|
PR LAPAROSCOPY W/OMENTOPEXY
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 49326
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$1,426.41 |
| Rate for Payer: Aetna Commercial |
$244.90
|
| Rate for Payer: Aetna Medicare |
$190.07
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$182.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.41
|
| Rate for Payer: BCN Commercial |
$272.19
|
| Rate for Payer: BCN Medicare Advantage |
$182.76
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$263.17
|
| Rate for Payer: Cofinity Commercial |
$244.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.76
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.90
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Nomi Health Commercial |
$219.31
|
| Rate for Payer: PACE SWMI |
$182.76
|
| Rate for Payer: PHP Medicare Advantage |
$182.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.60
|
| Rate for Payer: Priority Health HMO/PPO |
$333.50
|
| Rate for Payer: Priority Health Medicare |
$184.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.76
|
| Rate for Payer: UHC Exchange |
$182.76
|
| Rate for Payer: UHC Medicare Advantage |
$182.76
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 58671
|
| Min. Negotiated Rate |
$48.39 |
| Max. Negotiated Rate |
$991.90 |
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$370.36
|
| Rate for Payer: BCBS Complete |
$250.94
|
| Rate for Payer: BCBS MAPPO |
$356.12
|
| Rate for Payer: BCBS Trust/PPO |
$48.39
|
| Rate for Payer: BCN Commercial |
$546.34
|
| Rate for Payer: BCN Medicare Advantage |
$356.12
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| 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: Mclaren Medicaid |
$238.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.93
|
| Rate for Payer: Meridian Medicaid |
$250.94
|
| 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 Choice Medicaid |
$238.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$991.90
|
| Rate for Payer: Priority Health HMO/PPO |
$558.05
|
| Rate for Payer: Priority Health Medicare |
$359.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$558.05
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$238.99
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Min. Negotiated Rate |
$183.85 |
| Max. Negotiated Rate |
$1,783.60 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$955.85
|
| Rate for Payer: BCN Medicare Advantage |
$627.90
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$904.18
|
| Rate for Payer: Cofinity Commercial |
$841.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.90
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.30
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Nomi Health Commercial |
$753.48
|
| Rate for Payer: PACE SWMI |
$627.90
|
| Rate for Payer: PHP Medicare Advantage |
$627.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO |
$974.73
|
| Rate for Payer: Priority Health Medicare |
$634.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$974.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Exchange |
$627.90
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
IP
|
$2,744.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,783.60 |
| Max. Negotiated Rate |
$2,469.60 |
| Rate for Payer: Aetna Commercial |
$2,332.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,239.93
|
| Rate for Payer: BCN Commercial |
$2,120.56
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$2,359.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,195.20
|
| Rate for Payer: Healthscope Commercial |
$2,469.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,058.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,332.40
|
| Rate for Payer: Nomi Health Commercial |
$2,250.08
|
| Rate for Payer: PHP Commercial |
$2,332.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,387.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,838.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,414.72
|
| Rate for Payer: UHC Core |
$2,291.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,058.00
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,744.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$183.85 |
| Max. Negotiated Rate |
$1,783.60 |
| Rate for Payer: Aetna Commercial |
$841.39
|
| Rate for Payer: Aetna Medicare |
$653.02
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$627.90
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$955.85
|
| Rate for Payer: BCN Medicare Advantage |
$627.90
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$904.18
|
| Rate for Payer: Cofinity Commercial |
$841.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.90
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.30
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Nomi Health Commercial |
$753.48
|
| Rate for Payer: PACE SWMI |
$627.90
|
| Rate for Payer: PHP Medicare Advantage |
$627.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO |
$974.73
|
| Rate for Payer: Priority Health Medicare |
$634.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$974.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.90
|
| Rate for Payer: UHC Exchange |
$627.90
|
| Rate for Payer: UHC Medicare Advantage |
$627.90
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
OP
|
$2,744.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$651.70 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$2,332.40
|
| Rate for Payer: Aetna Medicare |
$713.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.50
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$686.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,255.84
|
| Rate for Payer: BCN Commercial |
$2,133.46
|
| Rate for Payer: BCN Medicare Advantage |
$686.00
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cash Price |
$2,195.20
|
| Rate for Payer: Cofinity Commercial |
$2,359.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.00
|
| Rate for Payer: Healthscope Commercial |
$2,469.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,058.00
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.30
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,332.40
|
| Rate for Payer: Nomi Health Commercial |
$2,250.08
|
| Rate for Payer: PACE Senior Care Partners |
$651.70
|
| Rate for Payer: PACE SWMI |
$686.00
|
| Rate for Payer: PHP Commercial |
$2,332.40
|
| Rate for Payer: PHP Medicare Advantage |
$686.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,783.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,387.28
|
| Rate for Payer: Priority Health Medicare |
$692.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,838.48
|
| Rate for Payer: Railroad Medicare Medicare |
$686.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,414.72
|
| Rate for Payer: UHC Core |
$2,291.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.00
|
| Rate for Payer: UHC Exchange |
$686.00
|
| Rate for Payer: UHC Medicare Advantage |
$686.00
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$686.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,058.00
|
|
|
PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 58570
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$1,608.75 |
| Rate for Payer: Aetna Commercial |
$1,039.16
|
| Rate for Payer: Aetna Medicare |
$806.51
|
| Rate for Payer: BCBS Complete |
$545.03
|
| Rate for Payer: BCBS MAPPO |
$775.49
|
| Rate for Payer: BCBS Trust/PPO |
$2.14
|
| Rate for Payer: BCN Commercial |
$1,184.06
|
| Rate for Payer: BCN Medicare Advantage |
$775.49
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$1,116.71
|
| Rate for Payer: Cofinity Commercial |
$1,039.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.49
|
| Rate for Payer: Mclaren Medicaid |
$519.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.26
|
| Rate for Payer: Meridian Medicaid |
$545.03
|
| Rate for Payer: Nomi Health Commercial |
$930.59
|
| Rate for Payer: PACE SWMI |
$775.49
|
| Rate for Payer: PHP Medicare Advantage |
$775.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,608.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,208.36
|
| Rate for Payer: Priority Health Medicare |
$783.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,208.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.49
|
| Rate for Payer: UHC Exchange |
$775.49
|
| Rate for Payer: UHC Medicare Advantage |
$775.49
|
| Rate for Payer: UHCCP Medicaid |
$519.08
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,116.00
|
|
|
Service Code
|
HCPCS 49653
|
| Min. Negotiated Rate |
$1,246.40 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Medicare |
$1,558.00
|
| Rate for Payer: BCBS Complete |
$1,246.40
|
| Rate for Payer: Cash Price |
$2,492.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.40
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 49654
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$1,833.65 |
| Rate for Payer: Aetna Medicare |
$1,410.50
|
| Rate for Payer: BCBS Complete |
$1,128.40
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,833.65
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
IP
|
$1,407.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$914.55 |
| Max. Negotiated Rate |
$1,266.30 |
| Rate for Payer: Aetna Commercial |
$1,195.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.53
|
| Rate for Payer: BCN Commercial |
$1,087.33
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,210.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.60
|
| Rate for Payer: Healthscope Commercial |
$1,266.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.95
|
| Rate for Payer: Nomi Health Commercial |
$1,153.74
|
| Rate for Payer: PHP Commercial |
$1,195.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,224.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.16
|
| Rate for Payer: UHC Core |
$1,174.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.25
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
OP
|
$1,407.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$334.16 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$1,195.95
|
| Rate for Payer: Aetna Medicare |
$365.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$439.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$439.69
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$351.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.69
|
| Rate for Payer: BCN Commercial |
$1,093.94
|
| Rate for Payer: BCN Medicare Advantage |
$351.75
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,210.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.75
|
| Rate for Payer: Healthscope Commercial |
$1,266.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.25
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.34
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.95
|
| Rate for Payer: Nomi Health Commercial |
$1,153.74
|
| Rate for Payer: PACE Senior Care Partners |
$334.16
|
| Rate for Payer: PACE SWMI |
$351.75
|
| Rate for Payer: PHP Commercial |
$1,195.95
|
| Rate for Payer: PHP Medicare Advantage |
$351.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,224.09
|
| Rate for Payer: Priority Health Medicare |
$355.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.69
|
| Rate for Payer: Railroad Medicare Medicare |
$351.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.16
|
| Rate for Payer: UHC Core |
$1,174.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.75
|
| Rate for Payer: UHC Exchange |
$351.75
|
| Rate for Payer: UHC Medicare Advantage |
$351.75
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$351.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.25
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 49320
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,309.66 |
| Rate for Payer: Aetna Commercial |
$429.85
|
| Rate for Payer: Aetna Medicare |
$333.61
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$320.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.66
|
| Rate for Payer: BCN Commercial |
$480.86
|
| Rate for Payer: BCN Medicare Advantage |
$320.78
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.78
|
| Rate for Payer: Mclaren Medicaid |
$213.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.82
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Nomi Health Commercial |
$384.94
|
| Rate for Payer: PACE SWMI |
$320.78
|
| Rate for Payer: PHP Medicare Advantage |
$320.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO |
$593.02
|
| Rate for Payer: Priority Health Medicare |
$323.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.78
|
| Rate for Payer: UHC Exchange |
$320.78
|
| Rate for Payer: UHC Medicare Advantage |
$320.78
|
| Rate for Payer: UHCCP Medicaid |
$213.64
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
49320
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,309.66 |
| Rate for Payer: Aetna Commercial |
$429.85
|
| Rate for Payer: Aetna Medicare |
$333.61
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$320.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.66
|
| Rate for Payer: BCN Commercial |
$480.86
|
| Rate for Payer: BCN Medicare Advantage |
$320.78
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.78
|
| Rate for Payer: Mclaren Medicaid |
$213.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.82
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Nomi Health Commercial |
$384.94
|
| Rate for Payer: PACE SWMI |
$320.78
|
| Rate for Payer: PHP Medicare Advantage |
$320.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO |
$593.02
|
| Rate for Payer: Priority Health Medicare |
$323.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.78
|
| Rate for Payer: UHC Exchange |
$320.78
|
| Rate for Payer: UHC Medicare Advantage |
$320.78
|
| Rate for Payer: UHCCP Medicaid |
$213.64
|
|
|
PR LAPS ABLTJ RENAL MASS LESION W/INTRAOP US
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 50542
|
| Min. Negotiated Rate |
$742.94 |
| Max. Negotiated Rate |
$3,188.29 |
| Rate for Payer: Aetna Commercial |
$1,489.22
|
| Rate for Payer: Aetna Medicare |
$1,155.81
|
| Rate for Payer: BCBS Complete |
$780.09
|
| Rate for Payer: BCBS MAPPO |
$1,111.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,188.29
|
| Rate for Payer: BCN Commercial |
$1,678.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,111.36
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$1,600.36
|
| Rate for Payer: Cofinity Commercial |
$1,489.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,111.36
|
| Rate for Payer: Mclaren Medicaid |
$742.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,166.93
|
| Rate for Payer: Meridian Medicaid |
$780.09
|
| Rate for Payer: Nomi Health Commercial |
$1,333.63
|
| Rate for Payer: PACE SWMI |
$1,111.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,111.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,838.53
|
| Rate for Payer: Priority Health Medicare |
$1,122.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,838.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,111.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,111.36
|
| Rate for Payer: UHC Exchange |
$1,111.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,111.36
|
| Rate for Payer: UHCCP Medicaid |
$742.94
|
|
|
PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1
|
Professional
|
Both
|
$1,869.00
|
|
|
Service Code
|
HCPCS 38572
|
| Min. Negotiated Rate |
$503.47 |
| Max. Negotiated Rate |
$1,792.20 |
| Rate for Payer: Aetna Commercial |
$1,153.40
|
| Rate for Payer: Aetna Medicare |
$895.18
|
| Rate for Payer: BCBS Complete |
$603.63
|
| Rate for Payer: BCBS MAPPO |
$860.75
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$1,316.01
|
| Rate for Payer: BCN Medicare Advantage |
$860.75
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cash Price |
$1,495.20
|
| Rate for Payer: Cofinity Commercial |
$1,239.48
|
| Rate for Payer: Cofinity Commercial |
$1,153.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$860.75
|
| Rate for Payer: Mclaren Medicaid |
$574.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$903.79
|
| Rate for Payer: Meridian Medicaid |
$603.63
|
| Rate for Payer: Nomi Health Commercial |
$1,032.90
|
| Rate for Payer: PACE SWMI |
$860.75
|
| Rate for Payer: PHP Medicare Advantage |
$860.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,214.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,792.20
|
| Rate for Payer: Priority Health Medicare |
$869.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,792.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$860.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$860.75
|
| Rate for Payer: UHC Exchange |
$860.75
|
| Rate for Payer: UHC Medicare Advantage |
$860.75
|
| Rate for Payer: UHCCP Medicaid |
$574.89
|
|
|
PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$3,833.00
|
|
|
Service Code
|
HCPCS 44227
|
| Min. Negotiated Rate |
$1,055.63 |
| Max. Negotiated Rate |
$2,945.38 |
| Rate for Payer: Aetna Commercial |
$2,137.21
|
| Rate for Payer: Aetna Medicare |
$1,658.73
|
| Rate for Payer: BCBS Complete |
$1,108.41
|
| Rate for Payer: BCBS MAPPO |
$1,594.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.81
|
| Rate for Payer: BCN Commercial |
$2,405.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,594.93
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cofinity Commercial |
$2,296.70
|
| Rate for Payer: Cofinity Commercial |
$2,137.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,594.93
|
| Rate for Payer: Mclaren Medicaid |
$1,055.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,674.68
|
| Rate for Payer: Meridian Medicaid |
$1,108.41
|
| Rate for Payer: Nomi Health Commercial |
$1,913.92
|
| Rate for Payer: PACE SWMI |
$1,594.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,594.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,055.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,491.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,945.38
|
| Rate for Payer: Priority Health Medicare |
$1,610.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,945.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,594.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,594.93
|
| Rate for Payer: UHC Exchange |
$1,594.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,594.93
|
| Rate for Payer: UHCCP Medicaid |
$1,055.63
|
|
|
PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS
|
Professional
|
Both
|
$6,309.00
|
|
|
Service Code
|
HCPCS 44211
|
| Min. Negotiated Rate |
$1,339.56 |
| Max. Negotiated Rate |
$4,100.85 |
| Rate for Payer: Aetna Commercial |
$2,683.14
|
| Rate for Payer: Aetna Medicare |
$2,082.43
|
| Rate for Payer: BCBS Complete |
$1,406.54
|
| Rate for Payer: BCBS MAPPO |
$2,002.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.09
|
| Rate for Payer: BCN Commercial |
$3,053.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,002.34
|
| Rate for Payer: Cash Price |
$5,047.20
|
| Rate for Payer: Cash Price |
$5,047.20
|
| Rate for Payer: Cofinity Commercial |
$2,883.37
|
| Rate for Payer: Cofinity Commercial |
$2,683.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,002.34
|
| Rate for Payer: Mclaren Medicaid |
$1,339.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,102.46
|
| Rate for Payer: Meridian Medicaid |
$1,406.54
|
| Rate for Payer: Nomi Health Commercial |
$2,402.81
|
| Rate for Payer: PACE SWMI |
$2,002.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,002.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,339.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,100.85
|
| Rate for Payer: Priority Health HMO/PPO |
$3,740.65
|
| Rate for Payer: Priority Health Medicare |
$2,022.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,740.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,002.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,002.34
|
| Rate for Payer: UHC Exchange |
$2,002.34
|
| Rate for Payer: UHC Medicare Advantage |
$2,002.34
|
| Rate for Payer: UHCCP Medicaid |
$1,339.56
|
|
|
PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST
|
Professional
|
Both
|
$4,661.00
|
|
|
Service Code
|
HCPCS 44208
|
| Min. Negotiated Rate |
$1,250.95 |
| Max. Negotiated Rate |
$3,497.23 |
| Rate for Payer: Aetna Commercial |
$2,525.47
|
| Rate for Payer: Aetna Medicare |
$1,960.07
|
| Rate for Payer: BCBS Complete |
$1,313.50
|
| Rate for Payer: BCBS MAPPO |
$1,884.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,882.86
|
| Rate for Payer: BCN Commercial |
$2,853.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,884.68
|
| Rate for Payer: Cash Price |
$3,728.80
|
| Rate for Payer: Cash Price |
$3,728.80
|
| Rate for Payer: Cofinity Commercial |
$2,713.94
|
| Rate for Payer: Cofinity Commercial |
$2,525.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,884.68
|
| Rate for Payer: Mclaren Medicaid |
$1,250.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,978.91
|
| Rate for Payer: Meridian Medicaid |
$1,313.50
|
| Rate for Payer: Nomi Health Commercial |
$2,261.62
|
| Rate for Payer: PACE SWMI |
$1,884.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,884.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,250.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,029.65
|
| Rate for Payer: Priority Health HMO/PPO |
$3,497.23
|
| Rate for Payer: Priority Health Medicare |
$1,903.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,497.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,884.68
|
| Rate for Payer: UHC Exchange |
$1,884.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,884.68
|
| Rate for Payer: UHCCP Medicaid |
$1,250.95
|
|
|
PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$6,262.00
|
|
|
Service Code
|
HCPCS 44212
|
| Min. Negotiated Rate |
$994.79 |
| Max. Negotiated Rate |
$4,070.30 |
| Rate for Payer: Aetna Commercial |
$2,590.81
|
| Rate for Payer: Aetna Medicare |
$2,010.78
|
| Rate for Payer: BCBS Complete |
$1,353.53
|
| Rate for Payer: BCBS MAPPO |
$1,933.44
|
| Rate for Payer: BCBS Trust/PPO |
$994.79
|
| Rate for Payer: BCN Commercial |
$2,925.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,933.44
|
| Rate for Payer: Cash Price |
$5,009.60
|
| Rate for Payer: Cash Price |
$5,009.60
|
| Rate for Payer: Cofinity Commercial |
$2,784.15
|
| Rate for Payer: Cofinity Commercial |
$2,590.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,933.44
|
| Rate for Payer: Mclaren Medicaid |
$1,289.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,030.11
|
| Rate for Payer: Meridian Medicaid |
$1,353.53
|
| Rate for Payer: Nomi Health Commercial |
$2,320.13
|
| Rate for Payer: PACE SWMI |
$1,933.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,933.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,289.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.30
|
| Rate for Payer: Priority Health HMO/PPO |
$3,587.32
|
| Rate for Payer: Priority Health Medicare |
$1,952.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,587.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,933.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,933.44
|
| Rate for Payer: UHC Exchange |
$1,933.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,933.44
|
| Rate for Payer: UHCCP Medicaid |
$1,289.08
|
|
|
PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST
|
Professional
|
Both
|
$4,592.00
|
|
|
Service Code
|
HCPCS 44207
|
| Min. Negotiated Rate |
$1,150.84 |
| Max. Negotiated Rate |
$3,212.06 |
| Rate for Payer: Aetna Commercial |
$2,327.69
|
| Rate for Payer: Aetna Medicare |
$1,806.56
|
| Rate for Payer: BCBS Complete |
$1,208.38
|
| Rate for Payer: BCBS MAPPO |
$1,737.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,992.75
|
| Rate for Payer: BCN Commercial |
$2,621.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,737.08
|
| Rate for Payer: Cash Price |
$3,673.60
|
| Rate for Payer: Cash Price |
$3,673.60
|
| Rate for Payer: Cofinity Commercial |
$2,501.40
|
| Rate for Payer: Cofinity Commercial |
$2,327.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,737.08
|
| Rate for Payer: Mclaren Medicaid |
$1,150.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,823.93
|
| Rate for Payer: Meridian Medicaid |
$1,208.38
|
| Rate for Payer: Nomi Health Commercial |
$2,084.50
|
| Rate for Payer: PACE SWMI |
$1,737.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,737.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,150.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,984.80
|
| Rate for Payer: Priority Health HMO/PPO |
$3,212.06
|
| Rate for Payer: Priority Health Medicare |
$1,754.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,212.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,737.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,737.08
|
| Rate for Payer: UHC Exchange |
$1,737.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,737.08
|
| Rate for Payer: UHCCP Medicaid |
$1,150.84
|
|
|
PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM
|
Professional
|
Both
|
$4,736.00
|
|
|
Service Code
|
HCPCS 44206
|
| Min. Negotiated Rate |
$1,107.39 |
| Max. Negotiated Rate |
$3,095.14 |
| Rate for Payer: Aetna Commercial |
$2,240.51
|
| Rate for Payer: Aetna Medicare |
$1,738.90
|
| Rate for Payer: BCBS Complete |
$1,162.76
|
| Rate for Payer: BCBS MAPPO |
$1,672.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$2,525.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,672.02
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cash Price |
$3,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,407.71
|
| Rate for Payer: Cofinity Commercial |
$2,240.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,672.02
|
| Rate for Payer: Mclaren Medicaid |
$1,107.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,755.62
|
| Rate for Payer: Meridian Medicaid |
$1,162.76
|
| Rate for Payer: Nomi Health Commercial |
$2,006.42
|
| Rate for Payer: PACE SWMI |
$1,672.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,672.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,107.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,078.40
|
| Rate for Payer: Priority Health HMO/PPO |
$3,095.14
|
| Rate for Payer: Priority Health Medicare |
$1,688.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,095.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,672.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,672.02
|
| Rate for Payer: UHC Exchange |
$1,672.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.02
|
| Rate for Payer: UHCCP Medicaid |
$1,107.39
|
|
|
PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM
|
Professional
|
Both
|
$4,199.00
|
|
|
Service Code
|
HCPCS 44205
|
| Min. Negotiated Rate |
$850.94 |
| Max. Negotiated Rate |
$2,729.35 |
| Rate for Payer: Aetna Commercial |
$1,719.85
|
| Rate for Payer: Aetna Medicare |
$1,334.81
|
| Rate for Payer: BCBS Complete |
$893.49
|
| Rate for Payer: BCBS MAPPO |
$1,283.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,868.07
|
| Rate for Payer: BCN Commercial |
$1,936.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.47
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,848.20
|
| Rate for Payer: Cofinity Commercial |
$1,719.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.47
|
| Rate for Payer: Mclaren Medicaid |
$850.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.64
|
| Rate for Payer: Meridian Medicaid |
$893.49
|
| Rate for Payer: Nomi Health Commercial |
$1,540.16
|
| Rate for Payer: PACE SWMI |
$1,283.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,729.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,372.06
|
| Rate for Payer: Priority Health Medicare |
$1,296.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,372.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.47
|
| Rate for Payer: UHC Exchange |
$1,283.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.47
|
| Rate for Payer: UHCCP Medicaid |
$850.94
|
|
|
PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$5,282.00
|
|
|
Service Code
|
HCPCS 44210
|
| Min. Negotiated Rate |
$1,124.43 |
| Max. Negotiated Rate |
$3,433.30 |
| Rate for Payer: Aetna Commercial |
$2,262.01
|
| Rate for Payer: Aetna Medicare |
$1,755.59
|
| Rate for Payer: BCBS Complete |
$1,180.65
|
| Rate for Payer: BCBS MAPPO |
$1,688.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,790.41
|
| Rate for Payer: BCN Commercial |
$2,564.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,688.07
|
| Rate for Payer: Cash Price |
$4,225.60
|
| Rate for Payer: Cash Price |
$4,225.60
|
| Rate for Payer: Cofinity Commercial |
$2,430.82
|
| Rate for Payer: Cofinity Commercial |
$2,262.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,688.07
|
| Rate for Payer: Mclaren Medicaid |
$1,124.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,772.47
|
| Rate for Payer: Meridian Medicaid |
$1,180.65
|
| Rate for Payer: Nomi Health Commercial |
$2,025.68
|
| Rate for Payer: PACE SWMI |
$1,688.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,688.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,124.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,433.30
|
| Rate for Payer: Priority Health HMO/PPO |
$3,141.66
|
| Rate for Payer: Priority Health Medicare |
$1,704.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,141.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,688.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,688.07
|
| Rate for Payer: UHC Exchange |
$1,688.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,688.07
|
| Rate for Payer: UHCCP Medicaid |
$1,124.43
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 44202
|
| Min. Negotiated Rate |
$764.98 |
| Max. Negotiated Rate |
$3,023.80 |
| Rate for Payer: Aetna Commercial |
$1,799.45
|
| Rate for Payer: Aetna Medicare |
$1,396.58
|
| Rate for Payer: BCBS Complete |
$932.84
|
| Rate for Payer: BCBS MAPPO |
$1,342.87
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$2,019.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.87
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,933.73
|
| Rate for Payer: Cofinity Commercial |
$1,799.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.87
|
| Rate for Payer: Mclaren Medicaid |
$888.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,410.01
|
| Rate for Payer: Meridian Medicaid |
$932.84
|
| Rate for Payer: Nomi Health Commercial |
$1,611.44
|
| Rate for Payer: PACE SWMI |
$1,342.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,475.86
|
| Rate for Payer: Priority Health Medicare |
$1,356.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,475.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.87
|
| Rate for Payer: UHC Exchange |
$1,342.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.87
|
| Rate for Payer: UHCCP Medicaid |
$888.42
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$764.98 |
| Max. Negotiated Rate |
$3,023.80 |
| Rate for Payer: Aetna Commercial |
$1,799.45
|
| Rate for Payer: Aetna Medicare |
$1,396.58
|
| Rate for Payer: BCBS Complete |
$932.84
|
| Rate for Payer: BCBS MAPPO |
$1,342.87
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$2,019.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.87
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,933.73
|
| Rate for Payer: Cofinity Commercial |
$1,799.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.87
|
| Rate for Payer: Mclaren Medicaid |
$888.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,410.01
|
| Rate for Payer: Meridian Medicaid |
$932.84
|
| Rate for Payer: Nomi Health Commercial |
$1,611.44
|
| Rate for Payer: PACE SWMI |
$1,342.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,475.86
|
| Rate for Payer: Priority Health Medicare |
$1,356.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,475.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.87
|
| Rate for Payer: UHC Exchange |
$1,342.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.87
|
| Rate for Payer: UHCCP Medicaid |
$888.42
|
|
