|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
IP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,758.96 |
| Max. Negotiated Rate |
$2,512.80 |
| Rate for Payer: Aetna Commercial |
$2,373.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.80
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$1,954.40
|
| Rate for Payer: Cofinity Commercial |
$2,401.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,954.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Healthscope Commercial |
$2,512.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.20
|
| Rate for Payer: PHP Commercial |
$2,373.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health SBD |
$1,758.96
|
|
|
PR LAPS SURG ESOPG/GSTR FUNDOPLASTY
|
Professional
|
Both
|
$4,149.00
|
|
|
Service Code
|
HCPCS 43280
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$192,992.00 |
| Rate for Payer: Aetna Commercial |
$1,403.85
|
| Rate for Payer: Aetna Medicare |
$1,089.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,508.62
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS MAPPO |
$1,047.65
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.65
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cofinity Commercial |
$1,508.62
|
| Rate for Payer: Cofinity Commercial |
$1,403.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.65
|
| Rate for Payer: Healthscope Commercial |
$1,938.15
|
| Rate for Payer: Healthscope Commercial |
$1,676.24
|
| Rate for Payer: Mclaren Medicaid |
$692.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.03
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192,992.00
|
| Rate for Payer: Nomi Health Commercial |
$1,257.18
|
| Rate for Payer: PACE SWMI |
$1,047.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,696.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.19
|
| Rate for Payer: Priority Health Medicare |
$1,047.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,928.19
|
| Rate for Payer: Priority Health SBD |
$1,928.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.65
|
| Rate for Payer: UHC Exchange |
$1,373.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.65
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
|
|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$103,108.00 |
| Rate for Payer: Aetna Commercial |
$751.86
|
| Rate for Payer: Aetna Medicare |
$583.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.97
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$561.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.13
|
| Rate for Payer: BCN Commercial |
$847.86
|
| Rate for Payer: BCN Medicare Advantage |
$561.09
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$807.97
|
| Rate for Payer: Cofinity Commercial |
$751.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.09
|
| Rate for Payer: Healthscope Commercial |
$897.74
|
| Rate for Payer: Healthscope Commercial |
$1,038.02
|
| Rate for Payer: Mclaren Medicaid |
$374.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.14
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103,108.00
|
| Rate for Payer: Nomi Health Commercial |
$673.31
|
| Rate for Payer: PACE SWMI |
$561.09
|
| Rate for Payer: PHP Medicare Advantage |
$561.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.85
|
| Rate for Payer: Priority Health Medicare |
$561.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.85
|
| Rate for Payer: Priority Health SBD |
$1,042.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$574.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.09
|
| Rate for Payer: UHC Exchange |
$574.83
|
| Rate for Payer: UHC Medicare Advantage |
$561.09
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT
|
Professional
|
Both
|
$3,339.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$761.69 |
| Max. Negotiated Rate |
$210,379.00 |
| Rate for Payer: Aetna Commercial |
$1,529.80
|
| Rate for Payer: Aetna Medicare |
$1,187.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,643.96
|
| Rate for Payer: BCBS Complete |
$799.77
|
| Rate for Payer: BCBS MAPPO |
$1,141.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.22
|
| Rate for Payer: BCN Commercial |
$1,719.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.64
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cofinity Commercial |
$1,643.96
|
| Rate for Payer: Cofinity Commercial |
$1,529.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.64
|
| Rate for Payer: Healthscope Commercial |
$2,112.03
|
| Rate for Payer: Healthscope Commercial |
$1,826.62
|
| Rate for Payer: Mclaren Medicaid |
$761.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.72
|
| Rate for Payer: Meridian Medicaid |
$799.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210,379.00
|
| Rate for Payer: Nomi Health Commercial |
$1,369.97
|
| Rate for Payer: PACE SWMI |
$1,141.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.32
|
| Rate for Payer: Priority Health Medicare |
$1,141.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,892.32
|
| Rate for Payer: Priority Health SBD |
$1,892.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,855.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.64
|
| Rate for Payer: UHC Exchange |
$1,855.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,141.64
|
| Rate for Payer: UHCCP Medicaid |
$761.69
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$618.03 |
| Max. Negotiated Rate |
$882.90 |
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.65
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$686.70
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.85
|
| Rate for Payer: PHP Commercial |
$833.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health SBD |
$618.03
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$550.86 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.65
|
| 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 |
$1,946.29
|
| Rate for Payer: BCN Commercial |
$1,946.29
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Cofinity Commercial |
$686.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| 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 |
$833.85
|
| 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 |
$833.85
|
| 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 |
$637.65
|
| 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 |
$618.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.86
|
| 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 LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$91,366.00 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.67
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Healthscope Commercial |
$918.16
|
| Rate for Payer: Healthscope Commercial |
$794.08
|
| Rate for Payer: Mclaren Medicaid |
$332.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,366.00
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$496.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: Priority Health SBD |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Exchange |
$647.76
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$91,366.00 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.67
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Healthscope Commercial |
$918.16
|
| Rate for Payer: Healthscope Commercial |
$794.08
|
| Rate for Payer: Mclaren Medicaid |
$332.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,366.00
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$496.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: Priority Health SBD |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Exchange |
$647.76
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$100,998.00 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.16
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Healthscope Commercial |
$880.18
|
| Rate for Payer: Healthscope Commercial |
$1,017.70
|
| Rate for Payer: Mclaren Medicaid |
$367.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,998.00
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$550.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.37
|
| Rate for Payer: Priority Health SBD |
$1,021.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Exchange |
$661.68
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
IP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,304.73 |
| Max. Negotiated Rate |
$1,863.90 |
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.15
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,449.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,449.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,760.35
|
| Rate for Payer: PHP Commercial |
$1,760.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health SBD |
$1,304.73
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$608.72 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.15
|
| 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 |
$3,381.46
|
| Rate for Payer: BCN Commercial |
$3,381.46
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Cofinity Commercial |
$1,449.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,449.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| 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 |
$1,760.35
|
| 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 |
$1,760.35
|
| 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 |
$1,346.15
|
| 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 |
$1,304.73
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.72
|
| 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 LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$100,998.00 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.16
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Healthscope Commercial |
$880.18
|
| Rate for Payer: Healthscope Commercial |
$1,017.70
|
| Rate for Payer: Mclaren Medicaid |
$367.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,998.00
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$550.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.37
|
| Rate for Payer: Priority Health SBD |
$1,021.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Exchange |
$661.68
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 43652
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$137,174.00 |
| Rate for Payer: Aetna Commercial |
$999.95
|
| Rate for Payer: Aetna Medicare |
$776.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.95
|
| Rate for Payer: BCBS Complete |
$519.99
|
| Rate for Payer: BCBS MAPPO |
$746.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.56
|
| Rate for Payer: BCN Commercial |
$1,121.52
|
| Rate for Payer: BCN Medicare Advantage |
$746.23
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$999.95
|
| Rate for Payer: Cofinity Commercial |
$1,074.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.23
|
| Rate for Payer: Healthscope Commercial |
$1,380.53
|
| Rate for Payer: Healthscope Commercial |
$1,193.97
|
| Rate for Payer: Mclaren Medicaid |
$495.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.54
|
| Rate for Payer: Meridian Medicaid |
$519.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137,174.00
|
| Rate for Payer: Nomi Health Commercial |
$895.48
|
| Rate for Payer: PACE SWMI |
$746.23
|
| Rate for Payer: PHP Medicare Advantage |
$746.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,378.72
|
| Rate for Payer: Priority Health Medicare |
$746.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,378.72
|
| Rate for Payer: Priority Health SBD |
$1,378.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.23
|
| Rate for Payer: UHC Exchange |
$843.76
|
| Rate for Payer: UHC Medicare Advantage |
$746.23
|
| Rate for Payer: UHCCP Medicaid |
$495.23
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV TRUNCAL
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 43651
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$117,459.00 |
| Rate for Payer: Aetna Commercial |
$858.23
|
| Rate for Payer: Aetna Medicare |
$666.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.28
|
| Rate for Payer: BCBS Complete |
$447.30
|
| Rate for Payer: BCBS MAPPO |
$640.47
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$640.47
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$922.28
|
| Rate for Payer: Cofinity Commercial |
$858.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.47
|
| Rate for Payer: Healthscope Commercial |
$1,184.87
|
| Rate for Payer: Healthscope Commercial |
$1,024.75
|
| Rate for Payer: Mclaren Medicaid |
$426.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.49
|
| Rate for Payer: Meridian Medicaid |
$447.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,459.00
|
| Rate for Payer: Nomi Health Commercial |
$768.56
|
| Rate for Payer: PACE SWMI |
$640.47
|
| Rate for Payer: PHP Medicare Advantage |
$640.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.84
|
| Rate for Payer: Priority Health Medicare |
$640.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.84
|
| Rate for Payer: Priority Health SBD |
$1,184.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.47
|
| Rate for Payer: UHC Exchange |
$708.19
|
| Rate for Payer: UHC Medicare Advantage |
$640.47
|
| Rate for Payer: UHCCP Medicaid |
$426.00
|
|
|
PR LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 49322
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$67,034.00 |
| Rate for Payer: Aetna Commercial |
$487.02
|
| Rate for Payer: Aetna Medicare |
$377.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.37
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$363.45
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$363.45
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$523.37
|
| Rate for Payer: Cofinity Commercial |
$487.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.45
|
| Rate for Payer: Healthscope Commercial |
$672.38
|
| Rate for Payer: Healthscope Commercial |
$581.52
|
| Rate for Payer: Mclaren Medicaid |
$241.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.62
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67,034.00
|
| Rate for Payer: Nomi Health Commercial |
$436.14
|
| Rate for Payer: PACE SWMI |
$363.45
|
| Rate for Payer: PHP Medicare Advantage |
$363.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.15
|
| Rate for Payer: Priority Health Medicare |
$363.45
|
| Rate for Payer: Priority Health Narrow Network |
$674.15
|
| Rate for Payer: Priority Health SBD |
$674.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.45
|
| Rate for Payer: UHC Exchange |
$446.40
|
| Rate for Payer: UHC Medicare Advantage |
$363.45
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
|
|
PR LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 49323
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$113,706.00 |
| Rate for Payer: Aetna Commercial |
$831.97
|
| Rate for Payer: Aetna Medicare |
$645.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.05
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$620.87
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$930.93
|
| Rate for Payer: BCN Medicare Advantage |
$620.87
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$894.05
|
| Rate for Payer: Cofinity Commercial |
$831.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.87
|
| Rate for Payer: Healthscope Commercial |
$993.39
|
| Rate for Payer: Healthscope Commercial |
$1,148.61
|
| Rate for Payer: Mclaren Medicaid |
$413.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.91
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,706.00
|
| Rate for Payer: Nomi Health Commercial |
$745.04
|
| Rate for Payer: PACE SWMI |
$620.87
|
| Rate for Payer: PHP Medicare Advantage |
$620.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.44
|
| Rate for Payer: Priority Health Medicare |
$620.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.44
|
| Rate for Payer: Priority Health SBD |
$1,148.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.87
|
| Rate for Payer: UHC Exchange |
$665.89
|
| Rate for Payer: UHC Medicare Advantage |
$620.87
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
|
|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$161,775.00 |
| Rate for Payer: Aetna Commercial |
$1,167.29
|
| Rate for Payer: Aetna Medicare |
$905.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.40
|
| Rate for Payer: BCBS Complete |
$612.35
|
| Rate for Payer: BCBS MAPPO |
$871.11
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$1,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$871.11
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cofinity Commercial |
$1,254.40
|
| Rate for Payer: Cofinity Commercial |
$1,167.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.11
|
| Rate for Payer: Healthscope Commercial |
$1,393.78
|
| Rate for Payer: Healthscope Commercial |
$1,611.55
|
| Rate for Payer: Mclaren Medicaid |
$583.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.67
|
| Rate for Payer: Meridian Medicaid |
$612.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161,775.00
|
| Rate for Payer: Nomi Health Commercial |
$1,045.33
|
| Rate for Payer: PACE SWMI |
$871.11
|
| Rate for Payer: PHP Medicare Advantage |
$871.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,360.66
|
| Rate for Payer: Priority Health Medicare |
$871.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.66
|
| Rate for Payer: Priority Health SBD |
$1,360.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$871.11
|
| Rate for Payer: UHC Medicare Advantage |
$871.11
|
| Rate for Payer: UHCCP Medicaid |
$583.19
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$284.23 |
| Max. Negotiated Rate |
$143,107.00 |
| Rate for Payer: Aetna Commercial |
$1,035.47
|
| Rate for Payer: Aetna Medicare |
$803.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.75
|
| Rate for Payer: BCBS Complete |
$535.65
|
| Rate for Payer: BCBS MAPPO |
$772.74
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$772.74
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,112.75
|
| Rate for Payer: Cofinity Commercial |
$1,035.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.74
|
| Rate for Payer: Healthscope Commercial |
$1,429.57
|
| Rate for Payer: Healthscope Commercial |
$1,236.38
|
| Rate for Payer: Mclaren Medicaid |
$510.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.38
|
| Rate for Payer: Meridian Medicaid |
$535.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143,107.00
|
| Rate for Payer: Nomi Health Commercial |
$927.29
|
| Rate for Payer: PACE SWMI |
$772.74
|
| Rate for Payer: PHP Medicare Advantage |
$772.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.76
|
| Rate for Payer: Priority Health Medicare |
$772.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.76
|
| Rate for Payer: Priority Health SBD |
$1,118.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.74
|
| Rate for Payer: UHC Exchange |
$827.90
|
| Rate for Payer: UHC Medicare Advantage |
$772.74
|
| Rate for Payer: UHCCP Medicaid |
$510.14
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$140,040.00 |
| Rate for Payer: Aetna Commercial |
$1,012.77
|
| Rate for Payer: Aetna Medicare |
$786.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.35
|
| Rate for Payer: BCBS Complete |
$523.56
|
| Rate for Payer: BCBS MAPPO |
$755.80
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$1,142.04
|
| Rate for Payer: BCN Medicare Advantage |
$755.80
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,088.35
|
| Rate for Payer: Cofinity Commercial |
$1,012.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.80
|
| Rate for Payer: Healthscope Commercial |
$1,398.23
|
| Rate for Payer: Healthscope Commercial |
$1,209.28
|
| Rate for Payer: Mclaren Medicaid |
$498.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.59
|
| Rate for Payer: Meridian Medicaid |
$523.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,040.00
|
| Rate for Payer: Nomi Health Commercial |
$906.96
|
| Rate for Payer: PACE SWMI |
$755.80
|
| Rate for Payer: PHP Medicare Advantage |
$755.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.54
|
| Rate for Payer: Priority Health Medicare |
$755.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.54
|
| Rate for Payer: Priority Health SBD |
$1,094.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$755.80
|
| Rate for Payer: UHC Exchange |
$810.05
|
| Rate for Payer: UHC Medicare Advantage |
$755.80
|
| Rate for Payer: UHCCP Medicaid |
$498.63
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,890.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$879.26 |
| Max. Negotiated Rate |
$242,955.00 |
| Rate for Payer: Aetna Commercial |
$1,765.12
|
| Rate for Payer: Aetna Medicare |
$1,369.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,765.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,896.84
|
| Rate for Payer: BCBS Complete |
$923.22
|
| Rate for Payer: BCBS MAPPO |
$1,317.25
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.13
|
| Rate for Payer: BCN Commercial |
$1,985.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.25
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cofinity Commercial |
$1,896.84
|
| Rate for Payer: Cofinity Commercial |
$1,765.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.25
|
| Rate for Payer: Healthscope Commercial |
$2,436.91
|
| Rate for Payer: Healthscope Commercial |
$2,107.60
|
| Rate for Payer: Mclaren Medicaid |
$879.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.11
|
| Rate for Payer: Meridian Medicaid |
$923.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242,955.00
|
| Rate for Payer: Nomi Health Commercial |
$1,580.70
|
| Rate for Payer: PACE SWMI |
$1,317.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$879.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,878.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,188.99
|
| Rate for Payer: Priority Health Medicare |
$1,317.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,188.99
|
| Rate for Payer: Priority Health SBD |
$2,188.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,764.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,317.25
|
| Rate for Payer: UHC Exchange |
$1,764.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,317.25
|
| Rate for Payer: UHCCP Medicaid |
$879.26
|
|
|
PR LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,617.00
|
|
|
Service Code
|
HCPCS 50948
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$223,720.00 |
| Rate for Payer: Aetna Commercial |
$1,632.60
|
| Rate for Payer: Aetna Medicare |
$1,267.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.44
|
| Rate for Payer: BCBS Complete |
$853.23
|
| Rate for Payer: BCBS MAPPO |
$1,218.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.36
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$1,754.44
|
| Rate for Payer: Cofinity Commercial |
$1,632.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.36
|
| Rate for Payer: Healthscope Commercial |
$2,253.97
|
| Rate for Payer: Healthscope Commercial |
$1,949.38
|
| Rate for Payer: Mclaren Medicaid |
$812.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.28
|
| Rate for Payer: Meridian Medicaid |
$853.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223,720.00
|
| Rate for Payer: Nomi Health Commercial |
$1,462.03
|
| Rate for Payer: PACE SWMI |
$1,218.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.38
|
| Rate for Payer: Priority Health Medicare |
$1,218.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,007.38
|
| Rate for Payer: Priority Health SBD |
$2,007.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.36
|
| Rate for Payer: UHC Exchange |
$1,614.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.36
|
| Rate for Payer: UHCCP Medicaid |
$812.60
|
|
|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,230.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$233,177.00 |
| Rate for Payer: Aetna Commercial |
$1,679.90
|
| Rate for Payer: Aetna Medicare |
$1,303.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.27
|
| Rate for Payer: BCBS Complete |
$876.49
|
| Rate for Payer: BCBS MAPPO |
$1,253.66
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.66
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cofinity Commercial |
$1,805.27
|
| Rate for Payer: Cofinity Commercial |
$1,679.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.66
|
| Rate for Payer: Healthscope Commercial |
$2,319.27
|
| Rate for Payer: Healthscope Commercial |
$2,005.86
|
| Rate for Payer: Mclaren Medicaid |
$834.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,316.34
|
| Rate for Payer: Meridian Medicaid |
$876.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233,177.00
|
| Rate for Payer: Nomi Health Commercial |
$1,504.39
|
| Rate for Payer: PACE SWMI |
$1,253.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,099.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,947.48
|
| Rate for Payer: Priority Health Medicare |
$1,253.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,947.48
|
| Rate for Payer: Priority Health SBD |
$1,947.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,253.66
|
| Rate for Payer: UHC Exchange |
$1,342.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.66
|
| Rate for Payer: UHCCP Medicaid |
$834.75
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$395.17 |
| Max. Negotiated Rate |
$157,671.00 |
| Rate for Payer: Aetna Commercial |
$1,136.99
|
| Rate for Payer: Aetna Medicare |
$882.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.84
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$848.50
|
| Rate for Payer: BCBS Trust/PPO |
$395.17
|
| Rate for Payer: BCN Commercial |
$1,292.55
|
| Rate for Payer: BCN Medicare Advantage |
$848.50
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,221.84
|
| Rate for Payer: Cofinity Commercial |
$1,136.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.50
|
| Rate for Payer: Healthscope Commercial |
$1,569.72
|
| Rate for Payer: Healthscope Commercial |
$1,357.60
|
| Rate for Payer: Mclaren Medicaid |
$566.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.92
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157,671.00
|
| Rate for Payer: Nomi Health Commercial |
$1,018.20
|
| Rate for Payer: PACE SWMI |
$848.50
|
| Rate for Payer: PHP Medicare Advantage |
$848.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,319.49
|
| Rate for Payer: Priority Health Medicare |
$848.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,319.49
|
| Rate for Payer: Priority Health SBD |
$1,319.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$848.50
|
| Rate for Payer: UHC Exchange |
$1,095.96
|
| Rate for Payer: UHC Medicare Advantage |
$848.50
|
| Rate for Payer: UHCCP Medicaid |
$566.58
|
|
|
PR LAPS W/REVISION INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 49325
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$74,011.00 |
| Rate for Payer: Aetna Commercial |
$537.34
|
| Rate for Payer: Aetna Medicare |
$417.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.44
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$401.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.92
|
| Rate for Payer: BCN Commercial |
$603.52
|
| Rate for Payer: BCN Medicare Advantage |
$401.00
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$577.44
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.00
|
| Rate for Payer: Healthscope Commercial |
$741.85
|
| Rate for Payer: Healthscope Commercial |
$641.60
|
| Rate for Payer: Mclaren Medicaid |
$265.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.05
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,011.00
|
| Rate for Payer: Nomi Health Commercial |
$481.20
|
| Rate for Payer: PACE SWMI |
$401.00
|
| Rate for Payer: PHP Medicare Advantage |
$401.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.79
|
| Rate for Payer: Priority Health Medicare |
$401.00
|
| Rate for Payer: Priority Health Narrow Network |
$739.79
|
| Rate for Payer: Priority Health SBD |
$739.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.00
|
| Rate for Payer: UHC Exchange |
$465.88
|
| Rate for Payer: UHC Medicare Advantage |
$401.00
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 58552
|
| Min. Negotiated Rate |
$549.43 |
| Max. Negotiated Rate |
$175,469.00 |
| Rate for Payer: Aetna Commercial |
$1,264.65
|
| Rate for Payer: Aetna Medicare |
$981.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.03
|
| Rate for Payer: BCBS Complete |
$661.33
|
| Rate for Payer: BCBS MAPPO |
$943.77
|
| Rate for Payer: BCBS Trust/PPO |
$549.43
|
| Rate for Payer: BCN Commercial |
$1,437.69
|
| Rate for Payer: BCN Medicare Advantage |
$943.77
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,359.03
|
| Rate for Payer: Cofinity Commercial |
$1,264.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.77
|
| Rate for Payer: Healthscope Commercial |
$1,745.97
|
| Rate for Payer: Healthscope Commercial |
$1,510.03
|
| Rate for Payer: Mclaren Medicaid |
$629.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.96
|
| Rate for Payer: Meridian Medicaid |
$661.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,469.00
|
| Rate for Payer: Nomi Health Commercial |
$1,132.52
|
| Rate for Payer: PACE SWMI |
$943.77
|
| Rate for Payer: PHP Medicare Advantage |
$943.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,465.32
|
| Rate for Payer: Priority Health Medicare |
$943.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,465.32
|
| Rate for Payer: Priority Health SBD |
$1,465.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,018.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.77
|
| Rate for Payer: UHC Exchange |
$1,018.72
|
| Rate for Payer: UHC Medicare Advantage |
$943.77
|
| Rate for Payer: UHCCP Medicaid |
$629.84
|
|
