|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,363.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$360.40 |
| Max. Negotiated Rate |
$1,772.25 |
| Rate for Payer: Aetna Commercial |
$744.49
|
| Rate for Payer: Aetna Medicare |
$577.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.05
|
| Rate for Payer: BCBS Complete |
$378.42
|
| Rate for Payer: BCBS MAPPO |
$555.59
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$555.59
|
| Rate for Payer: Cash Price |
$1,890.40
|
| Rate for Payer: Cash Price |
$1,890.40
|
| Rate for Payer: Cofinity Commercial |
$800.05
|
| Rate for Payer: Cofinity Commercial |
$744.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.59
|
| Rate for Payer: Healthscope Commercial |
$888.94
|
| Rate for Payer: Healthscope Commercial |
$1,027.84
|
| Rate for Payer: Mclaren Medicaid |
$360.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.37
|
| Rate for Payer: Meridian Medicaid |
$378.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$611.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,031.08
|
| Rate for Payer: Nomi Health Commercial |
$666.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,772.25
|
| Rate for Payer: PACE SWMI |
$555.59
|
| Rate for Payer: PHP Medicare Advantage |
$555.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,067.90
|
| Rate for Payer: Priority Health Medicare |
$555.59
|
| Rate for Payer: Priority Health SBD |
$1,067.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,067.90
|
| Rate for Payer: Railroad Medicare Medicare |
$555.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.51
|
| Rate for Payer: UHC Core |
$1,016.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$555.59
|
| Rate for Payer: UHC Exchange |
$1,016.51
|
| Rate for Payer: UHC Medicaid |
$360.40
|
| Rate for Payer: UHCCP Medicaid |
$360.40
|
|
|
PR LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX
|
Professional
|
Both
|
$2,649.00
|
|
|
Service Code
|
HCPCS 55868
|
| Min. Negotiated Rate |
$706.31 |
| Max. Negotiated Rate |
$2,040.55 |
| Rate for Payer: Aetna Commercial |
$1,470.62
|
| Rate for Payer: Aetna Medicare |
$1,141.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,470.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,580.37
|
| Rate for Payer: BCBS Complete |
$741.63
|
| Rate for Payer: BCBS MAPPO |
$1,097.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.48
|
| Rate for Payer: Cash Price |
$2,119.20
|
| Rate for Payer: Cash Price |
$2,119.20
|
| Rate for Payer: Cofinity Commercial |
$1,580.37
|
| Rate for Payer: Cofinity Commercial |
$1,470.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.48
|
| Rate for Payer: Healthscope Commercial |
$2,030.34
|
| Rate for Payer: Healthscope Commercial |
$1,755.97
|
| Rate for Payer: Mclaren Medicaid |
$706.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.35
|
| Rate for Payer: Meridian Medicaid |
$741.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,207.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,721.85
|
| Rate for Payer: Nomi Health Commercial |
$1,316.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,986.75
|
| Rate for Payer: PACE SWMI |
$1,097.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,633.08
|
| Rate for Payer: Priority Health Medicare |
$1,097.48
|
| Rate for Payer: Priority Health SBD |
$1,633.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,633.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,040.55
|
| Rate for Payer: UHC Core |
$2,040.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.48
|
| Rate for Payer: UHC Exchange |
$2,040.55
|
| Rate for Payer: UHC Medicaid |
$706.31
|
| Rate for Payer: UHCCP Medicaid |
$706.31
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC
|
Professional
|
Both
|
$3,296.00
|
|
|
Service Code
|
HCPCS 55869
|
| Min. Negotiated Rate |
$847.31 |
| Max. Negotiated Rate |
$2,472.00 |
| Rate for Payer: Aetna Commercial |
$1,766.59
|
| Rate for Payer: Aetna Medicare |
$1,371.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,898.42
|
| Rate for Payer: BCBS Complete |
$889.68
|
| Rate for Payer: BCBS MAPPO |
$1,318.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.35
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Cofinity Commercial |
$1,898.42
|
| Rate for Payer: Cofinity Commercial |
$1,766.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.35
|
| Rate for Payer: Healthscope Commercial |
$2,438.95
|
| Rate for Payer: Healthscope Commercial |
$2,109.36
|
| Rate for Payer: Mclaren Medicaid |
$847.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.27
|
| Rate for Payer: Meridian Medicaid |
$889.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,142.40
|
| Rate for Payer: Nomi Health Commercial |
$1,582.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,472.00
|
| Rate for Payer: PACE SWMI |
$1,318.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,959.10
|
| Rate for Payer: Priority Health Medicare |
$1,318.35
|
| Rate for Payer: Priority Health SBD |
$1,959.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,959.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,318.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,450.72
|
| Rate for Payer: UHC Core |
$2,450.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,318.35
|
| Rate for Payer: UHC Exchange |
$2,450.72
|
| Rate for Payer: UHC Medicaid |
$847.31
|
| Rate for Payer: UHCCP Medicaid |
$847.31
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING
|
Professional
|
Both
|
$3,439.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$689.91 |
| Max. Negotiated Rate |
$2,579.25 |
| Rate for Payer: Aetna Commercial |
$1,436.20
|
| Rate for Payer: Aetna Medicare |
$1,114.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.38
|
| Rate for Payer: BCBS Complete |
$724.41
|
| Rate for Payer: BCBS MAPPO |
$1,071.79
|
| Rate for Payer: BCN Commercial |
$1,780.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.79
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Cash Price |
$2,751.20
|
| Rate for Payer: Cofinity Commercial |
$1,543.38
|
| Rate for Payer: Cofinity Commercial |
$1,436.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.79
|
| Rate for Payer: Healthscope Commercial |
$1,982.81
|
| Rate for Payer: Healthscope Commercial |
$1,714.86
|
| Rate for Payer: Mclaren Medicaid |
$689.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.38
|
| Rate for Payer: Meridian Medicaid |
$724.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,178.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,103.79
|
| Rate for Payer: Nomi Health Commercial |
$1,286.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,579.25
|
| Rate for Payer: PACE SWMI |
$1,071.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$689.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,939.85
|
| Rate for Payer: Priority Health Medicare |
$1,071.79
|
| Rate for Payer: Priority Health SBD |
$1,939.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,939.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,071.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,554.79
|
| Rate for Payer: UHC Core |
$2,554.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,071.79
|
| Rate for Payer: UHC Exchange |
$2,554.79
|
| Rate for Payer: UHC Medicaid |
$689.91
|
| Rate for Payer: UHCCP Medicaid |
$689.91
|
|
|
PR LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE
|
Professional
|
Both
|
$2,580.00
|
|
|
Service Code
|
HCPCS 55867
|
| Min. Negotiated Rate |
$603.22 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Aetna Commercial |
$1,255.16
|
| Rate for Payer: Aetna Medicare |
$974.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,255.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.83
|
| Rate for Payer: BCBS Complete |
$633.38
|
| Rate for Payer: BCBS MAPPO |
$936.69
|
| Rate for Payer: BCN Commercial |
$1,564.66
|
| Rate for Payer: BCN Medicare Advantage |
$936.69
|
| Rate for Payer: Cash Price |
$2,064.00
|
| Rate for Payer: Cash Price |
$2,064.00
|
| Rate for Payer: Cofinity Commercial |
$1,348.83
|
| Rate for Payer: Cofinity Commercial |
$1,255.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.69
|
| Rate for Payer: Healthscope Commercial |
$1,732.88
|
| Rate for Payer: Healthscope Commercial |
$1,498.70
|
| Rate for Payer: Mclaren Medicaid |
$603.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.52
|
| Rate for Payer: Meridian Medicaid |
$633.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,030.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,845.97
|
| Rate for Payer: Nomi Health Commercial |
$1,124.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,935.00
|
| Rate for Payer: PACE SWMI |
$936.69
|
| Rate for Payer: PHP Medicare Advantage |
$936.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,704.42
|
| Rate for Payer: Priority Health Medicare |
$936.69
|
| Rate for Payer: Priority Health SBD |
$1,704.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,704.42
|
| Rate for Payer: Railroad Medicare Medicare |
$936.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,891.41
|
| Rate for Payer: UHC Core |
$1,891.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$936.69
|
| Rate for Payer: UHC Exchange |
$1,891.41
|
| Rate for Payer: UHC Medicaid |
$603.22
|
| Rate for Payer: UHCCP Medicaid |
$603.22
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$1,010.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$636.30 |
| Max. Negotiated Rate |
$909.00 |
| Rate for Payer: Aetna Commercial |
$858.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.50
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cofinity Advantage |
$707.00
|
| Rate for Payer: Cofinity Commercial |
$868.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.00
|
| Rate for Payer: Healthscope Commercial |
$909.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$858.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$757.50
|
| Rate for Payer: PHP Commercial |
$858.50
|
| Rate for Payer: Priority Health SBD |
$636.30
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,033.00 |
| Rate for Payer: Aetna Commercial |
$637.00
|
| Rate for Payer: Aetna Medicare |
$494.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.53
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$475.37
|
| Rate for Payer: BCN Commercial |
$776.35
|
| Rate for Payer: BCN Medicare Advantage |
$475.37
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cofinity Commercial |
$684.53
|
| Rate for Payer: Cofinity Commercial |
$637.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.37
|
| Rate for Payer: Healthscope Commercial |
$879.43
|
| Rate for Payer: Healthscope Commercial |
$760.59
|
| Rate for Payer: Mclaren Medicaid |
$306.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.14
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.66
|
| Rate for Payer: Nomi Health Commercial |
$570.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$757.50
|
| Rate for Payer: PACE SWMI |
$475.37
|
| Rate for Payer: PHP Medicare Advantage |
$475.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,033.00
|
| Rate for Payer: Priority Health Medicare |
$475.37
|
| Rate for Payer: Priority Health SBD |
$1,033.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,033.00
|
| Rate for Payer: Railroad Medicare Medicare |
$475.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.61
|
| Rate for Payer: UHC Core |
$902.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.37
|
| Rate for Payer: UHC Exchange |
$902.61
|
| Rate for Payer: UHC Medicaid |
$306.51
|
| Rate for Payer: UHCCP Medicaid |
$306.51
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,033.00 |
| Rate for Payer: Aetna Commercial |
$637.00
|
| Rate for Payer: Aetna Medicare |
$494.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.53
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$475.37
|
| Rate for Payer: BCN Commercial |
$776.35
|
| Rate for Payer: BCN Medicare Advantage |
$475.37
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cofinity Commercial |
$684.53
|
| Rate for Payer: Cofinity Commercial |
$637.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.37
|
| Rate for Payer: Healthscope Commercial |
$879.43
|
| Rate for Payer: Healthscope Commercial |
$760.59
|
| Rate for Payer: Mclaren Medicaid |
$306.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.14
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.66
|
| Rate for Payer: Nomi Health Commercial |
$570.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$757.50
|
| Rate for Payer: PACE SWMI |
$475.37
|
| Rate for Payer: PHP Medicare Advantage |
$475.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,033.00
|
| Rate for Payer: Priority Health Medicare |
$475.37
|
| Rate for Payer: Priority Health SBD |
$1,033.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,033.00
|
| Rate for Payer: Railroad Medicare Medicare |
$475.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.61
|
| Rate for Payer: UHC Core |
$902.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.37
|
| Rate for Payer: UHC Exchange |
$902.61
|
| Rate for Payer: UHC Medicaid |
$306.51
|
| Rate for Payer: UHCCP Medicaid |
$306.51
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$1,010.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$636.30 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$858.50
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,492.96
|
| Rate for Payer: BCN Commercial |
$2,492.96
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cofinity Advantage |
$707.00
|
| Rate for Payer: Cofinity Commercial |
$868.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$909.00
|
| 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 |
$858.50
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$757.50
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$858.50
|
| 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 |
$636.30
|
| 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 SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,133.00
|
|
|
Service Code
|
HCPCS 49651
|
| Min. Negotiated Rate |
$350.81 |
| Max. Negotiated Rate |
$1,599.75 |
| Rate for Payer: Aetna Commercial |
$725.62
|
| Rate for Payer: Aetna Medicare |
$563.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.77
|
| Rate for Payer: BCBS Complete |
$368.35
|
| Rate for Payer: BCBS MAPPO |
$541.51
|
| Rate for Payer: BCN Commercial |
$858.52
|
| Rate for Payer: BCN Medicare Advantage |
$541.51
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cofinity Commercial |
$779.77
|
| Rate for Payer: Cofinity Commercial |
$725.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.51
|
| Rate for Payer: Healthscope Commercial |
$866.42
|
| Rate for Payer: Healthscope Commercial |
$1,001.79
|
| Rate for Payer: Mclaren Medicaid |
$350.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$568.59
|
| Rate for Payer: Meridian Medicaid |
$368.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$595.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,009.98
|
| Rate for Payer: Nomi Health Commercial |
$649.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,599.75
|
| Rate for Payer: PACE SWMI |
$541.51
|
| Rate for Payer: PHP Medicare Advantage |
$541.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,046.04
|
| Rate for Payer: Priority Health Medicare |
$541.51
|
| Rate for Payer: Priority Health SBD |
$1,046.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,046.04
|
| Rate for Payer: Railroad Medicare Medicare |
$541.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.60
|
| Rate for Payer: UHC Core |
$990.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$541.51
|
| Rate for Payer: UHC Exchange |
$990.60
|
| Rate for Payer: UHC Medicaid |
$350.81
|
| Rate for Payer: UHCCP Medicaid |
$350.81
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,133.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,343.79 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$1,813.05
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.45
|
| 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 |
$4,331.23
|
| Rate for Payer: BCN Commercial |
$4,331.23
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cofinity Advantage |
$1,493.10
|
| Rate for Payer: Cofinity Commercial |
$1,834.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,919.70
|
| 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 |
$1,813.05
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,599.75
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$1,813.05
|
| 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 |
$1,343.79
|
| 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 SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
IP
|
$2,133.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,343.79 |
| Max. Negotiated Rate |
$1,919.70 |
| Rate for Payer: Aetna Commercial |
$1,813.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.45
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cofinity Advantage |
$1,493.10
|
| Rate for Payer: Cofinity Commercial |
$1,834.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.40
|
| Rate for Payer: Healthscope Commercial |
$1,919.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,813.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,599.75
|
| Rate for Payer: PHP Commercial |
$1,813.05
|
| Rate for Payer: Priority Health SBD |
$1,343.79
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,133.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$350.81 |
| Max. Negotiated Rate |
$1,599.75 |
| Rate for Payer: Aetna Commercial |
$725.62
|
| Rate for Payer: Aetna Medicare |
$563.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.77
|
| Rate for Payer: BCBS Complete |
$368.35
|
| Rate for Payer: BCBS MAPPO |
$541.51
|
| Rate for Payer: BCN Commercial |
$858.52
|
| Rate for Payer: BCN Medicare Advantage |
$541.51
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cofinity Commercial |
$779.77
|
| Rate for Payer: Cofinity Commercial |
$725.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.51
|
| Rate for Payer: Healthscope Commercial |
$866.42
|
| Rate for Payer: Healthscope Commercial |
$1,001.79
|
| Rate for Payer: Mclaren Medicaid |
$350.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$568.59
|
| Rate for Payer: Meridian Medicaid |
$368.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$595.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,009.98
|
| Rate for Payer: Nomi Health Commercial |
$649.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,599.75
|
| Rate for Payer: PACE SWMI |
$541.51
|
| Rate for Payer: PHP Medicare Advantage |
$541.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,046.04
|
| Rate for Payer: Priority Health Medicare |
$541.51
|
| Rate for Payer: Priority Health SBD |
$1,046.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,046.04
|
| Rate for Payer: Railroad Medicare Medicare |
$541.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.60
|
| Rate for Payer: UHC Core |
$990.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$541.51
|
| Rate for Payer: UHC Exchange |
$990.60
|
| Rate for Payer: UHC Medicaid |
$350.81
|
| Rate for Payer: UHCCP Medicaid |
$350.81
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV
|
Professional
|
Both
|
$1,643.00
|
|
|
Service Code
|
HCPCS 43652
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$1,410.72 |
| Rate for Payer: Aetna Commercial |
$972.75
|
| Rate for Payer: Aetna Medicare |
$754.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.75
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS MAPPO |
$725.93
|
| Rate for Payer: BCN Commercial |
$1,157.81
|
| Rate for Payer: BCN Medicare Advantage |
$725.93
|
| Rate for Payer: Cash Price |
$1,314.40
|
| Rate for Payer: Cash Price |
$1,314.40
|
| Rate for Payer: Cofinity Commercial |
$972.75
|
| Rate for Payer: Cofinity Commercial |
$1,045.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.93
|
| Rate for Payer: Healthscope Commercial |
$1,342.97
|
| Rate for Payer: Healthscope Commercial |
$1,161.49
|
| Rate for Payer: Mclaren Medicaid |
$467.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.23
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$798.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.74
|
| Rate for Payer: Nomi Health Commercial |
$871.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,232.25
|
| Rate for Payer: PACE SWMI |
$725.93
|
| Rate for Payer: PHP Medicare Advantage |
$725.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,410.72
|
| Rate for Payer: Priority Health Medicare |
$725.93
|
| Rate for Payer: Priority Health SBD |
$1,410.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,410.72
|
| Rate for Payer: Railroad Medicare Medicare |
$725.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,361.05
|
| Rate for Payer: UHC Core |
$1,361.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$725.93
|
| Rate for Payer: UHC Exchange |
$1,361.05
|
| Rate for Payer: UHC Medicaid |
$467.11
|
| Rate for Payer: UHCCP Medicaid |
$467.11
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV TRUNCAL
|
Professional
|
Both
|
$2,665.00
|
|
|
Service Code
|
HCPCS 43651
|
| Min. Negotiated Rate |
$404.27 |
| Max. Negotiated Rate |
$1,998.75 |
| Rate for Payer: Aetna Commercial |
$839.48
|
| Rate for Payer: Aetna Medicare |
$651.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.13
|
| Rate for Payer: BCBS Complete |
$424.48
|
| Rate for Payer: BCBS MAPPO |
$626.48
|
| Rate for Payer: BCN Commercial |
$995.96
|
| Rate for Payer: BCN Medicare Advantage |
$626.48
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cofinity Commercial |
$902.13
|
| Rate for Payer: Cofinity Commercial |
$839.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.48
|
| Rate for Payer: Healthscope Commercial |
$1,158.99
|
| Rate for Payer: Healthscope Commercial |
$1,002.37
|
| Rate for Payer: Mclaren Medicaid |
$404.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.80
|
| Rate for Payer: Meridian Medicaid |
$424.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.59
|
| Rate for Payer: Nomi Health Commercial |
$751.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,998.75
|
| Rate for Payer: PACE SWMI |
$626.48
|
| Rate for Payer: PHP Medicare Advantage |
$626.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,213.51
|
| Rate for Payer: Priority Health Medicare |
$626.48
|
| Rate for Payer: Priority Health SBD |
$1,213.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,213.51
|
| Rate for Payer: Railroad Medicare Medicare |
$626.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.35
|
| Rate for Payer: UHC Core |
$1,163.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.48
|
| Rate for Payer: UHC Exchange |
$1,163.35
|
| Rate for Payer: UHC Medicaid |
$404.27
|
| Rate for Payer: UHCCP Medicaid |
$404.27
|
|
|
PR LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 49322
|
| Min. Negotiated Rate |
$226.63 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$471.33
|
| Rate for Payer: Aetna Medicare |
$365.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.51
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCBS MAPPO |
$351.74
|
| Rate for Payer: BCN Commercial |
$565.21
|
| Rate for Payer: BCN Medicare Advantage |
$351.74
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$506.51
|
| Rate for Payer: Cofinity Commercial |
$471.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.74
|
| Rate for Payer: Healthscope Commercial |
$650.72
|
| Rate for Payer: Healthscope Commercial |
$562.78
|
| Rate for Payer: Mclaren Medicaid |
$226.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.33
|
| Rate for Payer: Meridian Medicaid |
$237.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$386.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.34
|
| Rate for Payer: Nomi Health Commercial |
$422.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE SWMI |
$351.74
|
| Rate for Payer: PHP Medicare Advantage |
$351.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$688.66
|
| Rate for Payer: Priority Health Medicare |
$351.74
|
| Rate for Payer: Priority Health SBD |
$688.66
|
| Rate for Payer: Priority Health Tiered Network |
$688.66
|
| Rate for Payer: Railroad Medicare Medicare |
$351.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.31
|
| Rate for Payer: UHC Core |
$662.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$351.74
|
| Rate for Payer: UHC Exchange |
$662.31
|
| Rate for Payer: UHC Medicaid |
$226.63
|
| Rate for Payer: UHCCP Medicaid |
$226.63
|
|
|
PR LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 49323
|
| Min. Negotiated Rate |
$385.32 |
| Max. Negotiated Rate |
$1,502.25 |
| Rate for Payer: Aetna Commercial |
$800.57
|
| Rate for Payer: Aetna Medicare |
$621.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.31
|
| Rate for Payer: BCBS Complete |
$404.59
|
| Rate for Payer: BCBS MAPPO |
$597.44
|
| Rate for Payer: BCN Commercial |
$966.08
|
| Rate for Payer: BCN Medicare Advantage |
$597.44
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$860.31
|
| Rate for Payer: Cofinity Commercial |
$800.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.44
|
| Rate for Payer: Healthscope Commercial |
$955.90
|
| Rate for Payer: Healthscope Commercial |
$1,105.26
|
| Rate for Payer: Mclaren Medicaid |
$385.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.31
|
| Rate for Payer: Meridian Medicaid |
$404.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,137.06
|
| Rate for Payer: Nomi Health Commercial |
$716.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.25
|
| Rate for Payer: PACE SWMI |
$597.44
|
| Rate for Payer: PHP Medicare Advantage |
$597.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,177.11
|
| Rate for Payer: Priority Health Medicare |
$597.44
|
| Rate for Payer: Priority Health SBD |
$1,177.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,177.11
|
| Rate for Payer: Railroad Medicare Medicare |
$597.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.65
|
| Rate for Payer: UHC Core |
$1,137.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$597.44
|
| Rate for Payer: UHC Exchange |
$1,137.65
|
| Rate for Payer: UHC Medicaid |
$385.32
|
| Rate for Payer: UHCCP Medicaid |
$385.32
|
|
|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,855.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$528.45 |
| Max. Negotiated Rate |
$2,141.25 |
| Rate for Payer: Aetna Commercial |
$1,099.50
|
| Rate for Payer: Aetna Medicare |
$853.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,181.55
|
| Rate for Payer: BCBS Complete |
$554.87
|
| Rate for Payer: BCBS MAPPO |
$820.52
|
| Rate for Payer: BCN Commercial |
$1,363.47
|
| Rate for Payer: BCN Medicare Advantage |
$820.52
|
| Rate for Payer: Cash Price |
$2,284.00
|
| Rate for Payer: Cash Price |
$2,284.00
|
| Rate for Payer: Cofinity Commercial |
$1,181.55
|
| Rate for Payer: Cofinity Commercial |
$1,099.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.52
|
| Rate for Payer: Healthscope Commercial |
$1,517.96
|
| Rate for Payer: Healthscope Commercial |
$1,312.83
|
| Rate for Payer: Mclaren Medicaid |
$528.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.55
|
| Rate for Payer: Meridian Medicaid |
$554.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$902.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.75
|
| Rate for Payer: Nomi Health Commercial |
$984.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,141.25
|
| Rate for Payer: PACE SWMI |
$820.52
|
| Rate for Payer: PHP Medicare Advantage |
$820.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,380.91
|
| Rate for Payer: Priority Health Medicare |
$820.52
|
| Rate for Payer: Priority Health SBD |
$1,380.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,380.91
|
| Rate for Payer: Railroad Medicare Medicare |
$820.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,582.36
|
| Rate for Payer: UHC Core |
$1,582.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.52
|
| Rate for Payer: UHC Exchange |
$1,582.36
|
| Rate for Payer: UHC Medicaid |
$528.45
|
| Rate for Payer: UHCCP Medicaid |
$528.45
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$454.76 |
| Max. Negotiated Rate |
$1,431.07 |
| Rate for Payer: Aetna Commercial |
$956.21
|
| Rate for Payer: Aetna Medicare |
$742.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.21
|
| Rate for Payer: BCBS Complete |
$477.50
|
| Rate for Payer: BCBS MAPPO |
$713.59
|
| Rate for Payer: BCN Commercial |
$1,192.67
|
| Rate for Payer: BCN Medicare Advantage |
$713.59
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$956.21
|
| Rate for Payer: Cofinity Commercial |
$1,027.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.59
|
| Rate for Payer: Healthscope Commercial |
$1,320.14
|
| Rate for Payer: Healthscope Commercial |
$1,141.74
|
| Rate for Payer: Mclaren Medicaid |
$454.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$749.27
|
| Rate for Payer: Meridian Medicaid |
$477.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$784.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,431.07
|
| Rate for Payer: Nomi Health Commercial |
$856.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,139.25
|
| Rate for Payer: PACE SWMI |
$713.59
|
| Rate for Payer: PHP Medicare Advantage |
$713.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,125.88
|
| Rate for Payer: Priority Health Medicare |
$713.59
|
| Rate for Payer: Priority Health SBD |
$1,125.88
|
| Rate for Payer: Priority Health Tiered Network |
$1,125.88
|
| Rate for Payer: Railroad Medicare Medicare |
$713.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,392.96
|
| Rate for Payer: UHC Core |
$1,392.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$713.59
|
| Rate for Payer: UHC Exchange |
$1,392.96
|
| Rate for Payer: UHC Medicaid |
$454.76
|
| Rate for Payer: UHCCP Medicaid |
$454.76
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,432.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Aetna Commercial |
$932.08
|
| Rate for Payer: Aetna Medicare |
$723.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.08
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$695.58
|
| Rate for Payer: BCN Commercial |
$1,165.78
|
| Rate for Payer: BCN Medicare Advantage |
$695.58
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Cofinity Commercial |
$932.08
|
| Rate for Payer: Cofinity Commercial |
$1,001.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.58
|
| Rate for Payer: Healthscope Commercial |
$1,286.82
|
| Rate for Payer: Healthscope Commercial |
$1,112.93
|
| Rate for Payer: Mclaren Medicaid |
$442.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.36
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$765.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,400.40
|
| Rate for Payer: Nomi Health Commercial |
$834.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.00
|
| Rate for Payer: PACE SWMI |
$695.58
|
| Rate for Payer: PHP Medicare Advantage |
$695.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,100.49
|
| Rate for Payer: Priority Health Medicare |
$695.58
|
| Rate for Payer: Priority Health SBD |
$1,100.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,100.49
|
| Rate for Payer: Railroad Medicare Medicare |
$695.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.70
|
| Rate for Payer: UHC Core |
$1,360.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$695.58
|
| Rate for Payer: UHC Exchange |
$1,360.70
|
| Rate for Payer: UHC Medicaid |
$442.83
|
| Rate for Payer: UHCCP Medicaid |
$442.83
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,977.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$786.82 |
| Max. Negotiated Rate |
$2,454.64 |
| Rate for Payer: Aetna Commercial |
$1,639.48
|
| Rate for Payer: Aetna Medicare |
$1,272.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.83
|
| Rate for Payer: BCBS Complete |
$826.16
|
| Rate for Payer: BCBS MAPPO |
$1,223.49
|
| Rate for Payer: BCN Commercial |
$2,055.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,223.49
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cash Price |
$2,381.60
|
| Rate for Payer: Cofinity Commercial |
$1,761.83
|
| Rate for Payer: Cofinity Commercial |
$1,639.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,223.49
|
| Rate for Payer: Healthscope Commercial |
$2,263.46
|
| Rate for Payer: Healthscope Commercial |
$1,957.58
|
| Rate for Payer: Mclaren Medicaid |
$786.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,284.66
|
| Rate for Payer: Meridian Medicaid |
$826.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,345.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,429.55
|
| Rate for Payer: Nomi Health Commercial |
$1,468.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,232.75
|
| Rate for Payer: PACE SWMI |
$1,223.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,223.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$786.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,239.28
|
| Rate for Payer: Priority Health Medicare |
$1,223.49
|
| Rate for Payer: Priority Health SBD |
$2,239.28
|
| Rate for Payer: Priority Health Tiered Network |
$2,239.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,223.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,454.64
|
| Rate for Payer: UHC Core |
$2,454.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,223.49
|
| Rate for Payer: UHC Exchange |
$2,454.64
|
| Rate for Payer: UHC Medicaid |
$786.82
|
| Rate for Payer: UHCCP Medicaid |
$786.82
|
|
|
PR LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,696.00
|
|
|
Service Code
|
HCPCS 50948
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,255.49 |
| Rate for Payer: Aetna Commercial |
$1,503.65
|
| Rate for Payer: Aetna Medicare |
$1,167.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,503.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,615.87
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS MAPPO |
$1,122.13
|
| Rate for Payer: BCN Commercial |
$1,899.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,122.13
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,615.87
|
| Rate for Payer: Cofinity Commercial |
$1,503.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,122.13
|
| Rate for Payer: Healthscope Commercial |
$2,075.94
|
| Rate for Payer: Healthscope Commercial |
$1,795.41
|
| Rate for Payer: Mclaren Medicaid |
$721.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,178.24
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,234.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.20
|
| Rate for Payer: Nomi Health Commercial |
$1,346.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,022.00
|
| Rate for Payer: PACE SWMI |
$1,122.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,122.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,069.50
|
| Rate for Payer: Priority Health Medicare |
$1,122.13
|
| Rate for Payer: Priority Health SBD |
$2,069.50
|
| Rate for Payer: Priority Health Tiered Network |
$2,069.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,122.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,255.49
|
| Rate for Payer: UHC Core |
$2,255.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,122.13
|
| Rate for Payer: UHC Exchange |
$2,255.49
|
| Rate for Payer: UHC Medicaid |
$721.43
|
| Rate for Payer: UHCCP Medicaid |
$721.43
|
|
|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,327.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$740.81 |
| Max. Negotiated Rate |
$2,495.25 |
| Rate for Payer: Aetna Commercial |
$1,548.79
|
| Rate for Payer: Aetna Medicare |
$1,202.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.37
|
| Rate for Payer: BCBS Complete |
$777.85
|
| Rate for Payer: BCBS MAPPO |
$1,155.81
|
| Rate for Payer: BCN Commercial |
$1,951.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.81
|
| Rate for Payer: Cash Price |
$2,661.60
|
| Rate for Payer: Cash Price |
$2,661.60
|
| Rate for Payer: Cofinity Commercial |
$1,664.37
|
| Rate for Payer: Cofinity Commercial |
$1,548.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.81
|
| Rate for Payer: Healthscope Commercial |
$2,138.25
|
| Rate for Payer: Healthscope Commercial |
$1,849.30
|
| Rate for Payer: Mclaren Medicaid |
$740.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.60
|
| Rate for Payer: Meridian Medicaid |
$777.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,271.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,331.77
|
| Rate for Payer: Nomi Health Commercial |
$1,386.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,495.25
|
| Rate for Payer: PACE SWMI |
$1,155.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,976.54
|
| Rate for Payer: Priority Health Medicare |
$1,155.81
|
| Rate for Payer: Priority Health SBD |
$1,976.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,976.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,333.44
|
| Rate for Payer: UHC Core |
$2,333.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,155.81
|
| Rate for Payer: UHC Exchange |
$2,333.44
|
| Rate for Payer: UHC Medicaid |
$740.81
|
| Rate for Payer: UHCCP Medicaid |
$740.81
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,593.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$501.62 |
| Max. Negotiated Rate |
$1,944.75 |
| Rate for Payer: Aetna Commercial |
$1,044.97
|
| Rate for Payer: Aetna Medicare |
$811.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,122.96
|
| Rate for Payer: BCBS Complete |
$526.70
|
| Rate for Payer: BCBS MAPPO |
$779.83
|
| Rate for Payer: BCN Commercial |
$1,324.63
|
| Rate for Payer: BCN Medicare Advantage |
$779.83
|
| Rate for Payer: Cash Price |
$2,074.40
|
| Rate for Payer: Cash Price |
$2,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,122.96
|
| Rate for Payer: Cofinity Commercial |
$1,044.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.83
|
| Rate for Payer: Healthscope Commercial |
$1,442.69
|
| Rate for Payer: Healthscope Commercial |
$1,247.73
|
| Rate for Payer: Mclaren Medicaid |
$501.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.82
|
| Rate for Payer: Meridian Medicaid |
$526.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$857.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.71
|
| Rate for Payer: Nomi Health Commercial |
$935.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,944.75
|
| Rate for Payer: PACE SWMI |
$779.83
|
| Rate for Payer: PHP Medicare Advantage |
$779.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$501.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,341.57
|
| Rate for Payer: Priority Health Medicare |
$779.83
|
| Rate for Payer: Priority Health SBD |
$1,341.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,341.57
|
| Rate for Payer: Railroad Medicare Medicare |
$779.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,563.46
|
| Rate for Payer: UHC Core |
$1,563.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$779.83
|
| Rate for Payer: UHC Exchange |
$1,563.46
|
| Rate for Payer: UHC Medicaid |
$501.62
|
| Rate for Payer: UHCCP Medicaid |
$501.62
|
|
|
PR LAPS W/REVISION INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 49325
|
| Min. Negotiated Rate |
$247.93 |
| Max. Negotiated Rate |
$755.41 |
| Rate for Payer: Aetna Commercial |
$518.27
|
| Rate for Payer: Aetna Medicare |
$402.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.95
|
| Rate for Payer: BCBS Complete |
$260.33
|
| Rate for Payer: BCBS MAPPO |
$386.77
|
| Rate for Payer: BCN Commercial |
$619.99
|
| Rate for Payer: BCN Medicare Advantage |
$386.77
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$556.95
|
| Rate for Payer: Cofinity Commercial |
$518.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.77
|
| Rate for Payer: Healthscope Commercial |
$715.52
|
| Rate for Payer: Healthscope Commercial |
$618.83
|
| Rate for Payer: Mclaren Medicaid |
$247.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.11
|
| Rate for Payer: Meridian Medicaid |
$260.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.11
|
| Rate for Payer: Nomi Health Commercial |
$464.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$739.50
|
| Rate for Payer: PACE SWMI |
$386.77
|
| Rate for Payer: PHP Medicare Advantage |
$386.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$755.41
|
| Rate for Payer: Priority Health Medicare |
$386.77
|
| Rate for Payer: Priority Health SBD |
$755.41
|
| Rate for Payer: Priority Health Tiered Network |
$755.41
|
| Rate for Payer: Railroad Medicare Medicare |
$386.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.25
|
| Rate for Payer: UHC Core |
$740.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$386.77
|
| Rate for Payer: UHC Exchange |
$740.25
|
| Rate for Payer: UHC Medicaid |
$247.93
|
| Rate for Payer: UHCCP Medicaid |
$247.93
|
|
