|
PR LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44203
|
| Min. Negotiated Rate |
$137.81 |
| Max. Negotiated Rate |
$823.50 |
| Rate for Payer: Aetna Commercial |
$291.58
|
| Rate for Payer: Aetna Medicare |
$226.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.34
|
| Rate for Payer: BCBS Complete |
$144.70
|
| Rate for Payer: BCBS MAPPO |
$217.60
|
| Rate for Payer: BCN Commercial |
$356.06
|
| Rate for Payer: BCN Medicare Advantage |
$217.60
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$313.34
|
| Rate for Payer: Cofinity Commercial |
$291.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.60
|
| Rate for Payer: Healthscope Commercial |
$402.56
|
| Rate for Payer: Healthscope Commercial |
$348.16
|
| Rate for Payer: Mclaren Medicaid |
$137.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.48
|
| Rate for Payer: Meridian Medicaid |
$144.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.65
|
| Rate for Payer: Nomi Health Commercial |
$261.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$823.50
|
| Rate for Payer: PACE SWMI |
$217.60
|
| Rate for Payer: PHP Medicare Advantage |
$217.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$433.84
|
| Rate for Payer: Priority Health Medicare |
$217.60
|
| Rate for Payer: Priority Health SBD |
$433.84
|
| Rate for Payer: Priority Health Tiered Network |
$433.84
|
| Rate for Payer: Railroad Medicare Medicare |
$217.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.96
|
| Rate for Payer: UHC Core |
$430.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.60
|
| Rate for Payer: UHC Exchange |
$430.96
|
| Rate for Payer: UHC Medicaid |
$137.81
|
| Rate for Payer: UHCCP Medicaid |
$137.81
|
|
|
PR LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 58541
|
| Min. Negotiated Rate |
$413.65 |
| Max. Negotiated Rate |
$1,564.50 |
| Rate for Payer: Aetna Commercial |
$859.17
|
| Rate for Payer: Aetna Medicare |
$666.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.28
|
| Rate for Payer: BCBS Complete |
$434.33
|
| Rate for Payer: BCBS MAPPO |
$641.17
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: BCN Medicare Advantage |
$641.17
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cofinity Commercial |
$923.28
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.17
|
| Rate for Payer: Healthscope Commercial |
$1,186.16
|
| Rate for Payer: Healthscope Commercial |
$1,025.87
|
| Rate for Payer: Mclaren Medicaid |
$413.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.23
|
| Rate for Payer: Meridian Medicaid |
$434.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,303.15
|
| Rate for Payer: Nomi Health Commercial |
$769.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: PACE SWMI |
$641.17
|
| Rate for Payer: PHP Medicare Advantage |
$641.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,111.07
|
| Rate for Payer: Priority Health Medicare |
$641.17
|
| Rate for Payer: Priority Health SBD |
$1,111.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,111.07
|
| Rate for Payer: Railroad Medicare Medicare |
$641.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.48
|
| Rate for Payer: UHC Core |
$1,285.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.17
|
| Rate for Payer: UHC Exchange |
$1,285.48
|
| Rate for Payer: UHC Medicaid |
$413.65
|
| Rate for Payer: UHCCP Medicaid |
$413.65
|
|
|
PR LAPAROSCOPY SURG ABLATION RENAL CYSTS
|
Professional
|
Both
|
$1,815.00
|
|
|
Service Code
|
HCPCS 50541
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,622.97 |
| Rate for Payer: Aetna Commercial |
$1,089.22
|
| Rate for Payer: Aetna Medicare |
$845.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.50
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS MAPPO |
$812.85
|
| Rate for Payer: BCN Commercial |
$1,367.95
|
| Rate for Payer: BCN Medicare Advantage |
$812.85
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.50
|
| Rate for Payer: Cofinity Commercial |
$1,089.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.85
|
| Rate for Payer: Healthscope Commercial |
$1,503.77
|
| Rate for Payer: Healthscope Commercial |
$1,300.56
|
| Rate for Payer: Mclaren Medicaid |
$523.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.49
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$894.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.27
|
| Rate for Payer: Nomi Health Commercial |
$975.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,361.25
|
| Rate for Payer: PACE SWMI |
$812.85
|
| Rate for Payer: PHP Medicare Advantage |
$812.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,490.15
|
| Rate for Payer: Priority Health Medicare |
$812.85
|
| Rate for Payer: Priority Health SBD |
$1,490.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,490.15
|
| Rate for Payer: Railroad Medicare Medicare |
$812.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,622.97
|
| Rate for Payer: UHC Core |
$1,622.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.85
|
| Rate for Payer: UHC Exchange |
$1,622.97
|
| Rate for Payer: UHC Medicaid |
$523.55
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
OP
|
$3,101.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,953.63 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$2,635.85
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,015.65
|
| 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 |
$3,709.70
|
| Rate for Payer: BCN Commercial |
$3,709.70
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Advantage |
$2,170.70
|
| Rate for Payer: Cofinity Commercial |
$2,666.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,480.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,790.90
|
| 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 |
$2,635.85
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$2,635.85
|
| 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 |
$1,953.63
|
| 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 LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$403.00 |
| Max. Negotiated Rate |
$2,325.75 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: Aetna Medicare |
$650.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.30
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS MAPPO |
$625.90
|
| Rate for Payer: BCN Commercial |
$998.95
|
| Rate for Payer: BCN Medicare Advantage |
$625.90
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$901.30
|
| Rate for Payer: Cofinity Commercial |
$838.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.90
|
| Rate for Payer: Healthscope Commercial |
$1,157.91
|
| Rate for Payer: Healthscope Commercial |
$1,001.44
|
| Rate for Payer: Mclaren Medicaid |
$403.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.20
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,180.64
|
| Rate for Payer: Nomi Health Commercial |
$751.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PACE SWMI |
$625.90
|
| Rate for Payer: PHP Medicare Advantage |
$625.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,217.15
|
| Rate for Payer: Priority Health Medicare |
$625.90
|
| Rate for Payer: Priority Health SBD |
$1,217.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,217.15
|
| Rate for Payer: Railroad Medicare Medicare |
$625.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.70
|
| Rate for Payer: UHC Core |
$1,171.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.90
|
| Rate for Payer: UHC Exchange |
$1,171.70
|
| Rate for Payer: UHC Medicaid |
$403.00
|
| Rate for Payer: UHCCP Medicaid |
$403.00
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
IP
|
$3,101.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,953.63 |
| Max. Negotiated Rate |
$2,790.90 |
| Rate for Payer: Aetna Commercial |
$2,635.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,015.65
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Advantage |
$2,170.70
|
| Rate for Payer: Cofinity Commercial |
$2,666.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,480.80
|
| Rate for Payer: Healthscope Commercial |
$2,790.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,635.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PHP Commercial |
$2,635.85
|
| Rate for Payer: Priority Health SBD |
$1,953.63
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 47562
|
| Min. Negotiated Rate |
$403.00 |
| Max. Negotiated Rate |
$2,325.75 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: Aetna Medicare |
$650.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.30
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS MAPPO |
$625.90
|
| Rate for Payer: BCN Commercial |
$998.95
|
| Rate for Payer: BCN Medicare Advantage |
$625.90
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$901.30
|
| Rate for Payer: Cofinity Commercial |
$838.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.90
|
| Rate for Payer: Healthscope Commercial |
$1,157.91
|
| Rate for Payer: Healthscope Commercial |
$1,001.44
|
| Rate for Payer: Mclaren Medicaid |
$403.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.20
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,180.64
|
| Rate for Payer: Nomi Health Commercial |
$751.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PACE SWMI |
$625.90
|
| Rate for Payer: PHP Medicare Advantage |
$625.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,217.15
|
| Rate for Payer: Priority Health Medicare |
$625.90
|
| Rate for Payer: Priority Health SBD |
$1,217.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,217.15
|
| Rate for Payer: Railroad Medicare Medicare |
$625.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.70
|
| Rate for Payer: UHC Core |
$1,171.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.90
|
| Rate for Payer: UHC Exchange |
$1,171.70
|
| Rate for Payer: UHC Medicaid |
$403.00
|
| Rate for Payer: UHCCP Medicaid |
$403.00
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,845.00
|
|
|
Service Code
|
HCPCS 44188
|
| Min. Negotiated Rate |
$726.76 |
| Max. Negotiated Rate |
$2,207.99 |
| Rate for Payer: PHP Medicare Advantage |
$1,125.70
|
| Rate for Payer: Aetna Commercial |
$1,508.44
|
| Rate for Payer: Aetna Medicare |
$1,170.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,508.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.01
|
| Rate for Payer: BCBS Complete |
$763.10
|
| Rate for Payer: BCBS MAPPO |
$1,125.70
|
| Rate for Payer: BCN Commercial |
$1,812.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,125.70
|
| Rate for Payer: Cash Price |
$2,276.00
|
| Rate for Payer: Cash Price |
$2,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,621.01
|
| Rate for Payer: Cofinity Commercial |
$1,508.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,125.70
|
| Rate for Payer: Healthscope Commercial |
$2,082.55
|
| Rate for Payer: Healthscope Commercial |
$1,801.12
|
| Rate for Payer: Mclaren Medicaid |
$726.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,181.98
|
| Rate for Payer: Meridian Medicaid |
$763.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,238.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,157.07
|
| Rate for Payer: Nomi Health Commercial |
$1,350.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,133.75
|
| Rate for Payer: PACE SWMI |
$1,125.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,207.99
|
| Rate for Payer: Priority Health Medicare |
$1,125.70
|
| Rate for Payer: Priority Health SBD |
$2,207.99
|
| Rate for Payer: Priority Health Tiered Network |
$2,207.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,125.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,160.85
|
| Rate for Payer: UHC Core |
$2,160.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,125.70
|
| Rate for Payer: UHC Exchange |
$2,160.85
|
| Rate for Payer: UHC Medicaid |
$726.76
|
| Rate for Payer: UHCCP Medicaid |
$726.76
|
|
|
PR LAPAROSCOPY SURGICAL JEJUNOSTOMY
|
Professional
|
Both
|
$2,058.00
|
|
|
Service Code
|
HCPCS 44186
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$1,543.50 |
| Rate for Payer: Aetna Commercial |
$829.00
|
| Rate for Payer: Aetna Medicare |
$643.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.87
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$618.66
|
| Rate for Payer: BCN Commercial |
$981.52
|
| Rate for Payer: BCN Medicare Advantage |
$618.66
|
| Rate for Payer: Cash Price |
$1,646.40
|
| Rate for Payer: Cash Price |
$1,646.40
|
| Rate for Payer: Cofinity Commercial |
$890.87
|
| Rate for Payer: Cofinity Commercial |
$829.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$618.66
|
| Rate for Payer: Healthscope Commercial |
$989.86
|
| Rate for Payer: Healthscope Commercial |
$1,144.52
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$649.59
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$680.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.19
|
| Rate for Payer: Nomi Health Commercial |
$742.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,543.50
|
| Rate for Payer: PACE SWMI |
$618.66
|
| Rate for Payer: PHP Medicare Advantage |
$618.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,195.92
|
| Rate for Payer: Priority Health Medicare |
$618.66
|
| Rate for Payer: Priority Health SBD |
$1,195.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,195.92
|
| Rate for Payer: Railroad Medicare Medicare |
$618.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.94
|
| Rate for Payer: UHC Core |
$1,158.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$618.66
|
| Rate for Payer: UHC Exchange |
$1,158.94
|
| Rate for Payer: UHC Medicaid |
$398.52
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR LAPAROSCOPY SURGICAL ORCHIECTOMY
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 54690
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$1,157.67 |
| Rate for Payer: Aetna Commercial |
$784.28
|
| Rate for Payer: Aetna Medicare |
$608.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$784.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.80
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS MAPPO |
$585.28
|
| Rate for Payer: BCN Commercial |
$982.52
|
| Rate for Payer: BCN Medicare Advantage |
$585.28
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$842.80
|
| Rate for Payer: Cofinity Commercial |
$784.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.28
|
| Rate for Payer: Healthscope Commercial |
$936.45
|
| Rate for Payer: Healthscope Commercial |
$1,082.77
|
| Rate for Payer: Mclaren Medicaid |
$378.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.54
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$643.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,152.09
|
| Rate for Payer: Nomi Health Commercial |
$702.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$585.28
|
| Rate for Payer: PHP Medicare Advantage |
$585.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,070.29
|
| Rate for Payer: Priority Health Medicare |
$585.28
|
| Rate for Payer: Priority Health SBD |
$1,070.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,070.29
|
| Rate for Payer: Railroad Medicare Medicare |
$585.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,157.67
|
| Rate for Payer: UHC Core |
$1,157.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$585.28
|
| Rate for Payer: UHC Exchange |
$1,157.67
|
| Rate for Payer: UHC Medicaid |
$378.29
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$3,114.00
|
|
|
Service Code
|
HCPCS 44187
|
| Min. Negotiated Rate |
$653.48 |
| Max. Negotiated Rate |
$2,335.50 |
| Rate for Payer: Aetna Commercial |
$1,352.64
|
| Rate for Payer: Aetna Medicare |
$1,049.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,453.58
|
| Rate for Payer: BCBS Complete |
$686.15
|
| Rate for Payer: BCBS MAPPO |
$1,009.43
|
| Rate for Payer: BCN Commercial |
$1,627.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,009.43
|
| Rate for Payer: Cash Price |
$2,491.20
|
| Rate for Payer: Cash Price |
$2,491.20
|
| Rate for Payer: Cofinity Commercial |
$1,453.58
|
| Rate for Payer: Cofinity Commercial |
$1,352.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,009.43
|
| Rate for Payer: Healthscope Commercial |
$1,867.45
|
| Rate for Payer: Healthscope Commercial |
$1,615.09
|
| Rate for Payer: Mclaren Medicaid |
$653.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,059.90
|
| Rate for Payer: Meridian Medicaid |
$686.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,110.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,933.18
|
| Rate for Payer: Nomi Health Commercial |
$1,211.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.50
|
| Rate for Payer: PACE SWMI |
$1,009.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,009.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,982.88
|
| Rate for Payer: Priority Health Medicare |
$1,009.43
|
| Rate for Payer: Priority Health SBD |
$1,982.88
|
| Rate for Payer: Priority Health Tiered Network |
$1,982.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,009.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,937.77
|
| Rate for Payer: UHC Core |
$1,937.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,009.43
|
| Rate for Payer: UHC Exchange |
$1,937.77
|
| Rate for Payer: UHC Medicaid |
$653.48
|
| Rate for Payer: UHCCP Medicaid |
$653.48
|
|
|
PR LAPAROSCOPY SURG PARTIAL NEPHRECTOMY
|
Professional
|
Both
|
$2,938.00
|
|
|
Service Code
|
HCPCS 50543
|
| Min. Negotiated Rate |
$847.95 |
| Max. Negotiated Rate |
$2,633.68 |
| Rate for Payer: Aetna Commercial |
$1,764.26
|
| Rate for Payer: Aetna Medicare |
$1,369.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,895.92
|
| Rate for Payer: BCBS Complete |
$890.35
|
| Rate for Payer: BCBS MAPPO |
$1,316.61
|
| Rate for Payer: BCN Commercial |
$2,217.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,316.61
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,895.92
|
| Rate for Payer: Cofinity Commercial |
$1,764.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,316.61
|
| Rate for Payer: Healthscope Commercial |
$2,435.73
|
| Rate for Payer: Healthscope Commercial |
$2,106.58
|
| Rate for Payer: Mclaren Medicaid |
$847.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,382.44
|
| Rate for Payer: Meridian Medicaid |
$890.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,448.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,614.70
|
| Rate for Payer: Nomi Health Commercial |
$1,579.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,203.50
|
| Rate for Payer: PACE SWMI |
$1,316.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,316.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,415.05
|
| Rate for Payer: Priority Health Medicare |
$1,316.61
|
| Rate for Payer: Priority Health SBD |
$2,415.05
|
| Rate for Payer: Priority Health Tiered Network |
$2,415.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,316.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.68
|
| Rate for Payer: UHC Core |
$2,633.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,316.61
|
| Rate for Payer: UHC Exchange |
$2,633.68
|
| Rate for Payer: UHC Medicaid |
$847.95
|
| Rate for Payer: UHCCP Medicaid |
$847.95
|
|
|
PR LAPAROSCOPY SURG PYELOPLASTY
|
Professional
|
Both
|
$2,469.00
|
|
|
Service Code
|
HCPCS 50544
|
| Min. Negotiated Rate |
$703.54 |
| Max. Negotiated Rate |
$2,205.24 |
| Rate for Payer: Aetna Commercial |
$1,466.98
|
| Rate for Payer: Aetna Medicare |
$1,138.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,466.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.45
|
| Rate for Payer: BCBS Complete |
$738.72
|
| Rate for Payer: BCBS MAPPO |
$1,094.76
|
| Rate for Payer: BCN Commercial |
$1,844.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.76
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cofinity Commercial |
$1,576.45
|
| Rate for Payer: Cofinity Commercial |
$1,466.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.76
|
| Rate for Payer: Healthscope Commercial |
$2,025.31
|
| Rate for Payer: Healthscope Commercial |
$1,751.62
|
| Rate for Payer: Mclaren Medicaid |
$703.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,149.50
|
| Rate for Payer: Meridian Medicaid |
$738.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,204.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,181.62
|
| Rate for Payer: Nomi Health Commercial |
$1,313.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,851.75
|
| Rate for Payer: PACE SWMI |
$1,094.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,008.74
|
| Rate for Payer: Priority Health Medicare |
$1,094.76
|
| Rate for Payer: Priority Health SBD |
$2,008.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,008.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,094.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,205.24
|
| Rate for Payer: UHC Core |
$2,205.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,094.76
|
| Rate for Payer: UHC Exchange |
$2,205.24
|
| Rate for Payer: UHC Medicaid |
$703.54
|
| Rate for Payer: UHCCP Medicaid |
$703.54
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,013.04 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Aetna Commercial |
$1,366.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.20
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Advantage |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,382.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.40
|
| Rate for Payer: Healthscope Commercial |
$1,447.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,366.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PHP Commercial |
$1,366.80
|
| Rate for Payer: Priority Health SBD |
$1,013.04
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 49650
|
| Hospital Charge Code |
49650
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Medicare |
$433.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.57
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$417.06
|
| Rate for Payer: BCN Commercial |
$658.33
|
| Rate for Payer: BCN Medicare Advantage |
$417.06
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$600.57
|
| Rate for Payer: Cofinity Commercial |
$558.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.06
|
| Rate for Payer: Healthscope Commercial |
$771.56
|
| Rate for Payer: Healthscope Commercial |
$667.30
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.91
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.61
|
| Rate for Payer: Nomi Health Commercial |
$500.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE SWMI |
$417.06
|
| Rate for Payer: PHP Medicare Advantage |
$417.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$802.13
|
| Rate for Payer: Priority Health Medicare |
$417.06
|
| Rate for Payer: Priority Health SBD |
$802.13
|
| Rate for Payer: Priority Health Tiered Network |
$802.13
|
| Rate for Payer: Railroad Medicare Medicare |
$417.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.14
|
| Rate for Payer: UHC Core |
$760.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.06
|
| Rate for Payer: UHC Exchange |
$760.14
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 49650
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Medicare |
$433.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.57
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$417.06
|
| Rate for Payer: BCN Commercial |
$658.33
|
| Rate for Payer: BCN Medicare Advantage |
$417.06
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$600.57
|
| Rate for Payer: Cofinity Commercial |
$558.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.06
|
| Rate for Payer: Healthscope Commercial |
$771.56
|
| Rate for Payer: Healthscope Commercial |
$667.30
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.91
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.61
|
| Rate for Payer: Nomi Health Commercial |
$500.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE SWMI |
$417.06
|
| Rate for Payer: PHP Medicare Advantage |
$417.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$802.13
|
| Rate for Payer: Priority Health Medicare |
$417.06
|
| Rate for Payer: Priority Health SBD |
$802.13
|
| Rate for Payer: Priority Health Tiered Network |
$802.13
|
| Rate for Payer: Railroad Medicare Medicare |
$417.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.14
|
| Rate for Payer: UHC Core |
$760.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.06
|
| Rate for Payer: UHC Exchange |
$760.14
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,013.04 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$1,366.80
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.20
|
| 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 |
$4,099.39
|
| Rate for Payer: BCN Commercial |
$4,099.39
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Advantage |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,382.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,447.20
|
| 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 |
$1,366.80
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$1,366.80
|
| 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 |
$1,013.04
|
| 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 LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 49321
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$1,212.75 |
| Rate for Payer: PHP Medicare Advantage |
$325.17
|
| Rate for Payer: Aetna Commercial |
$435.73
|
| Rate for Payer: Aetna Medicare |
$338.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.24
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$325.17
|
| Rate for Payer: BCN Commercial |
$520.39
|
| Rate for Payer: BCN Medicare Advantage |
$325.17
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$468.24
|
| Rate for Payer: Cofinity Commercial |
$435.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.17
|
| Rate for Payer: Healthscope Commercial |
$601.56
|
| Rate for Payer: Healthscope Commercial |
$520.27
|
| Rate for Payer: Mclaren Medicaid |
$210.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.43
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$357.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.52
|
| Rate for Payer: Nomi Health Commercial |
$390.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,212.75
|
| Rate for Payer: PACE SWMI |
$325.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$634.06
|
| Rate for Payer: Priority Health Medicare |
$325.17
|
| Rate for Payer: Priority Health SBD |
$634.06
|
| Rate for Payer: Priority Health Tiered Network |
$634.06
|
| Rate for Payer: Railroad Medicare Medicare |
$325.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.00
|
| Rate for Payer: UHC Core |
$611.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$325.17
|
| Rate for Payer: UHC Exchange |
$611.00
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM
|
Professional
|
Both
|
$3,059.00
|
|
|
Service Code
|
HCPCS 58572
|
| Min. Negotiated Rate |
$603.00 |
| Max. Negotiated Rate |
$2,294.25 |
| Rate for Payer: Aetna Commercial |
$1,257.63
|
| Rate for Payer: Aetna Medicare |
$976.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,257.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.48
|
| Rate for Payer: BCBS Complete |
$633.15
|
| Rate for Payer: BCBS MAPPO |
$938.53
|
| Rate for Payer: BCN Commercial |
$1,562.17
|
| Rate for Payer: BCN Medicare Advantage |
$938.53
|
| Rate for Payer: Cash Price |
$2,447.20
|
| Rate for Payer: Cash Price |
$2,447.20
|
| Rate for Payer: Cofinity Commercial |
$1,351.48
|
| Rate for Payer: Cofinity Commercial |
$1,257.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.53
|
| Rate for Payer: Healthscope Commercial |
$1,736.28
|
| Rate for Payer: Healthscope Commercial |
$1,501.65
|
| Rate for Payer: Mclaren Medicaid |
$603.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.46
|
| Rate for Payer: Meridian Medicaid |
$633.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,032.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.91
|
| Rate for Payer: Nomi Health Commercial |
$1,126.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,294.25
|
| Rate for Payer: PACE SWMI |
$938.53
|
| Rate for Payer: PHP Medicare Advantage |
$938.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,582.14
|
| Rate for Payer: Priority Health Medicare |
$938.53
|
| Rate for Payer: Priority Health SBD |
$1,582.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,582.14
|
| Rate for Payer: Railroad Medicare Medicare |
$938.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.47
|
| Rate for Payer: UHC Core |
$1,825.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$938.53
|
| Rate for Payer: UHC Exchange |
$1,825.47
|
| Rate for Payer: UHC Medicaid |
$603.00
|
| Rate for Payer: UHCCP Medicaid |
$603.00
|
|
|
PR LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR
|
Professional
|
Both
|
$3,569.00
|
|
|
Service Code
|
HCPCS 58573
|
| Min. Negotiated Rate |
$705.03 |
| Max. Negotiated Rate |
$2,676.75 |
| Rate for Payer: Aetna Commercial |
$1,471.05
|
| Rate for Payer: Aetna Medicare |
$1,141.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,471.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,580.83
|
| Rate for Payer: BCBS Complete |
$740.28
|
| Rate for Payer: BCBS MAPPO |
$1,097.80
|
| Rate for Payer: BCN Commercial |
$1,826.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.80
|
| Rate for Payer: Cash Price |
$2,855.20
|
| Rate for Payer: Cash Price |
$2,855.20
|
| Rate for Payer: Cofinity Commercial |
$1,580.83
|
| Rate for Payer: Cofinity Commercial |
$1,471.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.80
|
| Rate for Payer: Healthscope Commercial |
$2,030.93
|
| Rate for Payer: Healthscope Commercial |
$1,756.48
|
| Rate for Payer: Mclaren Medicaid |
$705.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.69
|
| Rate for Payer: Meridian Medicaid |
$740.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,207.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,170.42
|
| Rate for Payer: Nomi Health Commercial |
$1,317.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,676.75
|
| Rate for Payer: PACE SWMI |
$1,097.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,849.94
|
| Rate for Payer: Priority Health Medicare |
$1,097.80
|
| Rate for Payer: Priority Health SBD |
$1,849.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,849.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,140.93
|
| Rate for Payer: UHC Core |
$2,140.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.80
|
| Rate for Payer: UHC Exchange |
$2,140.93
|
| Rate for Payer: UHC Medicaid |
$705.03
|
| Rate for Payer: UHCCP Medicaid |
$705.03
|
|
|
PR LAPAROSCOPY W/LYSIS OF ADHESIONS
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 58660
|
| Min. Negotiated Rate |
$400.23 |
| Max. Negotiated Rate |
$2,076.00 |
| Rate for Payer: Aetna Commercial |
$834.74
|
| Rate for Payer: Aetna Medicare |
$647.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.03
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS MAPPO |
$622.94
|
| Rate for Payer: BCN Commercial |
$1,030.82
|
| Rate for Payer: BCN Medicare Advantage |
$622.94
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$897.03
|
| Rate for Payer: Cofinity Commercial |
$834.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.94
|
| Rate for Payer: Healthscope Commercial |
$996.70
|
| Rate for Payer: Healthscope Commercial |
$1,152.44
|
| Rate for Payer: Mclaren Medicaid |
$400.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.09
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.03
|
| Rate for Payer: Nomi Health Commercial |
$747.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,076.00
|
| Rate for Payer: PACE SWMI |
$622.94
|
| Rate for Payer: PHP Medicare Advantage |
$622.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,043.99
|
| Rate for Payer: Priority Health Medicare |
$622.94
|
| Rate for Payer: Priority Health SBD |
$1,043.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,043.99
|
| Rate for Payer: Railroad Medicare Medicare |
$622.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,201.37
|
| Rate for Payer: UHC Core |
$1,201.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$622.94
|
| Rate for Payer: UHC Exchange |
$1,201.37
|
| Rate for Payer: UHC Medicaid |
$400.23
|
| Rate for Payer: UHCCP Medicaid |
$400.23
|
|
|
PR LAPAROSCOPY W/OMENTOPEXY
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 49326
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$340.38 |
| Rate for Payer: Aetna Commercial |
$229.15
|
| Rate for Payer: Aetna Medicare |
$177.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.25
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$171.01
|
| Rate for Payer: BCN Commercial |
$279.37
|
| Rate for Payer: BCN Medicare Advantage |
$171.01
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$246.25
|
| Rate for Payer: Cofinity Commercial |
$229.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.01
|
| Rate for Payer: Healthscope Commercial |
$316.37
|
| Rate for Payer: Healthscope Commercial |
$273.62
|
| Rate for Payer: Mclaren Medicaid |
$107.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.56
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.18
|
| Rate for Payer: Nomi Health Commercial |
$205.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.50
|
| Rate for Payer: PACE SWMI |
$171.01
|
| Rate for Payer: PHP Medicare Advantage |
$171.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$340.38
|
| Rate for Payer: Priority Health Medicare |
$171.01
|
| Rate for Payer: Priority Health SBD |
$340.38
|
| Rate for Payer: Priority Health Tiered Network |
$340.38
|
| Rate for Payer: Railroad Medicare Medicare |
$171.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.27
|
| Rate for Payer: UHC Core |
$340.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.01
|
| Rate for Payer: UHC Exchange |
$340.27
|
| Rate for Payer: UHC Medicaid |
$107.99
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
|
|
PR LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 58671
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,179.00 |
| Rate for Payer: Aetna Commercial |
$439.69
|
| Rate for Payer: Aetna Medicare |
$341.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.51
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$328.13
|
| Rate for Payer: BCN Commercial |
$558.74
|
| Rate for Payer: BCN Medicare Advantage |
$328.13
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$472.51
|
| Rate for Payer: Cofinity Commercial |
$439.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.13
|
| Rate for Payer: Healthscope Commercial |
$607.04
|
| Rate for Payer: Healthscope Commercial |
$525.01
|
| Rate for Payer: Mclaren Medicaid |
$212.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.54
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.10
|
| Rate for Payer: Nomi Health Commercial |
$393.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,179.00
|
| Rate for Payer: PACE SWMI |
$328.13
|
| Rate for Payer: PHP Medicare Advantage |
$328.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.88
|
| Rate for Payer: Priority Health Medicare |
$328.13
|
| Rate for Payer: Priority Health SBD |
$565.88
|
| Rate for Payer: Priority Health Tiered Network |
$565.88
|
| Rate for Payer: Railroad Medicare Medicare |
$328.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.47
|
| Rate for Payer: UHC Core |
$649.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$328.13
|
| Rate for Payer: UHC Exchange |
$649.47
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,826.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$373.82 |
| Max. Negotiated Rate |
$2,119.50 |
| Rate for Payer: Aetna Commercial |
$780.84
|
| Rate for Payer: Aetna Medicare |
$606.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.12
|
| Rate for Payer: BCBS Complete |
$392.51
|
| Rate for Payer: BCBS MAPPO |
$582.72
|
| Rate for Payer: BCN Commercial |
$978.53
|
| Rate for Payer: BCN Medicare Advantage |
$582.72
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Commercial |
$839.12
|
| Rate for Payer: Cofinity Commercial |
$780.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.72
|
| Rate for Payer: Healthscope Commercial |
$932.35
|
| Rate for Payer: Healthscope Commercial |
$1,078.03
|
| Rate for Payer: Mclaren Medicaid |
$373.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.86
|
| Rate for Payer: Meridian Medicaid |
$392.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$640.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,167.66
|
| Rate for Payer: Nomi Health Commercial |
$699.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| Rate for Payer: PACE SWMI |
$582.72
|
| Rate for Payer: PHP Medicare Advantage |
$582.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$991.04
|
| Rate for Payer: Priority Health Medicare |
$582.72
|
| Rate for Payer: Priority Health SBD |
$991.04
|
| Rate for Payer: Priority Health Tiered Network |
$991.04
|
| Rate for Payer: Railroad Medicare Medicare |
$582.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,153.74
|
| Rate for Payer: UHC Core |
$1,153.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$582.72
|
| Rate for Payer: UHC Exchange |
$1,153.74
|
| Rate for Payer: UHC Medicaid |
$373.82
|
| Rate for Payer: UHCCP Medicaid |
$373.82
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
IP
|
$2,826.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,780.38 |
| Max. Negotiated Rate |
$2,543.40 |
| Rate for Payer: Aetna Commercial |
$2,402.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,836.90
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Advantage |
$1,978.20
|
| Rate for Payer: Cofinity Commercial |
$2,430.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,260.80
|
| Rate for Payer: Healthscope Commercial |
$2,543.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| Rate for Payer: PHP Commercial |
$2,402.10
|
| Rate for Payer: Priority Health SBD |
$1,780.38
|
|
