|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,862.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$616.21 |
| Max. Negotiated Rate |
$1,690.43 |
| Rate for Payer: Aetna Commercial |
$1,296.36
|
| Rate for Payer: BCBS Complete |
$647.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.07
|
| Rate for Payer: Cash Price |
$1,489.60
|
| Rate for Payer: Cash Price |
$1,489.60
|
| Rate for Payer: Meridian Medicaid |
$647.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,690.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,690.43
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: UMR Bronson Commercial |
$856.52
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$201.81 |
| Max. Negotiated Rate |
$1,408.79 |
| Rate for Payer: Aetna Commercial |
$1,077.26
|
| Rate for Payer: BCBS Complete |
$539.00
|
| Rate for Payer: BCBS Trust/PPO |
$201.81
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Meridian Medicaid |
$539.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,408.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.79
|
| Rate for Payer: Priority Health SBD |
$1,408.79
|
| Rate for Payer: UMR Bronson Commercial |
$750.72
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,276.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$245.38 |
| Max. Negotiated Rate |
$1,067.17 |
| Rate for Payer: Aetna Commercial |
$519.92
|
| Rate for Payer: BCBS Complete |
$257.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.17
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Meridian Medicaid |
$257.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$893.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.47
|
| Rate for Payer: Priority Health Narrow Network |
$615.47
|
| Rate for Payer: Priority Health SBD |
$615.47
|
| Rate for Payer: UMR Bronson Commercial |
$586.96
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,306.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$239.84 |
| Max. Negotiated Rate |
$1,215.62 |
| Rate for Payer: Aetna Commercial |
$504.08
|
| Rate for Payer: BCBS Complete |
$251.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,215.62
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Cash Price |
$1,044.80
|
| Rate for Payer: Meridian Medicaid |
$251.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.60
|
| Rate for Payer: Priority Health Narrow Network |
$592.60
|
| Rate for Payer: Priority Health SBD |
$592.60
|
| Rate for Payer: UMR Bronson Commercial |
$600.76
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,534.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$651.78 |
| Max. Negotiated Rate |
$1,865.43 |
| Rate for Payer: Aetna Commercial |
$1,380.43
|
| Rate for Payer: BCBS Complete |
$684.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,865.43
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Meridian Medicaid |
$684.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,793.32
|
| Rate for Payer: Priority Health SBD |
$1,793.32
|
| Rate for Payer: UMR Bronson Commercial |
$705.64
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$491.39 |
| Max. Negotiated Rate |
$1,350.58 |
| Rate for Payer: Aetna Commercial |
$1,039.20
|
| Rate for Payer: BCBS Complete |
$515.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.98
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Meridian Medicaid |
$515.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.58
|
| Rate for Payer: Priority Health SBD |
$1,350.58
|
| Rate for Payer: UMR Bronson Commercial |
$715.30
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$475.42 |
| Max. Negotiated Rate |
$2,889.80 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: BCBS Complete |
$499.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.80
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Meridian Medicaid |
$499.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,308.24
|
| Rate for Payer: Priority Health SBD |
$1,308.24
|
| Rate for Payer: UMR Bronson Commercial |
$836.74
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,819.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$800.36 |
| Max. Negotiated Rate |
$1,637.10 |
| Rate for Payer: Aetna American Axle |
$1,182.35
|
| Rate for Payer: Aetna Commercial |
$1,546.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.35
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$1,273.30
|
| Rate for Payer: Cofinity Commercial |
$1,564.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.20
|
| Rate for Payer: Healthscope Commercial |
$1,637.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,273.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.15
|
| Rate for Payer: PHP Commercial |
$1,546.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.30
|
| Rate for Payer: Priority Health SBD |
$1,145.97
|
| Rate for Payer: UMR Bronson Commercial |
$800.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$475.42 |
| Max. Negotiated Rate |
$2,889.80 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: BCBS Complete |
$499.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.80
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Meridian Medicaid |
$499.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,308.24
|
| Rate for Payer: Priority Health SBD |
$1,308.24
|
| Rate for Payer: UMR Bronson Commercial |
$836.74
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,819.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$673.03 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$1,182.35
|
| Rate for Payer: Aetna Commercial |
$1,546.15
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,740.95
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$1,273.30
|
| Rate for Payer: Cofinity Commercial |
$1,564.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$1,637.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,273.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.25
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.15
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$1,546.15
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$1,145.97
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$730.85
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$673.03
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,395.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$516.15 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$906.75
|
| Rate for Payer: Aetna Commercial |
$1,185.75
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,494.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,199.70
|
| Rate for Payer: Cofinity Commercial |
$976.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,255.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$976.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,046.25
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,185.75
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$1,185.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$878.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$561.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$516.15
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,046.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,395.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$365.30 |
| Max. Negotiated Rate |
$2,206.18 |
| Rate for Payer: Aetna Commercial |
$772.74
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,206.18
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,004.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,004.84
|
| Rate for Payer: Priority Health SBD |
$1,004.84
|
| Rate for Payer: UMR Bronson Commercial |
$641.70
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,395.00
|
|
|
Service Code
|
HCPCS 49593
|
| Min. Negotiated Rate |
$365.30 |
| Max. Negotiated Rate |
$2,206.18 |
| Rate for Payer: Aetna Commercial |
$772.74
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,206.18
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,004.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,004.84
|
| Rate for Payer: Priority Health SBD |
$1,004.84
|
| Rate for Payer: UMR Bronson Commercial |
$641.70
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,395.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$613.80 |
| Max. Negotiated Rate |
$1,255.50 |
| Rate for Payer: Aetna American Axle |
$906.75
|
| Rate for Payer: Aetna Commercial |
$1,185.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.75
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,199.70
|
| Rate for Payer: Cofinity Commercial |
$976.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.00
|
| Rate for Payer: Healthscope Commercial |
$1,255.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$976.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,046.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,185.75
|
| Rate for Payer: PHP Commercial |
$1,185.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health SBD |
$878.85
|
| Rate for Payer: UMR Bronson Commercial |
$613.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,046.25
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,159.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$428.83 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$753.35
|
| Rate for Payer: Aetna Commercial |
$985.15
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,740.95
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Cofinity Commercial |
$811.30
|
| Rate for Payer: Cofinity Commercial |
$996.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$1,043.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$811.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.25
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.15
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$985.15
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$730.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$466.28
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$428.83
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.25
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,159.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$303.31 |
| Max. Negotiated Rate |
$2,151.77 |
| Rate for Payer: Aetna Commercial |
$641.53
|
| Rate for Payer: BCBS Complete |
$318.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.77
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Meridian Medicaid |
$318.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.33
|
| Rate for Payer: Priority Health Narrow Network |
$834.33
|
| Rate for Payer: Priority Health SBD |
$834.33
|
| Rate for Payer: UMR Bronson Commercial |
$533.14
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,159.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$509.96 |
| Max. Negotiated Rate |
$1,043.10 |
| Rate for Payer: Aetna American Axle |
$753.35
|
| Rate for Payer: Aetna Commercial |
$985.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.35
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Cofinity Commercial |
$811.30
|
| Rate for Payer: Cofinity Commercial |
$996.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.20
|
| Rate for Payer: Healthscope Commercial |
$1,043.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$811.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.15
|
| Rate for Payer: PHP Commercial |
$985.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.30
|
| Rate for Payer: Priority Health SBD |
$730.17
|
| Rate for Payer: UMR Bronson Commercial |
$509.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.25
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,159.00
|
|
|
Service Code
|
HCPCS 49592
|
| Min. Negotiated Rate |
$303.31 |
| Max. Negotiated Rate |
$2,151.77 |
| Rate for Payer: Aetna Commercial |
$641.53
|
| Rate for Payer: BCBS Complete |
$318.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.77
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Cash Price |
$927.20
|
| Rate for Payer: Meridian Medicaid |
$318.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.33
|
| Rate for Payer: Priority Health Narrow Network |
$834.33
|
| Rate for Payer: Priority Health SBD |
$834.33
|
| Rate for Payer: UMR Bronson Commercial |
$533.14
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$460.31
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$599.73
|
| Rate for Payer: Priority Health Narrow Network |
$599.73
|
| Rate for Payer: Priority Health SBD |
$599.73
|
| Rate for Payer: UMR Bronson Commercial |
$391.92
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
IP
|
$852.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Aetna American Axle |
$553.80
|
| Rate for Payer: Aetna Commercial |
$724.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.80
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$596.40
|
| Rate for Payer: Cofinity Commercial |
$732.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.60
|
| Rate for Payer: Healthscope Commercial |
$766.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$596.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.20
|
| Rate for Payer: PHP Commercial |
$724.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health SBD |
$536.76
|
| Rate for Payer: UMR Bronson Commercial |
$374.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.00
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 49591
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$460.31
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$599.73
|
| Rate for Payer: Priority Health Narrow Network |
$599.73
|
| Rate for Payer: Priority Health SBD |
$599.73
|
| Rate for Payer: UMR Bronson Commercial |
$391.92
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
OP
|
$852.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$315.24 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$553.80
|
| Rate for Payer: Aetna Commercial |
$724.20
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,494.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$596.40
|
| Rate for Payer: Cofinity Commercial |
$732.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$766.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$596.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.00
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.20
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$724.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$536.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$335.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$315.24
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.00
|
|
|
PR RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 49618
|
| Min. Negotiated Rate |
$789.80 |
| Max. Negotiated Rate |
$2,982.78 |
| Rate for Payer: Aetna Commercial |
$1,673.34
|
| Rate for Payer: BCBS Complete |
$829.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,982.78
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Meridian Medicaid |
$829.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,169.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,173.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,173.15
|
| Rate for Payer: Priority Health SBD |
$2,173.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,425.54
|
|
|
PR RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,812.00
|
|
|
Service Code
|
HCPCS 49617
|
| Min. Negotiated Rate |
$563.81 |
| Max. Negotiated Rate |
$1,551.06 |
| Rate for Payer: Aetna Commercial |
$1,193.22
|
| Rate for Payer: BCBS Complete |
$592.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.13
|
| Rate for Payer: Cash Price |
$1,449.60
|
| Rate for Payer: Cash Price |
$1,449.60
|
| Rate for Payer: Meridian Medicaid |
$592.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,268.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,551.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,551.06
|
| Rate for Payer: Priority Health SBD |
$1,551.06
|
| Rate for Payer: UMR Bronson Commercial |
$833.52
|
|
|
PR RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 49616
|
| Min. Negotiated Rate |
$547.20 |
| Max. Negotiated Rate |
$1,505.80 |
| Rate for Payer: Aetna Commercial |
$1,159.17
|
| Rate for Payer: BCBS Complete |
$574.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.07
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Meridian Medicaid |
$574.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$547.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,505.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,505.80
|
| Rate for Payer: Priority Health SBD |
$1,505.80
|
| Rate for Payer: UMR Bronson Commercial |
$789.82
|
|
