|
PR LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$4,026.00
|
|
|
Service Code
|
HCPCS 38120
|
| Min. Negotiated Rate |
$1,028.92 |
| Max. Negotiated Rate |
$2,616.90 |
| Rate for Payer: Aetna Commercial |
$1,378.75
|
| Rate for Payer: Aetna Medicare |
$1,070.08
|
| Rate for Payer: BCBS Complete |
$1,610.40
|
| Rate for Payer: BCBS MAPPO |
$1,028.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,028.92
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,481.64
|
| Rate for Payer: Cofinity Commercial |
$1,378.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,028.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.37
|
| Rate for Payer: Nomi Health Commercial |
$1,234.70
|
| Rate for Payer: PACE SWMI |
$1,028.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,028.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,616.90
|
| Rate for Payer: Priority Health Medicare |
$1,039.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,028.92
|
| Rate for Payer: UHC Exchange |
$1,028.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,028.92
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$886.00 |
| Max. Negotiated Rate |
$1,666.40 |
| Rate for Payer: Aetna Commercial |
$1,550.67
|
| Rate for Payer: Aetna Medicare |
$1,203.51
|
| Rate for Payer: BCBS Complete |
$886.00
|
| Rate for Payer: BCBS MAPPO |
$1,157.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,157.22
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,666.40
|
| Rate for Payer: Cofinity Commercial |
$1,550.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,157.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,215.08
|
| Rate for Payer: Nomi Health Commercial |
$1,388.66
|
| Rate for Payer: PACE SWMI |
$1,157.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,157.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health Medicare |
$1,168.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,157.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,157.22
|
| Rate for Payer: UHC Exchange |
$1,157.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,157.22
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,626.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$1,450.40 |
| Max. Negotiated Rate |
$2,356.90 |
| Rate for Payer: Aetna Commercial |
$1,982.46
|
| Rate for Payer: Aetna Medicare |
$1,538.63
|
| Rate for Payer: BCBS Complete |
$1,450.40
|
| Rate for Payer: BCBS MAPPO |
$1,479.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.45
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Cofinity Commercial |
$2,130.41
|
| Rate for Payer: Cofinity Commercial |
$1,982.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.42
|
| Rate for Payer: Nomi Health Commercial |
$1,775.34
|
| Rate for Payer: PACE SWMI |
$1,479.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,356.90
|
| Rate for Payer: Priority Health Medicare |
$1,494.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,479.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,479.45
|
| Rate for Payer: UHC Exchange |
$1,479.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.45
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$810.00 |
| Max. Negotiated Rate |
$1,344.00 |
| Rate for Payer: Aetna Commercial |
$1,250.66
|
| Rate for Payer: Aetna Medicare |
$970.66
|
| Rate for Payer: BCBS Complete |
$810.00
|
| Rate for Payer: BCBS MAPPO |
$933.33
|
| Rate for Payer: BCN Medicare Advantage |
$933.33
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$1,250.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.00
|
| Rate for Payer: Nomi Health Commercial |
$1,120.00
|
| Rate for Payer: PACE SWMI |
$933.33
|
| Rate for Payer: PHP Medicare Advantage |
$933.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health Medicare |
$942.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$933.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.33
|
| Rate for Payer: UHC Exchange |
$933.33
|
| Rate for Payer: UHC Medicare Advantage |
$933.33
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 44180
|
| Min. Negotiated Rate |
$894.60 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,198.76
|
| Rate for Payer: Aetna Medicare |
$930.38
|
| Rate for Payer: BCBS Complete |
$930.00
|
| Rate for Payer: BCBS MAPPO |
$894.60
|
| Rate for Payer: BCN Medicare Advantage |
$894.60
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.22
|
| Rate for Payer: Cofinity Commercial |
$1,198.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.33
|
| Rate for Payer: Nomi Health Commercial |
$1,073.52
|
| Rate for Payer: PACE SWMI |
$894.60
|
| Rate for Payer: PHP Medicare Advantage |
$894.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health Medicare |
$903.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.60
|
| Rate for Payer: UHC Exchange |
$894.60
|
| Rate for Payer: UHC Medicare Advantage |
$894.60
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 44180
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$894.60 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,198.76
|
| Rate for Payer: Aetna Medicare |
$930.38
|
| Rate for Payer: BCBS Complete |
$930.00
|
| Rate for Payer: BCBS MAPPO |
$894.60
|
| Rate for Payer: BCN Medicare Advantage |
$894.60
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.22
|
| Rate for Payer: Cofinity Commercial |
$1,198.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.33
|
| Rate for Payer: Nomi Health Commercial |
$1,073.52
|
| Rate for Payer: PACE SWMI |
$894.60
|
| Rate for Payer: PHP Medicare Advantage |
$894.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health Medicare |
$903.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.60
|
| Rate for Payer: UHC Exchange |
$894.60
|
| Rate for Payer: UHC Medicare Advantage |
$894.60
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,511.25 |
| Max. Negotiated Rate |
$2,092.50 |
| Rate for Payer: Aetna Commercial |
$1,976.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,897.90
|
| Rate for Payer: BCN Commercial |
$1,796.76
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,999.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.00
|
| Rate for Payer: Healthscope Commercial |
$2,092.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,743.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: Nomi Health Commercial |
$1,906.50
|
| Rate for Payer: PHP Commercial |
$1,976.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,022.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,557.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,046.00
|
| Rate for Payer: UHC Core |
$1,941.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,743.75
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$552.19 |
| Max. Negotiated Rate |
$4,429.45 |
| Rate for Payer: Aetna Commercial |
$1,976.25
|
| Rate for Payer: Aetna Medicare |
$604.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$726.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$726.56
|
| Rate for Payer: BCBS Complete |
$4,429.45
|
| Rate for Payer: BCBS MAPPO |
$581.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,911.38
|
| Rate for Payer: BCN Commercial |
$1,807.69
|
| Rate for Payer: BCN Medicare Advantage |
$581.25
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,999.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.25
|
| Rate for Payer: Healthscope Commercial |
$2,092.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,743.75
|
| Rate for Payer: Mclaren Medicaid |
$4,218.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.31
|
| Rate for Payer: Meridian Medicaid |
$4,429.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$668.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: Nomi Health Commercial |
$1,906.50
|
| Rate for Payer: PACE Senior Care Partners |
$552.19
|
| Rate for Payer: PACE SWMI |
$581.25
|
| Rate for Payer: PHP Commercial |
$1,976.25
|
| Rate for Payer: PHP Medicare Advantage |
$581.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,218.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,022.75
|
| Rate for Payer: Priority Health Medicare |
$587.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,557.75
|
| Rate for Payer: Railroad Medicare Medicare |
$581.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,046.00
|
| Rate for Payer: UHC Core |
$1,941.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.25
|
| Rate for Payer: UHC Exchange |
$581.25
|
| Rate for Payer: UHC Medicare Advantage |
$581.25
|
| Rate for Payer: UHCCP Medicaid |
$4,218.24
|
| Rate for Payer: VA VA |
$581.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,743.75
|
|
|
PR LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 58670
|
| Min. Negotiated Rate |
$356.12 |
| Max. Negotiated Rate |
$962.00 |
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$370.36
|
| Rate for Payer: BCBS Complete |
$592.00
|
| Rate for Payer: BCBS MAPPO |
$356.12
|
| Rate for Payer: BCN Medicare Advantage |
$356.12
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$512.81
|
| Rate for Payer: Cofinity Commercial |
$477.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.93
|
| Rate for Payer: Nomi Health Commercial |
$427.34
|
| Rate for Payer: PACE SWMI |
$356.12
|
| Rate for Payer: PHP Medicare Advantage |
$356.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.00
|
| Rate for Payer: Priority Health Medicare |
$359.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.12
|
| Rate for Payer: UHC Exchange |
$356.12
|
| Rate for Payer: UHC Medicare Advantage |
$356.12
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT
|
Professional
|
Both
|
$3,008.00
|
|
|
Service Code
|
HCPCS 50546
|
| Min. Negotiated Rate |
$1,149.47 |
| Max. Negotiated Rate |
$1,955.20 |
| Rate for Payer: Aetna Commercial |
$1,540.29
|
| Rate for Payer: Aetna Medicare |
$1,195.45
|
| Rate for Payer: BCBS Complete |
$1,203.20
|
| Rate for Payer: BCBS MAPPO |
$1,149.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.47
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cofinity Commercial |
$1,655.24
|
| Rate for Payer: Cofinity Commercial |
$1,540.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.94
|
| Rate for Payer: Nomi Health Commercial |
$1,379.36
|
| Rate for Payer: PACE SWMI |
$1,149.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.20
|
| Rate for Payer: Priority Health Medicare |
$1,160.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,149.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.47
|
| Rate for Payer: UHC Exchange |
$1,149.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.47
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY
|
Professional
|
Both
|
$2,592.00
|
|
|
Service Code
|
HCPCS 50548
|
| Min. Negotiated Rate |
$1,036.80 |
| Max. Negotiated Rate |
$1,842.12 |
| Rate for Payer: Aetna Commercial |
$1,714.19
|
| Rate for Payer: Aetna Medicare |
$1,330.42
|
| Rate for Payer: BCBS Complete |
$1,036.80
|
| Rate for Payer: BCBS MAPPO |
$1,279.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.25
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,842.12
|
| Rate for Payer: Cofinity Commercial |
$1,714.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.21
|
| Rate for Payer: Nomi Health Commercial |
$1,535.10
|
| Rate for Payer: PACE SWMI |
$1,279.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.80
|
| Rate for Payer: Priority Health Medicare |
$1,292.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,279.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.25
|
| Rate for Payer: UHC Exchange |
$1,279.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.25
|
|
|
PR LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 54692
|
| Min. Negotiated Rate |
$722.62 |
| Max. Negotiated Rate |
$1,491.10 |
| Rate for Payer: Aetna Commercial |
$968.31
|
| Rate for Payer: Aetna Medicare |
$751.52
|
| Rate for Payer: BCBS Complete |
$917.60
|
| Rate for Payer: BCBS MAPPO |
$722.62
|
| Rate for Payer: BCN Medicare Advantage |
$722.62
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$968.31
|
| Rate for Payer: Cofinity Commercial |
$1,040.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.75
|
| Rate for Payer: Nomi Health Commercial |
$867.14
|
| Rate for Payer: PACE SWMI |
$722.62
|
| Rate for Payer: PHP Medicare Advantage |
$722.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health Medicare |
$729.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.62
|
| Rate for Payer: UHC Exchange |
$722.62
|
| Rate for Payer: UHC Medicare Advantage |
$722.62
|
|
|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE
|
Professional
|
Both
|
$3,345.00
|
|
|
Service Code
|
HCPCS 45400
|
| Min. Negotiated Rate |
$1,082.00 |
| Max. Negotiated Rate |
$2,174.25 |
| Rate for Payer: Aetna Commercial |
$1,449.88
|
| Rate for Payer: Aetna Medicare |
$1,125.28
|
| Rate for Payer: BCBS Complete |
$1,338.00
|
| Rate for Payer: BCBS MAPPO |
$1,082.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,082.00
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Cofinity Commercial |
$1,558.08
|
| Rate for Payer: Cofinity Commercial |
$1,449.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,082.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,136.10
|
| Rate for Payer: Nomi Health Commercial |
$1,298.40
|
| Rate for Payer: PACE SWMI |
$1,082.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,082.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,174.25
|
| Rate for Payer: Priority Health Medicare |
$1,092.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,082.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,082.00
|
| Rate for Payer: UHC Exchange |
$1,082.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,082.00
|
|
|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ
|
Professional
|
Both
|
$4,663.00
|
|
|
Service Code
|
HCPCS 45402
|
| Min. Negotiated Rate |
$1,451.59 |
| Max. Negotiated Rate |
$3,030.95 |
| Rate for Payer: Aetna Commercial |
$1,945.13
|
| Rate for Payer: Aetna Medicare |
$1,509.65
|
| Rate for Payer: BCBS Complete |
$1,865.20
|
| Rate for Payer: BCBS MAPPO |
$1,451.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.59
|
| Rate for Payer: Cash Price |
$3,730.40
|
| Rate for Payer: Cash Price |
$3,730.40
|
| Rate for Payer: Cofinity Commercial |
$2,090.29
|
| Rate for Payer: Cofinity Commercial |
$1,945.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,524.17
|
| Rate for Payer: Nomi Health Commercial |
$1,741.91
|
| Rate for Payer: PACE SWMI |
$1,451.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,030.95
|
| Rate for Payer: Priority Health Medicare |
$1,466.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,451.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.59
|
| Rate for Payer: UHC Exchange |
$1,451.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.59
|
|
|
PR LAPAROSCOPY RADICAL NEPHRECTOMY
|
Professional
|
Both
|
$4,089.00
|
|
|
Service Code
|
HCPCS 50545
|
| Min. Negotiated Rate |
$1,272.53 |
| Max. Negotiated Rate |
$2,657.85 |
| Rate for Payer: Aetna Commercial |
$1,705.19
|
| Rate for Payer: Aetna Medicare |
$1,323.43
|
| Rate for Payer: BCBS Complete |
$1,635.60
|
| Rate for Payer: BCBS MAPPO |
$1,272.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.53
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,832.44
|
| Rate for Payer: Cofinity Commercial |
$1,705.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,336.16
|
| Rate for Payer: Nomi Health Commercial |
$1,527.04
|
| Rate for Payer: PACE SWMI |
$1,272.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,657.85
|
| Rate for Payer: Priority Health Medicare |
$1,285.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,272.53
|
| Rate for Payer: UHC Exchange |
$1,272.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,272.53
|
|
|
PR LAPAROSCOPY SALPINGOSTOMY
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 58673
|
| Min. Negotiated Rate |
$762.46 |
| Max. Negotiated Rate |
$2,026.05 |
| Rate for Payer: Aetna Commercial |
$1,021.70
|
| Rate for Payer: Aetna Medicare |
$792.96
|
| Rate for Payer: BCBS Complete |
$1,246.80
|
| Rate for Payer: BCBS MAPPO |
$762.46
|
| Rate for Payer: BCN Medicare Advantage |
$762.46
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,097.94
|
| Rate for Payer: Cofinity Commercial |
$1,021.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$800.58
|
| Rate for Payer: Nomi Health Commercial |
$914.95
|
| Rate for Payer: PACE SWMI |
$762.46
|
| Rate for Payer: PHP Medicare Advantage |
$762.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health Medicare |
$770.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.46
|
| Rate for Payer: UHC Exchange |
$762.46
|
| Rate for Payer: UHC Medicare Advantage |
$762.46
|
|
|
PR LAPAROSCOPY SLING OPERATION STRESS INCONT
|
Professional
|
Both
|
$1,724.00
|
|
|
Service Code
|
HCPCS 51992
|
| Min. Negotiated Rate |
$689.60 |
| Max. Negotiated Rate |
$1,154.49 |
| Rate for Payer: Aetna Commercial |
$1,074.32
|
| Rate for Payer: Aetna Medicare |
$833.80
|
| Rate for Payer: BCBS Complete |
$689.60
|
| Rate for Payer: BCBS MAPPO |
$801.73
|
| Rate for Payer: BCN Medicare Advantage |
$801.73
|
| Rate for Payer: Cash Price |
$1,379.20
|
| Rate for Payer: Cash Price |
$1,379.20
|
| Rate for Payer: Cofinity Commercial |
$1,154.49
|
| Rate for Payer: Cofinity Commercial |
$1,074.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.82
|
| Rate for Payer: Nomi Health Commercial |
$962.08
|
| Rate for Payer: PACE SWMI |
$801.73
|
| Rate for Payer: PHP Medicare Advantage |
$801.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.60
|
| Rate for Payer: Priority Health Medicare |
$809.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$801.73
|
| Rate for Payer: UHC Exchange |
$801.73
|
| Rate for Payer: UHC Medicare Advantage |
$801.73
|
|
|
PR LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 44203
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$692.90 |
| Rate for Payer: Aetna Commercial |
$311.15
|
| Rate for Payer: Aetna Medicare |
$241.49
|
| Rate for Payer: BCBS Complete |
$426.40
|
| Rate for Payer: BCBS MAPPO |
$232.20
|
| Rate for Payer: BCN Medicare Advantage |
$232.20
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$334.37
|
| Rate for Payer: Cofinity Commercial |
$311.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.81
|
| Rate for Payer: Nomi Health Commercial |
$278.64
|
| Rate for Payer: PACE SWMI |
$232.20
|
| Rate for Payer: PHP Medicare Advantage |
$232.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.90
|
| Rate for Payer: Priority Health Medicare |
$234.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.20
|
| Rate for Payer: UHC Exchange |
$232.20
|
| Rate for Payer: UHC Medicare Advantage |
$232.20
|
|
|
PR LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 58541
|
| Min. Negotiated Rate |
$700.91 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$939.22
|
| Rate for Payer: Aetna Medicare |
$728.95
|
| Rate for Payer: BCBS Complete |
$810.00
|
| Rate for Payer: BCBS MAPPO |
$700.91
|
| Rate for Payer: BCN Medicare Advantage |
$700.91
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$939.22
|
| Rate for Payer: Cofinity Commercial |
$1,009.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.96
|
| Rate for Payer: Nomi Health Commercial |
$841.09
|
| Rate for Payer: PACE SWMI |
$700.91
|
| Rate for Payer: PHP Medicare Advantage |
$700.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health Medicare |
$707.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.91
|
| Rate for Payer: UHC Exchange |
$700.91
|
| Rate for Payer: UHC Medicare Advantage |
$700.91
|
|
|
PR LAPAROSCOPY SURG ABLATION RENAL CYSTS
|
Professional
|
Both
|
$1,762.00
|
|
|
Service Code
|
HCPCS 50541
|
| Min. Negotiated Rate |
$704.80 |
| Max. Negotiated Rate |
$1,261.17 |
| Rate for Payer: Aetna Commercial |
$1,173.59
|
| Rate for Payer: Aetna Medicare |
$910.84
|
| Rate for Payer: BCBS Complete |
$704.80
|
| Rate for Payer: BCBS MAPPO |
$875.81
|
| Rate for Payer: BCN Medicare Advantage |
$875.81
|
| Rate for Payer: Cash Price |
$1,409.60
|
| Rate for Payer: Cash Price |
$1,409.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.17
|
| Rate for Payer: Cofinity Commercial |
$1,173.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$919.60
|
| Rate for Payer: Nomi Health Commercial |
$1,050.97
|
| Rate for Payer: PACE SWMI |
$875.81
|
| Rate for Payer: PHP Medicare Advantage |
$875.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,145.30
|
| Rate for Payer: Priority Health Medicare |
$884.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.81
|
| Rate for Payer: UHC Exchange |
$875.81
|
| Rate for Payer: UHC Medicare Advantage |
$875.81
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,011.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$643.47 |
| Max. Negotiated Rate |
$1,957.15 |
| Rate for Payer: Aetna Commercial |
$862.25
|
| Rate for Payer: Aetna Medicare |
$669.21
|
| Rate for Payer: BCBS Complete |
$1,204.40
|
| Rate for Payer: BCBS MAPPO |
$643.47
|
| Rate for Payer: BCN Medicare Advantage |
$643.47
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$926.60
|
| Rate for Payer: Cofinity Commercial |
$862.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.64
|
| Rate for Payer: Nomi Health Commercial |
$772.16
|
| Rate for Payer: PACE SWMI |
$643.47
|
| Rate for Payer: PHP Medicare Advantage |
$643.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health Medicare |
$649.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.47
|
| Rate for Payer: UHC Exchange |
$643.47
|
| Rate for Payer: UHC Medicare Advantage |
$643.47
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,011.00
|
|
|
Service Code
|
HCPCS 47562
|
| Min. Negotiated Rate |
$643.47 |
| Max. Negotiated Rate |
$1,957.15 |
| Rate for Payer: Aetna Commercial |
$862.25
|
| Rate for Payer: Aetna Medicare |
$669.21
|
| Rate for Payer: BCBS Complete |
$1,204.40
|
| Rate for Payer: BCBS MAPPO |
$643.47
|
| Rate for Payer: BCN Medicare Advantage |
$643.47
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$926.60
|
| Rate for Payer: Cofinity Commercial |
$862.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.64
|
| Rate for Payer: Nomi Health Commercial |
$772.16
|
| Rate for Payer: PACE SWMI |
$643.47
|
| Rate for Payer: PHP Medicare Advantage |
$643.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health Medicare |
$649.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.47
|
| Rate for Payer: UHC Exchange |
$643.47
|
| Rate for Payer: UHC Medicare Advantage |
$643.47
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
IP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,957.15 |
| Max. Negotiated Rate |
$2,709.90 |
| Rate for Payer: Aetna Commercial |
$2,559.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,457.88
|
| Rate for Payer: BCN Commercial |
$2,326.90
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,589.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Healthscope Commercial |
$2,709.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,258.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,559.35
|
| Rate for Payer: Nomi Health Commercial |
$2,469.02
|
| Rate for Payer: PHP Commercial |
$2,559.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,619.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,017.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,649.68
|
| Rate for Payer: UHC Core |
$2,514.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,258.25
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
OP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$715.11 |
| Max. Negotiated Rate |
$4,429.45 |
| Rate for Payer: Aetna Commercial |
$2,559.35
|
| Rate for Payer: Aetna Medicare |
$782.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$940.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$940.94
|
| Rate for Payer: BCBS Complete |
$4,429.45
|
| Rate for Payer: BCBS MAPPO |
$752.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,475.34
|
| Rate for Payer: BCN Commercial |
$2,341.05
|
| Rate for Payer: BCN Medicare Advantage |
$752.75
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,589.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.75
|
| Rate for Payer: Healthscope Commercial |
$2,709.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,258.25
|
| Rate for Payer: Mclaren Medicaid |
$4,218.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.39
|
| Rate for Payer: Meridian Medicaid |
$4,429.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$865.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,559.35
|
| Rate for Payer: Nomi Health Commercial |
$2,469.02
|
| Rate for Payer: PACE Senior Care Partners |
$715.11
|
| Rate for Payer: PACE SWMI |
$752.75
|
| Rate for Payer: PHP Commercial |
$2,559.35
|
| Rate for Payer: PHP Medicare Advantage |
$752.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,218.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,619.57
|
| Rate for Payer: Priority Health Medicare |
$760.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,017.37
|
| Rate for Payer: Railroad Medicare Medicare |
$752.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,649.68
|
| Rate for Payer: UHC Core |
$2,514.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.75
|
| Rate for Payer: UHC Exchange |
$752.75
|
| Rate for Payer: UHC Medicare Advantage |
$752.75
|
| Rate for Payer: UHCCP Medicaid |
$4,218.24
|
| Rate for Payer: VA VA |
$752.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,258.25
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,762.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$1,104.80 |
| Max. Negotiated Rate |
$1,795.30 |
| Rate for Payer: Aetna Commercial |
$1,558.69
|
| Rate for Payer: Aetna Medicare |
$1,209.73
|
| Rate for Payer: BCBS Complete |
$1,104.80
|
| Rate for Payer: BCBS MAPPO |
$1,163.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.20
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$1,675.01
|
| Rate for Payer: Cofinity Commercial |
$1,558.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,221.36
|
| Rate for Payer: Nomi Health Commercial |
$1,395.84
|
| Rate for Payer: PACE SWMI |
$1,163.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health Medicare |
$1,174.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,163.20
|
| Rate for Payer: UHC Exchange |
$1,163.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.20
|
|
