|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,011.00
|
|
|
Service Code
|
HCPCS 47562
|
| Min. Negotiated Rate |
$427.28 |
| Max. Negotiated Rate |
$118,064.00 |
| Rate for Payer: Aetna Commercial |
$862.25
|
| Rate for Payer: Aetna Medicare |
$669.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$926.60
|
| Rate for Payer: BCBS Complete |
$448.64
|
| Rate for Payer: BCBS MAPPO |
$643.47
|
| Rate for Payer: BCBS Trust/PPO |
$481.23
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: BCN Medicare Advantage |
$643.47
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$926.60
|
| Rate for Payer: Cofinity Commercial |
$862.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.47
|
| Rate for Payer: Healthscope Commercial |
$1,190.42
|
| Rate for Payer: Healthscope Commercial |
$1,029.55
|
| Rate for Payer: Mclaren Medicaid |
$427.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.64
|
| Rate for Payer: Meridian Medicaid |
$448.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,064.00
|
| Rate for Payer: Nomi Health Commercial |
$772.16
|
| Rate for Payer: PACE SWMI |
$643.47
|
| Rate for Payer: PHP Medicare Advantage |
$643.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,188.42
|
| Rate for Payer: Priority Health Medicare |
$643.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,188.42
|
| Rate for Payer: Priority Health SBD |
$1,188.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.47
|
| Rate for Payer: UHC Exchange |
$890.68
|
| Rate for Payer: UHC Medicare Advantage |
$643.47
|
| Rate for Payer: UHCCP Medicaid |
$427.28
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
OP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$712.11 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$2,559.35
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,957.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,896.22
|
| Rate for Payer: BCN Commercial |
$2,896.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,589.46
|
| Rate for Payer: Cofinity Commercial |
$2,107.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,107.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,709.90
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,559.35
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$2,559.35
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$1,896.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.11
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,218.33
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
IP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,896.93 |
| Max. Negotiated Rate |
$2,709.90 |
| Rate for Payer: Aetna Commercial |
$2,559.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,957.15
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,107.70
|
| Rate for Payer: Cofinity Commercial |
$2,589.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,107.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Healthscope Commercial |
$2,709.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,559.35
|
| Rate for Payer: PHP Commercial |
$2,559.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health SBD |
$1,896.93
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,762.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$215,707.00 |
| Rate for Payer: Aetna Commercial |
$1,558.69
|
| Rate for Payer: Aetna Medicare |
$1,209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,675.01
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,163.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$1,768.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.20
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$1,675.01
|
| Rate for Payer: Cofinity Commercial |
$1,558.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.20
|
| Rate for Payer: Healthscope Commercial |
$2,151.92
|
| Rate for Payer: Healthscope Commercial |
$1,861.12
|
| Rate for Payer: Mclaren Medicaid |
$775.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,221.36
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215,707.00
|
| Rate for Payer: Nomi Health Commercial |
$1,395.84
|
| Rate for Payer: PACE SWMI |
$1,163.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,164.44
|
| Rate for Payer: Priority Health Medicare |
$1,163.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,164.44
|
| Rate for Payer: Priority Health SBD |
$2,164.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,163.20
|
| Rate for Payer: UHC Exchange |
$1,171.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.20
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Facility
|
IP
|
$2,762.00
|
|
|
Service Code
|
CPT 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$1,740.06 |
| Max. Negotiated Rate |
$2,485.80 |
| Rate for Payer: Aetna Commercial |
$2,347.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,795.30
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$1,933.40
|
| Rate for Payer: Cofinity Commercial |
$2,375.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,933.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,209.60
|
| Rate for Payer: Healthscope Commercial |
$2,485.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,347.70
|
| Rate for Payer: PHP Commercial |
$2,347.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health SBD |
$1,740.06
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,762.00
|
|
|
Service Code
|
HCPCS 44188
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$215,707.00 |
| Rate for Payer: Aetna Commercial |
$1,558.69
|
| Rate for Payer: Aetna Medicare |
$1,209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,675.01
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,163.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$1,768.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.20
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$1,675.01
|
| Rate for Payer: Cofinity Commercial |
$1,558.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.20
|
| Rate for Payer: Healthscope Commercial |
$2,151.92
|
| Rate for Payer: Healthscope Commercial |
$1,861.12
|
| Rate for Payer: Mclaren Medicaid |
$775.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,221.36
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215,707.00
|
| Rate for Payer: Nomi Health Commercial |
$1,395.84
|
| Rate for Payer: PACE SWMI |
$1,163.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,164.44
|
| Rate for Payer: Priority Health Medicare |
$1,163.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,164.44
|
| Rate for Payer: Priority Health SBD |
$2,164.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,163.20
|
| Rate for Payer: UHC Exchange |
$1,171.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.20
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Facility
|
OP
|
$2,762.00
|
|
|
Service Code
|
CPT 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$1,104.80 |
| Max. Negotiated Rate |
$3,362.00 |
| Rate for Payer: Aetna Commercial |
$2,347.70
|
| Rate for Payer: Aetna Medicare |
$1,381.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,795.30
|
| Rate for Payer: BCBS Complete |
$1,104.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,574.18
|
| Rate for Payer: BCN Commercial |
$2,574.18
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$1,933.40
|
| Rate for Payer: Cofinity Commercial |
$2,375.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,933.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,209.60
|
| Rate for Payer: Healthscope Commercial |
$2,485.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,347.70
|
| Rate for Payer: PHP Commercial |
$2,347.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health SBD |
$1,740.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,292.03
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
PR LAPAROSCOPY SURGICAL JEJUNOSTOMY
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
HCPCS 44186
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$116,419.00 |
| Rate for Payer: Aetna Commercial |
$847.40
|
| Rate for Payer: Aetna Medicare |
$657.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$847.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$910.64
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$632.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.47
|
| Rate for Payer: BCN Commercial |
$951.95
|
| Rate for Payer: BCN Medicare Advantage |
$632.39
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cofinity Commercial |
$910.64
|
| Rate for Payer: Cofinity Commercial |
$847.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.39
|
| Rate for Payer: Healthscope Commercial |
$1,169.92
|
| Rate for Payer: Healthscope Commercial |
$1,011.82
|
| Rate for Payer: Mclaren Medicaid |
$419.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.01
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,419.00
|
| Rate for Payer: Nomi Health Commercial |
$758.87
|
| Rate for Payer: PACE SWMI |
$632.39
|
| Rate for Payer: PHP Medicare Advantage |
$632.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,298.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.52
|
| Rate for Payer: Priority Health Medicare |
$632.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,170.52
|
| Rate for Payer: Priority Health SBD |
$1,170.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.39
|
| Rate for Payer: UHC Exchange |
$647.51
|
| Rate for Payer: UHC Medicare Advantage |
$632.39
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR LAPAROSCOPY SURGICAL ORCHIECTOMY
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 54690
|
| Min. Negotiated Rate |
$420.25 |
| Max. Negotiated Rate |
$115,209.00 |
| Rate for Payer: Aetna Commercial |
$840.33
|
| Rate for Payer: Aetna Medicare |
$652.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$903.04
|
| Rate for Payer: BCBS Complete |
$441.26
|
| Rate for Payer: BCBS MAPPO |
$627.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.35
|
| Rate for Payer: BCN Commercial |
$945.10
|
| Rate for Payer: BCN Medicare Advantage |
$627.11
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$903.04
|
| Rate for Payer: Cofinity Commercial |
$840.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.11
|
| Rate for Payer: Healthscope Commercial |
$1,160.15
|
| Rate for Payer: Healthscope Commercial |
$1,003.38
|
| Rate for Payer: Mclaren Medicaid |
$420.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.47
|
| Rate for Payer: Meridian Medicaid |
$441.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115,209.00
|
| Rate for Payer: Nomi Health Commercial |
$752.53
|
| Rate for Payer: PACE SWMI |
$627.11
|
| Rate for Payer: PHP Medicare Advantage |
$627.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.90
|
| Rate for Payer: Priority Health Medicare |
$627.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.90
|
| Rate for Payer: Priority Health SBD |
$1,043.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.11
|
| Rate for Payer: UHC Exchange |
$778.83
|
| Rate for Payer: UHC Medicare Advantage |
$627.11
|
| Rate for Payer: UHCCP Medicaid |
$420.25
|
|
|
PR LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$3,023.00
|
|
|
Service Code
|
HCPCS 44187
|
| Min. Negotiated Rate |
$696.08 |
| Max. Negotiated Rate |
$193,318.00 |
| Rate for Payer: Aetna Commercial |
$1,395.37
|
| Rate for Payer: Aetna Medicare |
$1,082.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.50
|
| Rate for Payer: BCBS Complete |
$730.88
|
| Rate for Payer: BCBS MAPPO |
$1,041.32
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,587.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.32
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Cofinity Commercial |
$1,499.50
|
| Rate for Payer: Cofinity Commercial |
$1,395.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.32
|
| Rate for Payer: Healthscope Commercial |
$1,926.44
|
| Rate for Payer: Healthscope Commercial |
$1,666.11
|
| Rate for Payer: Mclaren Medicaid |
$696.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.39
|
| Rate for Payer: Meridian Medicaid |
$730.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,318.00
|
| Rate for Payer: Nomi Health Commercial |
$1,249.58
|
| Rate for Payer: PACE SWMI |
$1,041.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,964.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,943.71
|
| Rate for Payer: Priority Health Medicare |
$1,041.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.71
|
| Rate for Payer: Priority Health SBD |
$1,943.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.32
|
| Rate for Payer: UHC Exchange |
$1,065.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,041.32
|
| Rate for Payer: UHCCP Medicaid |
$696.08
|
|
|
PR LAPAROSCOPY SURG PARTIAL NEPHRECTOMY
|
Professional
|
Both
|
$2,852.00
|
|
|
Service Code
|
HCPCS 50543
|
| Min. Negotiated Rate |
$948.28 |
| Max. Negotiated Rate |
$261,470.00 |
| Rate for Payer: Aetna Commercial |
$1,901.39
|
| Rate for Payer: Aetna Medicare |
$1,475.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,901.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,043.29
|
| Rate for Payer: BCBS Complete |
$995.69
|
| Rate for Payer: BCBS MAPPO |
$1,418.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,176.67
|
| Rate for Payer: BCN Commercial |
$2,139.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,418.95
|
| Rate for Payer: Cash Price |
$2,281.60
|
| Rate for Payer: Cash Price |
$2,281.60
|
| Rate for Payer: Cofinity Commercial |
$2,043.29
|
| Rate for Payer: Cofinity Commercial |
$1,901.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,418.95
|
| Rate for Payer: Healthscope Commercial |
$2,625.06
|
| Rate for Payer: Healthscope Commercial |
$2,270.32
|
| Rate for Payer: Mclaren Medicaid |
$948.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,489.90
|
| Rate for Payer: Meridian Medicaid |
$995.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261,470.00
|
| Rate for Payer: Nomi Health Commercial |
$1,702.74
|
| Rate for Payer: PACE SWMI |
$1,418.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,418.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$948.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,853.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,357.82
|
| Rate for Payer: Priority Health Medicare |
$1,418.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,357.82
|
| Rate for Payer: Priority Health SBD |
$2,357.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,540.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,418.95
|
| Rate for Payer: UHC Exchange |
$1,540.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,418.95
|
| Rate for Payer: UHCCP Medicaid |
$948.28
|
|
|
PR LAPAROSCOPY SURG PYELOPLASTY
|
Professional
|
Both
|
$2,397.00
|
|
|
Service Code
|
HCPCS 50544
|
| Min. Negotiated Rate |
$788.74 |
| Max. Negotiated Rate |
$218,162.00 |
| Rate for Payer: Aetna Commercial |
$1,584.36
|
| Rate for Payer: Aetna Medicare |
$1,229.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,584.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,702.60
|
| Rate for Payer: BCBS Complete |
$828.18
|
| Rate for Payer: BCBS MAPPO |
$1,182.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,666.86
|
| Rate for Payer: BCN Commercial |
$1,782.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.36
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cofinity Commercial |
$1,702.60
|
| Rate for Payer: Cofinity Commercial |
$1,584.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.36
|
| Rate for Payer: Healthscope Commercial |
$2,187.37
|
| Rate for Payer: Healthscope Commercial |
$1,891.78
|
| Rate for Payer: Mclaren Medicaid |
$788.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.48
|
| Rate for Payer: Meridian Medicaid |
$828.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,162.00
|
| Rate for Payer: Nomi Health Commercial |
$1,418.83
|
| Rate for Payer: PACE SWMI |
$1,182.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,960.50
|
| Rate for Payer: Priority Health Medicare |
$1,182.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,960.50
|
| Rate for Payer: Priority Health SBD |
$1,960.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,182.36
|
| Rate for Payer: UHC Exchange |
$1,342.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,182.36
|
| Rate for Payer: UHCCP Medicaid |
$788.74
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 49650
|
| Min. Negotiated Rate |
$281.59 |
| Max. Negotiated Rate |
$77,261.00 |
| Rate for Payer: Aetna Commercial |
$564.61
|
| Rate for Payer: Aetna Medicare |
$438.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.74
|
| Rate for Payer: BCBS Complete |
$295.67
|
| Rate for Payer: BCBS MAPPO |
$421.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,463.08
|
| Rate for Payer: BCN Commercial |
$635.28
|
| Rate for Payer: BCN Medicare Advantage |
$421.35
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$606.74
|
| Rate for Payer: Cofinity Commercial |
$564.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.35
|
| Rate for Payer: Healthscope Commercial |
$779.50
|
| Rate for Payer: Healthscope Commercial |
$674.16
|
| Rate for Payer: Mclaren Medicaid |
$281.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.42
|
| Rate for Payer: Meridian Medicaid |
$295.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,261.00
|
| Rate for Payer: Nomi Health Commercial |
$505.62
|
| Rate for Payer: PACE SWMI |
$421.35
|
| Rate for Payer: PHP Medicare Advantage |
$421.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$782.73
|
| Rate for Payer: Priority Health Medicare |
$421.35
|
| Rate for Payer: Priority Health Narrow Network |
$782.73
|
| Rate for Payer: Priority Health SBD |
$782.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.35
|
| Rate for Payer: UHC Exchange |
$514.74
|
| Rate for Payer: UHC Medicare Advantage |
$421.35
|
| Rate for Payer: UHCCP Medicaid |
$281.59
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
IP
|
$1,561.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$983.43 |
| Max. Negotiated Rate |
$1,404.90 |
| Rate for Payer: Aetna Commercial |
$1,326.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.65
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,092.70
|
| Rate for Payer: Cofinity Commercial |
$1,342.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,092.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.80
|
| Rate for Payer: Healthscope Commercial |
$1,404.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.85
|
| Rate for Payer: PHP Commercial |
$1,326.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health SBD |
$983.43
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
OP
|
$1,561.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$466.09 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$1,326.85
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,200.46
|
| Rate for Payer: BCN Commercial |
$3,200.46
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,342.46
|
| Rate for Payer: Cofinity Commercial |
$1,092.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,092.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,404.90
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.85
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$1,326.85
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$983.43
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.09
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,218.33
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 49650
|
| Hospital Charge Code |
49650
|
| Min. Negotiated Rate |
$281.59 |
| Max. Negotiated Rate |
$77,261.00 |
| Rate for Payer: Aetna Commercial |
$564.61
|
| Rate for Payer: Aetna Medicare |
$438.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.74
|
| Rate for Payer: BCBS Complete |
$295.67
|
| Rate for Payer: BCBS MAPPO |
$421.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,463.08
|
| Rate for Payer: BCN Commercial |
$635.28
|
| Rate for Payer: BCN Medicare Advantage |
$421.35
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$606.74
|
| Rate for Payer: Cofinity Commercial |
$564.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.35
|
| Rate for Payer: Healthscope Commercial |
$779.50
|
| Rate for Payer: Healthscope Commercial |
$674.16
|
| Rate for Payer: Mclaren Medicaid |
$281.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.42
|
| Rate for Payer: Meridian Medicaid |
$295.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,261.00
|
| Rate for Payer: Nomi Health Commercial |
$505.62
|
| Rate for Payer: PACE SWMI |
$421.35
|
| Rate for Payer: PHP Medicare Advantage |
$421.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$782.73
|
| Rate for Payer: Priority Health Medicare |
$421.35
|
| Rate for Payer: Priority Health Narrow Network |
$782.73
|
| Rate for Payer: Priority Health SBD |
$782.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.35
|
| Rate for Payer: UHC Exchange |
$514.74
|
| Rate for Payer: UHC Medicare Advantage |
$421.35
|
| Rate for Payer: UHCCP Medicaid |
$281.59
|
|
|
PR LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 49321
|
| Min. Negotiated Rate |
$222.59 |
| Max. Negotiated Rate |
$61,452.00 |
| Rate for Payer: Aetna Commercial |
$447.36
|
| Rate for Payer: Aetna Medicare |
$347.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.74
|
| Rate for Payer: BCBS Complete |
$233.72
|
| Rate for Payer: BCBS MAPPO |
$333.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.18
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: BCN Medicare Advantage |
$333.85
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$480.74
|
| Rate for Payer: Cofinity Commercial |
$447.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.85
|
| Rate for Payer: Healthscope Commercial |
$617.62
|
| Rate for Payer: Healthscope Commercial |
$534.16
|
| Rate for Payer: Mclaren Medicaid |
$222.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.54
|
| Rate for Payer: Meridian Medicaid |
$233.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,452.00
|
| Rate for Payer: Nomi Health Commercial |
$400.62
|
| Rate for Payer: PACE SWMI |
$333.85
|
| Rate for Payer: PHP Medicare Advantage |
$333.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.87
|
| Rate for Payer: Priority Health Medicare |
$333.85
|
| Rate for Payer: Priority Health Narrow Network |
$619.87
|
| Rate for Payer: Priority Health SBD |
$619.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.85
|
| Rate for Payer: UHC Exchange |
$410.40
|
| Rate for Payer: UHC Medicare Advantage |
$333.85
|
| Rate for Payer: UHCCP Medicaid |
$222.59
|
|
|
PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM
|
Professional
|
Both
|
$2,970.00
|
|
|
Service Code
|
HCPCS 58572
|
| Min. Negotiated Rate |
$61.81 |
| Max. Negotiated Rate |
$185,391.00 |
| Rate for Payer: Aetna Commercial |
$1,340.74
|
| Rate for Payer: Aetna Medicare |
$1,040.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.79
|
| Rate for Payer: BCBS Complete |
$701.59
|
| Rate for Payer: BCBS MAPPO |
$1,000.55
|
| Rate for Payer: BCBS Trust/PPO |
$61.81
|
| Rate for Payer: BCN Commercial |
$1,519.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.55
|
| Rate for Payer: Cash Price |
$2,376.00
|
| Rate for Payer: Cash Price |
$2,376.00
|
| Rate for Payer: Cofinity Commercial |
$1,440.79
|
| Rate for Payer: Cofinity Commercial |
$1,340.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.55
|
| Rate for Payer: Healthscope Commercial |
$1,600.88
|
| Rate for Payer: Healthscope Commercial |
$1,851.02
|
| Rate for Payer: Mclaren Medicaid |
$668.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.58
|
| Rate for Payer: Meridian Medicaid |
$701.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185,391.00
|
| Rate for Payer: Nomi Health Commercial |
$1,200.66
|
| Rate for Payer: PACE SWMI |
$1,000.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,930.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,515.92
|
| Rate for Payer: Priority Health Medicare |
$1,000.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,515.92
|
| Rate for Payer: Priority Health SBD |
$1,515.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,000.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,000.55
|
| Rate for Payer: UHCCP Medicaid |
$668.18
|
|
|
PR LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR
|
Professional
|
Both
|
$3,465.00
|
|
|
Service Code
|
HCPCS 58573
|
| Min. Negotiated Rate |
$61.81 |
| Max. Negotiated Rate |
$217,042.00 |
| Rate for Payer: Aetna Commercial |
$1,568.09
|
| Rate for Payer: Aetna Medicare |
$1,217.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.12
|
| Rate for Payer: BCBS Complete |
$820.34
|
| Rate for Payer: BCBS MAPPO |
$1,170.22
|
| Rate for Payer: BCBS Trust/PPO |
$61.81
|
| Rate for Payer: BCN Commercial |
$1,779.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,170.22
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,685.12
|
| Rate for Payer: Cofinity Commercial |
$1,568.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,170.22
|
| Rate for Payer: Healthscope Commercial |
$1,872.35
|
| Rate for Payer: Healthscope Commercial |
$2,164.91
|
| Rate for Payer: Mclaren Medicaid |
$781.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,228.73
|
| Rate for Payer: Meridian Medicaid |
$820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217,042.00
|
| Rate for Payer: Nomi Health Commercial |
$1,404.26
|
| Rate for Payer: PACE SWMI |
$1,170.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,170.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.49
|
| Rate for Payer: Priority Health Medicare |
$1,170.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,821.49
|
| Rate for Payer: Priority Health SBD |
$1,821.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,170.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,170.22
|
| Rate for Payer: UHCCP Medicaid |
$781.28
|
|
|
PR LAPAROSCOPY W/LYSIS OF ADHESIONS
|
Professional
|
Both
|
$2,687.00
|
|
|
Service Code
|
HCPCS 58660
|
| Min. Negotiated Rate |
$440.91 |
| Max. Negotiated Rate |
$122,103.00 |
| Rate for Payer: Aetna Commercial |
$887.63
|
| Rate for Payer: Aetna Medicare |
$688.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.87
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS MAPPO |
$662.41
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$999.34
|
| Rate for Payer: BCN Medicare Advantage |
$662.41
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$953.87
|
| Rate for Payer: Cofinity Commercial |
$887.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.41
|
| Rate for Payer: Healthscope Commercial |
$1,225.46
|
| Rate for Payer: Healthscope Commercial |
$1,059.86
|
| Rate for Payer: Mclaren Medicaid |
$440.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$695.53
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122,103.00
|
| Rate for Payer: Nomi Health Commercial |
$794.89
|
| Rate for Payer: PACE SWMI |
$662.41
|
| Rate for Payer: PHP Medicare Advantage |
$662.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,024.34
|
| Rate for Payer: Priority Health Medicare |
$662.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,024.34
|
| Rate for Payer: Priority Health SBD |
$1,024.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$774.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$662.41
|
| Rate for Payer: UHC Exchange |
$774.15
|
| Rate for Payer: UHC Medicare Advantage |
$662.41
|
| Rate for Payer: UHCCP Medicaid |
$440.91
|
|
|
PR LAPAROSCOPY W/OMENTOPEXY
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 49326
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$33,718.00 |
| Rate for Payer: Aetna Commercial |
$244.90
|
| Rate for Payer: Aetna Medicare |
$190.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.17
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$182.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.41
|
| Rate for Payer: BCN Commercial |
$272.19
|
| Rate for Payer: BCN Medicare Advantage |
$182.76
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$263.17
|
| Rate for Payer: Cofinity Commercial |
$244.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.76
|
| Rate for Payer: Healthscope Commercial |
$338.11
|
| Rate for Payer: Healthscope Commercial |
$292.42
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.90
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,718.00
|
| Rate for Payer: Nomi Health Commercial |
$219.31
|
| Rate for Payer: PACE SWMI |
$182.76
|
| Rate for Payer: PHP Medicare Advantage |
$182.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.50
|
| Rate for Payer: Priority Health Medicare |
$182.76
|
| Rate for Payer: Priority Health Narrow Network |
$333.50
|
| Rate for Payer: Priority Health SBD |
$333.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.76
|
| Rate for Payer: UHC Exchange |
$215.26
|
| Rate for Payer: UHC Medicare Advantage |
$182.76
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 58671
|
| Min. Negotiated Rate |
$48.39 |
| Max. Negotiated Rate |
$66,310.00 |
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$370.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.81
|
| Rate for Payer: BCBS Complete |
$250.94
|
| Rate for Payer: BCBS MAPPO |
$356.12
|
| Rate for Payer: BCBS Trust/PPO |
$48.39
|
| Rate for Payer: BCN Commercial |
$546.34
|
| 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: Mclaren Medicaid |
$238.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.93
|
| Rate for Payer: Meridian Medicaid |
$250.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,310.00
|
| 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 Choice Medicaid |
$238.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$991.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.05
|
| Rate for Payer: Priority Health Medicare |
$356.12
|
| Rate for Payer: Priority Health Narrow Network |
$558.05
|
| Rate for Payer: Priority Health SBD |
$558.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.12
|
| Rate for Payer: UHC Exchange |
$426.11
|
| Rate for Payer: UHC Medicare Advantage |
$356.12
|
| Rate for Payer: UHCCP Medicaid |
$238.99
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$183.85 |
| Max. Negotiated Rate |
$116,766.00 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.18
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$955.85
|
| 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 |
$1,161.62
|
| Rate for Payer: Healthscope Commercial |
$1,004.64
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.30
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,766.00
|
| 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 Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.73
|
| Rate for Payer: Priority Health Medicare |
$627.90
|
| Rate for Payer: Priority Health Narrow Network |
$974.73
|
| Rate for Payer: Priority Health SBD |
$974.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Exchange |
$747.84
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Min. Negotiated Rate |
$183.85 |
| Max. Negotiated Rate |
$116,766.00 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.18
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$955.85
|
| 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 |
$1,161.62
|
| Rate for Payer: Healthscope Commercial |
$1,004.64
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.30
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,766.00
|
| 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 Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.73
|
| Rate for Payer: Priority Health Medicare |
$627.90
|
| Rate for Payer: Priority Health Narrow Network |
$974.73
|
| Rate for Payer: Priority Health SBD |
$974.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Exchange |
$747.84
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
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
|
|
