|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$1,845.88 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$72.82
|
| Rate for Payer: BCN Medicare Advantage |
$38.97
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| Rate for Payer: Cofinity Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.97
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$46.76
|
| Rate for Payer: PACE SWMI |
$38.97
|
| Rate for Payer: PHP Medicare Advantage |
$38.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO |
$59.53
|
| Rate for Payer: Priority Health Medicare |
$39.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Exchange |
$38.97
|
| Rate for Payer: UHC Medicare Advantage |
$38.97
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$1,579.09 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.09
|
| Rate for Payer: BCN Commercial |
$120.16
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$61.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.87
|
| Rate for Payer: UHC Exchange |
$60.87
|
| Rate for Payer: UHC Medicare Advantage |
$60.87
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: BCBS Trust/PPO |
$175.50
|
| Rate for Payer: BCN Commercial |
$166.15
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$176.30
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$187.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
58100
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$1,579.09 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.09
|
| Rate for Payer: BCN Commercial |
$120.16
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$61.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.87
|
| Rate for Payer: UHC Exchange |
$60.87
|
| Rate for Payer: UHC Medicare Advantage |
$60.87
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$51.06 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$55.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.19
|
| Rate for Payer: BCBS Complete |
$149.64
|
| Rate for Payer: BCBS MAPPO |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$176.75
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$167.16
|
| Rate for Payer: BCN Medicare Advantage |
$53.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Mclaren Medicaid |
$142.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.44
|
| Rate for Payer: Meridian Medicaid |
$149.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$176.30
|
| Rate for Payer: PACE Senior Care Partners |
$51.06
|
| Rate for Payer: PACE SWMI |
$53.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$53.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$187.05
|
| Rate for Payer: Priority Health Medicare |
$54.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.05
|
| Rate for Payer: Railroad Medicare Medicare |
$53.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.75
|
| Rate for Payer: UHC Exchange |
$53.75
|
| Rate for Payer: UHC Medicare Advantage |
$53.75
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: VA VA |
$53.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,813.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$2,491.27 |
| Rate for Payer: Aetna Commercial |
$454.25
|
| Rate for Payer: Aetna Medicare |
$352.55
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$338.99
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$2,491.27
|
| Rate for Payer: BCN Medicare Advantage |
$338.99
|
| Rate for Payer: Cash Price |
$2,250.40
|
| Rate for Payer: Cash Price |
$2,250.40
|
| Rate for Payer: Cofinity Commercial |
$488.15
|
| Rate for Payer: Cofinity Commercial |
$454.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.99
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.94
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Nomi Health Commercial |
$406.79
|
| Rate for Payer: PACE SWMI |
$338.99
|
| Rate for Payer: PHP Medicare Advantage |
$338.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,828.45
|
| Rate for Payer: Priority Health HMO/PPO |
$527.30
|
| Rate for Payer: Priority Health Medicare |
$342.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$527.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.99
|
| Rate for Payer: UHC Exchange |
$338.99
|
| Rate for Payer: UHC Medicare Advantage |
$338.99
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$74.76 |
| Max. Negotiated Rate |
$786.11 |
| Rate for Payer: Aetna Commercial |
$150.31
|
| Rate for Payer: Aetna Medicare |
$116.66
|
| Rate for Payer: BCBS Complete |
$78.50
|
| Rate for Payer: BCBS MAPPO |
$112.17
|
| Rate for Payer: BCBS Trust/PPO |
$786.11
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$112.17
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cofinity Commercial |
$161.52
|
| Rate for Payer: Cofinity Commercial |
$150.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.17
|
| Rate for Payer: Mclaren Medicaid |
$74.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.78
|
| Rate for Payer: Meridian Medicaid |
$78.50
|
| Rate for Payer: Nomi Health Commercial |
$134.60
|
| Rate for Payer: PACE SWMI |
$112.17
|
| Rate for Payer: PHP Medicare Advantage |
$112.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.20
|
| Rate for Payer: Priority Health HMO/PPO |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$113.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.17
|
| Rate for Payer: UHC Exchange |
$112.17
|
| Rate for Payer: UHC Medicare Advantage |
$112.17
|
| Rate for Payer: UHCCP Medicaid |
$74.76
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Aetna Commercial |
$180.71
|
| Rate for Payer: Aetna Medicare |
$140.25
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$134.86
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$134.86
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$194.20
|
| Rate for Payer: Cofinity Commercial |
$180.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.86
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.60
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Nomi Health Commercial |
$161.83
|
| Rate for Payer: PACE SWMI |
$134.86
|
| Rate for Payer: PHP Medicare Advantage |
$134.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.75
|
| Rate for Payer: Priority Health HMO/PPO |
$253.55
|
| Rate for Payer: Priority Health Medicare |
$136.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.86
|
| Rate for Payer: UHC Exchange |
$134.86
|
| Rate for Payer: UHC Medicare Advantage |
$134.86
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 44361
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$642.20 |
| Rate for Payer: Aetna Commercial |
$200.02
|
| Rate for Payer: Aetna Medicare |
$155.24
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$149.27
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$149.27
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Commercial |
$214.95
|
| Rate for Payer: Cofinity Commercial |
$200.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.27
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.73
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$179.12
|
| Rate for Payer: PACE SWMI |
$149.27
|
| Rate for Payer: PHP Medicare Advantage |
$149.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health HMO/PPO |
$279.21
|
| Rate for Payer: Priority Health Medicare |
$150.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.27
|
| Rate for Payer: UHC Exchange |
$149.27
|
| Rate for Payer: UHC Medicare Advantage |
$149.27
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR ENDOVASC ABDO REPAIR W/PROS
|
Professional
|
Both
|
$5,333.00
|
|
|
Service Code
|
HCPCS 34805
|
| Min. Negotiated Rate |
$2,133.20 |
| Max. Negotiated Rate |
$3,466.45 |
| Rate for Payer: Aetna Medicare |
$2,666.50
|
| Rate for Payer: BCBS Complete |
$2,133.20
|
| Rate for Payer: Cash Price |
$4,266.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,466.45
|
|
|
PR ENDOVASCULAR REPAIR ILIAC ARTERY W ILIO-ILIAC PROSTHESIS
|
Professional
|
Both
|
$1,766.00
|
|
|
Service Code
|
HCPCS 34900
|
| Min. Negotiated Rate |
$706.40 |
| Max. Negotiated Rate |
$1,147.90 |
| Rate for Payer: Aetna Medicare |
$883.00
|
| Rate for Payer: BCBS Complete |
$706.40
|
| Rate for Payer: Cash Price |
$1,412.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.90
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,741.00
|
|
|
Service Code
|
HCPCS 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$1,781.65 |
| Rate for Payer: Aetna Commercial |
$355.60
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$265.37
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$265.37
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$382.13
|
| Rate for Payer: Cofinity Commercial |
$355.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.37
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.64
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Nomi Health Commercial |
$318.44
|
| Rate for Payer: PACE SWMI |
$265.37
|
| Rate for Payer: PHP Medicare Advantage |
$265.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$268.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.37
|
| Rate for Payer: UHC Exchange |
$265.37
|
| Rate for Payer: UHC Medicare Advantage |
$265.37
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,741.00
|
|
|
Service Code
|
HCPCS 36478
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$1,781.65 |
| Rate for Payer: Aetna Commercial |
$355.60
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$265.37
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$265.37
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$355.60
|
| Rate for Payer: Cofinity Commercial |
$382.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.37
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.64
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Nomi Health Commercial |
$318.44
|
| Rate for Payer: PACE SWMI |
$265.37
|
| Rate for Payer: PHP Medicare Advantage |
$265.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$268.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.37
|
| Rate for Payer: UHC Exchange |
$265.37
|
| Rate for Payer: UHC Medicare Advantage |
$265.37
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
OP
|
$2,741.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$650.99 |
| Max. Negotiated Rate |
$2,466.90 |
| Rate for Payer: Aetna Commercial |
$2,329.85
|
| Rate for Payer: Aetna Medicare |
$712.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$856.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$856.56
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$685.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,253.38
|
| Rate for Payer: BCN Commercial |
$2,131.13
|
| Rate for Payer: BCN Medicare Advantage |
$685.25
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$2,357.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.25
|
| Rate for Payer: Healthscope Commercial |
$2,466.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,055.75
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.51
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,329.85
|
| Rate for Payer: Nomi Health Commercial |
$2,247.62
|
| Rate for Payer: PACE Senior Care Partners |
$650.99
|
| Rate for Payer: PACE SWMI |
$685.25
|
| Rate for Payer: PHP Commercial |
$2,329.85
|
| Rate for Payer: PHP Medicare Advantage |
$685.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,384.67
|
| Rate for Payer: Priority Health Medicare |
$692.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,836.47
|
| Rate for Payer: Railroad Medicare Medicare |
$685.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,412.08
|
| Rate for Payer: UHC Core |
$2,288.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.25
|
| Rate for Payer: UHC Exchange |
$685.25
|
| Rate for Payer: UHC Medicare Advantage |
$685.25
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$685.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,055.75
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
IP
|
$2,741.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,781.65 |
| Max. Negotiated Rate |
$2,466.90 |
| Rate for Payer: Aetna Commercial |
$2,329.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,237.48
|
| Rate for Payer: BCN Commercial |
$2,118.24
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$2,357.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,192.80
|
| Rate for Payer: Healthscope Commercial |
$2,466.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,055.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,329.85
|
| Rate for Payer: Nomi Health Commercial |
$2,247.62
|
| Rate for Payer: PHP Commercial |
$2,329.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,384.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,836.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,412.08
|
| Rate for Payer: UHC Core |
$2,288.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,055.75
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,149.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$2,046.85 |
| Rate for Payer: Aetna Commercial |
$355.72
|
| Rate for Payer: Aetna Medicare |
$276.08
|
| Rate for Payer: BCBS Complete |
$182.50
|
| Rate for Payer: BCBS MAPPO |
$265.46
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$1,586.74
|
| Rate for Payer: BCN Medicare Advantage |
$265.46
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Cofinity Commercial |
$382.26
|
| Rate for Payer: Cofinity Commercial |
$355.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.46
|
| Rate for Payer: Mclaren Medicaid |
$173.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.73
|
| Rate for Payer: Meridian Medicaid |
$182.50
|
| Rate for Payer: Nomi Health Commercial |
$318.55
|
| Rate for Payer: PACE SWMI |
$265.46
|
| Rate for Payer: PHP Medicare Advantage |
$265.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.85
|
| Rate for Payer: Priority Health HMO/PPO |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$268.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.46
|
| Rate for Payer: UHC Exchange |
$265.46
|
| Rate for Payer: UHC Medicare Advantage |
$265.46
|
| Rate for Payer: UHCCP Medicaid |
$173.81
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$510.87 |
| Rate for Payer: Aetna Commercial |
$171.99
|
| Rate for Payer: Aetna Medicare |
$133.48
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$128.35
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$128.35
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Cofinity Commercial |
$171.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.35
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.77
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$154.02
|
| Rate for Payer: PACE SWMI |
$128.35
|
| Rate for Payer: PHP Medicare Advantage |
$128.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health HMO/PPO |
$207.41
|
| Rate for Payer: Priority Health Medicare |
$129.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.35
|
| Rate for Payer: UHC Exchange |
$128.35
|
| Rate for Payer: UHC Medicare Advantage |
$128.35
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$1,080.90 |
| Rate for Payer: Aetna Commercial |
$312.06
|
| Rate for Payer: Aetna Medicare |
$242.20
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: BCBS MAPPO |
$232.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: BCN Commercial |
$348.43
|
| Rate for Payer: BCN Medicare Advantage |
$232.88
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$335.35
|
| Rate for Payer: Cofinity Commercial |
$312.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.88
|
| Rate for Payer: Mclaren Medicaid |
$152.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.52
|
| Rate for Payer: Meridian Medicaid |
$160.36
|
| Rate for Payer: Nomi Health Commercial |
$279.46
|
| Rate for Payer: PACE SWMI |
$232.88
|
| Rate for Payer: PHP Medicare Advantage |
$232.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.35
|
| Rate for Payer: Priority Health HMO/PPO |
$426.57
|
| Rate for Payer: Priority Health Medicare |
$235.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.88
|
| Rate for Payer: UHC Exchange |
$232.88
|
| Rate for Payer: UHC Medicare Advantage |
$232.88
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,497.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$754.02 |
| Max. Negotiated Rate |
$2,273.05 |
| Rate for Payer: Aetna Commercial |
$1,526.65
|
| Rate for Payer: Aetna Medicare |
$1,184.86
|
| Rate for Payer: BCBS Complete |
$791.72
|
| Rate for Payer: BCBS MAPPO |
$1,139.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: BCN Commercial |
$1,708.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.29
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Cofinity Commercial |
$1,640.58
|
| Rate for Payer: Cofinity Commercial |
$1,526.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.29
|
| Rate for Payer: Mclaren Medicaid |
$754.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.25
|
| Rate for Payer: Meridian Medicaid |
$791.72
|
| Rate for Payer: Nomi Health Commercial |
$1,367.15
|
| Rate for Payer: PACE SWMI |
$1,139.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,273.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,100.01
|
| Rate for Payer: Priority Health Medicare |
$1,150.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,100.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,139.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.29
|
| Rate for Payer: UHC Exchange |
$1,139.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.29
|
| Rate for Payer: UHCCP Medicaid |
$754.02
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,877.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$881.61 |
| Max. Negotiated Rate |
$2,191.65 |
| Rate for Payer: Aetna Commercial |
$1,766.98
|
| Rate for Payer: Aetna Medicare |
$1,371.39
|
| Rate for Payer: BCBS Complete |
$925.69
|
| Rate for Payer: BCBS MAPPO |
$1,318.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$1,988.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.64
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$1,898.84
|
| Rate for Payer: Cofinity Commercial |
$1,766.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.64
|
| Rate for Payer: Mclaren Medicaid |
$881.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.57
|
| Rate for Payer: Meridian Medicaid |
$925.69
|
| Rate for Payer: Nomi Health Commercial |
$1,582.37
|
| Rate for Payer: PACE SWMI |
$1,318.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,191.65
|
| Rate for Payer: Priority Health Medicare |
$1,331.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,191.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,318.64
|
| Rate for Payer: UHC Exchange |
$1,318.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,318.64
|
| Rate for Payer: UHCCP Medicaid |
$881.61
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,172.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$2,351.77 |
| Rate for Payer: Aetna Commercial |
$1,711.41
|
| Rate for Payer: Aetna Medicare |
$1,328.26
|
| Rate for Payer: BCBS Complete |
$887.44
|
| Rate for Payer: BCBS MAPPO |
$1,277.17
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,916.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.17
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cofinity Commercial |
$1,839.12
|
| Rate for Payer: Cofinity Commercial |
$1,711.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.17
|
| Rate for Payer: Mclaren Medicaid |
$845.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.03
|
| Rate for Payer: Meridian Medicaid |
$887.44
|
| Rate for Payer: Nomi Health Commercial |
$1,532.60
|
| Rate for Payer: PACE SWMI |
$1,277.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$845.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,351.77
|
| Rate for Payer: Priority Health Medicare |
$1,289.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,351.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,277.17
|
| Rate for Payer: UHC Exchange |
$1,277.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,277.17
|
| Rate for Payer: UHCCP Medicaid |
$845.18
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$700.56 |
| Max. Negotiated Rate |
$1,951.45 |
| Rate for Payer: Aetna Commercial |
$1,420.12
|
| Rate for Payer: Aetna Medicare |
$1,102.18
|
| Rate for Payer: BCBS Complete |
$735.59
|
| Rate for Payer: BCBS MAPPO |
$1,059.79
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,059.79
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,526.10
|
| Rate for Payer: Cofinity Commercial |
$1,420.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,059.79
|
| Rate for Payer: Mclaren Medicaid |
$700.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,112.78
|
| Rate for Payer: Meridian Medicaid |
$735.59
|
| Rate for Payer: Nomi Health Commercial |
$1,271.75
|
| Rate for Payer: PACE SWMI |
$1,059.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,059.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$700.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.45
|
| Rate for Payer: Priority Health Medicare |
$1,070.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,951.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,059.79
|
| Rate for Payer: UHC Exchange |
$1,059.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.79
|
| Rate for Payer: UHCCP Medicaid |
$700.56
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$2,534.40 |
| Rate for Payer: Aetna Commercial |
$2,393.60
|
| Rate for Payer: Aetna Medicare |
$732.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$880.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$880.00
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCBS MAPPO |
$704.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,315.03
|
| Rate for Payer: BCN Commercial |
$2,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$704.00
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$2,421.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.00
|
| Rate for Payer: Healthscope Commercial |
$2,534.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,112.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$809.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: Nomi Health Commercial |
$2,309.12
|
| Rate for Payer: PACE Senior Care Partners |
$668.80
|
| Rate for Payer: PACE SWMI |
$704.00
|
| Rate for Payer: PHP Commercial |
$2,393.60
|
| Rate for Payer: PHP Medicare Advantage |
$704.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,449.92
|
| Rate for Payer: Priority Health Medicare |
$711.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,886.72
|
| Rate for Payer: Railroad Medicare Medicare |
$704.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,478.08
|
| Rate for Payer: UHC Core |
$2,351.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.00
|
| Rate for Payer: UHC Exchange |
$704.00
|
| Rate for Payer: UHC Medicare Advantage |
$704.00
|
| Rate for Payer: VA VA |
$704.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,112.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,830.40 |
| Max. Negotiated Rate |
$2,534.40 |
| Rate for Payer: Aetna Commercial |
$2,393.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,298.70
|
| Rate for Payer: BCN Commercial |
$2,176.20
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$2,421.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Healthscope Commercial |
$2,534.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,112.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: Nomi Health Commercial |
$2,309.12
|
| Rate for Payer: PHP Commercial |
$2,393.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,449.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,886.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,478.08
|
| Rate for Payer: UHC Core |
$2,351.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,112.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$700.56 |
| Max. Negotiated Rate |
$1,951.45 |
| Rate for Payer: Aetna Commercial |
$1,420.12
|
| Rate for Payer: Aetna Medicare |
$1,102.18
|
| Rate for Payer: BCBS Complete |
$735.59
|
| Rate for Payer: BCBS MAPPO |
$1,059.79
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,059.79
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,526.10
|
| Rate for Payer: Cofinity Commercial |
$1,420.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,059.79
|
| Rate for Payer: Mclaren Medicaid |
$700.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,112.78
|
| Rate for Payer: Meridian Medicaid |
$735.59
|
| Rate for Payer: Nomi Health Commercial |
$1,271.75
|
| Rate for Payer: PACE SWMI |
$1,059.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,059.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$700.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.45
|
| Rate for Payer: Priority Health Medicare |
$1,070.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,951.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,059.79
|
| Rate for Payer: UHC Exchange |
$1,059.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.79
|
| Rate for Payer: UHCCP Medicaid |
$700.56
|
|
