|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
OP
|
$2,826.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,780.38 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$2,402.10
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,836.90
|
| 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 |
$3,555.71
|
| Rate for Payer: BCN Commercial |
$3,555.71
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cash Price |
$2,260.80
|
| 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: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,543.40
|
| 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 |
$2,402.10
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$2,402.10
|
| 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 |
$1,780.38
|
| 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 W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,826.00
|
|
|
Service Code
|
HCPCS 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 TOTAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,549.00
|
|
|
Service Code
|
HCPCS 58570
|
| Min. Negotiated Rate |
$463.70 |
| Max. Negotiated Rate |
$1,911.75 |
| Rate for Payer: PHP Medicare Advantage |
$719.63
|
| Rate for Payer: Aetna Commercial |
$964.30
|
| Rate for Payer: Aetna Medicare |
$748.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,036.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.30
|
| Rate for Payer: BCBS Complete |
$486.88
|
| Rate for Payer: BCBS MAPPO |
$719.63
|
| Rate for Payer: BCN Commercial |
$1,213.58
|
| Rate for Payer: BCN Medicare Advantage |
$719.63
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cofinity Commercial |
$964.30
|
| Rate for Payer: Cofinity Commercial |
$1,036.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.63
|
| Rate for Payer: Healthscope Commercial |
$1,331.32
|
| Rate for Payer: Healthscope Commercial |
$1,151.41
|
| Rate for Payer: Mclaren Medicaid |
$463.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.61
|
| Rate for Payer: Meridian Medicaid |
$486.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.39
|
| Rate for Payer: Nomi Health Commercial |
$863.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,911.75
|
| Rate for Payer: PACE SWMI |
$719.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,229.09
|
| Rate for Payer: Priority Health Medicare |
$719.63
|
| Rate for Payer: Priority Health SBD |
$1,229.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,229.09
|
| Rate for Payer: Railroad Medicare Medicare |
$719.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,403.24
|
| Rate for Payer: UHC Core |
$1,403.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.63
|
| Rate for Payer: UHC Exchange |
$1,403.24
|
| Rate for Payer: UHC Medicaid |
$463.70
|
| Rate for Payer: UHCCP Medicaid |
$463.70
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,209.00
|
|
|
Service Code
|
HCPCS 49653
|
| Min. Negotiated Rate |
$1,283.60 |
| Max. Negotiated Rate |
$2,406.75 |
| Rate for Payer: Aetna Medicare |
$1,604.50
|
| Rate for Payer: BCBS Complete |
$1,283.60
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,085.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,406.75
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 49654
|
| Min. Negotiated Rate |
$1,162.40 |
| Max. Negotiated Rate |
$2,179.50 |
| Rate for Payer: Aetna Medicare |
$1,453.00
|
| Rate for Payer: BCBS Complete |
$1,162.40
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,888.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,179.50
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,449.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
49320
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$1,086.75 |
| Rate for Payer: Aetna Commercial |
$418.37
|
| Rate for Payer: Aetna Medicare |
$324.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.60
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$312.22
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$312.22
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$418.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.22
|
| Rate for Payer: Healthscope Commercial |
$577.61
|
| Rate for Payer: Healthscope Commercial |
$499.55
|
| Rate for Payer: Mclaren Medicaid |
$201.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.83
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.57
|
| Rate for Payer: Nomi Health Commercial |
$374.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PACE SWMI |
$312.22
|
| Rate for Payer: PHP Medicare Advantage |
$312.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$608.59
|
| Rate for Payer: Priority Health Medicare |
$312.22
|
| Rate for Payer: Priority Health SBD |
$608.59
|
| Rate for Payer: Priority Health Tiered Network |
$608.59
|
| Rate for Payer: Railroad Medicare Medicare |
$312.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.60
|
| Rate for Payer: UHC Core |
$581.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.22
|
| Rate for Payer: UHC Exchange |
$581.60
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$912.87 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$1,231.65
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.85
|
| 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 |
$3,044.82
|
| Rate for Payer: BCN Commercial |
$3,044.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Advantage |
$1,014.30
|
| Rate for Payer: Cofinity Commercial |
$1,246.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,304.10
|
| 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 |
$1,231.65
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$1,231.65
|
| 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 |
$912.87
|
| 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 LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$912.87 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Aetna Commercial |
$1,231.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.85
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Advantage |
$1,014.30
|
| Rate for Payer: Cofinity Commercial |
$1,246.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.20
|
| Rate for Payer: Healthscope Commercial |
$1,304.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PHP Commercial |
$1,231.65
|
| Rate for Payer: Priority Health SBD |
$912.87
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,449.00
|
|
|
Service Code
|
HCPCS 49320
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$1,086.75 |
| Rate for Payer: Aetna Commercial |
$418.37
|
| Rate for Payer: Aetna Medicare |
$324.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.60
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$312.22
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$312.22
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$418.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.22
|
| Rate for Payer: Healthscope Commercial |
$577.61
|
| Rate for Payer: Healthscope Commercial |
$499.55
|
| Rate for Payer: Mclaren Medicaid |
$201.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.83
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.57
|
| Rate for Payer: Nomi Health Commercial |
$374.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PACE SWMI |
$312.22
|
| Rate for Payer: PHP Medicare Advantage |
$312.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$608.59
|
| Rate for Payer: Priority Health Medicare |
$312.22
|
| Rate for Payer: Priority Health SBD |
$608.59
|
| Rate for Payer: Priority Health Tiered Network |
$608.59
|
| Rate for Payer: Railroad Medicare Medicare |
$312.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.60
|
| Rate for Payer: UHC Core |
$581.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.22
|
| Rate for Payer: UHC Exchange |
$581.60
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR LAPS ABLTJ RENAL MASS LESION W/INTRAOP US
|
Professional
|
Both
|
$2,178.00
|
|
|
Service Code
|
HCPCS 50542
|
| Min. Negotiated Rate |
$666.26 |
| Max. Negotiated Rate |
$2,060.98 |
| Rate for Payer: Aetna Commercial |
$1,385.61
|
| Rate for Payer: Aetna Medicare |
$1,075.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,385.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.02
|
| Rate for Payer: BCBS Complete |
$699.57
|
| Rate for Payer: BCBS MAPPO |
$1,034.04
|
| Rate for Payer: BCN Commercial |
$1,736.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,742.40
|
| Rate for Payer: Cash Price |
$1,742.40
|
| Rate for Payer: Cofinity Commercial |
$1,489.02
|
| Rate for Payer: Cofinity Commercial |
$1,385.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,034.04
|
| Rate for Payer: Healthscope Commercial |
$1,912.97
|
| Rate for Payer: Healthscope Commercial |
$1,654.46
|
| Rate for Payer: Mclaren Medicaid |
$666.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.74
|
| Rate for Payer: Meridian Medicaid |
$699.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,137.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,050.99
|
| Rate for Payer: Nomi Health Commercial |
$1,240.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,633.50
|
| Rate for Payer: PACE SWMI |
$1,034.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,034.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,892.12
|
| Rate for Payer: Priority Health Medicare |
$1,034.04
|
| Rate for Payer: Priority Health SBD |
$1,892.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,892.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,034.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,060.98
|
| Rate for Payer: UHC Core |
$2,060.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,034.04
|
| Rate for Payer: UHC Exchange |
$2,060.98
|
| Rate for Payer: UHC Medicaid |
$666.26
|
| Rate for Payer: UHCCP Medicaid |
$666.26
|
|
|
PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 38572
|
| Min. Negotiated Rate |
$526.54 |
| Max. Negotiated Rate |
$1,788.36 |
| Rate for Payer: Aetna Commercial |
$1,097.59
|
| Rate for Payer: Aetna Medicare |
$851.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,179.50
|
| Rate for Payer: BCBS Complete |
$552.87
|
| Rate for Payer: BCBS MAPPO |
$819.10
|
| Rate for Payer: BCN Commercial |
$1,344.05
|
| Rate for Payer: BCN Medicare Advantage |
$819.10
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,179.50
|
| Rate for Payer: Cofinity Commercial |
$1,097.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.10
|
| Rate for Payer: Healthscope Commercial |
$1,515.34
|
| Rate for Payer: Healthscope Commercial |
$1,310.56
|
| Rate for Payer: Mclaren Medicaid |
$526.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.05
|
| Rate for Payer: Meridian Medicaid |
$552.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$901.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.80
|
| Rate for Payer: Nomi Health Commercial |
$982.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,443.75
|
| Rate for Payer: PACE SWMI |
$819.10
|
| Rate for Payer: PHP Medicare Advantage |
$819.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,788.36
|
| Rate for Payer: Priority Health Medicare |
$819.10
|
| Rate for Payer: Priority Health SBD |
$1,788.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,788.36
|
| Rate for Payer: Railroad Medicare Medicare |
$819.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,608.02
|
| Rate for Payer: UHC Core |
$1,608.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$819.10
|
| Rate for Payer: UHC Exchange |
$1,608.02
|
| Rate for Payer: UHC Medicaid |
$526.54
|
| Rate for Payer: UHCCP Medicaid |
$526.54
|
|
|
PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$3,948.00
|
|
|
Service Code
|
HCPCS 44227
|
| Min. Negotiated Rate |
$968.94 |
| Max. Negotiated Rate |
$3,007.09 |
| Rate for Payer: Aetna Commercial |
$2,027.45
|
| Rate for Payer: Aetna Medicare |
$1,573.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,027.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.75
|
| Rate for Payer: BCBS Complete |
$1,017.39
|
| Rate for Payer: BCBS MAPPO |
$1,513.02
|
| Rate for Payer: BCN Commercial |
$2,468.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,513.02
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cofinity Commercial |
$2,178.75
|
| Rate for Payer: Cofinity Commercial |
$2,027.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,513.02
|
| Rate for Payer: Healthscope Commercial |
$2,799.09
|
| Rate for Payer: Healthscope Commercial |
$2,420.83
|
| Rate for Payer: Mclaren Medicaid |
$968.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,588.67
|
| Rate for Payer: Meridian Medicaid |
$1,017.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,664.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,952.23
|
| Rate for Payer: Nomi Health Commercial |
$1,815.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,961.00
|
| Rate for Payer: PACE SWMI |
$1,513.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,513.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$968.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,007.09
|
| Rate for Payer: Priority Health Medicare |
$1,513.02
|
| Rate for Payer: Priority Health SBD |
$3,007.09
|
| Rate for Payer: Priority Health Tiered Network |
$3,007.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,513.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,966.13
|
| Rate for Payer: UHC Core |
$2,966.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,513.02
|
| Rate for Payer: UHC Exchange |
$2,966.13
|
| Rate for Payer: UHC Medicaid |
$968.94
|
| Rate for Payer: UHCCP Medicaid |
$968.94
|
|
|
PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS
|
Professional
|
Both
|
$6,498.00
|
|
|
Service Code
|
HCPCS 44211
|
| Min. Negotiated Rate |
$1,229.01 |
| Max. Negotiated Rate |
$4,873.50 |
| Rate for Payer: Aetna Commercial |
$2,548.75
|
| Rate for Payer: Aetna Medicare |
$1,978.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,548.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,738.95
|
| Rate for Payer: BCBS Complete |
$1,290.46
|
| Rate for Payer: BCBS MAPPO |
$1,902.05
|
| Rate for Payer: BCN Commercial |
$3,131.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,902.05
|
| Rate for Payer: Cash Price |
$5,198.40
|
| Rate for Payer: Cash Price |
$5,198.40
|
| Rate for Payer: Cofinity Commercial |
$2,738.95
|
| Rate for Payer: Cofinity Commercial |
$2,548.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,902.05
|
| Rate for Payer: Healthscope Commercial |
$3,518.79
|
| Rate for Payer: Healthscope Commercial |
$3,043.28
|
| Rate for Payer: Mclaren Medicaid |
$1,229.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,997.15
|
| Rate for Payer: Meridian Medicaid |
$1,290.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,092.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,723.17
|
| Rate for Payer: Nomi Health Commercial |
$2,282.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,873.50
|
| Rate for Payer: PACE SWMI |
$1,902.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,902.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,229.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,815.89
|
| Rate for Payer: Priority Health Medicare |
$1,902.05
|
| Rate for Payer: Priority Health SBD |
$3,815.89
|
| Rate for Payer: Priority Health Tiered Network |
$3,815.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,902.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,740.20
|
| Rate for Payer: UHC Core |
$3,740.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,902.05
|
| Rate for Payer: UHC Exchange |
$3,740.20
|
| Rate for Payer: UHC Medicaid |
$1,229.01
|
| Rate for Payer: UHCCP Medicaid |
$1,229.01
|
|
|
PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST
|
Professional
|
Both
|
$4,801.00
|
|
|
Service Code
|
HCPCS 44208
|
| Min. Negotiated Rate |
$1,149.14 |
| Max. Negotiated Rate |
$3,600.75 |
| Rate for Payer: Aetna Commercial |
$2,398.49
|
| Rate for Payer: Aetna Medicare |
$1,861.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,398.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,577.48
|
| Rate for Payer: BCBS Complete |
$1,206.60
|
| Rate for Payer: BCBS MAPPO |
$1,789.92
|
| Rate for Payer: BCN Commercial |
$2,924.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,789.92
|
| Rate for Payer: Cash Price |
$3,840.80
|
| Rate for Payer: Cash Price |
$3,840.80
|
| Rate for Payer: Cofinity Commercial |
$2,577.48
|
| Rate for Payer: Cofinity Commercial |
$2,398.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,789.92
|
| Rate for Payer: Healthscope Commercial |
$3,311.35
|
| Rate for Payer: Healthscope Commercial |
$2,863.87
|
| Rate for Payer: Mclaren Medicaid |
$1,149.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,879.42
|
| Rate for Payer: Meridian Medicaid |
$1,206.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,968.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,496.14
|
| Rate for Payer: Nomi Health Commercial |
$2,147.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,600.75
|
| Rate for Payer: PACE SWMI |
$1,789.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,789.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,149.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,563.49
|
| Rate for Payer: Priority Health Medicare |
$1,789.92
|
| Rate for Payer: Priority Health SBD |
$3,563.49
|
| Rate for Payer: Priority Health Tiered Network |
$3,563.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,789.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,512.29
|
| Rate for Payer: UHC Core |
$3,512.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,789.92
|
| Rate for Payer: UHC Exchange |
$3,512.29
|
| Rate for Payer: UHC Medicaid |
$1,149.14
|
| Rate for Payer: UHCCP Medicaid |
$1,149.14
|
|
|
PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$6,450.00
|
|
|
Service Code
|
HCPCS 44212
|
| Min. Negotiated Rate |
$1,187.48 |
| Max. Negotiated Rate |
$4,837.50 |
| Rate for Payer: Aetna Commercial |
$2,467.64
|
| Rate for Payer: Aetna Medicare |
$1,915.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,467.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,651.79
|
| Rate for Payer: BCBS Complete |
$1,246.85
|
| Rate for Payer: BCBS MAPPO |
$1,841.52
|
| Rate for Payer: BCN Commercial |
$3,013.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,841.52
|
| Rate for Payer: Cash Price |
$5,160.00
|
| Rate for Payer: Cash Price |
$5,160.00
|
| Rate for Payer: Cofinity Commercial |
$2,651.79
|
| Rate for Payer: Cofinity Commercial |
$2,467.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,841.52
|
| Rate for Payer: Healthscope Commercial |
$3,406.81
|
| Rate for Payer: Healthscope Commercial |
$2,946.43
|
| Rate for Payer: Mclaren Medicaid |
$1,187.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,933.60
|
| Rate for Payer: Meridian Medicaid |
$1,246.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,025.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,571.76
|
| Rate for Payer: Nomi Health Commercial |
$2,209.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,837.50
|
| Rate for Payer: PACE SWMI |
$1,841.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,841.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,187.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,672.10
|
| Rate for Payer: Priority Health Medicare |
$1,841.52
|
| Rate for Payer: Priority Health SBD |
$3,672.10
|
| Rate for Payer: Priority Health Tiered Network |
$3,672.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,841.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,606.31
|
| Rate for Payer: UHC Core |
$3,606.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,841.52
|
| Rate for Payer: UHC Exchange |
$3,606.31
|
| Rate for Payer: UHC Medicaid |
$1,187.48
|
| Rate for Payer: UHCCP Medicaid |
$1,187.48
|
|
|
PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST
|
Professional
|
Both
|
$4,730.00
|
|
|
Service Code
|
HCPCS 44207
|
| Min. Negotiated Rate |
$1,051.79 |
| Max. Negotiated Rate |
$3,547.50 |
| Rate for Payer: Aetna Commercial |
$2,200.49
|
| Rate for Payer: Aetna Medicare |
$1,707.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,200.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,364.71
|
| Rate for Payer: BCBS Complete |
$1,104.38
|
| Rate for Payer: BCBS MAPPO |
$1,642.16
|
| Rate for Payer: BCN Commercial |
$2,690.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,642.16
|
| Rate for Payer: Cash Price |
$3,784.00
|
| Rate for Payer: Cash Price |
$3,784.00
|
| Rate for Payer: Cofinity Commercial |
$2,364.71
|
| Rate for Payer: Cofinity Commercial |
$2,200.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,642.16
|
| Rate for Payer: Healthscope Commercial |
$3,038.00
|
| Rate for Payer: Healthscope Commercial |
$2,627.46
|
| Rate for Payer: Mclaren Medicaid |
$1,051.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,724.27
|
| Rate for Payer: Meridian Medicaid |
$1,104.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,806.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.23
|
| Rate for Payer: Nomi Health Commercial |
$1,970.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.50
|
| Rate for Payer: PACE SWMI |
$1,642.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,642.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,278.31
|
| Rate for Payer: Priority Health Medicare |
$1,642.16
|
| Rate for Payer: Priority Health SBD |
$3,278.31
|
| Rate for Payer: Priority Health Tiered Network |
$3,278.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,642.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,230.34
|
| Rate for Payer: UHC Core |
$3,230.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,642.16
|
| Rate for Payer: UHC Exchange |
$3,230.34
|
| Rate for Payer: UHC Medicaid |
$1,051.79
|
| Rate for Payer: UHCCP Medicaid |
$1,051.79
|
|
|
PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM
|
Professional
|
Both
|
$4,878.00
|
|
|
Service Code
|
HCPCS 44206
|
| Min. Negotiated Rate |
$1,020.70 |
| Max. Negotiated Rate |
$3,658.50 |
| Rate for Payer: Aetna Commercial |
$2,134.70
|
| Rate for Payer: Aetna Medicare |
$1,656.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,134.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,294.01
|
| Rate for Payer: BCBS Complete |
$1,071.73
|
| Rate for Payer: BCBS MAPPO |
$1,593.06
|
| Rate for Payer: BCN Commercial |
$2,589.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,593.06
|
| Rate for Payer: Cash Price |
$3,902.40
|
| Rate for Payer: Cash Price |
$3,902.40
|
| Rate for Payer: Cofinity Commercial |
$2,294.01
|
| Rate for Payer: Cofinity Commercial |
$2,134.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,593.06
|
| Rate for Payer: Healthscope Commercial |
$2,947.16
|
| Rate for Payer: Healthscope Commercial |
$2,548.90
|
| Rate for Payer: Mclaren Medicaid |
$1,020.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,672.71
|
| Rate for Payer: Meridian Medicaid |
$1,071.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,752.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,097.40
|
| Rate for Payer: Nomi Health Commercial |
$1,911.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,658.50
|
| Rate for Payer: PACE SWMI |
$1,593.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,593.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,154.52
|
| Rate for Payer: Priority Health Medicare |
$1,593.06
|
| Rate for Payer: Priority Health SBD |
$3,154.52
|
| Rate for Payer: Priority Health Tiered Network |
$3,154.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,593.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,110.18
|
| Rate for Payer: UHC Core |
$3,110.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,593.06
|
| Rate for Payer: UHC Exchange |
$3,110.18
|
| Rate for Payer: UHC Medicaid |
$1,020.70
|
| Rate for Payer: UHCCP Medicaid |
$1,020.70
|
|
|
PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM
|
Professional
|
Both
|
$4,325.00
|
|
|
Service Code
|
HCPCS 44205
|
| Min. Negotiated Rate |
$781.92 |
| Max. Negotiated Rate |
$3,243.75 |
| Rate for Payer: Aetna Commercial |
$1,633.45
|
| Rate for Payer: Aetna Medicare |
$1,267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,755.35
|
| Rate for Payer: BCBS Complete |
$821.02
|
| Rate for Payer: BCBS MAPPO |
$1,218.99
|
| Rate for Payer: BCN Commercial |
$1,989.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.99
|
| Rate for Payer: Cash Price |
$3,460.00
|
| Rate for Payer: Cash Price |
$3,460.00
|
| Rate for Payer: Cofinity Commercial |
$1,755.35
|
| Rate for Payer: Cofinity Commercial |
$1,633.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.99
|
| Rate for Payer: Healthscope Commercial |
$2,255.13
|
| Rate for Payer: Healthscope Commercial |
$1,950.38
|
| Rate for Payer: Mclaren Medicaid |
$781.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.94
|
| Rate for Payer: Meridian Medicaid |
$821.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,340.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.61
|
| Rate for Payer: Nomi Health Commercial |
$1,462.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,243.75
|
| Rate for Payer: PACE SWMI |
$1,218.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,423.99
|
| Rate for Payer: Priority Health Medicare |
$1,218.99
|
| Rate for Payer: Priority Health SBD |
$2,423.99
|
| Rate for Payer: Priority Health Tiered Network |
$2,423.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,218.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,377.66
|
| Rate for Payer: UHC Core |
$2,377.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,218.99
|
| Rate for Payer: UHC Exchange |
$2,377.66
|
| Rate for Payer: UHC Medicaid |
$781.92
|
| Rate for Payer: UHCCP Medicaid |
$781.92
|
|
|
PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$5,440.00
|
|
|
Service Code
|
HCPCS 44210
|
| Min. Negotiated Rate |
$1,037.95 |
| Max. Negotiated Rate |
$4,080.00 |
| Rate for Payer: Aetna Commercial |
$2,158.98
|
| Rate for Payer: Aetna Medicare |
$1,675.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,158.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.10
|
| Rate for Payer: BCBS Complete |
$1,089.85
|
| Rate for Payer: BCBS MAPPO |
$1,611.18
|
| Rate for Payer: BCN Commercial |
$2,628.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,611.18
|
| Rate for Payer: Cash Price |
$4,352.00
|
| Rate for Payer: Cash Price |
$4,352.00
|
| Rate for Payer: Cofinity Commercial |
$2,320.10
|
| Rate for Payer: Cofinity Commercial |
$2,158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,611.18
|
| Rate for Payer: Healthscope Commercial |
$2,980.68
|
| Rate for Payer: Healthscope Commercial |
$2,577.89
|
| Rate for Payer: Mclaren Medicaid |
$1,037.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,691.74
|
| Rate for Payer: Meridian Medicaid |
$1,089.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,772.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,133.67
|
| Rate for Payer: Nomi Health Commercial |
$1,933.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,080.00
|
| Rate for Payer: PACE SWMI |
$1,611.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,611.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,037.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,203.07
|
| Rate for Payer: Priority Health Medicare |
$1,611.18
|
| Rate for Payer: Priority Health SBD |
$3,203.07
|
| Rate for Payer: Priority Health Tiered Network |
$3,203.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,611.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,138.42
|
| Rate for Payer: UHC Core |
$3,138.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,611.18
|
| Rate for Payer: UHC Exchange |
$3,138.42
|
| Rate for Payer: UHC Medicaid |
$1,037.95
|
| Rate for Payer: UHCCP Medicaid |
$1,037.95
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 44202
|
| Min. Negotiated Rate |
$821.97 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$1,719.78
|
| Rate for Payer: Aetna Medicare |
$1,334.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,848.12
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,283.42
|
| Rate for Payer: BCN Commercial |
$2,077.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.42
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cofinity Commercial |
$1,848.12
|
| Rate for Payer: Cofinity Commercial |
$1,719.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.42
|
| Rate for Payer: Healthscope Commercial |
$2,374.33
|
| Rate for Payer: Healthscope Commercial |
$2,053.47
|
| Rate for Payer: Mclaren Medicaid |
$821.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.59
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,411.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,478.26
|
| Rate for Payer: Nomi Health Commercial |
$1,540.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: PACE SWMI |
$1,283.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,530.78
|
| Rate for Payer: Priority Health Medicare |
$1,283.42
|
| Rate for Payer: Priority Health SBD |
$2,530.78
|
| Rate for Payer: Priority Health Tiered Network |
$2,530.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,283.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,470.56
|
| Rate for Payer: UHC Core |
$2,470.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,283.42
|
| Rate for Payer: UHC Exchange |
$2,470.56
|
| Rate for Payer: UHC Medicaid |
$821.97
|
| Rate for Payer: UHCCP Medicaid |
$821.97
|
|
|
PR LAPS ESOPHAGEAL LENGTHENING ADDL
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 43283
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$283.59 |
| Rate for Payer: Aetna Commercial |
$191.94
|
| Rate for Payer: Aetna Medicare |
$148.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.27
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$143.24
|
| Rate for Payer: BCN Commercial |
$232.55
|
| Rate for Payer: BCN Medicare Advantage |
$143.24
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$206.27
|
| Rate for Payer: Cofinity Commercial |
$191.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.24
|
| Rate for Payer: Healthscope Commercial |
$264.99
|
| Rate for Payer: Healthscope Commercial |
$229.18
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.40
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.65
|
| Rate for Payer: Nomi Health Commercial |
$171.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.25
|
| Rate for Payer: PACE SWMI |
$143.24
|
| Rate for Payer: PHP Medicare Advantage |
$143.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$283.36
|
| Rate for Payer: Priority Health Medicare |
$143.24
|
| Rate for Payer: Priority Health SBD |
$283.36
|
| Rate for Payer: Priority Health Tiered Network |
$283.36
|
| Rate for Payer: Railroad Medicare Medicare |
$143.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.59
|
| Rate for Payer: UHC Core |
$283.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.24
|
| Rate for Payer: UHC Exchange |
$283.59
|
| Rate for Payer: UHC Medicaid |
$90.53
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 43279
|
| Min. Negotiated Rate |
$765.10 |
| Max. Negotiated Rate |
$2,338.44 |
| Rate for Payer: Aetna Commercial |
$1,605.67
|
| Rate for Payer: Aetna Medicare |
$1,246.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,605.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,725.49
|
| Rate for Payer: BCBS Complete |
$803.36
|
| Rate for Payer: BCBS MAPPO |
$1,198.26
|
| Rate for Payer: BCN Commercial |
$1,919.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,198.26
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,725.49
|
| Rate for Payer: Cofinity Commercial |
$1,605.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,198.26
|
| Rate for Payer: Healthscope Commercial |
$2,216.78
|
| Rate for Payer: Healthscope Commercial |
$1,917.22
|
| Rate for Payer: Mclaren Medicaid |
$765.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,258.17
|
| Rate for Payer: Meridian Medicaid |
$803.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,318.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,296.28
|
| Rate for Payer: Nomi Health Commercial |
$1,437.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,856.25
|
| Rate for Payer: PACE SWMI |
$1,198.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,198.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,338.44
|
| Rate for Payer: Priority Health Medicare |
$1,198.26
|
| Rate for Payer: Priority Health SBD |
$2,338.44
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,198.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.94
|
| Rate for Payer: UHC Core |
$2,302.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,198.26
|
| Rate for Payer: UHC Exchange |
$2,302.94
|
| Rate for Payer: UHC Medicaid |
$765.10
|
| Rate for Payer: UHCCP Medicaid |
$765.10
|
|
|
PR LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 58662
|
| Min. Negotiated Rate |
$412.37 |
| Max. Negotiated Rate |
$1,721.25 |
| Rate for Payer: Aetna Commercial |
$859.49
|
| Rate for Payer: Aetna Medicare |
$667.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.63
|
| Rate for Payer: BCBS Complete |
$432.99
|
| Rate for Payer: BCBS MAPPO |
$641.41
|
| Rate for Payer: BCN Commercial |
$1,070.66
|
| Rate for Payer: BCN Medicare Advantage |
$641.41
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Cofinity Commercial |
$923.63
|
| Rate for Payer: Cofinity Commercial |
$859.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.41
|
| Rate for Payer: Healthscope Commercial |
$1,186.61
|
| Rate for Payer: Healthscope Commercial |
$1,026.26
|
| Rate for Payer: Mclaren Medicaid |
$412.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.48
|
| Rate for Payer: Meridian Medicaid |
$432.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,272.78
|
| Rate for Payer: Nomi Health Commercial |
$769.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,721.25
|
| Rate for Payer: PACE SWMI |
$641.41
|
| Rate for Payer: PHP Medicare Advantage |
$641.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,084.35
|
| Rate for Payer: Priority Health Medicare |
$641.41
|
| Rate for Payer: Priority Health SBD |
$1,084.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,084.35
|
| Rate for Payer: Railroad Medicare Medicare |
$641.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,260.56
|
| Rate for Payer: UHC Core |
$1,260.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.41
|
| Rate for Payer: UHC Exchange |
$1,260.56
|
| Rate for Payer: UHC Medicaid |
$412.37
|
| Rate for Payer: UHCCP Medicaid |
$412.37
|
|
|
PR LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT
|
Professional
|
Both
|
$1,778.00
|
|
|
Service Code
|
HCPCS 43774
|
| Min. Negotiated Rate |
$578.72 |
| Max. Negotiated Rate |
$1,765.66 |
| Rate for Payer: Aetna Commercial |
$1,209.46
|
| Rate for Payer: Aetna Medicare |
$938.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.72
|
| Rate for Payer: BCBS Complete |
$607.66
|
| Rate for Payer: BCBS MAPPO |
$902.58
|
| Rate for Payer: BCN Commercial |
$1,591.97
|
| Rate for Payer: BCN Medicare Advantage |
$902.58
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cofinity Commercial |
$1,299.72
|
| Rate for Payer: Cofinity Commercial |
$1,209.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.58
|
| Rate for Payer: Healthscope Commercial |
$1,669.77
|
| Rate for Payer: Healthscope Commercial |
$1,444.13
|
| Rate for Payer: Mclaren Medicaid |
$578.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.71
|
| Rate for Payer: Meridian Medicaid |
$607.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$992.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,722.69
|
| Rate for Payer: Nomi Health Commercial |
$1,083.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,333.50
|
| Rate for Payer: PACE SWMI |
$902.58
|
| Rate for Payer: PHP Medicare Advantage |
$902.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,765.66
|
| Rate for Payer: Priority Health Medicare |
$902.58
|
| Rate for Payer: Priority Health SBD |
$1,765.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,765.66
|
| Rate for Payer: Railroad Medicare Medicare |
$902.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,713.47
|
| Rate for Payer: UHC Core |
$1,713.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$902.58
|
| Rate for Payer: UHC Exchange |
$1,713.47
|
| Rate for Payer: UHC Medicaid |
$578.72
|
| Rate for Payer: UHCCP Medicaid |
$578.72
|
|
|
PR LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY
|
Professional
|
Both
|
$4,807.00
|
|
|
Service Code
|
HCPCS 43775
|
| Min. Negotiated Rate |
$637.72 |
| Max. Negotiated Rate |
$3,605.25 |
| Rate for Payer: Aetna Commercial |
$1,351.67
|
| Rate for Payer: Aetna Medicare |
$1,049.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,452.54
|
| Rate for Payer: BCBS Complete |
$669.61
|
| Rate for Payer: BCBS MAPPO |
$1,008.71
|
| Rate for Payer: BCN Commercial |
$2,540.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.71
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cofinity Commercial |
$1,452.54
|
| Rate for Payer: Cofinity Commercial |
$1,351.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.71
|
| Rate for Payer: Healthscope Commercial |
$1,866.11
|
| Rate for Payer: Healthscope Commercial |
$1,613.94
|
| Rate for Payer: Mclaren Medicaid |
$637.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,059.15
|
| Rate for Payer: Meridian Medicaid |
$669.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,109.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,994.40
|
| Rate for Payer: Nomi Health Commercial |
$1,210.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,605.25
|
| Rate for Payer: PACE SWMI |
$1,008.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,012.61
|
| Rate for Payer: Priority Health Medicare |
$1,008.71
|
| Rate for Payer: Priority Health SBD |
$2,012.61
|
| Rate for Payer: Priority Health Tiered Network |
$2,012.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,008.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,005.89
|
| Rate for Payer: UHC Core |
$2,005.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,008.71
|
| Rate for Payer: UHC Exchange |
$2,005.89
|
| Rate for Payer: UHC Medicaid |
$637.72
|
| Rate for Payer: UHCCP Medicaid |
$637.72
|
|
