091.11
|
| Rate for Payer: Mclaren Medicaid |
$392.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,441.00
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,090.58
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.58
|
| Rate for Payer: Priority Health SBD |
$1,090.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$638.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Exchange |
$638.50
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$674.73 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health SBD |
$674.73
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,481.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$466.26 |
| Max. Negotiated Rate |
$129,836.00 |
| Rate for Payer: Aetna Commercial |
$941.44
|
| Rate for Payer: Aetna Medicare |
$730.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.44
|
| Rate for Payer: BCBS Complete |
$489.57
|
| Rate for Payer: BCBS MAPPO |
$702.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: BCN Commercial |
$1,060.92
|
| Rate for Payer: BCN Medicare Advantage |
$702.57
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cofinity Commercial |
$941.44
|
| Rate for Payer: Cofinity Commercial |
$1,011.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.57
|
| Rate for Payer: Healthscope Commercial |
$1,299.75
|
| Rate for Payer: Healthscope Commercial |
$1,124.11
|
| Rate for Payer: Mclaren Medicaid |
$466.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.70
|
| Rate for Payer: Meridian Medicaid |
$489.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129,836.00
|
| Rate for Payer: Nomi Health Commercial |
$843.08
|
| Rate for Payer: PACE SWMI |
$702.57
|
| Rate for Payer: PHP Medicare Advantage |
$702.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,300.58
|
| Rate for Payer: Priority Health Medicare |
$702.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.58
|
| Rate for Payer: Priority Health SBD |
$1,300.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$702.57
|
| Rate for Payer: UHC Exchange |
$779.38
|
| Rate for Payer: UHC Medicare Advantage |
$702.57
|
| Rate for Payer: UHCCP Medicaid |
$466.26
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,723.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,491.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,084.23 |
| Max. Negotiated Rate |
$1,548.90 |
| Rate for Payer: Aetna Commercial |
$1,462.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.65
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,204.70
|
| Rate for Payer: Cofinity Commercial |
$1,480.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,204.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Healthscope Commercial |
$1,548.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: PHP Commercial |
$1,462.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health SBD |
$1,084.23
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$113,479.00 |
| Rate for Payer: Aetna Commercial |
$826.93
|
| Rate for Payer: Aetna Medicare |
$641.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.64
|
| Rate for Payer: BCBS Complete |
$430.53
|
| Rate for Payer: BCBS MAPPO |
$617.11
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$617.11
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$888.64
|
| Rate for Payer: Cofinity Commercial |
$826.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.11
|
| Rate for Payer: Healthscope Commercial |
$987.38
|
| Rate for Payer: Healthscope Commercial |
$1,141.65
|
| Rate for Payer: Mclaren Medicaid |
$410.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.97
|
| Rate for Payer: Meridian Medicaid |
$430.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,479.00
|
| Rate for Payer: Nomi Health Commercial |
$740.53
|
| Rate for Payer: PACE SWMI |
$617.11
|
| Rate for Payer: PHP Medicare Advantage |
$617.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,141.88
|
| Rate for Payer: Priority Health Medicare |
$617.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,141.88
|
| Rate for Payer: Priority Health SBD |
$1,141.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.11
|
| Rate for Payer: UHC Exchange |
$761.77
|
| Rate for Payer: UHC Medicare Advantage |
$617.11
|
| Rate for Payer: UHCCP Medicaid |
$410.03
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$683.94 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$1,462.85
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,168.33
|
| Rate for Payer: BCN Commercial |
$2,168.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,480.06
|
| Rate for Payer: Cofinity Commercial |
$1,204.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,204.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,548.90
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,462.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,084.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$683.94
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
