|
UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$21,328.14
|
|
|
Service Code
|
MS-DRG 383
|
| Min. Negotiated Rate |
$10,034.15 |
| Max. Negotiated Rate |
$21,328.14 |
| Rate for Payer: Aetna Medicare |
$10,984.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,202.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,202.82
|
| Rate for Payer: BCBS MAPPO |
$10,562.26
|
| Rate for Payer: BCBS Trust/PPO |
$19,471.05
|
| Rate for Payer: BCN Medicare Advantage |
$10,562.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,562.26
|
| Rate for Payer: Mclaren Medicare |
$10,562.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,090.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,146.60
|
| Rate for Payer: PACE Medicare |
$10,034.15
|
| Rate for Payer: PACE SWMI |
$10,562.26
|
| Rate for Payer: PHP Medicare Advantage |
$10,562.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,064.06
|
| Rate for Payer: Priority Health Medicare |
$10,562.26
|
| Rate for Payer: Priority Health Narrow Network |
$16,051.25
|
| Rate for Payer: Railroad Medicare Medicare |
$10,562.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,328.14
|
| Rate for Payer: UHC Core |
$13,087.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,562.26
|
| Rate for Payer: UHC Exchange |
$14,016.96
|
| Rate for Payer: UHC Medicare Advantage |
$10,879.13
|
| Rate for Payer: VA VA |
$10,562.26
|
|
|
UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
|
IP
|
$13,357.93
|
|
|
Service Code
|
MS-DRG 384
|
| Min. Negotiated Rate |
$6,459.36 |
| Max. Negotiated Rate |
$13,357.93 |
| Rate for Payer: Aetna Medicare |
$7,071.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,499.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,499.16
|
| Rate for Payer: BCBS MAPPO |
$6,799.33
|
| Rate for Payer: BCBS Trust/PPO |
$12,193.83
|
| Rate for Payer: BCN Medicare Advantage |
$6,799.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,799.33
|
| Rate for Payer: Mclaren Medicare |
$6,799.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,139.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,819.23
|
| Rate for Payer: PACE Medicare |
$6,459.36
|
| Rate for Payer: PACE SWMI |
$6,799.33
|
| Rate for Payer: PHP Medicare Advantage |
$6,799.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,566.22
|
| Rate for Payer: Priority Health Medicare |
$6,799.33
|
| Rate for Payer: Priority Health Narrow Network |
$10,052.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6,799.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,357.93
|
| Rate for Payer: UHC Core |
$8,196.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,799.33
|
| Rate for Payer: UHC Exchange |
$8,778.89
|
| Rate for Payer: UHC Medicare Advantage |
$7,003.31
|
| Rate for Payer: VA VA |
$6,799.33
|
|
|
UNLISTED LAPAROSCOPIC PROCEDURE, LIVER
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 47379
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 49329
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,247.28 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,247.28
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 44979
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, BLADDER
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 51999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 49659
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM)
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 44238
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY
|
Facility
|
OP
|
$6,837.00
|
|
|
Service Code
|
CPT 58679
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$6,837.00 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, STOMACH
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 43659
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, URETER
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 50949
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED LAPAROSCOPY PROCEDURE, UTERUS
|
Facility
|
OP
|
$15,754.72
|
|
|
Service Code
|
CPT 58578
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,185.80 |
| Max. Negotiated Rate |
$15,754.72 |
| Rate for Payer: Aetna Medicare |
$5,339.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,417.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,417.61
|
| Rate for Payer: BCBS Complete |
$2,949.02
|
| Rate for Payer: BCBS MAPPO |
$5,134.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,185.80
|
| Rate for Payer: BCN Medicare Advantage |
$5,134.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,134.09
|
| Rate for Payer: Mclaren Medicaid |
$2,808.35
|
| Rate for Payer: Mclaren Medicare |
$5,134.09
|
| Rate for Payer: Meridian Medicaid |
$2,949.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,390.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,904.20
|
| Rate for Payer: PACE Medicare |
$4,877.39
|
| Rate for Payer: PACE SWMI |
$5,134.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,134.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,808.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,754.72
|
| Rate for Payer: Priority Health Medicare |
$5,134.09
|
| Rate for Payer: Priority Health Narrow Network |
$12,603.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,134.09
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,134.09
|
| Rate for Payer: UHC Medicare Advantage |
$5,288.11
|
| Rate for Payer: VA VA |
$5,134.09
|
|
|
UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTEM
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 22999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$218.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
| Rate for Payer: BCBS Complete |
$120.53
|
| Rate for Payer: BCBS MAPPO |
$209.83
|
| Rate for Payer: BCBS Trust/PPO |
$104.02
|
| Rate for Payer: BCN Medicare Advantage |
$209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
| Rate for Payer: Mclaren Medicaid |
$114.78
|
| Rate for Payer: Mclaren Medicare |
$209.83
|
| Rate for Payer: Meridian Medicaid |
$120.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
| Rate for Payer: PACE Medicare |
$199.34
|
| Rate for Payer: PACE SWMI |
$209.83
|
| Rate for Payer: PHP Medicare Advantage |
$209.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.74
|
| Rate for Payer: Priority Health Medicare |
$209.83
|
| Rate for Payer: Priority Health Narrow Network |
$496.59
|
| Rate for Payer: Railroad Medicare Medicare |
$209.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
| Rate for Payer: UHC Medicare Advantage |
$216.12
|
| Rate for Payer: VA VA |
$209.83
|
|
|
UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
|
Facility
|
OP
|
$3,138.00
|
|
|
Service Code
|
CPT 49999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$364.26 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Medicare |
$838.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,008.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,008.22
|
| Rate for Payer: BCBS Complete |
$463.30
|
| Rate for Payer: BCBS MAPPO |
$806.58
|
| Rate for Payer: BCBS Trust/PPO |
$364.26
|
| Rate for Payer: BCN Medicare Advantage |
$806.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.58
|
| Rate for Payer: Mclaren Medicaid |
$441.20
|
| Rate for Payer: Mclaren Medicare |
$806.58
|
| Rate for Payer: Meridian Medicaid |
$463.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$927.57
|
| Rate for Payer: PACE Medicare |
$766.25
|
| Rate for Payer: PACE SWMI |
$806.58
|
| Rate for Payer: PHP Medicare Advantage |
$806.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,519.41
|
| Rate for Payer: Priority Health Medicare |
$806.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,015.53
|
| Rate for Payer: Railroad Medicare Medicare |
$806.58
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$806.58
|
| Rate for Payer: UHC Medicare Advantage |
$830.78
|
| Rate for Payer: VA VA |
$806.58
|
|
|
UNLISTED PROCEDURE, ANUS
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
CPT 46999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$347.54 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Medicare |
$845.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.54
|
| Rate for Payer: BCBS Complete |
$467.12
|
| Rate for Payer: BCBS MAPPO |
$813.23
|
| Rate for Payer: BCBS Trust/PPO |
$347.54
|
| Rate for Payer: BCN Medicare Advantage |
$813.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.23
|
| Rate for Payer: Mclaren Medicaid |
$444.84
|
| Rate for Payer: Mclaren Medicare |
$813.23
|
| Rate for Payer: Meridian Medicaid |
$467.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$935.21
|
| Rate for Payer: PACE Medicare |
$772.57
|
| Rate for Payer: PACE SWMI |
$813.23
|
| Rate for Payer: PHP Medicare Advantage |
$813.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.84
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Railroad Medicare Medicare |
$813.23
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.23
|
| Rate for Payer: UHC Medicare Advantage |
$837.63
|
| Rate for Payer: VA VA |
$813.23
|
|
|
UNLISTED PROCEDURE, ARTHROSCOPY
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 29999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$114.78 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$218.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
| Rate for Payer: BCBS Complete |
$120.53
|
| Rate for Payer: BCBS MAPPO |
$209.83
|
| Rate for Payer: BCBS Trust/PPO |
$324.50
|
| Rate for Payer: BCN Medicare Advantage |
$209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
| Rate for Payer: Mclaren Medicaid |
$114.78
|
| Rate for Payer: Mclaren Medicare |
$209.83
|
| Rate for Payer: Meridian Medicaid |
$120.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
| Rate for Payer: PACE Medicare |
$199.34
|
| Rate for Payer: PACE SWMI |
$209.83
|
| Rate for Payer: PHP Medicare Advantage |
$209.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
| Rate for Payer: Priority Health Medicare |
$209.83
|
| Rate for Payer: Railroad Medicare Medicare |
$209.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
| Rate for Payer: UHC Medicare Advantage |
$216.12
|
| Rate for Payer: VA VA |
$209.83
|
|
|
UNLISTED PROCEDURE, BREAST
|
Facility
|
OP
|
$10,308.37
|
|
|
Service Code
|
CPT 19499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,301.08 |
| Max. Negotiated Rate |
$10,308.37 |
| Rate for Payer: Aetna Medicare |
$3,527.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,239.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,239.58
|
| Rate for Payer: BCBS Complete |
$1,948.17
|
| Rate for Payer: BCBS MAPPO |
$3,391.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,391.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,391.66
|
| Rate for Payer: Mclaren Medicaid |
$1,855.24
|
| Rate for Payer: Mclaren Medicare |
$3,391.66
|
| Rate for Payer: Meridian Medicaid |
$1,948.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,561.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,900.41
|
| Rate for Payer: PACE Medicare |
$3,222.08
|
| Rate for Payer: PACE SWMI |
$3,391.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,391.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,855.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,308.37
|
| Rate for Payer: Priority Health Medicare |
$3,391.66
|
| Rate for Payer: Priority Health Narrow Network |
$8,246.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,391.66
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,391.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,493.41
|
| Rate for Payer: VA VA |
$3,391.66
|
|
|
UNLISTED PROCEDURE, EXTERNAL EAR
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 69399
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$92.18 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$226.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.68
|
| Rate for Payer: BCBS Complete |
$124.84
|
| Rate for Payer: BCBS MAPPO |
$217.34
|
| Rate for Payer: BCBS Trust/PPO |
$92.18
|
| Rate for Payer: BCN Medicare Advantage |
$217.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.34
|
| Rate for Payer: Mclaren Medicaid |
$118.88
|
| Rate for Payer: Mclaren Medicare |
$217.34
|
| Rate for Payer: Meridian Medicaid |
$124.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.94
|
| Rate for Payer: PACE Medicare |
$206.47
|
| Rate for Payer: PACE SWMI |
$217.34
|
| Rate for Payer: PHP Medicare Advantage |
$217.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.88
|
| Rate for Payer: Priority Health Medicare |
$217.34
|
| Rate for Payer: Railroad Medicare Medicare |
$217.34
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.34
|
| Rate for Payer: UHC Medicare Advantage |
$223.86
|
| Rate for Payer: VA VA |
$217.34
|
|
|
UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 58999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$184.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.64
|
| Rate for Payer: BCBS Complete |
$101.85
|
| Rate for Payer: BCBS MAPPO |
$177.31
|
| Rate for Payer: BCBS Trust/PPO |
$79.23
|
| Rate for Payer: BCN Medicare Advantage |
$177.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.31
|
| Rate for Payer: Mclaren Medicaid |
$96.99
|
| Rate for Payer: Mclaren Medicare |
$177.31
|
| Rate for Payer: Meridian Medicaid |
$101.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.91
|
| Rate for Payer: PACE Medicare |
$168.44
|
| Rate for Payer: PACE SWMI |
$177.31
|
| Rate for Payer: PHP Medicare Advantage |
$177.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.99
|
| Rate for Payer: Priority Health Medicare |
$177.31
|
| Rate for Payer: Railroad Medicare Medicare |
$177.31
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.31
|
| Rate for Payer: UHC Medicare Advantage |
$182.63
|
| Rate for Payer: VA VA |
$177.31
|
|
|
UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 27599
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$218.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
| Rate for Payer: BCBS Complete |
$120.53
|
| Rate for Payer: BCBS MAPPO |
$209.83
|
| Rate for Payer: BCBS Trust/PPO |
$104.02
|
| Rate for Payer: BCN Medicare Advantage |
$209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
| Rate for Payer: Mclaren Medicaid |
$114.78
|
| Rate for Payer: Mclaren Medicare |
$209.83
|
| Rate for Payer: Meridian Medicaid |
$120.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
| Rate for Payer: PACE Medicare |
$199.34
|
| Rate for Payer: PACE SWMI |
$209.83
|
| Rate for Payer: PHP Medicare Advantage |
$209.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.74
|
| Rate for Payer: Priority Health Medicare |
$209.83
|
| Rate for Payer: Priority Health Narrow Network |
$496.59
|
| Rate for Payer: Railroad Medicare Medicare |
$209.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
| Rate for Payer: UHC Medicare Advantage |
$216.12
|
| Rate for Payer: VA VA |
$209.83
|
|
|
UNLISTED PROCEDURE, LEG OR ANKLE
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 27899
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$218.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
| Rate for Payer: BCBS Complete |
$120.53
|
| Rate for Payer: BCBS MAPPO |
$209.83
|
| Rate for Payer: BCBS Trust/PPO |
$104.02
|
| Rate for Payer: BCN Medicare Advantage |
$209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
| Rate for Payer: Mclaren Medicaid |
$114.78
|
| Rate for Payer: Mclaren Medicare |
$209.83
|
| Rate for Payer: Meridian Medicaid |
$120.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
| Rate for Payer: PACE Medicare |
$199.34
|
| Rate for Payer: PACE SWMI |
$209.83
|
| Rate for Payer: PHP Medicare Advantage |
$209.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.75
|
| Rate for Payer: Priority Health Medicare |
$209.83
|
| Rate for Payer: Priority Health Narrow Network |
$513.40
|
| Rate for Payer: Railroad Medicare Medicare |
$209.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
| Rate for Payer: UHC Medicare Advantage |
$216.12
|
| Rate for Payer: VA VA |
$209.83
|
|
|
UNLISTED PROCEDURE, MALE GENITAL SYSTEM
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 55899
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$112.46 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$228.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.89
|
| Rate for Payer: BCBS Complete |
$126.32
|
| Rate for Payer: BCBS MAPPO |
$219.91
|
| Rate for Payer: BCBS Trust/PPO |
$112.46
|
| Rate for Payer: BCN Medicare Advantage |
$219.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.91
|
| Rate for Payer: Mclaren Medicaid |
$120.29
|
| Rate for Payer: Mclaren Medicare |
$219.91
|
| Rate for Payer: Meridian Medicaid |
$126.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.90
|
| Rate for Payer: PACE Medicare |
$208.91
|
| Rate for Payer: PACE SWMI |
$219.91
|
| Rate for Payer: PHP Medicare Advantage |
$219.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.29
|
| Rate for Payer: Priority Health Medicare |
$219.91
|
| Rate for Payer: Railroad Medicare Medicare |
$219.91
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.91
|
| Rate for Payer: UHC Medicare Advantage |
$226.51
|
| Rate for Payer: VA VA |
$219.91
|
|
|
UNLISTED PROCEDURE, PELVIS OR HIP JOINT
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 27299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$218.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.29
|
| Rate for Payer: BCBS Complete |
$120.53
|
| Rate for Payer: BCBS MAPPO |
$209.83
|
| Rate for Payer: BCBS Trust/PPO |
$104.02
|
| Rate for Payer: BCN Medicare Advantage |
$209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.83
|
| Rate for Payer: Mclaren Medicaid |
$114.78
|
| Rate for Payer: Mclaren Medicare |
$209.83
|
| Rate for Payer: Meridian Medicaid |
$120.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.30
|
| Rate for Payer: PACE Medicare |
$199.34
|
| Rate for Payer: PACE SWMI |
$209.83
|
| Rate for Payer: PHP Medicare Advantage |
$209.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.75
|
| Rate for Payer: Priority Health Medicare |
$209.83
|
| Rate for Payer: Priority Health Narrow Network |
$513.40
|
| Rate for Payer: Railroad Medicare Medicare |
$209.83
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.83
|
| Rate for Payer: UHC Medicare Advantage |
$216.12
|
| Rate for Payer: VA VA |
$209.83
|
|
|
UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 42999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$92.18 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Medicare |
$226.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.68
|
| Rate for Payer: BCBS Complete |
$124.84
|
| Rate for Payer: BCBS MAPPO |
$217.34
|
| Rate for Payer: BCBS Trust/PPO |
$92.18
|
| Rate for Payer: BCN Medicare Advantage |
$217.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.34
|
| Rate for Payer: Mclaren Medicaid |
$118.88
|
| Rate for Payer: Mclaren Medicare |
$217.34
|
| Rate for Payer: Meridian Medicaid |
$124.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.94
|
| Rate for Payer: PACE Medicare |
$206.47
|
| Rate for Payer: PACE SWMI |
$217.34
|
| Rate for Payer: PHP Medicare Advantage |
$217.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$658.72
|
| Rate for Payer: Priority Health Medicare |
$217.34
|
| Rate for Payer: Priority Health Narrow Network |
$526.98
|
| Rate for Payer: Railroad Medicare Medicare |
$217.34
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.34
|
| Rate for Payer: UHC Medicare Advantage |
$223.86
|
| Rate for Payer: VA VA |
$217.34
|
|
|
UNLISTED PROCEDURE, RECTUM
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
CPT 45999
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$347.54 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Medicare |
$845.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.54
|
| Rate for Payer: BCBS Complete |
$467.12
|
| Rate for Payer: BCBS MAPPO |
$813.23
|
| Rate for Payer: BCBS Trust/PPO |
$347.54
|
| Rate for Payer: BCN Medicare Advantage |
$813.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.23
|
| Rate for Payer: Mclaren Medicaid |
$444.84
|
| Rate for Payer: Mclaren Medicare |
$813.23
|
| Rate for Payer: Meridian Medicaid |
$467.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$935.21
|
| Rate for Payer: PACE Medicare |
$772.57
|
| Rate for Payer: PACE SWMI |
$813.23
|
| Rate for Payer: PHP Medicare Advantage |
$813.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.84
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Railroad Medicare Medicare |
$813.23
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.23
|
| Rate for Payer: UHC Medicare Advantage |
$837.63
|
| Rate for Payer: VA VA |
$813.23
|
|
