|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$2,151.77 |
| Rate for Payer: Aetna Commercial |
$623.06
|
| Rate for Payer: Aetna Medicare |
$483.57
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS MAPPO |
$464.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.77
|
| Rate for Payer: BCN Commercial |
$693.44
|
| Rate for Payer: BCN Medicare Advantage |
$464.97
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$669.56
|
| Rate for Payer: Cofinity Commercial |
$623.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.97
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.22
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Nomi Health Commercial |
$557.96
|
| Rate for Payer: PACE SWMI |
$464.97
|
| Rate for Payer: PHP Medicare Advantage |
$464.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO |
$849.54
|
| Rate for Payer: Priority Health Medicare |
$469.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.97
|
| Rate for Payer: UHC Exchange |
$464.97
|
| Rate for Payer: UHC Medicare Advantage |
$464.97
|
| Rate for Payer: UHCCP Medicaid |
$305.44
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$280.72 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$1,004.70
|
| Rate for Payer: Aetna Medicare |
$307.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$369.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$369.38
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$295.50
|
| Rate for Payer: BCBS Trust/PPO |
$971.72
|
| Rate for Payer: BCN Commercial |
$919.00
|
| Rate for Payer: BCN Medicare Advantage |
$295.50
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.50
|
| Rate for Payer: Healthscope Commercial |
$1,063.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$886.50
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.28
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,004.70
|
| Rate for Payer: Nomi Health Commercial |
$969.24
|
| Rate for Payer: PACE Senior Care Partners |
$280.72
|
| Rate for Payer: PACE SWMI |
$295.50
|
| Rate for Payer: PHP Commercial |
$1,004.70
|
| Rate for Payer: PHP Medicare Advantage |
$295.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,028.34
|
| Rate for Payer: Priority Health Medicare |
$298.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$791.94
|
| Rate for Payer: Railroad Medicare Medicare |
$295.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.16
|
| Rate for Payer: UHC Core |
$986.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.50
|
| Rate for Payer: UHC Exchange |
$295.50
|
| Rate for Payer: UHC Medicare Advantage |
$295.50
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$295.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$886.50
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 49591
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$446.80
|
| Rate for Payer: Aetna Medicare |
$346.77
|
| Rate for Payer: BCBS Complete |
$230.58
|
| Rate for Payer: BCBS MAPPO |
$333.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: BCN Medicare Advantage |
$333.43
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$480.14
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.43
|
| Rate for Payer: Mclaren Medicaid |
$219.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.10
|
| Rate for Payer: Meridian Medicaid |
$230.58
|
| Rate for Payer: Nomi Health Commercial |
$400.12
|
| Rate for Payer: PACE SWMI |
$333.43
|
| Rate for Payer: PHP Medicare Advantage |
$333.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO |
$611.51
|
| Rate for Payer: Priority Health Medicare |
$336.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.43
|
| Rate for Payer: UHC Exchange |
$333.43
|
| Rate for Payer: UHC Medicare Advantage |
$333.43
|
| Rate for Payer: UHCCP Medicaid |
$219.60
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$446.80
|
| Rate for Payer: Aetna Medicare |
$346.77
|
| Rate for Payer: BCBS Complete |
$230.58
|
| Rate for Payer: BCBS MAPPO |
$333.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: BCN Medicare Advantage |
$333.43
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$480.14
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.43
|
| Rate for Payer: Mclaren Medicaid |
$219.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.10
|
| Rate for Payer: Meridian Medicaid |
$230.58
|
| Rate for Payer: Nomi Health Commercial |
$400.12
|
| Rate for Payer: PACE SWMI |
$333.43
|
| Rate for Payer: PHP Medicare Advantage |
$333.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO |
$611.51
|
| Rate for Payer: Priority Health Medicare |
$336.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.43
|
| Rate for Payer: UHC Exchange |
$333.43
|
| Rate for Payer: UHC Medicare Advantage |
$333.43
|
| Rate for Payer: UHCCP Medicaid |
$219.60
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
OP
|
$869.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$206.39 |
| Max. Negotiated Rate |
$2,625.09 |
| Rate for Payer: Aetna Commercial |
$738.65
|
| Rate for Payer: Aetna Medicare |
$225.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.56
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$217.25
|
| Rate for Payer: BCBS Trust/PPO |
$714.40
|
| Rate for Payer: BCN Commercial |
$675.65
|
| Rate for Payer: BCN Medicare Advantage |
$217.25
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$747.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.25
|
| Rate for Payer: Healthscope Commercial |
$782.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.75
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.11
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.65
|
| Rate for Payer: Nomi Health Commercial |
$712.58
|
| Rate for Payer: PACE Senior Care Partners |
$206.39
|
| Rate for Payer: PACE SWMI |
$217.25
|
| Rate for Payer: PHP Commercial |
$738.65
|
| Rate for Payer: PHP Medicare Advantage |
$217.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO |
$756.03
|
| Rate for Payer: Priority Health Medicare |
$219.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$582.23
|
| Rate for Payer: Railroad Medicare Medicare |
$217.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.72
|
| Rate for Payer: UHC Core |
$725.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.25
|
| Rate for Payer: UHC Exchange |
$217.25
|
| Rate for Payer: UHC Medicare Advantage |
$217.25
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$217.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.75
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
IP
|
$869.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$564.85 |
| Max. Negotiated Rate |
$782.10 |
| Rate for Payer: Aetna Commercial |
$738.65
|
| Rate for Payer: BCBS Trust/PPO |
$709.36
|
| Rate for Payer: BCN Commercial |
$671.56
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$747.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Healthscope Commercial |
$782.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.65
|
| Rate for Payer: Nomi Health Commercial |
$712.58
|
| Rate for Payer: PHP Commercial |
$738.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO |
$756.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$582.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.72
|
| Rate for Payer: UHC Core |
$725.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.75
|
|
|
PR RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,161.00
|
|
|
Service Code
|
HCPCS 49618
|
| Min. Negotiated Rate |
$797.26 |
| Max. Negotiated Rate |
$2,982.78 |
| Rate for Payer: Aetna Commercial |
$1,629.15
|
| Rate for Payer: Aetna Medicare |
$1,264.41
|
| Rate for Payer: BCBS Complete |
$837.12
|
| Rate for Payer: BCBS MAPPO |
$1,215.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,982.78
|
| Rate for Payer: BCN Commercial |
$1,806.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.78
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.72
|
| Rate for Payer: Cofinity Commercial |
$1,629.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.78
|
| Rate for Payer: Mclaren Medicaid |
$797.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.57
|
| Rate for Payer: Meridian Medicaid |
$837.12
|
| Rate for Payer: Nomi Health Commercial |
$1,458.94
|
| Rate for Payer: PACE SWMI |
$1,215.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,054.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,212.17
|
| Rate for Payer: Priority Health Medicare |
$1,227.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,212.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,215.78
|
| Rate for Payer: UHC Exchange |
$1,215.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,215.78
|
| Rate for Payer: UHCCP Medicaid |
$797.26
|
|
|
PR RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,848.00
|
|
|
Service Code
|
HCPCS 49617
|
| Min. Negotiated Rate |
$569.14 |
| Max. Negotiated Rate |
$1,579.18 |
| Rate for Payer: Aetna Commercial |
$1,161.10
|
| Rate for Payer: Aetna Medicare |
$901.15
|
| Rate for Payer: BCBS Complete |
$597.60
|
| Rate for Payer: BCBS MAPPO |
$866.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.13
|
| Rate for Payer: BCN Commercial |
$1,289.14
|
| Rate for Payer: BCN Medicare Advantage |
$866.49
|
| Rate for Payer: Cash Price |
$1,478.40
|
| Rate for Payer: Cash Price |
$1,478.40
|
| Rate for Payer: Cofinity Commercial |
$1,247.75
|
| Rate for Payer: Cofinity Commercial |
$1,161.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.49
|
| Rate for Payer: Mclaren Medicaid |
$569.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.81
|
| Rate for Payer: Meridian Medicaid |
$597.60
|
| Rate for Payer: Nomi Health Commercial |
$1,039.79
|
| Rate for Payer: PACE SWMI |
$866.49
|
| Rate for Payer: PHP Medicare Advantage |
$866.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,579.18
|
| Rate for Payer: Priority Health Medicare |
$875.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,579.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.49
|
| Rate for Payer: UHC Exchange |
$866.49
|
| Rate for Payer: UHC Medicare Advantage |
$866.49
|
| Rate for Payer: UHCCP Medicaid |
$569.14
|
|
|
PR RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 49616
|
| Min. Negotiated Rate |
$549.97 |
| Max. Negotiated Rate |
$1,532.66 |
| Rate for Payer: Aetna Commercial |
$1,123.36
|
| Rate for Payer: Aetna Medicare |
$871.86
|
| Rate for Payer: BCBS Complete |
$577.47
|
| Rate for Payer: BCBS MAPPO |
$838.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.07
|
| Rate for Payer: BCN Commercial |
$1,251.51
|
| Rate for Payer: BCN Medicare Advantage |
$838.33
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,207.20
|
| Rate for Payer: Cofinity Commercial |
$1,123.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.33
|
| Rate for Payer: Mclaren Medicaid |
$549.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.25
|
| Rate for Payer: Meridian Medicaid |
$577.47
|
| Rate for Payer: Nomi Health Commercial |
$1,006.00
|
| Rate for Payer: PACE SWMI |
$838.33
|
| Rate for Payer: PHP Medicare Advantage |
$838.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,532.66
|
| Rate for Payer: Priority Health Medicare |
$846.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,532.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$838.33
|
| Rate for Payer: UHC Exchange |
$838.33
|
| Rate for Payer: UHC Medicare Advantage |
$838.33
|
| Rate for Payer: UHCCP Medicaid |
$549.97
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,589.00
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$1,032.85 |
| Max. Negotiated Rate |
$1,430.10 |
| Rate for Payer: Aetna Commercial |
$1,350.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,297.10
|
| Rate for Payer: BCN Commercial |
$1,227.98
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,366.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Healthscope Commercial |
$1,430.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,191.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| Rate for Payer: PHP Commercial |
$1,350.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,382.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,064.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,398.32
|
| Rate for Payer: UHC Core |
$1,326.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,191.75
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,589.00
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$377.39 |
| Max. Negotiated Rate |
$4,641.43 |
| Rate for Payer: Aetna Commercial |
$1,350.65
|
| Rate for Payer: Aetna Medicare |
$413.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$496.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$496.56
|
| Rate for Payer: BCBS Complete |
$4,641.43
|
| Rate for Payer: BCBS MAPPO |
$397.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,306.32
|
| Rate for Payer: BCN Commercial |
$1,235.45
|
| Rate for Payer: BCN Medicare Advantage |
$397.25
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,366.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.25
|
| Rate for Payer: Healthscope Commercial |
$1,430.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,191.75
|
| Rate for Payer: Mclaren Medicaid |
$4,420.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.11
|
| Rate for Payer: Meridian Medicaid |
$4,641.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$456.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| Rate for Payer: PACE Senior Care Partners |
$377.39
|
| Rate for Payer: PACE SWMI |
$397.25
|
| Rate for Payer: PHP Commercial |
$1,350.65
|
| Rate for Payer: PHP Medicare Advantage |
$397.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,420.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,382.43
|
| Rate for Payer: Priority Health Medicare |
$401.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,064.63
|
| Rate for Payer: Railroad Medicare Medicare |
$397.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,398.32
|
| Rate for Payer: UHC Core |
$1,326.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.25
|
| Rate for Payer: UHC Exchange |
$397.25
|
| Rate for Payer: UHC Medicare Advantage |
$397.25
|
| Rate for Payer: UHCCP Medicaid |
$4,420.12
|
| Rate for Payer: VA VA |
$397.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,191.75
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$648.49
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$623.55
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: BCN Medicare Advantage |
$623.55
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$897.91
|
| Rate for Payer: Cofinity Commercial |
$835.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.55
|
| Rate for Payer: Mclaren Medicaid |
$409.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.73
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Nomi Health Commercial |
$748.26
|
| Rate for Payer: PACE SWMI |
$623.55
|
| Rate for Payer: PHP Medicare Advantage |
$623.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,140.69
|
| Rate for Payer: Priority Health Medicare |
$629.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.55
|
| Rate for Payer: UHC Exchange |
$623.55
|
| Rate for Payer: UHC Medicare Advantage |
$623.55
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$648.49
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$623.55
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: BCN Medicare Advantage |
$623.55
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$897.91
|
| Rate for Payer: Cofinity Commercial |
$835.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.55
|
| Rate for Payer: Mclaren Medicaid |
$409.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.73
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Nomi Health Commercial |
$748.26
|
| Rate for Payer: PACE SWMI |
$623.55
|
| Rate for Payer: PHP Medicare Advantage |
$623.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,140.69
|
| Rate for Payer: Priority Health Medicare |
$629.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.55
|
| Rate for Payer: UHC Exchange |
$623.55
|
| Rate for Payer: UHC Medicare Advantage |
$623.55
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$276.69 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$990.25
|
| Rate for Payer: Aetna Medicare |
$302.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$364.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$364.06
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$291.25
|
| Rate for Payer: BCBS Trust/PPO |
$957.75
|
| Rate for Payer: BCN Commercial |
$905.79
|
| Rate for Payer: BCN Medicare Advantage |
$291.25
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,001.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.25
|
| Rate for Payer: Healthscope Commercial |
$1,048.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.75
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.81
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.25
|
| Rate for Payer: Nomi Health Commercial |
$955.30
|
| Rate for Payer: PACE Senior Care Partners |
$276.69
|
| Rate for Payer: PACE SWMI |
$291.25
|
| Rate for Payer: PHP Commercial |
$990.25
|
| Rate for Payer: PHP Medicare Advantage |
$291.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,013.55
|
| Rate for Payer: Priority Health Medicare |
$294.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.55
|
| Rate for Payer: Railroad Medicare Medicare |
$291.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.20
|
| Rate for Payer: UHC Core |
$972.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.25
|
| Rate for Payer: UHC Exchange |
$291.25
|
| Rate for Payer: UHC Medicare Advantage |
$291.25
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$291.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.75
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$757.25 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Aetna Commercial |
$990.25
|
| Rate for Payer: BCBS Trust/PPO |
$950.99
|
| Rate for Payer: BCN Commercial |
$900.31
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,001.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Healthscope Commercial |
$1,048.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.25
|
| Rate for Payer: Nomi Health Commercial |
$955.30
|
| Rate for Payer: PHP Commercial |
$990.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,013.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.20
|
| Rate for Payer: UHC Core |
$972.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.75
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$747.44
|
| Rate for Payer: Aetna Medicare |
$580.10
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$557.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: BCN Medicare Advantage |
$557.79
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$803.22
|
| Rate for Payer: Cofinity Commercial |
$747.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.79
|
| Rate for Payer: Mclaren Medicaid |
$366.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.68
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Nomi Health Commercial |
$669.35
|
| Rate for Payer: PACE SWMI |
$557.79
|
| Rate for Payer: PHP Medicare Advantage |
$557.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,020.18
|
| Rate for Payer: Priority Health Medicare |
$563.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.79
|
| Rate for Payer: UHC Exchange |
$557.79
|
| Rate for Payer: UHC Medicare Advantage |
$557.79
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$747.44
|
| Rate for Payer: Aetna Medicare |
$580.10
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$557.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: BCN Medicare Advantage |
$557.79
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$803.22
|
| Rate for Payer: Cofinity Commercial |
$747.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.79
|
| Rate for Payer: Mclaren Medicaid |
$366.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.68
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Nomi Health Commercial |
$669.35
|
| Rate for Payer: PACE SWMI |
$557.79
|
| Rate for Payer: PHP Medicare Advantage |
$557.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,020.18
|
| Rate for Payer: Priority Health Medicare |
$563.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.79
|
| Rate for Payer: UHC Exchange |
$557.79
|
| Rate for Payer: UHC Medicare Advantage |
$557.79
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Professional
|
Both
|
$857.00
|
|
|
Service Code
|
HCPCS 49613
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$2,199.84 |
| Rate for Payer: Aetna Commercial |
$549.76
|
| Rate for Payer: Aetna Medicare |
$426.68
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS MAPPO |
$410.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,199.84
|
| Rate for Payer: BCN Commercial |
$614.26
|
| Rate for Payer: BCN Medicare Advantage |
$410.27
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Cofinity Commercial |
$590.79
|
| Rate for Payer: Cofinity Commercial |
$549.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.27
|
| Rate for Payer: Mclaren Medicaid |
$270.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.78
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Nomi Health Commercial |
$492.32
|
| Rate for Payer: PACE SWMI |
$410.27
|
| Rate for Payer: PHP Medicare Advantage |
$410.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.05
|
| Rate for Payer: Priority Health HMO/PPO |
$753.50
|
| Rate for Payer: Priority Health Medicare |
$414.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$753.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.27
|
| Rate for Payer: UHC Exchange |
$410.27
|
| Rate for Payer: UHC Medicare Advantage |
$410.27
|
| Rate for Payer: UHCCP Medicaid |
$270.08
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 35190
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,185.44 |
| Rate for Payer: Aetna Commercial |
$968.34
|
| Rate for Payer: Aetna Medicare |
$751.55
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS MAPPO |
$722.64
|
| Rate for Payer: BCBS Trust/PPO |
$706.87
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: BCN Medicare Advantage |
$722.64
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$968.34
|
| Rate for Payer: Cofinity Commercial |
$1,040.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.64
|
| Rate for Payer: Mclaren Medicaid |
$474.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.77
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Nomi Health Commercial |
$867.17
|
| Rate for Payer: PACE SWMI |
$722.64
|
| Rate for Payer: PHP Medicare Advantage |
$722.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,185.44
|
| Rate for Payer: Priority Health Medicare |
$729.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,185.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.64
|
| Rate for Payer: UHC Exchange |
$722.64
|
| Rate for Payer: UHC Medicare Advantage |
$722.64
|
| Rate for Payer: UHCCP Medicaid |
$474.14
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,240.00
|
|
|
Service Code
|
HCPCS 35188
|
| Min. Negotiated Rate |
$836.88 |
| Max. Negotiated Rate |
$2,756.00 |
| Rate for Payer: Aetna Commercial |
$1,704.68
|
| Rate for Payer: Aetna Medicare |
$1,323.04
|
| Rate for Payer: BCBS Complete |
$878.72
|
| Rate for Payer: BCBS MAPPO |
$1,272.15
|
| Rate for Payer: BCBS Trust/PPO |
$933.51
|
| Rate for Payer: BCN Commercial |
$1,893.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.15
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cofinity Commercial |
$1,831.90
|
| Rate for Payer: Cofinity Commercial |
$1,704.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.15
|
| Rate for Payer: Mclaren Medicaid |
$836.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.76
|
| Rate for Payer: Meridian Medicaid |
$878.72
|
| Rate for Payer: Nomi Health Commercial |
$1,526.58
|
| Rate for Payer: PACE SWMI |
$1,272.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,756.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,080.50
|
| Rate for Payer: Priority Health Medicare |
$1,284.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,080.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,272.15
|
| Rate for Payer: UHC Exchange |
$1,272.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,272.15
|
| Rate for Payer: UHCCP Medicaid |
$836.88
|
|
|
PR RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26350
|
| Min. Negotiated Rate |
$329.13 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Commercial |
$929.13
|
| Rate for Payer: Aetna Medicare |
$721.12
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS MAPPO |
$693.38
|
| Rate for Payer: BCBS Trust/PPO |
$329.13
|
| Rate for Payer: BCN Commercial |
$1,111.25
|
| Rate for Payer: BCN Medicare Advantage |
$693.38
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$998.47
|
| Rate for Payer: Cofinity Commercial |
$929.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.38
|
| Rate for Payer: Mclaren Medicaid |
$481.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$728.05
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Nomi Health Commercial |
$832.06
|
| Rate for Payer: PACE SWMI |
$693.38
|
| Rate for Payer: PHP Medicare Advantage |
$693.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,156.13
|
| Rate for Payer: Priority Health Medicare |
$700.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,156.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$693.38
|
| Rate for Payer: UHC Exchange |
$693.38
|
| Rate for Payer: UHC Medicare Advantage |
$693.38
|
| Rate for Payer: UHCCP Medicaid |
$481.17
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$641.34 |
| Max. Negotiated Rate |
$1,760.85 |
| Rate for Payer: Aetna Commercial |
$1,266.73
|
| Rate for Payer: Aetna Medicare |
$983.13
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS MAPPO |
$945.32
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$945.32
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cofinity Commercial |
$1,361.26
|
| Rate for Payer: Cofinity Commercial |
$1,266.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.32
|
| Rate for Payer: Mclaren Medicaid |
$641.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.59
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Nomi Health Commercial |
$1,134.38
|
| Rate for Payer: PACE SWMI |
$945.32
|
| Rate for Payer: PHP Medicare Advantage |
$945.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,522.00
|
| Rate for Payer: Priority Health Medicare |
$954.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.32
|
| Rate for Payer: UHC Exchange |
$945.32
|
| Rate for Payer: UHC Medicare Advantage |
$945.32
|
| Rate for Payer: UHCCP Medicaid |
$641.34
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 26356
|
| Min. Negotiated Rate |
$521.21 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$1,023.56
|
| Rate for Payer: Aetna Medicare |
$794.40
|
| Rate for Payer: BCBS Complete |
$547.27
|
| Rate for Payer: BCBS MAPPO |
$763.85
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$1,176.25
|
| Rate for Payer: BCN Medicare Advantage |
$763.85
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,099.94
|
| Rate for Payer: Cofinity Commercial |
$1,023.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.85
|
| Rate for Payer: Mclaren Medicaid |
$521.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$802.04
|
| Rate for Payer: Meridian Medicaid |
$547.27
|
| Rate for Payer: Nomi Health Commercial |
$916.62
|
| Rate for Payer: PACE SWMI |
$763.85
|
| Rate for Payer: PHP Medicare Advantage |
$763.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,233.98
|
| Rate for Payer: Priority Health Medicare |
$771.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,233.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.85
|
| Rate for Payer: UHC Exchange |
$763.85
|
| Rate for Payer: UHC Medicare Advantage |
$763.85
|
| Rate for Payer: UHCCP Medicaid |
$521.21
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 26357
|
| Min. Negotiated Rate |
$511.92 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,147.04
|
| Rate for Payer: Aetna Medicare |
$890.24
|
| Rate for Payer: BCBS Complete |
$611.24
|
| Rate for Payer: BCBS MAPPO |
$856.00
|
| Rate for Payer: BCBS Trust/PPO |
$511.92
|
| Rate for Payer: BCN Commercial |
$1,316.50
|
| Rate for Payer: BCN Medicare Advantage |
$856.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,232.64
|
| Rate for Payer: Cofinity Commercial |
$1,147.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$856.00
|
| Rate for Payer: Mclaren Medicaid |
$582.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.80
|
| Rate for Payer: Meridian Medicaid |
$611.24
|
| Rate for Payer: Nomi Health Commercial |
$1,027.20
|
| Rate for Payer: PACE SWMI |
$856.00
|
| Rate for Payer: PHP Medicare Advantage |
$856.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,381.56
|
| Rate for Payer: Priority Health Medicare |
$864.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,381.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$856.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$856.00
|
| Rate for Payer: UHC Exchange |
$856.00
|
| Rate for Payer: UHC Medicare Advantage |
$856.00
|
| Rate for Payer: UHCCP Medicaid |
$582.13
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 26370
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$980.26
|
| Rate for Payer: Aetna Medicare |
$760.80
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$731.54
|
| Rate for Payer: BCBS Trust/PPO |
$732.75
|
| Rate for Payer: BCN Commercial |
$1,166.96
|
| Rate for Payer: BCN Medicare Advantage |
$731.54
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$980.26
|
| Rate for Payer: Cofinity Commercial |
$1,053.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.54
|
| Rate for Payer: Mclaren Medicaid |
$505.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$768.12
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Nomi Health Commercial |
$877.85
|
| Rate for Payer: PACE SWMI |
$731.54
|
| Rate for Payer: PHP Medicare Advantage |
$731.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,210.58
|
| Rate for Payer: Priority Health Medicare |
$738.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,210.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.54
|
| Rate for Payer: UHC Exchange |
$731.54
|
| Rate for Payer: UHC Medicare Advantage |
$731.54
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
|
