|
PR LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR
|
Professional
|
Both
|
$5,916.00
|
|
|
Service Code
|
HCPCS 63200
|
| Min. Negotiated Rate |
$1,534.62 |
| Max. Negotiated Rate |
$3,845.40 |
| Rate for Payer: Aetna Commercial |
$2,056.39
|
| Rate for Payer: Aetna Medicare |
$1,596.00
|
| Rate for Payer: BCBS Complete |
$2,366.40
|
| Rate for Payer: BCBS MAPPO |
$1,534.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,534.62
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cofinity Commercial |
$2,209.85
|
| Rate for Payer: Cofinity Commercial |
$2,056.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,534.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,611.35
|
| Rate for Payer: Nomi Health Commercial |
$1,841.54
|
| Rate for Payer: PACE SWMI |
$1,534.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,534.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,845.40
|
| Rate for Payer: Priority Health Medicare |
$1,549.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,534.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,534.62
|
| Rate for Payer: UHC Exchange |
$1,534.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,534.62
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR
|
Professional
|
Both
|
$5,033.00
|
|
|
Service Code
|
HCPCS 63005
|
| Min. Negotiated Rate |
$1,187.70 |
| Max. Negotiated Rate |
$3,271.45 |
| Rate for Payer: Aetna Commercial |
$1,591.52
|
| Rate for Payer: Aetna Medicare |
$1,235.21
|
| Rate for Payer: BCBS Complete |
$2,013.20
|
| Rate for Payer: BCBS MAPPO |
$1,187.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,187.70
|
| Rate for Payer: Cash Price |
$4,026.40
|
| Rate for Payer: Cash Price |
$4,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,710.29
|
| Rate for Payer: Cofinity Commercial |
$1,591.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.09
|
| Rate for Payer: Nomi Health Commercial |
$1,425.24
|
| Rate for Payer: PACE SWMI |
$1,187.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,187.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,271.45
|
| Rate for Payer: Priority Health Medicare |
$1,199.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,187.70
|
| Rate for Payer: UHC Exchange |
$1,187.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,187.70
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL
|
Professional
|
Both
|
$2,241.00
|
|
|
Service Code
|
HCPCS 63011
|
| Min. Negotiated Rate |
$896.40 |
| Max. Negotiated Rate |
$1,524.24 |
| Rate for Payer: Aetna Commercial |
$1,418.39
|
| Rate for Payer: Aetna Medicare |
$1,100.84
|
| Rate for Payer: BCBS Complete |
$896.40
|
| Rate for Payer: BCBS MAPPO |
$1,058.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,058.50
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,524.24
|
| Rate for Payer: Cofinity Commercial |
$1,418.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,058.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,111.42
|
| Rate for Payer: Nomi Health Commercial |
$1,270.20
|
| Rate for Payer: PACE SWMI |
$1,058.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,058.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.65
|
| Rate for Payer: Priority Health Medicare |
$1,069.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,058.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,058.50
|
| Rate for Payer: UHC Exchange |
$1,058.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,058.50
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,183.00
|
|
|
Service Code
|
HCPCS 63003
|
| Min. Negotiated Rate |
$1,222.81 |
| Max. Negotiated Rate |
$4,018.95 |
| Rate for Payer: Aetna Commercial |
$1,638.57
|
| Rate for Payer: Aetna Medicare |
$1,271.72
|
| Rate for Payer: BCBS Complete |
$2,473.20
|
| Rate for Payer: BCBS MAPPO |
$1,222.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.81
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cofinity Commercial |
$1,760.85
|
| Rate for Payer: Cofinity Commercial |
$1,638.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.95
|
| Rate for Payer: Nomi Health Commercial |
$1,467.37
|
| Rate for Payer: PACE SWMI |
$1,222.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,018.95
|
| Rate for Payer: Priority Health Medicare |
$1,235.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,222.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.81
|
| Rate for Payer: UHC Exchange |
$1,222.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.81
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL
|
Professional
|
Both
|
$6,256.00
|
|
|
Service Code
|
HCPCS 63015
|
| Min. Negotiated Rate |
$1,465.69 |
| Max. Negotiated Rate |
$4,066.40 |
| Rate for Payer: Aetna Commercial |
$1,964.02
|
| Rate for Payer: Aetna Medicare |
$1,524.32
|
| Rate for Payer: BCBS Complete |
$2,502.40
|
| Rate for Payer: BCBS MAPPO |
$1,465.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,465.69
|
| Rate for Payer: Cash Price |
$5,004.80
|
| Rate for Payer: Cash Price |
$5,004.80
|
| Rate for Payer: Cofinity Commercial |
$2,110.59
|
| Rate for Payer: Cofinity Commercial |
$1,964.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,465.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,538.97
|
| Rate for Payer: Nomi Health Commercial |
$1,758.83
|
| Rate for Payer: PACE SWMI |
$1,465.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,465.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,066.40
|
| Rate for Payer: Priority Health Medicare |
$1,480.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,465.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,465.69
|
| Rate for Payer: UHC Exchange |
$1,465.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,465.69
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR
|
Professional
|
Both
|
$6,258.00
|
|
|
Service Code
|
HCPCS 63017
|
| Min. Negotiated Rate |
$1,250.72 |
| Max. Negotiated Rate |
$4,067.70 |
| Rate for Payer: Aetna Commercial |
$1,675.96
|
| Rate for Payer: Aetna Medicare |
$1,300.75
|
| Rate for Payer: BCBS Complete |
$2,503.20
|
| Rate for Payer: BCBS MAPPO |
$1,250.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,250.72
|
| Rate for Payer: Cash Price |
$5,006.40
|
| Rate for Payer: Cash Price |
$5,006.40
|
| Rate for Payer: Cofinity Commercial |
$1,801.04
|
| Rate for Payer: Cofinity Commercial |
$1,675.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,250.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,313.26
|
| Rate for Payer: Nomi Health Commercial |
$1,500.86
|
| Rate for Payer: PACE SWMI |
$1,250.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,250.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,067.70
|
| Rate for Payer: Priority Health Medicare |
$1,263.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,250.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,250.72
|
| Rate for Payer: UHC Exchange |
$1,250.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,250.72
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,773.00
|
|
|
Service Code
|
HCPCS 63016
|
| Min. Negotiated Rate |
$1,504.32 |
| Max. Negotiated Rate |
$4,402.45 |
| Rate for Payer: Aetna Commercial |
$2,015.79
|
| Rate for Payer: Aetna Medicare |
$1,564.49
|
| Rate for Payer: BCBS Complete |
$2,709.20
|
| Rate for Payer: BCBS MAPPO |
$1,504.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,504.32
|
| Rate for Payer: Cash Price |
$5,418.40
|
| Rate for Payer: Cash Price |
$5,418.40
|
| Rate for Payer: Cofinity Commercial |
$2,166.22
|
| Rate for Payer: Cofinity Commercial |
$2,015.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,504.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,579.54
|
| Rate for Payer: Nomi Health Commercial |
$1,805.18
|
| Rate for Payer: PACE SWMI |
$1,504.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,504.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,402.45
|
| Rate for Payer: Priority Health Medicare |
$1,519.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,504.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,504.32
|
| Rate for Payer: UHC Exchange |
$1,504.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,504.32
|
|
|
PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS
|
Professional
|
Both
|
$5,784.00
|
|
|
Service Code
|
HCPCS 63185
|
| Min. Negotiated Rate |
$1,221.17 |
| Max. Negotiated Rate |
$3,759.60 |
| Rate for Payer: Aetna Commercial |
$1,636.37
|
| Rate for Payer: Aetna Medicare |
$1,270.02
|
| Rate for Payer: BCBS Complete |
$2,313.60
|
| Rate for Payer: BCBS MAPPO |
$1,221.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,221.17
|
| Rate for Payer: Cash Price |
$4,627.20
|
| Rate for Payer: Cash Price |
$4,627.20
|
| Rate for Payer: Cofinity Commercial |
$1,758.48
|
| Rate for Payer: Cofinity Commercial |
$1,636.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,221.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,282.23
|
| Rate for Payer: Nomi Health Commercial |
$1,465.40
|
| Rate for Payer: PACE SWMI |
$1,221.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,221.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,759.60
|
| Rate for Payer: Priority Health Medicare |
$1,233.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,221.17
|
| Rate for Payer: UHC Exchange |
$1,221.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,221.17
|
|
|
PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR
|
Professional
|
Both
|
$6,155.00
|
|
|
Service Code
|
HCPCS 63012
|
| Min. Negotiated Rate |
$1,172.26 |
| Max. Negotiated Rate |
$4,000.75 |
| Rate for Payer: Aetna Commercial |
$1,570.83
|
| Rate for Payer: Aetna Medicare |
$1,219.15
|
| Rate for Payer: BCBS Complete |
$2,462.00
|
| Rate for Payer: BCBS MAPPO |
$1,172.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,172.26
|
| Rate for Payer: Cash Price |
$4,924.00
|
| Rate for Payer: Cash Price |
$4,924.00
|
| Rate for Payer: Cofinity Commercial |
$1,688.05
|
| Rate for Payer: Cofinity Commercial |
$1,570.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,172.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.87
|
| Rate for Payer: Nomi Health Commercial |
$1,406.71
|
| Rate for Payer: PACE SWMI |
$1,172.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,172.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,000.75
|
| Rate for Payer: Priority Health Medicare |
$1,183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,172.26
|
| Rate for Payer: UHC Exchange |
$1,172.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.26
|
|
|
PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 63191
|
| Min. Negotiated Rate |
$892.80 |
| Max. Negotiated Rate |
$1,977.35 |
| Rate for Payer: Aetna Commercial |
$1,840.03
|
| Rate for Payer: Aetna Medicare |
$1,428.09
|
| Rate for Payer: BCBS Complete |
$892.80
|
| Rate for Payer: BCBS MAPPO |
$1,373.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,373.16
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cofinity Commercial |
$1,977.35
|
| Rate for Payer: Cofinity Commercial |
$1,840.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,373.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,441.82
|
| Rate for Payer: Nomi Health Commercial |
$1,647.79
|
| Rate for Payer: PACE SWMI |
$1,373.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,373.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health Medicare |
$1,386.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,373.16
|
| Rate for Payer: UHC Exchange |
$1,373.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,373.16
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC
|
Professional
|
Both
|
$5,746.00
|
|
|
Service Code
|
HCPCS 63020
|
| Min. Negotiated Rate |
$1,078.77 |
| Max. Negotiated Rate |
$3,734.90 |
| Rate for Payer: Aetna Commercial |
$1,445.55
|
| Rate for Payer: Aetna Medicare |
$1,121.92
|
| Rate for Payer: BCBS Complete |
$2,298.40
|
| Rate for Payer: BCBS MAPPO |
$1,078.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,078.77
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Cofinity Commercial |
$1,553.43
|
| Rate for Payer: Cofinity Commercial |
$1,445.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,078.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,132.71
|
| Rate for Payer: Nomi Health Commercial |
$1,294.52
|
| Rate for Payer: PACE SWMI |
$1,078.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,078.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,734.90
|
| Rate for Payer: Priority Health Medicare |
$1,089.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,078.77
|
| Rate for Payer: UHC Exchange |
$1,078.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,078.77
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR
|
Professional
|
Both
|
$5,564.00
|
|
|
Service Code
|
HCPCS 63030
|
| Min. Negotiated Rate |
$894.04 |
| Max. Negotiated Rate |
$3,616.60 |
| Rate for Payer: Aetna Commercial |
$1,198.01
|
| Rate for Payer: Aetna Medicare |
$929.80
|
| Rate for Payer: BCBS Complete |
$2,225.60
|
| Rate for Payer: BCBS MAPPO |
$894.04
|
| Rate for Payer: BCN Medicare Advantage |
$894.04
|
| Rate for Payer: Cash Price |
$4,451.20
|
| Rate for Payer: Cash Price |
$4,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,287.42
|
| Rate for Payer: Cofinity Commercial |
$1,198.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$938.74
|
| Rate for Payer: Nomi Health Commercial |
$1,072.85
|
| Rate for Payer: PACE SWMI |
$894.04
|
| Rate for Payer: PHP Medicare Advantage |
$894.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,616.60
|
| Rate for Payer: Priority Health Medicare |
$902.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.04
|
| Rate for Payer: UHC Exchange |
$894.04
|
| Rate for Payer: UHC Medicare Advantage |
$894.04
|
|
|
PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63035
|
| Min. Negotiated Rate |
$226.71 |
| Max. Negotiated Rate |
$1,182.35 |
| Rate for Payer: Aetna Commercial |
$303.79
|
| Rate for Payer: Aetna Medicare |
$235.78
|
| Rate for Payer: BCBS Complete |
$727.60
|
| Rate for Payer: BCBS MAPPO |
$226.71
|
| Rate for Payer: BCN Medicare Advantage |
$226.71
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$303.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.05
|
| Rate for Payer: Nomi Health Commercial |
$272.05
|
| Rate for Payer: PACE SWMI |
$226.71
|
| Rate for Payer: PHP Medicare Advantage |
$226.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health Medicare |
$228.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.71
|
| Rate for Payer: UHC Exchange |
$226.71
|
| Rate for Payer: UHC Medicare Advantage |
$226.71
|
|
|
PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ
|
Professional
|
Both
|
$8,543.00
|
|
|
Service Code
|
HCPCS 63051
|
| Min. Negotiated Rate |
$1,651.42 |
| Max. Negotiated Rate |
$5,552.95 |
| Rate for Payer: Aetna Commercial |
$2,212.90
|
| Rate for Payer: Aetna Medicare |
$1,717.48
|
| Rate for Payer: BCBS Complete |
$3,417.20
|
| Rate for Payer: BCBS MAPPO |
$1,651.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,651.42
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Cofinity Commercial |
$2,378.04
|
| Rate for Payer: Cofinity Commercial |
$2,212.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,651.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,733.99
|
| Rate for Payer: Nomi Health Commercial |
$1,981.70
|
| Rate for Payer: PACE SWMI |
$1,651.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,651.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,552.95
|
| Rate for Payer: Priority Health Medicare |
$1,667.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,651.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,651.42
|
| Rate for Payer: UHC Exchange |
$1,651.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,651.42
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$6,673.00
|
|
|
Service Code
|
HCPCS 63040
|
| Min. Negotiated Rate |
$1,346.20 |
| Max. Negotiated Rate |
$4,337.45 |
| Rate for Payer: Aetna Commercial |
$1,803.91
|
| Rate for Payer: Aetna Medicare |
$1,400.05
|
| Rate for Payer: BCBS Complete |
$2,669.20
|
| Rate for Payer: BCBS MAPPO |
$1,346.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,346.20
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,938.53
|
| Rate for Payer: Cofinity Commercial |
$1,803.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,346.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,413.51
|
| Rate for Payer: Nomi Health Commercial |
$1,615.44
|
| Rate for Payer: PACE SWMI |
$1,346.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,346.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,337.45
|
| Rate for Payer: Priority Health Medicare |
$1,359.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,346.20
|
| Rate for Payer: UHC Exchange |
$1,346.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,346.20
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV
|
Professional
|
Both
|
$2,182.00
|
|
|
Service Code
|
HCPCS 63043
|
| Min. Negotiated Rate |
$872.80 |
| Max. Negotiated Rate |
$1,418.30 |
| Rate for Payer: Aetna Medicare |
$1,091.00
|
| Rate for Payer: BCBS Complete |
$872.80
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.30
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 63042
|
| Min. Negotiated Rate |
$1,077.20 |
| Max. Negotiated Rate |
$1,819.07 |
| Rate for Payer: Aetna Commercial |
$1,692.74
|
| Rate for Payer: Aetna Medicare |
$1,313.77
|
| Rate for Payer: BCBS Complete |
$1,077.20
|
| Rate for Payer: BCBS MAPPO |
$1,263.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,263.24
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cofinity Commercial |
$1,819.07
|
| Rate for Payer: Cofinity Commercial |
$1,692.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,263.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,326.40
|
| Rate for Payer: Nomi Health Commercial |
$1,515.89
|
| Rate for Payer: PACE SWMI |
$1,263.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,263.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health Medicare |
$1,275.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,263.24
|
| Rate for Payer: UHC Exchange |
$1,263.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,263.24
|
|
|
PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 63044
|
| Min. Negotiated Rate |
$850.00 |
| Max. Negotiated Rate |
$1,381.25 |
| Rate for Payer: Aetna Medicare |
$1,062.50
|
| Rate for Payer: BCBS Complete |
$850.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,381.25
|
|
|
PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID
|
Professional
|
Both
|
$6,322.00
|
|
|
Service Code
|
HCPCS 63172
|
| Min. Negotiated Rate |
$1,405.86 |
| Max. Negotiated Rate |
$4,109.30 |
| Rate for Payer: Aetna Commercial |
$1,883.85
|
| Rate for Payer: Aetna Medicare |
$1,462.09
|
| Rate for Payer: BCBS Complete |
$2,528.80
|
| Rate for Payer: BCBS MAPPO |
$1,405.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,405.86
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Cofinity Commercial |
$2,024.44
|
| Rate for Payer: Cofinity Commercial |
$1,883.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,405.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,476.15
|
| Rate for Payer: Nomi Health Commercial |
$1,687.03
|
| Rate for Payer: PACE SWMI |
$1,405.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,405.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,109.30
|
| Rate for Payer: Priority Health Medicare |
$1,419.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,405.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,405.86
|
| Rate for Payer: UHC Exchange |
$1,405.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,405.86
|
|
|
PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL
|
Professional
|
Both
|
$6,858.00
|
|
|
Service Code
|
HCPCS 63173
|
| Min. Negotiated Rate |
$1,714.37 |
| Max. Negotiated Rate |
$4,457.70 |
| Rate for Payer: Aetna Commercial |
$2,297.26
|
| Rate for Payer: Aetna Medicare |
$1,782.94
|
| Rate for Payer: BCBS Complete |
$2,743.20
|
| Rate for Payer: BCBS MAPPO |
$1,714.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,714.37
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Cofinity Commercial |
$2,297.26
|
| Rate for Payer: Cofinity Commercial |
$2,468.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,714.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,800.09
|
| Rate for Payer: Nomi Health Commercial |
$2,057.24
|
| Rate for Payer: PACE SWMI |
$1,714.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,714.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,457.70
|
| Rate for Payer: Priority Health Medicare |
$1,731.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,714.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,714.37
|
| Rate for Payer: UHC Exchange |
$1,714.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,714.37
|
|
|
PR LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV
|
Professional
|
Both
|
$5,092.00
|
|
|
Service Code
|
HCPCS 63001
|
| Min. Negotiated Rate |
$1,217.59 |
| Max. Negotiated Rate |
$3,309.80 |
| Rate for Payer: Aetna Commercial |
$1,631.57
|
| Rate for Payer: Aetna Medicare |
$1,266.29
|
| Rate for Payer: BCBS Complete |
$2,036.80
|
| Rate for Payer: BCBS MAPPO |
$1,217.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,217.59
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,753.33
|
| Rate for Payer: Cofinity Commercial |
$1,631.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,217.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,278.47
|
| Rate for Payer: Nomi Health Commercial |
$1,461.11
|
| Rate for Payer: PACE SWMI |
$1,217.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,217.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,309.80
|
| Rate for Payer: Priority Health Medicare |
$1,229.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,217.59
|
| Rate for Payer: UHC Exchange |
$1,217.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,217.59
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$585.75 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$784.90
|
| Rate for Payer: Aetna Medicare |
$609.18
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$585.75
|
| Rate for Payer: BCN Medicare Advantage |
$585.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$843.48
|
| Rate for Payer: Cofinity Commercial |
$784.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.04
|
| Rate for Payer: Nomi Health Commercial |
$702.90
|
| Rate for Payer: PACE SWMI |
$585.75
|
| Rate for Payer: PHP Medicare Advantage |
$585.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$591.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.75
|
| Rate for Payer: UHC Exchange |
$585.75
|
| Rate for Payer: UHC Medicare Advantage |
$585.75
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$478.56 |
| Max. Negotiated Rate |
$4,429.45 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$523.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$629.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$629.69
|
| Rate for Payer: BCBS Complete |
$4,429.45
|
| Rate for Payer: BCBS MAPPO |
$503.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.53
|
| Rate for Payer: BCN Commercial |
$1,566.66
|
| Rate for Payer: BCN Medicare Advantage |
$503.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.75
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Mclaren Medicaid |
$4,218.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.94
|
| Rate for Payer: Meridian Medicaid |
$4,429.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$579.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PACE Senior Care Partners |
$478.56
|
| Rate for Payer: PACE SWMI |
$503.75
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$503.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,218.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,753.05
|
| Rate for Payer: Priority Health Medicare |
$508.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,350.05
|
| Rate for Payer: Railroad Medicare Medicare |
$503.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,773.20
|
| Rate for Payer: UHC Core |
$1,682.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.75
|
| Rate for Payer: UHC Exchange |
$503.75
|
| Rate for Payer: UHC Medicare Advantage |
$503.75
|
| Rate for Payer: UHCCP Medicaid |
$4,218.24
|
| Rate for Payer: VA VA |
$503.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$1,813.50 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.84
|
| Rate for Payer: BCN Commercial |
$1,557.19
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,753.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,350.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,773.20
|
| Rate for Payer: UHC Core |
$1,682.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$585.75 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$784.90
|
| Rate for Payer: Aetna Medicare |
$609.18
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$585.75
|
| Rate for Payer: BCN Medicare Advantage |
$585.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$843.48
|
| Rate for Payer: Cofinity Commercial |
$784.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.04
|
| Rate for Payer: Nomi Health Commercial |
$702.90
|
| Rate for Payer: PACE SWMI |
$585.75
|
| Rate for Payer: PHP Medicare Advantage |
$585.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$591.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.75
|
| Rate for Payer: UHC Exchange |
$585.75
|
| Rate for Payer: UHC Medicare Advantage |
$585.75
|
|
