|
PR LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 58671
|
| Min. Negotiated Rate |
$356.12 |
| Max. Negotiated Rate |
$991.90 |
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$370.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.20
|
| Rate for Payer: BCBS Complete |
$610.40
|
| Rate for Payer: BCBS MAPPO |
$356.12
|
| Rate for Payer: BCN Medicare Advantage |
$356.12
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$512.81
|
| Rate for Payer: Cofinity Commercial |
$477.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.12
|
| Rate for Payer: Healthscope Commercial |
$658.82
|
| Rate for Payer: Healthscope Commercial |
$569.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.90
|
| Rate for Payer: Nomi Health Commercial |
$427.34
|
| Rate for Payer: PACE SWMI |
$356.12
|
| Rate for Payer: PHP Medicare Advantage |
$356.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$991.90
|
| Rate for Payer: Priority Health Medicare |
$356.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.12
|
| Rate for Payer: UHC Medicare Advantage |
$356.12
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Min. Negotiated Rate |
$627.90 |
| Max. Negotiated Rate |
$1,783.60 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.39
|
| Rate for Payer: BCBS Complete |
$1,097.60
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCN Medicare Advantage |
$627.90
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$904.18
|
| Rate for Payer: Cofinity Commercial |
$841.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.90
|
| Rate for Payer: Healthscope Commercial |
$1,004.64
|
| Rate for Payer: Healthscope Commercial |
$1,161.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,783.60
|
| Rate for Payer: Nomi Health Commercial |
$753.48
|
| Rate for Payer: PACE SWMI |
$627.90
|
| Rate for Payer: PHP Medicare Advantage |
$627.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health Medicare |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
IP
|
$2,744.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,728.72 |
| Max. Negotiated Rate |
$2,469.60 |
| Rate for Payer: Aetna Commercial |
$2,332.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,783.60
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$1,920.80
|
| Rate for Payer: Cofinity Commercial |
$2,359.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,920.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,195.20
|
| Rate for Payer: Healthscope Commercial |
$2,469.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,332.40
|
| Rate for Payer: PHP Commercial |
$2,332.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health SBD |
$1,728.72
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$627.90 |
| Max. Negotiated Rate |
$1,783.60 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.39
|
| Rate for Payer: BCBS Complete |
$1,097.60
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCN Medicare Advantage |
$627.90
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$904.18
|
| Rate for Payer: Cofinity Commercial |
$841.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.90
|
| Rate for Payer: Healthscope Commercial |
$1,004.64
|
| Rate for Payer: Healthscope Commercial |
$1,161.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,783.60
|
| Rate for Payer: Nomi Health Commercial |
$753.48
|
| Rate for Payer: PACE SWMI |
$627.90
|
| Rate for Payer: PHP Medicare Advantage |
$627.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health Medicare |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
OP
|
$2,744.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,728.72 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$2,332.40
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,783.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$2,359.84
|
| Rate for Payer: Cofinity Commercial |
$1,920.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,920.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$2,469.60
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,332.40
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$2,332.40
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$1,728.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 58570
|
| Min. Negotiated Rate |
$775.49 |
| Max. Negotiated Rate |
$1,608.75 |
| Rate for Payer: Aetna Commercial |
$1,039.16
|
| Rate for Payer: Aetna Medicare |
$806.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.16
|
| Rate for Payer: BCBS Complete |
$990.00
|
| Rate for Payer: BCBS MAPPO |
$775.49
|
| Rate for Payer: BCN Medicare Advantage |
$775.49
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,116.71
|
| Rate for Payer: Cofinity Commercial |
$1,039.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.49
|
| Rate for Payer: Healthscope Commercial |
$1,240.78
|
| Rate for Payer: Healthscope Commercial |
$1,434.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.75
|
| Rate for Payer: Nomi Health Commercial |
$930.59
|
| Rate for Payer: PACE SWMI |
$775.49
|
| Rate for Payer: PHP Medicare Advantage |
$775.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,608.75
|
| Rate for Payer: Priority Health Medicare |
$775.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.49
|
| Rate for Payer: UHC Medicare Advantage |
$775.49
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 49653
|
| Min. Negotiated Rate |
$1,246.40 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Medicare |
$1,558.00
|
| Rate for Payer: BCBS Complete |
$1,246.40
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,025.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 49654
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$1,833.65 |
| Rate for Payer: Aetna Medicare |
$1,410.50
|
| Rate for Payer: BCBS Complete |
$1,128.40
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,833.65
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
OP
|
$1,407.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$886.41 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna Commercial |
$1,195.95
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Cofinity Commercial |
$1,210.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$984.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$1,266.30
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.95
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$1,195.95
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$886.41
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,203.54
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
IP
|
$1,407.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$886.41 |
| Max. Negotiated Rate |
$1,266.30 |
| Rate for Payer: Aetna Commercial |
$1,195.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.55
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,210.02
|
| Rate for Payer: Cofinity Commercial |
$984.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$984.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.60
|
| Rate for Payer: Healthscope Commercial |
$1,266.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.95
|
| Rate for Payer: PHP Commercial |
$1,195.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health SBD |
$886.41
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
49320
|
| Min. Negotiated Rate |
$320.78 |
| Max. Negotiated Rate |
$914.55 |
| Rate for Payer: Aetna Commercial |
$429.85
|
| Rate for Payer: Aetna Medicare |
$333.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.92
|
| Rate for Payer: BCBS Complete |
$562.80
|
| Rate for Payer: BCBS MAPPO |
$320.78
|
| Rate for Payer: BCN Medicare Advantage |
$320.78
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.78
|
| Rate for Payer: Healthscope Commercial |
$593.44
|
| Rate for Payer: Healthscope Commercial |
$513.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.55
|
| Rate for Payer: Nomi Health Commercial |
$384.94
|
| Rate for Payer: PACE SWMI |
$320.78
|
| Rate for Payer: PHP Medicare Advantage |
$320.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health Medicare |
$320.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.78
|
| Rate for Payer: UHC Medicare Advantage |
$320.78
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 49320
|
| Min. Negotiated Rate |
$320.78 |
| Max. Negotiated Rate |
$914.55 |
| Rate for Payer: Aetna Commercial |
$429.85
|
| Rate for Payer: Aetna Medicare |
$333.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.85
|
| Rate for Payer: BCBS Complete |
$562.80
|
| Rate for Payer: BCBS MAPPO |
$320.78
|
| Rate for Payer: BCN Medicare Advantage |
$320.78
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.78
|
| Rate for Payer: Healthscope Commercial |
$593.44
|
| Rate for Payer: Healthscope Commercial |
$513.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.55
|
| Rate for Payer: Nomi Health Commercial |
$384.94
|
| Rate for Payer: PACE SWMI |
$320.78
|
| Rate for Payer: PHP Medicare Advantage |
$320.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health Medicare |
$320.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.78
|
| Rate for Payer: UHC Medicare Advantage |
$320.78
|
|
|
PR LAPS ABLTJ RENAL MASS LESION W/INTRAOP US
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 50542
|
| Min. Negotiated Rate |
$846.00 |
| Max. Negotiated Rate |
$2,056.02 |
| Rate for Payer: Aetna Commercial |
$1,489.22
|
| Rate for Payer: Aetna Medicare |
$1,155.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,600.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.22
|
| Rate for Payer: BCBS Complete |
$846.00
|
| Rate for Payer: BCBS MAPPO |
$1,111.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,111.36
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$1,600.36
|
| Rate for Payer: Cofinity Commercial |
$1,489.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,111.36
|
| Rate for Payer: Healthscope Commercial |
$1,778.18
|
| Rate for Payer: Healthscope Commercial |
$2,056.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,166.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,374.75
|
| Rate for Payer: Nomi Health Commercial |
$1,333.63
|
| Rate for Payer: PACE SWMI |
$1,111.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,111.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.75
|
| Rate for Payer: Priority Health Medicare |
$1,111.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,111.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,111.36
|
|
|
PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1
|
Professional
|
Both
|
$1,869.00
|
|
|
Service Code
|
HCPCS 38572
|
| Min. Negotiated Rate |
$747.60 |
| Max. Negotiated Rate |
$1,592.39 |
| Rate for Payer: Aetna Commercial |
$1,153.40
|
| Rate for Payer: Aetna Medicare |
$895.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,239.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,153.40
|
| Rate for Payer: BCBS Complete |
$747.60
|
| Rate for Payer: BCBS MAPPO |
$860.75
|
| Rate for Payer: BCN Medicare Advantage |
$860.75
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cofinity Commercial |
$1,239.48
|
| Rate for Payer: Cofinity Commercial |
$1,153.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$860.75
|
| Rate for Payer: Healthscope Commercial |
$1,592.39
|
| Rate for Payer: Healthscope Commercial |
$1,377.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$903.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.85
|
| Rate for Payer: Nomi Health Commercial |
$1,032.90
|
| Rate for Payer: PACE SWMI |
$860.75
|
| Rate for Payer: PHP Medicare Advantage |
$860.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,214.85
|
| Rate for Payer: Priority Health Medicare |
$860.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$860.75
|
| Rate for Payer: UHC Medicare Advantage |
$860.75
|
|
|
PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$3,833.00
|
|
|
Service Code
|
HCPCS 44227
|
| Min. Negotiated Rate |
$1,533.20 |
| Max. Negotiated Rate |
$2,950.62 |
| Rate for Payer: Aetna Commercial |
$2,137.21
|
| Rate for Payer: Aetna Medicare |
$1,658.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,296.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.21
|
| Rate for Payer: BCBS Complete |
$1,533.20
|
| Rate for Payer: BCBS MAPPO |
$1,594.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,594.93
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cofinity Commercial |
$2,296.70
|
| Rate for Payer: Cofinity Commercial |
$2,137.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,594.93
|
| Rate for Payer: Healthscope Commercial |
$2,551.89
|
| Rate for Payer: Healthscope Commercial |
$2,950.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,674.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,491.45
|
| Rate for Payer: Nomi Health Commercial |
$1,913.92
|
| Rate for Payer: PACE SWMI |
$1,594.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,594.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,491.45
|
| Rate for Payer: Priority Health Medicare |
$1,594.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,594.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,594.93
|
|
|
PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS
|
Professional
|
Both
|
$6,309.00
|
|
|
Service Code
|
HCPCS 44211
|
| Min. Negotiated Rate |
$2,002.34 |
| Max. Negotiated Rate |
$4,100.85 |
| Rate for Payer: Aetna Commercial |
$2,683.14
|
| Rate for Payer: Aetna Medicare |
$2,082.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,883.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,683.14
|
| Rate for Payer: BCBS Complete |
$2,523.60
|
| Rate for Payer: BCBS MAPPO |
$2,002.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,002.34
|
| Rate for Payer: Cash Price |
$5,047.20
|
| Rate for Payer: Cash Price |
$5,047.20
|
| Rate for Payer: Cofinity Commercial |
$2,883.37
|
| Rate for Payer: Cofinity Commercial |
$2,683.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,002.34
|
| Rate for Payer: Healthscope Commercial |
$3,704.33
|
| Rate for Payer: Healthscope Commercial |
$3,203.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,102.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,100.85
|
| Rate for Payer: Nomi Health Commercial |
$2,402.81
|
| Rate for Payer: PACE SWMI |
$2,002.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,002.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,100.85
|
| Rate for Payer: Priority Health Medicare |
$2,002.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,002.34
|
| Rate for Payer: UHC Medicare Advantage |
$2,002.34
|
|
|
PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST
|
Professional
|
Both
|
$4,661.00
|
|
|
Service Code
|
HCPCS 44208
|
| Min. Negotiated Rate |
$1,864.40 |
| Max. Negotiated Rate |
$3,486.66 |
| Rate for Payer: Aetna Commercial |
$2,525.47
|
| Rate for Payer: Aetna Medicare |
$1,960.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,713.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,525.47
|
| Rate for Payer: BCBS Complete |
$1,864.40
|
| Rate for Payer: BCBS MAPPO |
$1,884.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,884.68
|
| Rate for Payer: Cash Price |
$3,728.80
|
| Rate for Payer: Cash Price |
$3,728.80
|
| Rate for Payer: Cofinity Commercial |
$2,713.94
|
| Rate for Payer: Cofinity Commercial |
$2,525.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,884.68
|
| Rate for Payer: Healthscope Commercial |
$3,015.49
|
| Rate for Payer: Healthscope Commercial |
$3,486.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,978.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,029.65
|
| Rate for Payer: Nomi Health Commercial |
$2,261.62
|
| Rate for Payer: PACE SWMI |
$1,884.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,884.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,029.65
|
| Rate for Payer: Priority Health Medicare |
$1,884.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,884.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,884.68
|
|
|
PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$6,262.00
|
|
|
Service Code
|
HCPCS 44212
|
| Min. Negotiated Rate |
$1,933.44 |
| Max. Negotiated Rate |
$4,070.30 |
| Rate for Payer: Aetna Commercial |
$2,590.81
|
| Rate for Payer: Aetna Medicare |
$2,010.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,784.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.81
|
| Rate for Payer: BCBS Complete |
$2,504.80
|
| Rate for Payer: BCBS MAPPO |
$1,933.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,933.44
|
| Rate for Payer: Cash Price |
$5,009.60
|
| Rate for Payer: Cash Price |
$5,009.60
|
| Rate for Payer: Cofinity Commercial |
$2,784.15
|
| Rate for Payer: Cofinity Commercial |
$2,590.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,933.44
|
| Rate for Payer: Healthscope Commercial |
$3,576.86
|
| Rate for Payer: Healthscope Commercial |
$3,093.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,030.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,070.30
|
| Rate for Payer: Nomi Health Commercial |
$2,320.13
|
| Rate for Payer: PACE SWMI |
$1,933.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,933.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.30
|
| Rate for Payer: Priority Health Medicare |
$1,933.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,933.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,933.44
|
|
|
PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST
|
Professional
|
Both
|
$4,592.00
|
|
|
Service Code
|
HCPCS 44207
|
| Min. Negotiated Rate |
$1,737.08 |
| Max. Negotiated Rate |
$3,213.60 |
| Rate for Payer: Aetna Commercial |
$2,327.69
|
| Rate for Payer: Aetna Medicare |
$1,806.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,501.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,327.69
|
| Rate for Payer: BCBS Complete |
$1,836.80
|
| Rate for Payer: BCBS MAPPO |
$1,737.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,737.08
|
| Rate for Payer: Cash Price |
$3,673.60
|
| Rate for Payer: Cash Price |
$3,673.60
|
| Rate for Payer: Cofinity Commercial |
$2,501.40
|
| Rate for Payer: Cofinity Commercial |
$2,327.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,737.08
|
| Rate for Payer: Healthscope Commercial |
$2,779.33
|
| Rate for Payer: Healthscope Commercial |
$3,213.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,823.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,984.80
|
| Rate for Payer: Nomi Health Commercial |
$2,084.50
|
| Rate for Payer: PACE SWMI |
$1,737.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,737.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,984.80
|
| Rate for Payer: Priority Health Medicare |
$1,737.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,737.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,737.08
|
|
|
PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM
|
Professional
|
Both
|
$4,736.00
|
|
|
Service Code
|
HCPCS 44206
|
| Min. Negotiated Rate |
$1,672.02 |
| Max. Negotiated Rate |
$3,093.24 |
| Rate for Payer: Aetna Commercial |
$2,240.51
|
| Rate for Payer: Aetna Medicare |
$1,738.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,407.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,240.51
|
| Rate for Payer: BCBS Complete |
$1,894.40
|
| Rate for Payer: BCBS MAPPO |
$1,672.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,672.02
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,407.71
|
| Rate for Payer: Cofinity Commercial |
$2,240.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,672.02
|
| Rate for Payer: Healthscope Commercial |
$3,093.24
|
| Rate for Payer: Healthscope Commercial |
$2,675.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,755.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,078.40
|
| Rate for Payer: Nomi Health Commercial |
$2,006.42
|
| Rate for Payer: PACE SWMI |
$1,672.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,672.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,078.40
|
| Rate for Payer: Priority Health Medicare |
$1,672.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,672.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.02
|
|
|
PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM
|
Professional
|
Both
|
$4,199.00
|
|
|
Service Code
|
HCPCS 44205
|
| Min. Negotiated Rate |
$1,283.47 |
| Max. Negotiated Rate |
$2,729.35 |
| Rate for Payer: Aetna Commercial |
$1,719.85
|
| Rate for Payer: Aetna Medicare |
$1,334.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,848.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.85
|
| Rate for Payer: BCBS Complete |
$1,679.60
|
| Rate for Payer: BCBS MAPPO |
$1,283.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.47
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,848.20
|
| Rate for Payer: Cofinity Commercial |
$1,719.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.47
|
| Rate for Payer: Healthscope Commercial |
$2,053.55
|
| Rate for Payer: Healthscope Commercial |
$2,374.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.35
|
| Rate for Payer: Nomi Health Commercial |
$1,540.16
|
| Rate for Payer: PACE SWMI |
$1,283.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,729.35
|
| Rate for Payer: Priority Health Medicare |
$1,283.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.47
|
|
|
PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$5,282.00
|
|
|
Service Code
|
HCPCS 44210
|
| Min. Negotiated Rate |
$1,688.07 |
| Max. Negotiated Rate |
$3,433.30 |
| Rate for Payer: Aetna Commercial |
$2,262.01
|
| Rate for Payer: Aetna Medicare |
$1,755.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,430.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,262.01
|
| Rate for Payer: BCBS Complete |
$2,112.80
|
| Rate for Payer: BCBS MAPPO |
$1,688.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,688.07
|
| Rate for Payer: Cash Price |
$4,225.60
|
| Rate for Payer: Cash Price |
$4,225.60
|
| Rate for Payer: Cofinity Commercial |
$2,430.82
|
| Rate for Payer: Cofinity Commercial |
$2,262.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,688.07
|
| Rate for Payer: Healthscope Commercial |
$3,122.93
|
| Rate for Payer: Healthscope Commercial |
$2,700.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,772.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,433.30
|
| Rate for Payer: Nomi Health Commercial |
$2,025.68
|
| Rate for Payer: PACE SWMI |
$1,688.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,688.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,433.30
|
| Rate for Payer: Priority Health Medicare |
$1,688.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,688.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,688.07
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 44202
|
| Min. Negotiated Rate |
$1,342.87 |
| Max. Negotiated Rate |
$3,023.80 |
| Rate for Payer: Aetna Commercial |
$1,799.45
|
| Rate for Payer: Aetna Medicare |
$1,396.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,933.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,799.45
|
| Rate for Payer: BCBS Complete |
$1,860.80
|
| Rate for Payer: BCBS MAPPO |
$1,342.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.87
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,933.73
|
| Rate for Payer: Cofinity Commercial |
$1,799.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.87
|
| Rate for Payer: Healthscope Commercial |
$2,148.59
|
| Rate for Payer: Healthscope Commercial |
$2,484.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,410.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,023.80
|
| Rate for Payer: Nomi Health Commercial |
$1,611.44
|
| Rate for Payer: PACE SWMI |
$1,342.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health Medicare |
$1,342.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.87
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Facility
|
IP
|
$4,652.00
|
|
|
Service Code
|
CPT 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$2,930.76 |
| Max. Negotiated Rate |
$4,186.80 |
| Rate for Payer: Aetna Commercial |
$3,954.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,023.80
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$3,256.40
|
| Rate for Payer: Cofinity Commercial |
$4,000.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,256.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,721.60
|
| Rate for Payer: Healthscope Commercial |
$4,186.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,954.20
|
| Rate for Payer: PHP Commercial |
$3,954.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health SBD |
$2,930.76
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$1,342.87 |
| Max. Negotiated Rate |
$3,023.80 |
| Rate for Payer: Aetna Commercial |
$1,799.45
|
| Rate for Payer: Aetna Medicare |
$1,396.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,799.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,933.73
|
| Rate for Payer: BCBS Complete |
$1,860.80
|
| Rate for Payer: BCBS MAPPO |
$1,342.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.87
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,799.45
|
| Rate for Payer: Cofinity Commercial |
$1,933.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.87
|
| Rate for Payer: Healthscope Commercial |
$2,484.31
|
| Rate for Payer: Healthscope Commercial |
$2,148.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,410.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,023.80
|
| Rate for Payer: Nomi Health Commercial |
$1,611.44
|
| Rate for Payer: PACE SWMI |
$1,342.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health Medicare |
$1,342.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.87
|
|
