|
PR LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR
|
Professional
|
Both
|
$6,446.00
|
|
|
Service Code
|
HCPCS 63017
|
| Min. Negotiated Rate |
$794.06 |
| Max. Negotiated Rate |
$4,834.50 |
| Rate for Payer: Aetna Commercial |
$1,628.24
|
| Rate for Payer: Aetna Medicare |
$3,223.00
|
| Rate for Payer: BCBS Complete |
$833.76
|
| Rate for Payer: BCN Commercial |
$2,126.45
|
| Rate for Payer: Cash Price |
$5,156.80
|
| Rate for Payer: Cash Price |
$5,156.80
|
| Rate for Payer: Mclaren Medicaid |
$794.06
|
| Rate for Payer: Meridian Medicaid |
$833.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,834.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,248.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,248.23
|
| Rate for Payer: UHC Medicaid |
$794.06
|
| Rate for Payer: UHCCP Medicaid |
$794.06
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,976.00
|
|
|
Service Code
|
HCPCS 63016
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$5,232.00 |
| Rate for Payer: Aetna Commercial |
$1,969.01
|
| Rate for Payer: Aetna Medicare |
$3,488.00
|
| Rate for Payer: BCBS Complete |
$979.81
|
| Rate for Payer: BCN Commercial |
$2,550.44
|
| Rate for Payer: Cash Price |
$5,580.80
|
| Rate for Payer: Cash Price |
$5,580.80
|
| Rate for Payer: Mclaren Medicaid |
$933.15
|
| Rate for Payer: Meridian Medicaid |
$979.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,232.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,696.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,696.47
|
| Rate for Payer: UHC Medicaid |
$933.15
|
| Rate for Payer: UHCCP Medicaid |
$933.15
|
|
|
PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS
|
Professional
|
Both
|
$5,958.00
|
|
|
Service Code
|
HCPCS 63185
|
| Min. Negotiated Rate |
$788.53 |
| Max. Negotiated Rate |
$4,468.50 |
| Rate for Payer: Aetna Commercial |
$1,466.36
|
| Rate for Payer: Aetna Medicare |
$2,979.00
|
| Rate for Payer: BCBS Complete |
$827.96
|
| Rate for Payer: BCN Commercial |
$1,886.35
|
| Rate for Payer: Cash Price |
$4,766.40
|
| Rate for Payer: Cash Price |
$4,766.40
|
| Rate for Payer: Mclaren Medicaid |
$788.53
|
| Rate for Payer: Meridian Medicaid |
$827.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,468.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,190.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,190.97
|
| Rate for Payer: UHC Medicaid |
$788.53
|
| Rate for Payer: UHCCP Medicaid |
$788.53
|
|
|
PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR
|
Professional
|
Both
|
$6,340.00
|
|
|
Service Code
|
HCPCS 63012
|
| Min. Negotiated Rate |
$733.15 |
| Max. Negotiated Rate |
$4,755.00 |
| Rate for Payer: Aetna Commercial |
$1,539.11
|
| Rate for Payer: Aetna Medicare |
$3,170.00
|
| Rate for Payer: BCBS Complete |
$769.81
|
| Rate for Payer: BCN Commercial |
$1,997.35
|
| Rate for Payer: Cash Price |
$5,072.00
|
| Rate for Payer: Cash Price |
$5,072.00
|
| Rate for Payer: Mclaren Medicaid |
$733.15
|
| Rate for Payer: Meridian Medicaid |
$769.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,755.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,111.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,111.72
|
| Rate for Payer: UHC Medicaid |
$733.15
|
| Rate for Payer: UHCCP Medicaid |
$733.15
|
|
|
PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 63191
|
| Min. Negotiated Rate |
$877.99 |
| Max. Negotiated Rate |
$2,458.76 |
| Rate for Payer: Aetna Commercial |
$1,782.81
|
| Rate for Payer: Aetna Medicare |
$1,149.50
|
| Rate for Payer: BCBS Complete |
$921.89
|
| Rate for Payer: BCN Commercial |
$2,116.91
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Mclaren Medicaid |
$877.99
|
| Rate for Payer: Meridian Medicaid |
$921.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,458.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,458.76
|
| Rate for Payer: UHC Medicaid |
$877.99
|
| Rate for Payer: UHCCP Medicaid |
$877.99
|
|
|
PR LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$5,918.00
|
|
|
Service Code
|
HCPCS 63020
|
| Min. Negotiated Rate |
$678.62 |
| Max. Negotiated Rate |
$4,438.50 |
| Rate for Payer: Aetna Commercial |
$1,495.35
|
| Rate for Payer: Aetna Medicare |
$2,959.00
|
| Rate for Payer: BCBS Complete |
$712.55
|
| Rate for Payer: BCN Commercial |
$1,845.81
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Mclaren Medicaid |
$678.62
|
| Rate for Payer: Meridian Medicaid |
$712.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,438.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,951.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,951.50
|
| Rate for Payer: UHC Medicaid |
$678.62
|
| Rate for Payer: UHCCP Medicaid |
$678.62
|
|
|
PR LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$5,731.00
|
|
|
Service Code
|
HCPCS 63030
|
| Min. Negotiated Rate |
$572.76 |
| Max. Negotiated Rate |
$4,298.25 |
| Rate for Payer: Aetna Commercial |
$1,255.97
|
| Rate for Payer: Aetna Medicare |
$2,865.50
|
| Rate for Payer: BCBS Complete |
$601.40
|
| Rate for Payer: BCN Commercial |
$1,146.75
|
| Rate for Payer: Cash Price |
$4,584.80
|
| Rate for Payer: Cash Price |
$4,584.80
|
| Rate for Payer: Mclaren Medicaid |
$572.76
|
| Rate for Payer: Meridian Medicaid |
$601.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,298.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,622.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.97
|
| Rate for Payer: UHC Medicaid |
$572.76
|
| Rate for Payer: UHCCP Medicaid |
$572.76
|
|
|
PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ
|
Professional
|
Both
|
$8,799.00
|
|
|
Service Code
|
HCPCS 63051
|
| Min. Negotiated Rate |
$1,004.30 |
| Max. Negotiated Rate |
$6,599.25 |
| Rate for Payer: Aetna Commercial |
$2,195.15
|
| Rate for Payer: Aetna Medicare |
$4,399.50
|
| Rate for Payer: BCBS Complete |
$1,054.52
|
| Rate for Payer: BCN Commercial |
$2,560.12
|
| Rate for Payer: Cash Price |
$7,039.20
|
| Rate for Payer: Cash Price |
$7,039.20
|
| Rate for Payer: Mclaren Medicaid |
$1,004.30
|
| Rate for Payer: Meridian Medicaid |
$1,054.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,599.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,004.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,973.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,973.53
|
| Rate for Payer: UHC Medicaid |
$1,004.30
|
| Rate for Payer: UHCCP Medicaid |
$1,004.30
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$6,873.00
|
|
|
Service Code
|
HCPCS 63040
|
| Min. Negotiated Rate |
$821.33 |
| Max. Negotiated Rate |
$5,154.75 |
| Rate for Payer: Aetna Commercial |
$1,795.55
|
| Rate for Payer: Aetna Medicare |
$3,436.50
|
| Rate for Payer: BCBS Complete |
$862.40
|
| Rate for Payer: BCN Commercial |
$2,295.50
|
| Rate for Payer: Cash Price |
$5,498.40
|
| Rate for Payer: Cash Price |
$5,498.40
|
| Rate for Payer: Mclaren Medicaid |
$821.33
|
| Rate for Payer: Meridian Medicaid |
$862.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,154.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,426.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,426.95
|
| Rate for Payer: UHC Medicaid |
$821.33
|
| Rate for Payer: UHCCP Medicaid |
$821.33
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV
|
Professional
|
Both
|
$2,247.00
|
|
|
Service Code
|
HCPCS 63043
|
| Min. Negotiated Rate |
$191.17 |
| Max. Negotiated Rate |
$1,685.25 |
| Rate for Payer: Aetna Commercial |
$780.02
|
| Rate for Payer: Aetna Medicare |
$1,123.50
|
| Rate for Payer: BCBS Complete |
$200.73
|
| Rate for Payer: BCN Commercial |
$378.69
|
| Rate for Payer: Cash Price |
$1,797.60
|
| Rate for Payer: Cash Price |
$1,797.60
|
| Rate for Payer: Mclaren Medicaid |
$191.17
|
| Rate for Payer: Meridian Medicaid |
$200.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,685.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,059.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.62
|
| Rate for Payer: UHC Medicaid |
$191.17
|
| Rate for Payer: UHCCP Medicaid |
$191.17
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 63042
|
| Min. Negotiated Rate |
$777.88 |
| Max. Negotiated Rate |
$2,282.34 |
| Rate for Payer: Aetna Commercial |
$1,671.08
|
| Rate for Payer: Aetna Medicare |
$1,387.00
|
| Rate for Payer: BCBS Complete |
$816.77
|
| Rate for Payer: BCN Commercial |
$2,158.73
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Mclaren Medicaid |
$777.88
|
| Rate for Payer: Meridian Medicaid |
$816.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,080.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,282.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,282.34
|
| Rate for Payer: UHC Medicaid |
$777.88
|
| Rate for Payer: UHCCP Medicaid |
$777.88
|
|
|
PR LAMOT W/DCMPRN NRV RT EA ADDL NTRSPC CRV/LMBR
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 63035
|
| Min. Negotiated Rate |
$131.63 |
| Max. Negotiated Rate |
$1,405.50 |
| Rate for Payer: Aetna Commercial |
$248.65
|
| Rate for Payer: Aetna Medicare |
$937.00
|
| Rate for Payer: BCBS Complete |
$138.21
|
| Rate for Payer: BCN Commercial |
$381.85
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Mclaren Medicaid |
$131.63
|
| Rate for Payer: Meridian Medicaid |
$138.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$403.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.72
|
| Rate for Payer: UHC Medicaid |
$131.63
|
| Rate for Payer: UHCCP Medicaid |
$131.63
|
|
|
PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR
|
Professional
|
Both
|
$2,189.00
|
|
|
Service Code
|
HCPCS 63044
|
| Min. Negotiated Rate |
$179.97 |
| Max. Negotiated Rate |
$1,641.75 |
| Rate for Payer: Aetna Commercial |
$741.31
|
| Rate for Payer: Aetna Medicare |
$1,094.50
|
| Rate for Payer: BCBS Complete |
$188.97
|
| Rate for Payer: BCN Commercial |
$378.69
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Mclaren Medicaid |
$179.97
|
| Rate for Payer: Meridian Medicaid |
$188.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,006.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,006.98
|
| Rate for Payer: UHC Medicaid |
$179.97
|
| Rate for Payer: UHCCP Medicaid |
$179.97
|
|
|
PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID
|
Professional
|
Both
|
$6,512.00
|
|
|
Service Code
|
HCPCS 63172
|
| Min. Negotiated Rate |
$892.04 |
| Max. Negotiated Rate |
$4,884.00 |
| Rate for Payer: Aetna Commercial |
$1,825.56
|
| Rate for Payer: Aetna Medicare |
$3,256.00
|
| Rate for Payer: BCBS Complete |
$936.64
|
| Rate for Payer: BCN Commercial |
$2,376.46
|
| Rate for Payer: Cash Price |
$5,209.60
|
| Rate for Payer: Cash Price |
$5,209.60
|
| Rate for Payer: Mclaren Medicaid |
$892.04
|
| Rate for Payer: Meridian Medicaid |
$936.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,884.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$892.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,512.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,512.55
|
| Rate for Payer: UHC Medicaid |
$892.04
|
| Rate for Payer: UHCCP Medicaid |
$892.04
|
|
|
PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL
|
Professional
|
Both
|
$7,064.00
|
|
|
Service Code
|
HCPCS 63173
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$5,298.00 |
| Rate for Payer: Aetna Commercial |
$2,229.76
|
| Rate for Payer: Aetna Medicare |
$3,532.00
|
| Rate for Payer: BCBS Complete |
$1,136.36
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: Cash Price |
$5,651.20
|
| Rate for Payer: Cash Price |
$5,651.20
|
| Rate for Payer: Mclaren Medicaid |
$1,082.25
|
| Rate for Payer: Meridian Medicaid |
$1,136.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,298.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,061.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,061.45
|
| Rate for Payer: UHC Medicaid |
$1,082.25
|
| Rate for Payer: UHCCP Medicaid |
$1,082.25
|
|
|
PR LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV
|
Professional
|
Both
|
$5,245.00
|
|
|
Service Code
|
HCPCS 63001
|
| Min. Negotiated Rate |
$761.26 |
| Max. Negotiated Rate |
$3,933.75 |
| Rate for Payer: Aetna Commercial |
$1,593.74
|
| Rate for Payer: Aetna Medicare |
$2,622.50
|
| Rate for Payer: BCBS Complete |
$799.32
|
| Rate for Payer: BCN Commercial |
$2,065.18
|
| Rate for Payer: Cash Price |
$4,196.00
|
| Rate for Payer: Cash Price |
$4,196.00
|
| Rate for Payer: Mclaren Medicaid |
$761.26
|
| Rate for Payer: Meridian Medicaid |
$799.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,933.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,183.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,183.44
|
| Rate for Payer: UHC Medicaid |
$761.26
|
| Rate for Payer: UHCCP Medicaid |
$761.26
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,075.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,556.25 |
| Rate for Payer: Aetna Commercial |
$811.51
|
| Rate for Payer: Aetna Medicare |
$1,037.50
|
| Rate for Payer: BCBS Complete |
$387.13
|
| Rate for Payer: BCN Commercial |
$910.81
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Mclaren Medicaid |
$368.70
|
| Rate for Payer: Meridian Medicaid |
$387.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,109.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.76
|
| Rate for Payer: UHC Medicaid |
$368.70
|
| Rate for Payer: UHCCP Medicaid |
$368.70
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
OP
|
$2,075.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$365.82 |
| Max. Negotiated Rate |
$1,867.50 |
| Rate for Payer: Aetna Commercial |
$1,763.75
|
| Rate for Payer: Aetna Medicare |
$539.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.44
|
| Rate for Payer: BCBS Complete |
$384.08
|
| Rate for Payer: BCBS MAPPO |
$518.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.86
|
| Rate for Payer: BCN Commercial |
$1,705.86
|
| Rate for Payer: BCN Medicare Advantage |
$518.75
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,784.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.75
|
| Rate for Payer: Healthscope Commercial |
$1,867.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.25
|
| Rate for Payer: Mclaren Medicaid |
$365.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.69
|
| Rate for Payer: Meridian Medicaid |
$384.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.75
|
| Rate for Payer: Nomi Health Commercial |
$1,701.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: PACE Senior Care Partners |
$492.81
|
| Rate for Payer: PACE SWMI |
$518.75
|
| Rate for Payer: PHP Commercial |
$1,763.75
|
| Rate for Payer: PHP Medicare Advantage |
$518.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,805.25
|
| Rate for Payer: Priority Health Medicare |
$523.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.20
|
| Rate for Payer: Railroad Medicare Medicare |
$518.75
|
| Rate for Payer: UHC Core |
$1,732.62
|
| Rate for Payer: UHC Exchange |
$518.75
|
| Rate for Payer: UHC Medicaid |
$365.82
|
| Rate for Payer: UHC Medicare Advantage |
$518.75
|
| Rate for Payer: UHCCP Medicaid |
$365.82
|
| Rate for Payer: VA VA |
$518.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,075.00
|
|
|
Service Code
|
HCPCS 44970
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,556.25 |
| Rate for Payer: Aetna Commercial |
$811.51
|
| Rate for Payer: Aetna Medicare |
$1,037.50
|
| Rate for Payer: BCBS Complete |
$387.13
|
| Rate for Payer: BCN Commercial |
$910.81
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Mclaren Medicaid |
$368.70
|
| Rate for Payer: Meridian Medicaid |
$387.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,109.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.76
|
| Rate for Payer: UHC Medicaid |
$368.70
|
| Rate for Payer: UHCCP Medicaid |
$368.70
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
IP
|
$2,075.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,444.20 |
| Max. Negotiated Rate |
$1,867.50 |
| Rate for Payer: Aetna Commercial |
$1,763.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,713.74
|
| Rate for Payer: BCN Commercial |
$1,713.74
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,784.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.00
|
| Rate for Payer: Healthscope Commercial |
$1,867.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.75
|
| Rate for Payer: Nomi Health Commercial |
$1,701.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: PHP Commercial |
$1,763.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,805.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.20
|
| Rate for Payer: UHC Core |
$1,732.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.25
|
|
|
PR LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$4,147.00
|
|
|
Service Code
|
HCPCS 38120
|
| Min. Negotiated Rate |
$636.87 |
| Max. Negotiated Rate |
$3,110.25 |
| Rate for Payer: Aetna Commercial |
$1,317.62
|
| Rate for Payer: Aetna Medicare |
$2,073.50
|
| Rate for Payer: BCBS Complete |
$668.71
|
| Rate for Payer: BCN Commercial |
$1,595.04
|
| Rate for Payer: Cash Price |
$3,317.60
|
| Rate for Payer: Cash Price |
$3,317.60
|
| Rate for Payer: Mclaren Medicaid |
$636.87
|
| Rate for Payer: Meridian Medicaid |
$668.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,110.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,122.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,122.32
|
| Rate for Payer: UHC Medicaid |
$636.87
|
| Rate for Payer: UHCCP Medicaid |
$636.87
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,281.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$703.97 |
| Max. Negotiated Rate |
$1,941.77 |
| Rate for Payer: Aetna Commercial |
$1,544.16
|
| Rate for Payer: Aetna Medicare |
$1,140.50
|
| Rate for Payer: BCBS Complete |
$739.17
|
| Rate for Payer: BCN Commercial |
$1,790.74
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Mclaren Medicaid |
$703.97
|
| Rate for Payer: Meridian Medicaid |
$739.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,710.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,941.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,941.77
|
| Rate for Payer: UHC Medicaid |
$703.97
|
| Rate for Payer: UHCCP Medicaid |
$703.97
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,735.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$901.20 |
| Max. Negotiated Rate |
$2,801.25 |
| Rate for Payer: Aetna Commercial |
$2,065.92
|
| Rate for Payer: Aetna Medicare |
$1,867.50
|
| Rate for Payer: BCBS Complete |
$946.26
|
| Rate for Payer: BCN Commercial |
$2,290.71
|
| Rate for Payer: Cash Price |
$2,988.00
|
| Rate for Payer: Cash Price |
$2,988.00
|
| Rate for Payer: Mclaren Medicaid |
$901.20
|
| Rate for Payer: Meridian Medicaid |
$946.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,801.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$901.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,791.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,791.09
|
| Rate for Payer: UHC Medicaid |
$901.20
|
| Rate for Payer: UHCCP Medicaid |
$901.20
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$1,564.50 |
| Rate for Payer: Aetna Commercial |
$1,163.50
|
| Rate for Payer: Aetna Medicare |
$1,043.00
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCN Commercial |
$1,456.60
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Mclaren Medicaid |
$548.48
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,475.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,475.22
|
| Rate for Payer: UHC Medicaid |
$548.48
|
| Rate for Payer: UHCCP Medicaid |
$548.48
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,666.92 |
| Max. Negotiated Rate |
$2,155.50 |
| Rate for Payer: Aetna Commercial |
$2,035.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,978.03
|
| Rate for Payer: BCN Commercial |
$1,978.03
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,059.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,155.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,796.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,796.25
|
| Rate for Payer: PHP Commercial |
$2,035.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,083.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,666.92
|
| Rate for Payer: UHC Core |
$1,999.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,796.25
|
|
