|
PR RPR CLOACAL ANOMALY SACROPERINEAL
|
Professional
|
Both
|
$6,454.00
|
|
|
Service Code
|
HCPCS 46744
|
| Min. Negotiated Rate |
$741.73 |
| Max. Negotiated Rate |
$6,197.23 |
| Rate for Payer: Aetna Commercial |
$4,778.09
|
| Rate for Payer: BCBS Complete |
$2,367.56
|
| Rate for Payer: BCBS Trust/PPO |
$741.73
|
| Rate for Payer: Cash Price |
$5,163.20
|
| Rate for Payer: Cash Price |
$5,163.20
|
| Rate for Payer: Meridian Medicaid |
$2,367.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,517.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,197.23
|
| Rate for Payer: Priority Health Narrow Network |
$6,197.23
|
| Rate for Payer: Priority Health SBD |
$6,197.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,968.84
|
|
|
PR RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 26540
|
| Min. Negotiated Rate |
$400.45 |
| Max. Negotiated Rate |
$1,360.80 |
| Rate for Payer: Aetna Commercial |
$924.08
|
| Rate for Payer: BCBS Complete |
$475.92
|
| Rate for Payer: BCBS Trust/PPO |
$400.45
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Meridian Medicaid |
$475.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.71
|
| Rate for Payer: Priority Health SBD |
$1,088.71
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
|
|
PR RPR COMPONENT INFLATABLE PENILE PROSTHESIS
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 54408
|
| Min. Negotiated Rate |
$503.96 |
| Max. Negotiated Rate |
$2,176.77 |
| Rate for Payer: Aetna Commercial |
$1,014.50
|
| Rate for Payer: BCBS Complete |
$529.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.77
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Meridian Medicaid |
$529.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.74
|
| Rate for Payer: Priority Health SBD |
$1,261.74
|
| Rate for Payer: UMR Bronson Commercial |
$678.50
|
|
|
PR RPR CONGENITAL AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$4,140.00
|
|
|
Service Code
|
HCPCS 35184
|
| Min. Negotiated Rate |
$602.79 |
| Max. Negotiated Rate |
$2,898.00 |
| Rate for Payer: Aetna Commercial |
$1,296.30
|
| Rate for Payer: BCBS Complete |
$632.93
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: Cash Price |
$3,312.00
|
| Rate for Payer: Cash Price |
$3,312.00
|
| Rate for Payer: Meridian Medicaid |
$632.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,898.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,498.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,498.52
|
| Rate for Payer: Priority Health SBD |
$1,498.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,904.40
|
|
|
PR RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS
|
Professional
|
Both
|
$5,695.00
|
|
|
Service Code
|
HCPCS 33500
|
| Min. Negotiated Rate |
$426.34 |
| Max. Negotiated Rate |
$3,986.50 |
| Rate for Payer: Aetna Commercial |
$2,094.69
|
| Rate for Payer: BCBS Complete |
$1,024.99
|
| Rate for Payer: BCBS Trust/PPO |
$426.34
|
| Rate for Payer: Cash Price |
$4,556.00
|
| Rate for Payer: Cash Price |
$4,556.00
|
| Rate for Payer: Meridian Medicaid |
$1,024.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$976.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,986.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,433.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,433.71
|
| Rate for Payer: Priority Health SBD |
$2,433.71
|
| Rate for Payer: UMR Bronson Commercial |
$2,619.70
|
|
|
PR RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 36576
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$1,186.03 |
| Rate for Payer: Aetna Commercial |
$245.57
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.03
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.32
|
| Rate for Payer: Priority Health Narrow Network |
$288.32
|
| Rate for Payer: Priority Health SBD |
$288.32
|
| Rate for Payer: UMR Bronson Commercial |
$384.10
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT
|
Professional
|
Both
|
$5,875.00
|
|
|
Service Code
|
HCPCS 39540
|
| Min. Negotiated Rate |
$552.74 |
| Max. Negotiated Rate |
$4,112.50 |
| Rate for Payer: Aetna Commercial |
$887.30
|
| Rate for Payer: BCBS Complete |
$580.38
|
| Rate for Payer: BCBS Trust/PPO |
$676.75
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Meridian Medicaid |
$580.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,112.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,368.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,368.73
|
| Rate for Payer: Priority Health SBD |
$1,368.73
|
| Rate for Payer: UMR Bronson Commercial |
$2,702.50
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 39541
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,476.72 |
| Rate for Payer: Aetna Commercial |
$964.34
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS Trust/PPO |
$509.28
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,476.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,476.72
|
| Rate for Payer: Priority Health SBD |
$1,476.72
|
| Rate for Payer: UMR Bronson Commercial |
$771.88
|
|
|
PR RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 27675
|
| Min. Negotiated Rate |
$221.89 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$654.05
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS Trust/PPO |
$221.89
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Meridian Medicaid |
$336.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.90
|
| Rate for Payer: Priority Health Narrow Network |
$762.90
|
| Rate for Payer: Priority Health SBD |
$762.90
|
| Rate for Payer: UMR Bronson Commercial |
$586.50
|
|
|
PR RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM
|
Professional
|
Both
|
$1,890.04
|
|
|
Service Code
|
HCPCS 63707
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$1,608.08 |
| Rate for Payer: Aetna Commercial |
$1,204.37
|
| Rate for Payer: BCBS Complete |
$639.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.28
|
| Rate for Payer: Cash Price |
$1,512.03
|
| Rate for Payer: Cash Price |
$1,512.03
|
| Rate for Payer: Meridian Medicaid |
$639.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,608.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,608.08
|
| Rate for Payer: Priority Health SBD |
$1,608.08
|
| Rate for Payer: UMR Bronson Commercial |
$869.42
|
|
|
PR RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM
|
Professional
|
Both
|
$5,910.00
|
|
|
Service Code
|
HCPCS 63709
|
| Min. Negotiated Rate |
$722.07 |
| Max. Negotiated Rate |
$4,137.00 |
| Rate for Payer: Aetna Commercial |
$1,435.43
|
| Rate for Payer: BCBS Complete |
$758.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.00
|
| Rate for Payer: Cash Price |
$4,728.00
|
| Rate for Payer: Cash Price |
$4,728.00
|
| Rate for Payer: Meridian Medicaid |
$758.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,904.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,904.22
|
| Rate for Payer: Priority Health SBD |
$1,904.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,718.60
|
|
|
PR RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY
|
Professional
|
Both
|
$5,729.00
|
|
|
Service Code
|
HCPCS 62120
|
| Min. Negotiated Rate |
$1,110.49 |
| Max. Negotiated Rate |
$4,010.30 |
| Rate for Payer: Aetna Commercial |
$2,715.90
|
| Rate for Payer: BCBS Complete |
$1,413.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Meridian Medicaid |
$1,413.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,346.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,559.85
|
| Rate for Payer: Priority Health Narrow Network |
$3,559.85
|
| Rate for Payer: Priority Health SBD |
$3,559.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,635.34
|
|
|
PR RPR EPIGASTRIC HERNIA INCARCERATED
|
Professional
|
Both
|
$1,459.00
|
|
|
Service Code
|
HCPCS 49572
|
| Min. Negotiated Rate |
$583.60 |
| Max. Negotiated Rate |
$1,021.30 |
| Rate for Payer: BCBS Complete |
$583.60
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.30
|
| Rate for Payer: UMR Bronson Commercial |
$671.14
|
|
|
PR RPR EPIGASTRIC HERNIA REDUCIBLE SPX
|
Professional
|
Both
|
$1,148.00
|
|
|
Service Code
|
HCPCS 49570
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$803.60 |
| Rate for Payer: BCBS Complete |
$459.20
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$803.60
|
| Rate for Payer: UMR Bronson Commercial |
$528.08
|
|
|
PR RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 27664
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$480.09
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.15
|
| Rate for Payer: Priority Health Narrow Network |
$559.15
|
| Rate for Payer: Priority Health SBD |
$559.15
|
| Rate for Payer: UMR Bronson Commercial |
$273.70
|
|
|
PR RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 27665
|
| Min. Negotiated Rate |
$275.20 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$558.66
|
| Rate for Payer: BCBS Complete |
$288.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Meridian Medicaid |
$288.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.99
|
| Rate for Payer: Priority Health Narrow Network |
$646.99
|
| Rate for Payer: Priority Health SBD |
$646.99
|
| Rate for Payer: UMR Bronson Commercial |
$387.32
|
|
|
PR RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 27659
|
| Min. Negotiated Rate |
$305.66 |
| Max. Negotiated Rate |
$1,861.44 |
| Rate for Payer: Aetna Commercial |
$625.38
|
| Rate for Payer: BCBS Complete |
$320.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,861.44
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Meridian Medicaid |
$320.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Priority Health SBD |
$720.53
|
| Rate for Payer: UMR Bronson Commercial |
$490.82
|
|
|
PR RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$5,448.00
|
|
|
Service Code
|
HCPCS 46740
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$3,813.60 |
| Rate for Payer: Aetna Commercial |
$2,917.67
|
| Rate for Payer: BCBS Complete |
$1,457.98
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: Cash Price |
$4,358.40
|
| Rate for Payer: Cash Price |
$4,358.40
|
| Rate for Payer: Meridian Medicaid |
$1,457.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,388.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,813.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,811.24
|
| Rate for Payer: Priority Health Narrow Network |
$3,811.24
|
| Rate for Payer: Priority Health SBD |
$3,811.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,506.08
|
|
|
PR RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL
|
Professional
|
Both
|
$5,046.00
|
|
|
Service Code
|
HCPCS 46742
|
| Min. Negotiated Rate |
$477.58 |
| Max. Negotiated Rate |
$4,399.21 |
| Rate for Payer: Aetna Commercial |
$3,377.01
|
| Rate for Payer: BCBS Complete |
$1,682.52
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: Cash Price |
$4,036.80
|
| Rate for Payer: Cash Price |
$4,036.80
|
| Rate for Payer: Meridian Medicaid |
$1,682.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,602.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,532.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,399.21
|
| Rate for Payer: Priority Health Narrow Network |
$4,399.21
|
| Rate for Payer: Priority Health SBD |
$4,399.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,321.16
|
|
|
PR RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$3,803.00
|
|
|
Service Code
|
HCPCS 46730
|
| Min. Negotiated Rate |
$105.13 |
| Max. Negotiated Rate |
$3,495.49 |
| Rate for Payer: Aetna Commercial |
$2,672.39
|
| Rate for Payer: BCBS Complete |
$1,336.98
|
| Rate for Payer: BCBS Trust/PPO |
$105.13
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Meridian Medicaid |
$1,336.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,273.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,662.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,495.49
|
| Rate for Payer: Priority Health Narrow Network |
$3,495.49
|
| Rate for Payer: Priority Health SBD |
$3,495.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,749.38
|
|
|
PR RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE
|
Professional
|
Both
|
$1,946.00
|
|
|
Service Code
|
HCPCS 54340
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$2,917.27 |
| Rate for Payer: Aetna Commercial |
$730.32
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,917.27
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.96
|
| Rate for Payer: Priority Health Narrow Network |
$909.96
|
| Rate for Payer: Priority Health SBD |
$909.96
|
| Rate for Payer: UMR Bronson Commercial |
$895.16
|
|
|
PR RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR
|
Professional
|
Both
|
$7,400.00
|
|
|
Service Code
|
HCPCS 33660
|
| Min. Negotiated Rate |
$1,101.42 |
| Max. Negotiated Rate |
$5,180.00 |
| Rate for Payer: Aetna Commercial |
$2,358.28
|
| Rate for Payer: BCBS Complete |
$1,156.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: Cash Price |
$5,920.00
|
| Rate for Payer: Cash Price |
$5,920.00
|
| Rate for Payer: Meridian Medicaid |
$1,156.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,101.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.05
|
| Rate for Payer: Priority Health SBD |
$2,739.05
|
| Rate for Payer: UMR Bronson Commercial |
$3,404.00
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
IP
|
$1,604.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$705.76 |
| Max. Negotiated Rate |
$1,443.60 |
| Rate for Payer: Aetna American Axle |
$1,042.60
|
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.60
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,122.80
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,122.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,363.40
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health SBD |
$1,010.52
|
| Rate for Payer: UMR Bronson Commercial |
$705.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
OP
|
$1,604.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$567.78 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$1,042.60
|
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.60
|
| 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 |
$2,519.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,122.80
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,122.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| 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 |
$1,363.40
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| 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 |
$1,122.80
|
| 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 |
$1,010.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$567.78
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$593.48
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$369.34 |
| Max. Negotiated Rate |
$1,122.80 |
| Rate for Payer: Aetna Commercial |
$773.33
|
| Rate for Payer: BCBS Complete |
$387.81
|
| Rate for Payer: BCBS Trust/PPO |
$515.62
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Meridian Medicaid |
$387.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,013.67
|
| Rate for Payer: Priority Health SBD |
$1,013.67
|
| Rate for Payer: UMR Bronson Commercial |
$737.84
|
|
