|
PR LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY
|
Professional
|
Both
|
$1,554.00
|
|
|
Service Code
|
HCPCS 38571
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,316.18 |
| Rate for Payer: Aetna Commercial |
$849.40
|
| Rate for Payer: Aetna Medicare |
$659.24
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$633.88
|
| Rate for Payer: BCBS Trust/PPO |
$459.62
|
| Rate for Payer: BCN Commercial |
$956.83
|
| Rate for Payer: BCN Medicare Advantage |
$633.88
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cofinity Commercial |
$912.79
|
| Rate for Payer: Cofinity Commercial |
$849.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.88
|
| Rate for Payer: Mclaren Medicaid |
$423.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.57
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Nomi Health Commercial |
$760.66
|
| Rate for Payer: PACE SWMI |
$633.88
|
| Rate for Payer: PHP Medicare Advantage |
$633.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,316.18
|
| Rate for Payer: Priority Health Medicare |
$640.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.88
|
| Rate for Payer: UHC Exchange |
$633.88
|
| Rate for Payer: UHC Medicare Advantage |
$633.88
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR LAPS SURG CHOLECSTC W/EXPL COMMON DUCT
|
Professional
|
Both
|
$3,358.00
|
|
|
Service Code
|
HCPCS 47564
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,228.90 |
| Rate for Payer: Aetna Commercial |
$1,458.17
|
| Rate for Payer: Aetna Medicare |
$1,131.72
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS MAPPO |
$1,088.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,228.90
|
| Rate for Payer: BCN Commercial |
$1,633.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,088.19
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Cofinity Commercial |
$1,566.99
|
| Rate for Payer: Cofinity Commercial |
$1,458.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,088.19
|
| Rate for Payer: Mclaren Medicaid |
$721.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,142.60
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Nomi Health Commercial |
$1,305.83
|
| Rate for Payer: PACE SWMI |
$1,088.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,088.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,007.53
|
| Rate for Payer: Priority Health Medicare |
$1,099.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,088.19
|
| Rate for Payer: UHC Exchange |
$1,088.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,088.19
|
| Rate for Payer: UHCCP Medicaid |
$721.43
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$938.27
|
| Rate for Payer: Aetna Medicare |
$728.21
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$700.20
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: BCN Medicare Advantage |
$700.20
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$938.27
|
| Rate for Payer: Cofinity Commercial |
$1,008.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.20
|
| Rate for Payer: Mclaren Medicaid |
$464.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.21
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Nomi Health Commercial |
$840.24
|
| Rate for Payer: PACE SWMI |
$700.20
|
| Rate for Payer: PHP Medicare Advantage |
$700.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,291.62
|
| Rate for Payer: Priority Health Medicare |
$707.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,291.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.20
|
| Rate for Payer: UHC Exchange |
$700.20
|
| Rate for Payer: UHC Medicare Advantage |
$700.20
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$938.27
|
| Rate for Payer: Aetna Medicare |
$728.21
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$700.20
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: BCN Medicare Advantage |
$700.20
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$938.27
|
| Rate for Payer: Cofinity Commercial |
$1,008.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.20
|
| Rate for Payer: Mclaren Medicaid |
$464.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.21
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Nomi Health Commercial |
$840.24
|
| Rate for Payer: PACE SWMI |
$700.20
|
| Rate for Payer: PHP Medicare Advantage |
$700.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,291.62
|
| Rate for Payer: Priority Health Medicare |
$707.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,291.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.20
|
| Rate for Payer: UHC Exchange |
$700.20
|
| Rate for Payer: UHC Medicare Advantage |
$700.20
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
OP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$663.10 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$2,373.20
|
| Rate for Payer: Aetna Medicare |
$725.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$872.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$872.50
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$698.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,295.30
|
| Rate for Payer: BCN Commercial |
$2,170.78
|
| Rate for Payer: BCN Medicare Advantage |
$698.00
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,401.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.00
|
| Rate for Payer: Healthscope Commercial |
$2,512.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,094.00
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.90
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$802.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.20
|
| Rate for Payer: Nomi Health Commercial |
$2,289.44
|
| Rate for Payer: PACE Senior Care Partners |
$663.10
|
| Rate for Payer: PACE SWMI |
$698.00
|
| Rate for Payer: PHP Commercial |
$2,373.20
|
| Rate for Payer: PHP Medicare Advantage |
$698.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,429.04
|
| Rate for Payer: Priority Health Medicare |
$704.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.64
|
| Rate for Payer: Railroad Medicare Medicare |
$698.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,456.96
|
| Rate for Payer: UHC Core |
$2,331.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.00
|
| Rate for Payer: UHC Exchange |
$698.00
|
| Rate for Payer: UHC Medicare Advantage |
$698.00
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$698.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,094.00
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
IP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,814.80 |
| Max. Negotiated Rate |
$2,512.80 |
| Rate for Payer: Aetna Commercial |
$2,373.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,279.11
|
| Rate for Payer: BCN Commercial |
$2,157.66
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,401.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Healthscope Commercial |
$2,512.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,094.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.20
|
| Rate for Payer: Nomi Health Commercial |
$2,289.44
|
| Rate for Payer: PHP Commercial |
$2,373.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,429.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,456.96
|
| Rate for Payer: UHC Core |
$2,331.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,094.00
|
|
|
PR LAPS SURG ESOPG/GSTR FUNDOPLASTY
|
Professional
|
Both
|
$4,149.00
|
|
|
Service Code
|
HCPCS 43280
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$2,696.85 |
| Rate for Payer: Aetna Commercial |
$1,403.85
|
| Rate for Payer: Aetna Medicare |
$1,089.56
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS MAPPO |
$1,047.65
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.65
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cofinity Commercial |
$1,508.62
|
| Rate for Payer: Cofinity Commercial |
$1,403.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.65
|
| Rate for Payer: Mclaren Medicaid |
$692.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.03
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Nomi Health Commercial |
$1,257.18
|
| Rate for Payer: PACE SWMI |
$1,047.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,696.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,928.19
|
| Rate for Payer: Priority Health Medicare |
$1,058.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,928.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.65
|
| Rate for Payer: UHC Exchange |
$1,047.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.65
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
|
|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,491.10 |
| Rate for Payer: Aetna Commercial |
$751.86
|
| Rate for Payer: Aetna Medicare |
$583.53
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$561.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.13
|
| Rate for Payer: BCN Commercial |
$847.86
|
| Rate for Payer: BCN Medicare Advantage |
$561.09
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$807.97
|
| Rate for Payer: Cofinity Commercial |
$751.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.09
|
| Rate for Payer: Mclaren Medicaid |
$374.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.14
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Nomi Health Commercial |
$673.31
|
| Rate for Payer: PACE SWMI |
$561.09
|
| Rate for Payer: PHP Medicare Advantage |
$561.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,042.85
|
| Rate for Payer: Priority Health Medicare |
$566.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.09
|
| Rate for Payer: UHC Exchange |
$561.09
|
| Rate for Payer: UHC Medicare Advantage |
$561.09
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT
|
Professional
|
Both
|
$3,339.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$761.69 |
| Max. Negotiated Rate |
$2,170.35 |
| Rate for Payer: Aetna Commercial |
$1,529.80
|
| Rate for Payer: Aetna Medicare |
$1,187.31
|
| Rate for Payer: BCBS Complete |
$799.77
|
| Rate for Payer: BCBS MAPPO |
$1,141.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.22
|
| Rate for Payer: BCN Commercial |
$1,719.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.64
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cofinity Commercial |
$1,643.96
|
| Rate for Payer: Cofinity Commercial |
$1,529.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.64
|
| Rate for Payer: Mclaren Medicaid |
$761.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.72
|
| Rate for Payer: Meridian Medicaid |
$799.77
|
| Rate for Payer: Nomi Health Commercial |
$1,369.97
|
| Rate for Payer: PACE SWMI |
$1,141.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,892.32
|
| Rate for Payer: Priority Health Medicare |
$1,153.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,892.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,141.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.64
|
| Rate for Payer: UHC Exchange |
$1,141.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,141.64
|
| Rate for Payer: UHCCP Medicaid |
$761.69
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$232.99 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: Aetna Medicare |
$255.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$306.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$306.56
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$245.25
|
| Rate for Payer: BCBS Trust/PPO |
$806.48
|
| Rate for Payer: BCN Commercial |
$762.73
|
| Rate for Payer: BCN Medicare Advantage |
$245.25
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.25
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.75
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.51
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.85
|
| Rate for Payer: Nomi Health Commercial |
$804.42
|
| Rate for Payer: PACE Senior Care Partners |
$232.99
|
| Rate for Payer: PACE SWMI |
$245.25
|
| Rate for Payer: PHP Commercial |
$833.85
|
| Rate for Payer: PHP Medicare Advantage |
$245.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO |
$853.47
|
| Rate for Payer: Priority Health Medicare |
$247.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$657.27
|
| Rate for Payer: Railroad Medicare Medicare |
$245.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$863.28
|
| Rate for Payer: UHC Core |
$819.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.25
|
| Rate for Payer: UHC Exchange |
$245.25
|
| Rate for Payer: UHC Medicare Advantage |
$245.25
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$245.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.75
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Mclaren Medicaid |
$332.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$501.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Exchange |
$496.30
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$637.65 |
| Max. Negotiated Rate |
$882.90 |
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: BCBS Trust/PPO |
$800.79
|
| Rate for Payer: BCN Commercial |
$758.12
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.85
|
| Rate for Payer: Nomi Health Commercial |
$804.42
|
| Rate for Payer: PHP Commercial |
$833.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO |
$853.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$657.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$863.28
|
| Rate for Payer: UHC Core |
$819.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.75
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Mclaren Medicaid |
$332.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$501.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Exchange |
$496.30
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$491.86 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: Aetna Medicare |
$538.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$647.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$647.19
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$517.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,702.57
|
| Rate for Payer: BCN Commercial |
$1,610.20
|
| Rate for Payer: BCN Medicare Advantage |
$517.75
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.75
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,553.25
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.64
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,760.35
|
| Rate for Payer: Nomi Health Commercial |
$1,698.22
|
| Rate for Payer: PACE Senior Care Partners |
$491.86
|
| Rate for Payer: PACE SWMI |
$517.75
|
| Rate for Payer: PHP Commercial |
$1,760.35
|
| Rate for Payer: PHP Medicare Advantage |
$517.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,801.77
|
| Rate for Payer: Priority Health Medicare |
$522.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,387.57
|
| Rate for Payer: Railroad Medicare Medicare |
$517.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,822.48
|
| Rate for Payer: UHC Core |
$1,729.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.75
|
| Rate for Payer: UHC Exchange |
$517.75
|
| Rate for Payer: UHC Medicare Advantage |
$517.75
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$517.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,553.25
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
IP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,346.15 |
| Max. Negotiated Rate |
$1,863.90 |
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.56
|
| Rate for Payer: BCN Commercial |
$1,600.47
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,553.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,760.35
|
| Rate for Payer: Nomi Health Commercial |
$1,698.22
|
| Rate for Payer: PHP Commercial |
$1,760.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,801.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,387.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,822.48
|
| Rate for Payer: UHC Core |
$1,729.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,553.25
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Mclaren Medicaid |
$367.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$555.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,021.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Exchange |
$550.11
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Mclaren Medicaid |
$367.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$555.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,021.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Exchange |
$550.11
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 43652
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$1,378.72 |
| Rate for Payer: Aetna Commercial |
$999.95
|
| Rate for Payer: Aetna Medicare |
$776.08
|
| Rate for Payer: BCBS Complete |
$519.99
|
| Rate for Payer: BCBS MAPPO |
$746.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.56
|
| Rate for Payer: BCN Commercial |
$1,121.52
|
| Rate for Payer: BCN Medicare Advantage |
$746.23
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$999.95
|
| Rate for Payer: Cofinity Commercial |
$1,074.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.23
|
| Rate for Payer: Mclaren Medicaid |
$495.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.54
|
| Rate for Payer: Meridian Medicaid |
$519.99
|
| Rate for Payer: Nomi Health Commercial |
$895.48
|
| Rate for Payer: PACE SWMI |
$746.23
|
| Rate for Payer: PHP Medicare Advantage |
$746.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,378.72
|
| Rate for Payer: Priority Health Medicare |
$753.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,378.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.23
|
| Rate for Payer: UHC Exchange |
$746.23
|
| Rate for Payer: UHC Medicare Advantage |
$746.23
|
| Rate for Payer: UHCCP Medicaid |
$495.23
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV TRUNCAL
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 43651
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$1,681.55 |
| Rate for Payer: Aetna Commercial |
$858.23
|
| Rate for Payer: Aetna Medicare |
$666.09
|
| Rate for Payer: BCBS Complete |
$447.30
|
| Rate for Payer: BCBS MAPPO |
$640.47
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$640.47
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$922.28
|
| Rate for Payer: Cofinity Commercial |
$858.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.47
|
| Rate for Payer: Mclaren Medicaid |
$426.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.49
|
| Rate for Payer: Meridian Medicaid |
$447.30
|
| Rate for Payer: Nomi Health Commercial |
$768.56
|
| Rate for Payer: PACE SWMI |
$640.47
|
| Rate for Payer: PHP Medicare Advantage |
$640.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,184.84
|
| Rate for Payer: Priority Health Medicare |
$646.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,184.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.47
|
| Rate for Payer: UHC Exchange |
$640.47
|
| Rate for Payer: UHC Medicare Advantage |
$640.47
|
| Rate for Payer: UHCCP Medicaid |
$426.00
|
|
|
PR LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 49322
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$1,014.65 |
| Rate for Payer: Aetna Commercial |
$487.02
|
| Rate for Payer: Aetna Medicare |
$377.99
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$363.45
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$363.45
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$523.37
|
| Rate for Payer: Cofinity Commercial |
$487.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.45
|
| Rate for Payer: Mclaren Medicaid |
$241.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.62
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Nomi Health Commercial |
$436.14
|
| Rate for Payer: PACE SWMI |
$363.45
|
| Rate for Payer: PHP Medicare Advantage |
$363.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO |
$674.15
|
| Rate for Payer: Priority Health Medicare |
$367.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$674.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.45
|
| Rate for Payer: UHC Exchange |
$363.45
|
| Rate for Payer: UHC Medicare Advantage |
$363.45
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
|
|
PR LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 49323
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$1,264.25 |
| Rate for Payer: Aetna Commercial |
$831.97
|
| Rate for Payer: Aetna Medicare |
$645.70
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$620.87
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$930.93
|
| Rate for Payer: BCN Medicare Advantage |
$620.87
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$894.05
|
| Rate for Payer: Cofinity Commercial |
$831.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.87
|
| Rate for Payer: Mclaren Medicaid |
$413.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.91
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Nomi Health Commercial |
$745.04
|
| Rate for Payer: PACE SWMI |
$620.87
|
| Rate for Payer: PHP Medicare Advantage |
$620.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,148.44
|
| Rate for Payer: Priority Health Medicare |
$627.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.87
|
| Rate for Payer: UHC Exchange |
$620.87
|
| Rate for Payer: UHC Medicare Advantage |
$620.87
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
|
|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$1,801.80 |
| Rate for Payer: Aetna Commercial |
$1,167.29
|
| Rate for Payer: Aetna Medicare |
$905.95
|
| Rate for Payer: BCBS Complete |
$612.35
|
| Rate for Payer: BCBS MAPPO |
$871.11
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$1,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$871.11
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cofinity Commercial |
$1,254.40
|
| Rate for Payer: Cofinity Commercial |
$1,167.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.11
|
| Rate for Payer: Mclaren Medicaid |
$583.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.67
|
| Rate for Payer: Meridian Medicaid |
$612.35
|
| Rate for Payer: Nomi Health Commercial |
$1,045.33
|
| Rate for Payer: PACE SWMI |
$871.11
|
| Rate for Payer: PHP Medicare Advantage |
$871.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,360.66
|
| Rate for Payer: Priority Health Medicare |
$879.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,360.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$871.11
|
| Rate for Payer: UHC Exchange |
$871.11
|
| Rate for Payer: UHC Medicare Advantage |
$871.11
|
| Rate for Payer: UHCCP Medicaid |
$583.19
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$284.23 |
| Max. Negotiated Rate |
$1,167.45 |
| Rate for Payer: Aetna Commercial |
$1,035.47
|
| Rate for Payer: Aetna Medicare |
$803.65
|
| Rate for Payer: BCBS Complete |
$535.65
|
| Rate for Payer: BCBS MAPPO |
$772.74
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$772.74
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,112.75
|
| Rate for Payer: Cofinity Commercial |
$1,035.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.74
|
| Rate for Payer: Mclaren Medicaid |
$510.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.38
|
| Rate for Payer: Meridian Medicaid |
$535.65
|
| Rate for Payer: Nomi Health Commercial |
$927.29
|
| Rate for Payer: PACE SWMI |
$772.74
|
| Rate for Payer: PHP Medicare Advantage |
$772.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,118.76
|
| Rate for Payer: Priority Health Medicare |
$780.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,118.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.74
|
| Rate for Payer: UHC Exchange |
$772.74
|
| Rate for Payer: UHC Medicare Advantage |
$772.74
|
| Rate for Payer: UHCCP Medicaid |
$510.14
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$1,142.04 |
| Rate for Payer: Aetna Commercial |
$1,012.77
|
| Rate for Payer: Aetna Medicare |
$786.03
|
| Rate for Payer: BCBS Complete |
$523.56
|
| Rate for Payer: BCBS MAPPO |
$755.80
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$1,142.04
|
| Rate for Payer: BCN Medicare Advantage |
$755.80
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,088.35
|
| Rate for Payer: Cofinity Commercial |
$1,012.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.80
|
| Rate for Payer: Mclaren Medicaid |
$498.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.59
|
| Rate for Payer: Meridian Medicaid |
$523.56
|
| Rate for Payer: Nomi Health Commercial |
$906.96
|
| Rate for Payer: PACE SWMI |
$755.80
|
| Rate for Payer: PHP Medicare Advantage |
$755.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,094.54
|
| Rate for Payer: Priority Health Medicare |
$763.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$755.80
|
| Rate for Payer: UHC Exchange |
$755.80
|
| Rate for Payer: UHC Medicare Advantage |
$755.80
|
| Rate for Payer: UHCCP Medicaid |
$498.63
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,890.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$879.26 |
| Max. Negotiated Rate |
$5,304.13 |
| Rate for Payer: Aetna Commercial |
$1,765.12
|
| Rate for Payer: Aetna Medicare |
$1,369.94
|
| Rate for Payer: BCBS Complete |
$923.22
|
| Rate for Payer: BCBS MAPPO |
$1,317.25
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.13
|
| Rate for Payer: BCN Commercial |
$1,985.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.25
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cofinity Commercial |
$1,896.84
|
| Rate for Payer: Cofinity Commercial |
$1,765.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.25
|
| Rate for Payer: Mclaren Medicaid |
$879.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.11
|
| Rate for Payer: Meridian Medicaid |
$923.22
|
| Rate for Payer: Nomi Health Commercial |
$1,580.70
|
| Rate for Payer: PACE SWMI |
$1,317.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$879.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,878.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,188.99
|
| Rate for Payer: Priority Health Medicare |
$1,330.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,188.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,317.25
|
| Rate for Payer: UHC Exchange |
$1,317.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,317.25
|
| Rate for Payer: UHCCP Medicaid |
$879.26
|
|
