|
PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63035
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$1,182.35 |
| Rate for Payer: Aetna Commercial |
$303.79
|
| Rate for Payer: Aetna Medicare |
$235.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.46
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCBS MAPPO |
$226.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.30
|
| Rate for Payer: BCN Commercial |
$375.03
|
| Rate for Payer: BCN Medicare Advantage |
$226.71
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$303.79
|
| Rate for Payer: Cofinity Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.05
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Nomi Health Commercial |
$272.05
|
| Rate for Payer: PACE SWMI |
$226.71
|
| Rate for Payer: PHP Commercial |
$317.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.97
|
| Rate for Payer: Priority Health Medicare |
$226.71
|
| Rate for Payer: Priority Health Narrow Network |
$396.97
|
| Rate for Payer: Priority Health SBD |
$396.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.71
|
| Rate for Payer: UHC Medicare Advantage |
$226.71
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
| Rate for Payer: UMR Bronson Commercial |
$836.74
|
|
|
PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ
|
Professional
|
Both
|
$8,543.00
|
|
|
Service Code
|
HCPCS 63051
|
| Min. Negotiated Rate |
$405.21 |
| Max. Negotiated Rate |
$5,552.95 |
| Rate for Payer: Aetna Commercial |
$2,212.90
|
| Rate for Payer: Aetna Medicare |
$1,717.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,212.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,378.04
|
| Rate for Payer: BCBS Complete |
$1,149.78
|
| Rate for Payer: BCBS MAPPO |
$1,651.42
|
| Rate for Payer: BCBS Trust/PPO |
$405.21
|
| Rate for Payer: BCN Commercial |
$2,484.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,651.42
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Cofinity Commercial |
$2,212.90
|
| Rate for Payer: Cofinity Commercial |
$2,378.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,651.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,733.99
|
| Rate for Payer: Meridian Medicaid |
$1,149.78
|
| Rate for Payer: Nomi Health Commercial |
$1,981.70
|
| Rate for Payer: PACE SWMI |
$1,651.42
|
| Rate for Payer: PHP Commercial |
$2,311.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,651.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,095.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,552.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,909.55
|
| Rate for Payer: Priority Health Medicare |
$1,651.42
|
| Rate for Payer: Priority Health Narrow Network |
$2,909.55
|
| Rate for Payer: Priority Health SBD |
$2,909.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,651.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,651.42
|
| Rate for Payer: UHCCP Medicaid |
$1,095.03
|
| Rate for Payer: UMR Bronson Commercial |
$3,929.78
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$6,673.00
|
|
|
Service Code
|
HCPCS 63040
|
| Min. Negotiated Rate |
$893.75 |
| Max. Negotiated Rate |
$4,337.45 |
| Rate for Payer: Aetna Commercial |
$1,803.91
|
| Rate for Payer: Aetna Medicare |
$1,400.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,803.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,938.53
|
| Rate for Payer: BCBS Complete |
$938.44
|
| Rate for Payer: BCBS MAPPO |
$1,346.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$2,234.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,346.20
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,803.91
|
| Rate for Payer: Cofinity Commercial |
$1,938.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,346.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,413.51
|
| Rate for Payer: Meridian Medicaid |
$938.44
|
| Rate for Payer: Nomi Health Commercial |
$1,615.44
|
| Rate for Payer: PACE SWMI |
$1,346.20
|
| Rate for Payer: PHP Commercial |
$1,884.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,346.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,337.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,373.82
|
| Rate for Payer: Priority Health Medicare |
$1,346.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,373.82
|
| Rate for Payer: Priority Health SBD |
$2,373.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,346.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,346.20
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,069.58
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV
|
Professional
|
Both
|
$2,182.00
|
|
|
Service Code
|
HCPCS 63043
|
| Min. Negotiated Rate |
$191.17 |
| Max. Negotiated Rate |
$1,862.26 |
| Rate for Payer: Aetna Commercial |
$780.02
|
| Rate for Payer: Aetna Medicare |
$1,091.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.02
|
| Rate for Payer: BCBS Complete |
$200.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,862.26
|
| Rate for Payer: BCN Commercial |
$374.64
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Meridian Medicaid |
$200.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.91
|
| Rate for Payer: Priority Health SBD |
$1,037.91
|
| Rate for Payer: UHCCP Medicaid |
$191.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,003.72
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 63042
|
| Min. Negotiated Rate |
$840.50 |
| Max. Negotiated Rate |
$2,234.49 |
| Rate for Payer: Aetna Commercial |
$1,692.74
|
| Rate for Payer: Aetna Medicare |
$1,313.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,692.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,819.07
|
| Rate for Payer: BCBS Complete |
$882.52
|
| Rate for Payer: BCBS MAPPO |
$1,263.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.75
|
| Rate for Payer: BCN Commercial |
$2,094.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,263.24
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cofinity Commercial |
$1,819.07
|
| Rate for Payer: Cofinity Commercial |
$1,692.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,263.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,326.40
|
| Rate for Payer: Meridian Medicaid |
$882.52
|
| Rate for Payer: Nomi Health Commercial |
$1,515.89
|
| Rate for Payer: PACE SWMI |
$1,263.24
|
| Rate for Payer: PHP Commercial |
$1,768.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,263.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,234.49
|
| Rate for Payer: Priority Health Medicare |
$1,263.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,234.49
|
| Rate for Payer: Priority Health SBD |
$2,234.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,263.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,263.24
|
| Rate for Payer: UHCCP Medicaid |
$840.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,238.78
|
|
|
PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 63044
|
| Min. Negotiated Rate |
$179.97 |
| Max. Negotiated Rate |
$1,908.75 |
| Rate for Payer: Aetna Commercial |
$741.31
|
| Rate for Payer: Aetna Medicare |
$1,062.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$741.31
|
| Rate for Payer: BCBS Complete |
$188.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,908.75
|
| Rate for Payer: BCN Commercial |
$374.64
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Meridian Medicaid |
$188.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,381.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.58
|
| Rate for Payer: Priority Health Narrow Network |
$985.58
|
| Rate for Payer: Priority Health SBD |
$985.58
|
| Rate for Payer: UHCCP Medicaid |
$179.97
|
| Rate for Payer: UMR Bronson Commercial |
$977.50
|
|
|
PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID
|
Professional
|
Both
|
$6,322.00
|
|
|
Service Code
|
HCPCS 63172
|
| Min. Negotiated Rate |
$925.27 |
| Max. Negotiated Rate |
$4,109.30 |
| Rate for Payer: Aetna Commercial |
$1,883.85
|
| Rate for Payer: Aetna Medicare |
$1,462.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,883.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,024.44
|
| Rate for Payer: BCBS Complete |
$971.53
|
| Rate for Payer: BCBS MAPPO |
$1,405.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,470.40
|
| Rate for Payer: BCN Commercial |
$2,301.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,405.86
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Cofinity Commercial |
$2,024.44
|
| Rate for Payer: Cofinity Commercial |
$1,883.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,405.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,476.15
|
| Rate for Payer: Meridian Medicaid |
$971.53
|
| Rate for Payer: Nomi Health Commercial |
$1,687.03
|
| Rate for Payer: PACE SWMI |
$1,405.86
|
| Rate for Payer: PHP Commercial |
$1,968.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,405.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,109.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,455.71
|
| Rate for Payer: Priority Health Medicare |
$1,405.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,455.71
|
| Rate for Payer: Priority Health SBD |
$2,455.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,405.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,405.86
|
| Rate for Payer: UHCCP Medicaid |
$925.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,908.12
|
|
|
PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL
|
Professional
|
Both
|
$6,858.00
|
|
|
Service Code
|
HCPCS 63173
|
| Min. Negotiated Rate |
$1,127.41 |
| Max. Negotiated Rate |
$4,457.70 |
| Rate for Payer: Aetna Commercial |
$2,297.26
|
| Rate for Payer: Aetna Medicare |
$1,782.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,297.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,468.69
|
| Rate for Payer: BCBS Complete |
$1,183.78
|
| Rate for Payer: BCBS MAPPO |
$1,714.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,763.08
|
| Rate for Payer: BCN Commercial |
$2,549.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,714.37
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Cofinity Commercial |
$2,297.26
|
| Rate for Payer: Cofinity Commercial |
$2,468.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,714.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,800.09
|
| Rate for Payer: Meridian Medicaid |
$1,183.78
|
| Rate for Payer: Nomi Health Commercial |
$2,057.24
|
| Rate for Payer: PACE SWMI |
$1,714.37
|
| Rate for Payer: PHP Commercial |
$2,400.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,714.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,127.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,457.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,997.69
|
| Rate for Payer: Priority Health Medicare |
$1,714.37
|
| Rate for Payer: Priority Health Narrow Network |
$2,997.69
|
| Rate for Payer: Priority Health SBD |
$2,997.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,714.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,714.37
|
| Rate for Payer: UHCCP Medicaid |
$1,127.41
|
| Rate for Payer: UMR Bronson Commercial |
$3,154.68
|
|
|
PR LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV
|
Professional
|
Both
|
$5,092.00
|
|
|
Service Code
|
HCPCS 63001
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$3,309.80 |
| Rate for Payer: Aetna Commercial |
$1,631.57
|
| Rate for Payer: Aetna Medicare |
$1,266.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,631.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,753.33
|
| Rate for Payer: BCBS Complete |
$844.28
|
| Rate for Payer: BCBS MAPPO |
$1,217.59
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$2,002.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,217.59
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,631.57
|
| Rate for Payer: Cofinity Commercial |
$1,753.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,217.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,278.47
|
| Rate for Payer: Meridian Medicaid |
$844.28
|
| Rate for Payer: Nomi Health Commercial |
$1,461.11
|
| Rate for Payer: PACE SWMI |
$1,217.59
|
| Rate for Payer: PHP Commercial |
$1,704.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,217.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,309.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,129.26
|
| Rate for Payer: Priority Health Medicare |
$1,217.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,129.26
|
| Rate for Payer: Priority Health SBD |
$2,129.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,217.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,217.59
|
| Rate for Payer: UHCCP Medicaid |
$804.08
|
| Rate for Payer: UMR Bronson Commercial |
$2,342.32
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$886.60 |
| Max. Negotiated Rate |
$1,813.50 |
| Rate for Payer: Aetna American Axle |
$1,309.75
|
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: UMR Bronson Commercial |
$886.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$389.58 |
| Max. Negotiated Rate |
$2,450.78 |
| Rate for Payer: Aetna Commercial |
$784.90
|
| Rate for Payer: Aetna Medicare |
$609.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$784.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.48
|
| Rate for Payer: BCBS Complete |
$409.06
|
| Rate for Payer: BCBS MAPPO |
$585.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.78
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: BCN Medicare Advantage |
$585.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$784.90
|
| Rate for Payer: Cofinity Commercial |
$843.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.04
|
| Rate for Payer: Meridian Medicaid |
$409.06
|
| Rate for Payer: Nomi Health Commercial |
$702.90
|
| Rate for Payer: PACE SWMI |
$585.75
|
| Rate for Payer: PHP Commercial |
$820.05
|
| Rate for Payer: PHP Medicare Advantage |
$585.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.61
|
| Rate for Payer: Priority Health Medicare |
$585.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.61
|
| Rate for Payer: Priority Health SBD |
$1,084.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.75
|
| Rate for Payer: UHC Medicare Advantage |
$585.75
|
| Rate for Payer: UHCCP Medicaid |
$389.58
|
| Rate for Payer: UMR Bronson Commercial |
$926.90
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$589.92 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$1,309.75
|
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$5,054.28
|
| Rate for Payer: BCN Commercial |
$5,054.28
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.91
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$589.92
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$745.55
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$389.58 |
| Max. Negotiated Rate |
$2,450.78 |
| Rate for Payer: Aetna Commercial |
$784.90
|
| Rate for Payer: Aetna Medicare |
$609.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$784.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.48
|
| Rate for Payer: BCBS Complete |
$409.06
|
| Rate for Payer: BCBS MAPPO |
$585.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.78
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: BCN Medicare Advantage |
$585.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$843.48
|
| Rate for Payer: Cofinity Commercial |
$784.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.04
|
| Rate for Payer: Meridian Medicaid |
$409.06
|
| Rate for Payer: Nomi Health Commercial |
$702.90
|
| Rate for Payer: PACE SWMI |
$585.75
|
| Rate for Payer: PHP Commercial |
$820.05
|
| Rate for Payer: PHP Medicare Advantage |
$585.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.61
|
| Rate for Payer: Priority Health Medicare |
$585.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.61
|
| Rate for Payer: Priority Health SBD |
$1,084.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.75
|
| Rate for Payer: UHC Medicare Advantage |
$585.75
|
| Rate for Payer: UHCCP Medicaid |
$389.58
|
| Rate for Payer: UMR Bronson Commercial |
$926.90
|
|
|
PR LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$4,026.00
|
|
|
Service Code
|
HCPCS 38120
|
| Min. Negotiated Rate |
$410.49 |
| Max. Negotiated Rate |
$2,616.90 |
| Rate for Payer: Aetna Commercial |
$1,378.75
|
| Rate for Payer: Aetna Medicare |
$1,070.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,378.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,481.64
|
| Rate for Payer: BCBS Complete |
$716.35
|
| Rate for Payer: BCBS MAPPO |
$1,028.92
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$1,545.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,028.92
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,378.75
|
| Rate for Payer: Cofinity Commercial |
$1,481.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,028.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.37
|
| Rate for Payer: Meridian Medicaid |
$716.35
|
| Rate for Payer: Nomi Health Commercial |
$1,234.70
|
| Rate for Payer: PACE SWMI |
$1,028.92
|
| Rate for Payer: PHP Commercial |
$1,440.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,028.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,616.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,119.74
|
| Rate for Payer: Priority Health Medicare |
$1,028.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,119.74
|
| Rate for Payer: Priority Health SBD |
$2,119.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,028.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,028.92
|
| Rate for Payer: UHCCP Medicaid |
$682.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,851.96
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$533.05 |
| Max. Negotiated Rate |
$1,921.36 |
| Rate for Payer: Aetna Commercial |
$1,550.67
|
| Rate for Payer: Aetna Medicare |
$1,203.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,550.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,666.40
|
| Rate for Payer: BCBS Complete |
$804.25
|
| Rate for Payer: BCBS MAPPO |
$1,157.22
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$1,729.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,157.22
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,550.67
|
| Rate for Payer: Cofinity Commercial |
$1,666.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,157.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,215.08
|
| Rate for Payer: Meridian Medicaid |
$804.25
|
| Rate for Payer: Nomi Health Commercial |
$1,388.66
|
| Rate for Payer: PACE SWMI |
$1,157.22
|
| Rate for Payer: PHP Commercial |
$1,620.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,157.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,921.36
|
| Rate for Payer: Priority Health Medicare |
$1,157.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,921.36
|
| Rate for Payer: Priority Health SBD |
$1,921.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,157.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,157.22
|
| Rate for Payer: UHCCP Medicaid |
$765.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,018.90
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,626.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$979.80 |
| Max. Negotiated Rate |
$2,732.40 |
| Rate for Payer: Aetna Commercial |
$1,982.46
|
| Rate for Payer: Aetna Medicare |
$1,538.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,982.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.41
|
| Rate for Payer: BCBS Complete |
$1,028.79
|
| Rate for Payer: BCBS MAPPO |
$1,479.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.45
|
| Rate for Payer: BCN Commercial |
$2,229.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.45
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Cofinity Commercial |
$1,982.46
|
| Rate for Payer: Cofinity Commercial |
$2,130.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.42
|
| Rate for Payer: Meridian Medicaid |
$1,028.79
|
| Rate for Payer: Nomi Health Commercial |
$1,775.34
|
| Rate for Payer: PACE SWMI |
$1,479.45
|
| Rate for Payer: PHP Commercial |
$2,071.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$979.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,356.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,732.40
|
| Rate for Payer: Priority Health Medicare |
$1,479.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,732.40
|
| Rate for Payer: Priority Health SBD |
$2,732.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,479.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.45
|
| Rate for Payer: UHCCP Medicaid |
$979.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,667.96
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$540.98 |
| Max. Negotiated Rate |
$1,451.43 |
| Rate for Payer: Aetna Commercial |
$1,250.66
|
| Rate for Payer: Aetna Medicare |
$970.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.00
|
| Rate for Payer: BCBS Complete |
$654.18
|
| Rate for Payer: BCBS MAPPO |
$933.33
|
| Rate for Payer: BCBS Trust/PPO |
$540.98
|
| Rate for Payer: BCN Commercial |
$1,422.05
|
| Rate for Payer: BCN Medicare Advantage |
$933.33
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,250.66
|
| Rate for Payer: Cofinity Commercial |
$1,344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.00
|
| Rate for Payer: Meridian Medicaid |
$654.18
|
| Rate for Payer: Nomi Health Commercial |
$1,120.00
|
| Rate for Payer: PACE SWMI |
$933.33
|
| Rate for Payer: PHP Commercial |
$1,306.66
|
| Rate for Payer: PHP Medicare Advantage |
$933.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,451.43
|
| Rate for Payer: Priority Health Medicare |
$933.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,451.43
|
| Rate for Payer: Priority Health SBD |
$1,451.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.33
|
| Rate for Payer: UHC Medicare Advantage |
$933.33
|
| Rate for Payer: UHCCP Medicaid |
$623.03
|
| Rate for Payer: UMR Bronson Commercial |
$931.50
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,023.00 |
| Max. Negotiated Rate |
$2,092.50 |
| Rate for Payer: Aetna American Axle |
$1,511.25
|
| Rate for Payer: Aetna Commercial |
$1,976.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.25
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,627.50
|
| Rate for Payer: Cofinity Commercial |
$1,999.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,627.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.00
|
| Rate for Payer: Healthscope Commercial |
$2,092.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,627.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,743.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: PHP Commercial |
$1,976.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health SBD |
$1,464.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,023.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,743.75
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$860.25 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$1,511.25
|
| Rate for Payer: Aetna Commercial |
$1,976.25
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,765.22
|
| Rate for Payer: BCN Commercial |
$4,765.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,627.50
|
| Rate for Payer: Cofinity Commercial |
$1,999.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,627.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,092.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,627.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,743.75
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$1,976.25
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$1,464.75
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.54
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$900.49
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$860.25
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,743.75
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 44180
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$1,647.79 |
| Rate for Payer: Aetna Commercial |
$1,198.76
|
| Rate for Payer: Aetna Medicare |
$930.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.22
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS MAPPO |
$894.60
|
| Rate for Payer: BCBS Trust/PPO |
$952.00
|
| Rate for Payer: BCN Commercial |
$1,341.91
|
| Rate for Payer: BCN Medicare Advantage |
$894.60
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,198.76
|
| Rate for Payer: Cofinity Commercial |
$1,288.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.33
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Nomi Health Commercial |
$1,073.52
|
| Rate for Payer: PACE SWMI |
$894.60
|
| Rate for Payer: PHP Commercial |
$1,252.44
|
| Rate for Payer: PHP Medicare Advantage |
$894.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.79
|
| Rate for Payer: Priority Health Medicare |
$894.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,647.79
|
| Rate for Payer: Priority Health SBD |
$1,647.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.60
|
| Rate for Payer: UHC Medicare Advantage |
$894.60
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.50
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 44180
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$1,647.79 |
| Rate for Payer: Aetna Commercial |
$1,198.76
|
| Rate for Payer: Aetna Medicare |
$930.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.22
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS MAPPO |
$894.60
|
| Rate for Payer: BCBS Trust/PPO |
$952.00
|
| Rate for Payer: BCN Commercial |
$1,341.91
|
| Rate for Payer: BCN Medicare Advantage |
$894.60
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.22
|
| Rate for Payer: Cofinity Commercial |
$1,198.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.33
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Nomi Health Commercial |
$1,073.52
|
| Rate for Payer: PACE SWMI |
$894.60
|
| Rate for Payer: PHP Commercial |
$1,252.44
|
| Rate for Payer: PHP Medicare Advantage |
$894.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.79
|
| Rate for Payer: Priority Health Medicare |
$894.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,647.79
|
| Rate for Payer: Priority Health SBD |
$1,647.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.60
|
| Rate for Payer: UHC Medicare Advantage |
$894.60
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.50
|
|
|
PR LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 58670
|
| Min. Negotiated Rate |
$238.99 |
| Max. Negotiated Rate |
$962.00 |
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$370.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.81
|
| Rate for Payer: BCBS Complete |
$250.94
|
| Rate for Payer: BCBS MAPPO |
$356.12
|
| Rate for Payer: BCBS Trust/PPO |
$373.07
|
| Rate for Payer: BCN Commercial |
$546.34
|
| Rate for Payer: BCN Medicare Advantage |
$356.12
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$477.20
|
| Rate for Payer: Cofinity Commercial |
$512.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.93
|
| Rate for Payer: Meridian Medicaid |
$250.94
|
| Rate for Payer: Nomi Health Commercial |
$427.34
|
| Rate for Payer: PACE SWMI |
$356.12
|
| Rate for Payer: PHP Commercial |
$498.57
|
| Rate for Payer: PHP Medicare Advantage |
$356.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.05
|
| Rate for Payer: Priority Health Medicare |
$356.12
|
| Rate for Payer: Priority Health Narrow Network |
$558.05
|
| Rate for Payer: Priority Health SBD |
$558.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.12
|
| Rate for Payer: UHC Medicare Advantage |
$356.12
|
| Rate for Payer: UHCCP Medicaid |
$238.99
|
| Rate for Payer: UMR Bronson Commercial |
$680.80
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT
|
Professional
|
Both
|
$3,008.00
|
|
|
Service Code
|
HCPCS 50546
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$1,955.20 |
| Rate for Payer: Aetna Commercial |
$1,540.29
|
| Rate for Payer: Aetna Medicare |
$1,195.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,655.24
|
| Rate for Payer: BCBS Complete |
$806.03
|
| Rate for Payer: BCBS MAPPO |
$1,149.47
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$1,731.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.47
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cofinity Commercial |
$1,540.29
|
| Rate for Payer: Cofinity Commercial |
$1,655.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,206.94
|
| Rate for Payer: Meridian Medicaid |
$806.03
|
| Rate for Payer: Nomi Health Commercial |
$1,379.36
|
| Rate for Payer: PACE SWMI |
$1,149.47
|
| Rate for Payer: PHP Commercial |
$1,609.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,907.25
|
| Rate for Payer: Priority Health Medicare |
$1,149.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,907.25
|
| Rate for Payer: Priority Health SBD |
$1,907.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.47
|
| Rate for Payer: UHCCP Medicaid |
$767.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,383.68
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY
|
Professional
|
Both
|
$2,592.00
|
|
|
Service Code
|
HCPCS 50548
|
| Min. Negotiated Rate |
$852.85 |
| Max. Negotiated Rate |
$2,995.46 |
| Rate for Payer: Aetna Commercial |
$1,714.20
|
| Rate for Payer: Aetna Medicare |
$1,330.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,714.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,842.12
|
| Rate for Payer: BCBS Complete |
$895.49
|
| Rate for Payer: BCBS MAPPO |
$1,279.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,995.46
|
| Rate for Payer: BCN Commercial |
$1,925.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.25
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,714.20
|
| Rate for Payer: Cofinity Commercial |
$1,842.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.21
|
| Rate for Payer: Meridian Medicaid |
$895.49
|
| Rate for Payer: Nomi Health Commercial |
$1,535.10
|
| Rate for Payer: PACE SWMI |
$1,279.25
|
| Rate for Payer: PHP Commercial |
$1,790.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,120.82
|
| Rate for Payer: Priority Health Medicare |
$1,279.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,120.82
|
| Rate for Payer: Priority Health SBD |
$2,120.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.25
|
| Rate for Payer: UHCCP Medicaid |
$852.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.32
|
|
|
PR LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 54692
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$1,686.86 |
| Rate for Payer: Aetna Commercial |
$968.31
|
| Rate for Payer: Aetna Medicare |
$751.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.31
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS MAPPO |
$722.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.86
|
| Rate for Payer: BCN Commercial |
$1,088.77
|
| Rate for Payer: BCN Medicare Advantage |
$722.62
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$1,040.57
|
| Rate for Payer: Cofinity Commercial |
$968.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.75
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Nomi Health Commercial |
$867.14
|
| Rate for Payer: PACE SWMI |
$722.62
|
| Rate for Payer: PHP Commercial |
$1,011.67
|
| Rate for Payer: PHP Medicare Advantage |
$722.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.48
|
| Rate for Payer: Priority Health Medicare |
$722.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.48
|
| Rate for Payer: Priority Health SBD |
$1,200.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.62
|
| Rate for Payer: UHC Medicare Advantage |
$722.62
|
| Rate for Payer: UHCCP Medicaid |
$483.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.24
|
|
