|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$2,672.00
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$912.49 |
| Max. Negotiated Rate |
$2,508.89 |
| Rate for Payer: Aetna Commercial |
$1,952.76
|
| Rate for Payer: BCBS Complete |
$958.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.04
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Meridian Medicaid |
$958.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$912.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,508.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,508.89
|
| Rate for Payer: Priority Health SBD |
$2,508.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,229.12
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$732.08 |
| Max. Negotiated Rate |
$2,006.75 |
| Rate for Payer: Aetna Commercial |
$1,555.18
|
| Rate for Payer: BCBS Complete |
$768.68
|
| Rate for Payer: BCBS Trust/PPO |
$822.56
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Meridian Medicaid |
$768.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,453.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,006.75
|
| Rate for Payer: Priority Health SBD |
$2,006.75
|
| Rate for Payer: UMR Bronson Commercial |
$954.96
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$2,746.00
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$840.07 |
| Max. Negotiated Rate |
$2,308.97 |
| Rate for Payer: Aetna Commercial |
$1,798.20
|
| Rate for Payer: BCBS Complete |
$882.07
|
| Rate for Payer: BCBS Trust/PPO |
$871.97
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Meridian Medicaid |
$882.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,922.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,308.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,308.97
|
| Rate for Payer: Priority Health SBD |
$2,308.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,263.16
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$3,372.00
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$782.14 |
| Max. Negotiated Rate |
$2,360.40 |
| Rate for Payer: Aetna Commercial |
$1,680.36
|
| Rate for Payer: BCBS Complete |
$821.25
|
| Rate for Payer: BCBS Trust/PPO |
$940.03
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Cash Price |
$2,697.60
|
| Rate for Payer: Meridian Medicaid |
$821.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$782.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,360.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,153.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,153.16
|
| Rate for Payer: Priority Health SBD |
$2,153.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.12
|
|
|
PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 49621
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$3,534.33 |
| Rate for Payer: Aetna Commercial |
$999.36
|
| Rate for Payer: BCBS Complete |
$496.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,534.33
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Meridian Medicaid |
$496.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,300.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.01
|
| Rate for Payer: Priority Health SBD |
$1,300.01
|
| Rate for Payer: UMR Bronson Commercial |
$699.20
|
|
|
PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 49622
|
| Min. Negotiated Rate |
$582.77 |
| Max. Negotiated Rate |
$2,705.42 |
| Rate for Payer: Aetna Commercial |
$1,233.64
|
| Rate for Payer: BCBS Complete |
$611.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,705.42
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Meridian Medicaid |
$611.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,603.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.99
|
| Rate for Payer: Priority Health SBD |
$1,603.99
|
| Rate for Payer: UMR Bronson Commercial |
$862.04
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS
|
Professional
|
Both
|
$7,416.00
|
|
|
Service Code
|
HCPCS 33925
|
| Min. Negotiated Rate |
$843.70 |
| Max. Negotiated Rate |
$5,191.20 |
| Rate for Payer: Aetna Commercial |
$2,306.29
|
| Rate for Payer: BCBS Complete |
$1,129.65
|
| Rate for Payer: BCBS Trust/PPO |
$843.70
|
| Rate for Payer: Cash Price |
$5,932.80
|
| Rate for Payer: Cash Price |
$5,932.80
|
| Rate for Payer: Meridian Medicaid |
$1,129.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,191.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,677.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,677.87
|
| Rate for Payer: Priority Health SBD |
$2,677.87
|
| Rate for Payer: UMR Bronson Commercial |
$3,411.36
|
|
|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$5,761.00
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$1,600.75 |
| Max. Negotiated Rate |
$4,766.87 |
| Rate for Payer: Aetna Commercial |
$4,126.09
|
| Rate for Payer: BCBS Complete |
$2,005.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.75
|
| Rate for Payer: Cash Price |
$4,608.80
|
| Rate for Payer: Cash Price |
$4,608.80
|
| Rate for Payer: Meridian Medicaid |
$2,005.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,910.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,032.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,766.87
|
| Rate for Payer: Priority Health Narrow Network |
$4,766.87
|
| Rate for Payer: Priority Health SBD |
$4,766.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,650.06
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$1,913.00
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$2,507.31 |
| Rate for Payer: Aetna Commercial |
$631.52
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.31
|
| Rate for Payer: Cash Price |
$1,530.40
|
| Rate for Payer: Cash Price |
$1,530.40
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.02
|
| Rate for Payer: Priority Health Narrow Network |
$744.02
|
| Rate for Payer: Priority Health SBD |
$744.02
|
| Rate for Payer: UMR Bronson Commercial |
$879.98
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$432.82 |
| Max. Negotiated Rate |
$1,373.05 |
| Rate for Payer: Aetna Commercial |
$885.74
|
| Rate for Payer: BCBS Complete |
$454.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,373.05
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Meridian Medicaid |
$454.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,013.13
|
| Rate for Payer: Priority Health SBD |
$1,013.13
|
| Rate for Payer: UMR Bronson Commercial |
$471.50
|
|
|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$1,866.00
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,306.20 |
| Rate for Payer: Aetna Commercial |
$901.97
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,041.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,041.73
|
| Rate for Payer: Priority Health SBD |
$1,041.73
|
| Rate for Payer: UMR Bronson Commercial |
$858.36
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,849.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$353.79 |
| Max. Negotiated Rate |
$1,994.30 |
| Rate for Payer: Aetna Commercial |
$735.71
|
| Rate for Payer: BCBS Complete |
$371.48
|
| Rate for Payer: BCBS Trust/PPO |
$620.09
|
| Rate for Payer: Cash Price |
$2,279.20
|
| Rate for Payer: Cash Price |
$2,279.20
|
| Rate for Payer: Meridian Medicaid |
$371.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,994.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.01
|
| Rate for Payer: Priority Health Narrow Network |
$840.01
|
| Rate for Payer: Priority Health SBD |
$840.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,310.54
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$1,496.60 |
| Rate for Payer: Aetna Commercial |
$1,057.57
|
| Rate for Payer: BCBS Complete |
$543.69
|
| Rate for Payer: BCBS Trust/PPO |
$89.28
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Meridian Medicaid |
$543.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.92
|
| Rate for Payer: Priority Health SBD |
$1,242.92
|
| Rate for Payer: UMR Bronson Commercial |
$983.48
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,050.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$462.00 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna American Axle |
$682.50
|
| Rate for Payer: Aetna Commercial |
$892.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.50
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$735.00
|
| Rate for Payer: Cofinity Commercial |
$903.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$840.00
|
| Rate for Payer: Healthscope Commercial |
$945.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$735.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$787.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$892.50
|
| Rate for Payer: PHP Commercial |
$892.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health SBD |
$661.50
|
| Rate for Payer: UMR Bronson Commercial |
$462.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$787.50
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,050.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$388.50 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$682.50
|
| Rate for Payer: Aetna Commercial |
$892.50
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.50
|
| 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 |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$903.00
|
| Rate for Payer: Cofinity Commercial |
$735.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$840.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$945.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$735.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$787.50
|
| 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 |
$892.50
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$892.50
|
| 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 |
$735.00
|
| 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 |
$661.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$598.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$388.50
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$787.50
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$813.50
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.35
|
| Rate for Payer: Priority Health SBD |
$1,068.35
|
| Rate for Payer: UMR Bronson Commercial |
$483.00
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$813.50
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.35
|
| Rate for Payer: Priority Health SBD |
$1,068.35
|
| Rate for Payer: UMR Bronson Commercial |
$483.00
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$464.34 |
| Max. Negotiated Rate |
$1,663.62 |
| Rate for Payer: Aetna Commercial |
$975.41
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,276.49
|
| Rate for Payer: Priority Health SBD |
$1,276.49
|
| Rate for Payer: UMR Bronson Commercial |
$667.92
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,040.00 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: BCBS Complete |
$1,040.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.00
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,250.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: BCBS Complete |
$900.00
|
| Rate for Payer: Cash Price |
$1,800.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,575.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,035.00
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,687.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$742.28 |
| Max. Negotiated Rate |
$1,518.30 |
| Rate for Payer: Aetna American Axle |
$1,096.55
|
| Rate for Payer: Aetna Commercial |
$1,433.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.55
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$1,180.90
|
| Rate for Payer: Cofinity Commercial |
$1,450.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.60
|
| Rate for Payer: Healthscope Commercial |
$1,518.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.95
|
| Rate for Payer: PHP Commercial |
$1,433.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health SBD |
$1,062.81
|
| Rate for Payer: UMR Bronson Commercial |
$742.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.25
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,687.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$624.19 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$1,096.55
|
| Rate for Payer: Aetna Commercial |
$1,433.95
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.55
|
| 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 |
$3,602.32
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$1,180.90
|
| Rate for Payer: Cofinity Commercial |
$1,450.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,518.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.25
|
| 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 |
$1,433.95
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$1,433.95
|
| 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 |
$1,180.90
|
| 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 |
$1,062.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$626.72
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$624.19
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.25
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,180.90 |
| Rate for Payer: Aetna Commercial |
$853.76
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.15
|
| Rate for Payer: Priority Health SBD |
$1,117.15
|
| Rate for Payer: UMR Bronson Commercial |
$776.02
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,180.90 |
| Rate for Payer: Aetna Commercial |
$853.76
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.15
|
| Rate for Payer: Priority Health SBD |
$1,117.15
|
| Rate for Payer: UMR Bronson Commercial |
$776.02
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,051.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$707.93 |
| Max. Negotiated Rate |
$21,170.20 |
| Rate for Payer: Aetna American Axle |
$1,333.15
|
| Rate for Payer: Aetna Commercial |
$1,743.35
|
| Rate for Payer: Aetna Medicare |
$6,993.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,406.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,406.09
|
| Rate for Payer: BCBS Complete |
$3,862.77
|
| Rate for Payer: BCBS MAPPO |
$6,724.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,519.12
|
| Rate for Payer: BCN Medicare Advantage |
$6,724.87
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,435.70
|
| Rate for Payer: Cofinity Commercial |
$1,763.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,724.87
|
| Rate for Payer: Healthscope Commercial |
$1,845.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,435.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,538.25
|
| Rate for Payer: Mclaren Medicaid |
$3,678.50
|
| Rate for Payer: Mclaren Medicare |
$6,724.87
|
| Rate for Payer: Meridian Medicaid |
$3,862.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,061.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.35
|
| Rate for Payer: PACE Medicare |
$6,388.63
|
| Rate for Payer: PACE SWMI |
$6,724.87
|
| Rate for Payer: PHP Commercial |
$1,743.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,724.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,678.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,170.20
|
| Rate for Payer: Priority Health Medicare |
$6,724.87
|
| Rate for Payer: Priority Health Narrow Network |
$16,936.16
|
| Rate for Payer: Priority Health SBD |
$1,292.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6,724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,724.87
|
| Rate for Payer: UHC Exchange |
$707.93
|
| Rate for Payer: UHC Medicare Advantage |
$6,926.62
|
| Rate for Payer: UMR Bronson Commercial |
$758.87
|
| Rate for Payer: VA VA |
$6,724.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,538.25
|
|
