|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 49550
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,069.12 |
| Rate for Payer: Aetna Commercial |
$777.96
|
| Rate for Payer: Aetna Medicare |
$445.00
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Mclaren Medicaid |
$356.14
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,069.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.12
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$619.44 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: BCBS Trust/PPO |
$735.05
|
| Rate for Payer: BCN Commercial |
$735.05
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.50
|
| Rate for Payer: Nomi Health Commercial |
$729.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$774.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.44
|
| Rate for Payer: UHC Core |
$743.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
PR RPR 1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 49561
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Medicare |
$1,155.00
|
| Rate for Payer: BCBS Complete |
$924.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$790.43
|
| Rate for Payer: Aetna Medicare |
$857.50
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Mclaren Medicaid |
$362.31
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,085.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,085.49
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$790.43
|
| Rate for Payer: Aetna Medicare |
$857.50
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Mclaren Medicaid |
$362.31
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,085.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,085.49
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
IP
|
$1,715.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,193.64 |
| Max. Negotiated Rate |
$1,543.50 |
| Rate for Payer: Aetna Commercial |
$1,457.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.42
|
| Rate for Payer: BCN Commercial |
$1,416.42
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,474.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.00
|
| Rate for Payer: Healthscope Commercial |
$1,543.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,286.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.75
|
| Rate for Payer: Nomi Health Commercial |
$1,406.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PHP Commercial |
$1,457.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,492.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,193.64
|
| Rate for Payer: UHC Core |
$1,432.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,286.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
OP
|
$1,715.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$302.35 |
| Max. Negotiated Rate |
$1,543.50 |
| Rate for Payer: Aetna Commercial |
$1,457.75
|
| Rate for Payer: Aetna Medicare |
$445.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$535.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$535.94
|
| Rate for Payer: BCBS Complete |
$317.45
|
| Rate for Payer: BCBS MAPPO |
$428.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.90
|
| Rate for Payer: BCN Commercial |
$1,409.90
|
| Rate for Payer: BCN Medicare Advantage |
$428.75
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,474.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.75
|
| Rate for Payer: Healthscope Commercial |
$1,543.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,286.25
|
| Rate for Payer: Mclaren Medicaid |
$302.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.19
|
| Rate for Payer: Meridian Medicaid |
$317.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$493.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$471.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.75
|
| Rate for Payer: Nomi Health Commercial |
$1,406.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE Senior Care Partners |
$407.31
|
| Rate for Payer: PACE SWMI |
$428.75
|
| Rate for Payer: PHP Commercial |
$1,457.75
|
| Rate for Payer: PHP Medicare Advantage |
$428.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,492.05
|
| Rate for Payer: Priority Health Medicare |
$433.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,193.64
|
| Rate for Payer: Railroad Medicare Medicare |
$428.75
|
| Rate for Payer: UHC Core |
$1,432.03
|
| Rate for Payer: UHC Exchange |
$428.75
|
| Rate for Payer: UHC Medicaid |
$302.35
|
| Rate for Payer: UHC Medicare Advantage |
$428.75
|
| Rate for Payer: UHCCP Medicaid |
$302.35
|
| Rate for Payer: VA VA |
$428.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,286.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$703.82
|
| Rate for Payer: Aetna Medicare |
$869.50
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Mclaren Medicaid |
$323.97
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$967.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$967.17
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$703.82
|
| Rate for Payer: Aetna Medicare |
$869.50
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Mclaren Medicaid |
$323.97
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$967.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$967.17
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$306.59 |
| Max. Negotiated Rate |
$1,565.10 |
| Rate for Payer: Aetna Commercial |
$1,478.15
|
| Rate for Payer: Aetna Medicare |
$452.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$543.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$543.44
|
| Rate for Payer: BCBS Complete |
$321.89
|
| Rate for Payer: BCBS MAPPO |
$434.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.63
|
| Rate for Payer: BCN Commercial |
$1,429.63
|
| Rate for Payer: BCN Medicare Advantage |
$434.75
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,495.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.75
|
| Rate for Payer: Healthscope Commercial |
$1,565.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,304.25
|
| Rate for Payer: Mclaren Medicaid |
$306.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.49
|
| Rate for Payer: Meridian Medicaid |
$321.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$499.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$478.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Nomi Health Commercial |
$1,425.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE Senior Care Partners |
$413.01
|
| Rate for Payer: PACE SWMI |
$434.75
|
| Rate for Payer: PHP Commercial |
$1,478.15
|
| Rate for Payer: PHP Medicare Advantage |
$434.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,512.93
|
| Rate for Payer: Priority Health Medicare |
$439.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,210.34
|
| Rate for Payer: Railroad Medicare Medicare |
$434.75
|
| Rate for Payer: UHC Core |
$1,452.07
|
| Rate for Payer: UHC Exchange |
$434.75
|
| Rate for Payer: UHC Medicaid |
$306.59
|
| Rate for Payer: UHC Medicare Advantage |
$434.75
|
| Rate for Payer: UHCCP Medicaid |
$306.59
|
| Rate for Payer: VA VA |
$434.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,304.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,210.34 |
| Max. Negotiated Rate |
$1,565.10 |
| Rate for Payer: Aetna Commercial |
$1,478.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.24
|
| Rate for Payer: BCN Commercial |
$1,436.24
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,495.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Healthscope Commercial |
$1,565.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,304.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Nomi Health Commercial |
$1,425.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PHP Commercial |
$1,478.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,512.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,210.34
|
| Rate for Payer: UHC Core |
$1,452.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,304.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$374.03 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$818.16
|
| Rate for Payer: Aetna Medicare |
$893.00
|
| Rate for Payer: BCBS Complete |
$392.73
|
| Rate for Payer: BCN Commercial |
$920.77
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Mclaren Medicaid |
$374.03
|
| Rate for Payer: Meridian Medicaid |
$392.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,121.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,121.90
|
| Rate for Payer: UHC Medicaid |
$374.03
|
| Rate for Payer: UHCCP Medicaid |
$374.03
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,403.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$263.06 |
| Max. Negotiated Rate |
$1,052.25 |
| Rate for Payer: Aetna Commercial |
$557.36
|
| Rate for Payer: Aetna Medicare |
$701.50
|
| Rate for Payer: BCBS Complete |
$276.21
|
| Rate for Payer: BCN Commercial |
$633.43
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Mclaren Medicaid |
$263.06
|
| Rate for Payer: Meridian Medicaid |
$276.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,052.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$771.80
|
| Rate for Payer: UHC Medicaid |
$263.06
|
| Rate for Payer: UHCCP Medicaid |
$263.06
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$380.21 |
| Max. Negotiated Rate |
$1,389.75 |
| Rate for Payer: Aetna Commercial |
$828.71
|
| Rate for Payer: Aetna Medicare |
$926.50
|
| Rate for Payer: BCBS Complete |
$399.22
|
| Rate for Payer: BCN Commercial |
$934.21
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Mclaren Medicaid |
$380.21
|
| Rate for Payer: Meridian Medicaid |
$399.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,389.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,138.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,138.28
|
| Rate for Payer: UHC Medicaid |
$380.21
|
| Rate for Payer: UHCCP Medicaid |
$380.21
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,559.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$1,169.25 |
| Rate for Payer: Aetna Commercial |
$551.37
|
| Rate for Payer: Aetna Medicare |
$779.50
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Mclaren Medicaid |
$254.75
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,169.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$757.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.23
|
| Rate for Payer: UHC Medicaid |
$254.75
|
| Rate for Payer: UHCCP Medicaid |
$254.75
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$1,765.06 |
| Rate for Payer: Aetna Commercial |
$1,296.36
|
| Rate for Payer: Aetna Medicare |
$978.00
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCN Commercial |
$1,448.62
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Mclaren Medicaid |
$581.06
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,467.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,765.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,765.06
|
| Rate for Payer: UHC Medicaid |
$581.06
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,470.78 |
| Rate for Payer: Aetna Commercial |
$1,077.26
|
| Rate for Payer: Aetna Medicare |
$857.50
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCN Commercial |
$1,207.10
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,470.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,470.78
|
| Rate for Payer: UHC Medicaid |
$487.13
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$1,005.75 |
| Rate for Payer: Aetna Commercial |
$519.92
|
| Rate for Payer: Aetna Medicare |
$670.50
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCN Commercial |
$575.17
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$618.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.52
|
| Rate for Payer: UHC Medicaid |
$222.16
|
| Rate for Payer: UHCCP Medicaid |
$222.16
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$217.69 |
| Max. Negotiated Rate |
$1,029.00 |
| Rate for Payer: Aetna Commercial |
$504.08
|
| Rate for Payer: Aetna Medicare |
$686.00
|
| Rate for Payer: BCBS Complete |
$228.57
|
| Rate for Payer: BCN Commercial |
$563.22
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Mclaren Medicaid |
$217.69
|
| Rate for Payer: Meridian Medicaid |
$228.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$605.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.67
|
| Rate for Payer: UHC Medicaid |
$217.69
|
| Rate for Payer: UHCCP Medicaid |
$217.69
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,873.67 |
| Rate for Payer: Aetna Commercial |
$1,380.43
|
| Rate for Payer: Aetna Medicare |
$806.00
|
| Rate for Payer: BCBS Complete |
$627.11
|
| Rate for Payer: BCN Commercial |
$1,537.77
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Mclaren Medicaid |
$597.25
|
| Rate for Payer: Meridian Medicaid |
$627.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,873.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,873.67
|
| Rate for Payer: UHC Medicaid |
$597.25
|
| Rate for Payer: UHCCP Medicaid |
$597.25
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$449.22 |
| Max. Negotiated Rate |
$1,411.32 |
| Rate for Payer: Aetna Commercial |
$1,039.20
|
| Rate for Payer: Aetna Medicare |
$817.00
|
| Rate for Payer: BCBS Complete |
$471.68
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Mclaren Medicaid |
$449.22
|
| Rate for Payer: Meridian Medicaid |
$471.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,411.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.32
|
| Rate for Payer: UHC Medicaid |
$449.22
|
| Rate for Payer: UHCCP Medicaid |
$449.22
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: Aetna Medicare |
$955.50
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,361.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.57
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$336.91 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna Medicare |
$496.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$597.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$597.19
|
| Rate for Payer: BCBS Complete |
$353.73
|
| Rate for Payer: BCBS MAPPO |
$477.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,571.03
|
| Rate for Payer: BCN Commercial |
$1,571.03
|
| Rate for Payer: BCN Medicare Advantage |
$477.75
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.75
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Mclaren Medicaid |
$336.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.64
|
| Rate for Payer: Meridian Medicaid |
$353.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$525.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Nomi Health Commercial |
$1,567.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE Senior Care Partners |
$453.86
|
| Rate for Payer: PACE SWMI |
$477.75
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: PHP Medicare Advantage |
$477.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,662.57
|
| Rate for Payer: Priority Health Medicare |
$482.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.06
|
| Rate for Payer: Railroad Medicare Medicare |
$477.75
|
| Rate for Payer: UHC Core |
$1,595.68
|
| Rate for Payer: UHC Exchange |
$477.75
|
| Rate for Payer: UHC Medicaid |
$336.91
|
| Rate for Payer: UHC Medicare Advantage |
$477.75
|
| Rate for Payer: UHCCP Medicaid |
$336.91
|
| Rate for Payer: VA VA |
$477.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: Aetna Medicare |
$955.50
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,361.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.57
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,330.06 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,578.29
|
| Rate for Payer: BCN Commercial |
$1,578.29
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Nomi Health Commercial |
$1,567.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,662.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.06
|
| Rate for Payer: UHC Core |
$1,595.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
