|
PR LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,493.00
|
|
|
Service Code
|
HCPCS 49656
|
| Min. Negotiated Rate |
$597.20 |
| Max. Negotiated Rate |
$970.45 |
| Rate for Payer: Aetna Medicare |
$746.50
|
| Rate for Payer: BCBS Complete |
$597.20
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.45
|
| Rate for Payer: UMR Bronson Commercial |
$686.78
|
|
|
PR LAPS SUPRACERVICAL HYSTERECTOMY >250
|
Professional
|
Both
|
$2,256.00
|
|
|
Service Code
|
HCPCS 58543
|
| Min. Negotiated Rate |
$362.94 |
| Max. Negotiated Rate |
$1,466.40 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$841.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.63
|
| Rate for Payer: BCBS Complete |
$566.96
|
| Rate for Payer: BCBS MAPPO |
$808.77
|
| Rate for Payer: BCBS Trust/PPO |
$362.94
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: BCN Medicare Advantage |
$808.77
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cofinity Commercial |
$1,164.63
|
| Rate for Payer: Cofinity Commercial |
$1,083.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.21
|
| Rate for Payer: Meridian Medicaid |
$566.96
|
| Rate for Payer: Nomi Health Commercial |
$970.52
|
| Rate for Payer: PACE SWMI |
$808.77
|
| Rate for Payer: PHP Commercial |
$1,132.28
|
| Rate for Payer: PHP Medicare Advantage |
$808.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.46
|
| Rate for Payer: Priority Health Medicare |
$808.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.46
|
| Rate for Payer: Priority Health SBD |
$1,260.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$808.77
|
| Rate for Payer: UHC Medicare Advantage |
$808.77
|
| Rate for Payer: UHCCP Medicaid |
$539.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,037.76
|
|
|
PR LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,458.00
|
|
|
Service Code
|
HCPCS 58544
|
| Min. Negotiated Rate |
$387.24 |
| Max. Negotiated Rate |
$1,597.70 |
| Rate for Payer: Aetna Commercial |
$1,166.51
|
| Rate for Payer: Aetna Medicare |
$905.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,253.56
|
| Rate for Payer: BCBS Complete |
$609.89
|
| Rate for Payer: BCBS MAPPO |
$870.53
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$1,331.16
|
| Rate for Payer: BCN Medicare Advantage |
$870.53
|
| Rate for Payer: Cash Price |
$1,966.40
|
| Rate for Payer: Cash Price |
$1,966.40
|
| Rate for Payer: Cofinity Commercial |
$1,166.51
|
| Rate for Payer: Cofinity Commercial |
$1,253.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.06
|
| Rate for Payer: Meridian Medicaid |
$609.89
|
| Rate for Payer: Nomi Health Commercial |
$1,044.64
|
| Rate for Payer: PACE SWMI |
$870.53
|
| Rate for Payer: PHP Commercial |
$1,218.74
|
| Rate for Payer: PHP Medicare Advantage |
$870.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,597.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.21
|
| Rate for Payer: Priority Health Medicare |
$870.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.21
|
| Rate for Payer: Priority Health SBD |
$1,354.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.53
|
| Rate for Payer: UHC Medicare Advantage |
$870.53
|
| Rate for Payer: UHCCP Medicaid |
$580.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,130.68
|
|
|
PR LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 58542
|
| Min. Negotiated Rate |
$383.55 |
| Max. Negotiated Rate |
$1,447.55 |
| Rate for Payer: Aetna Commercial |
$1,067.12
|
| Rate for Payer: Aetna Medicare |
$828.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.76
|
| Rate for Payer: BCBS Complete |
$558.67
|
| Rate for Payer: BCBS MAPPO |
$796.36
|
| Rate for Payer: BCBS Trust/PPO |
$383.55
|
| Rate for Payer: BCN Commercial |
$1,218.27
|
| Rate for Payer: BCN Medicare Advantage |
$796.36
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cofinity Commercial |
$1,067.12
|
| Rate for Payer: Cofinity Commercial |
$1,146.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.18
|
| Rate for Payer: Meridian Medicaid |
$558.67
|
| Rate for Payer: Nomi Health Commercial |
$955.63
|
| Rate for Payer: PACE SWMI |
$796.36
|
| Rate for Payer: PHP Commercial |
$1,114.90
|
| Rate for Payer: PHP Medicare Advantage |
$796.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,447.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,241.10
|
| Rate for Payer: Priority Health Medicare |
$796.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.10
|
| Rate for Payer: Priority Health SBD |
$1,241.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.36
|
| Rate for Payer: UHC Medicare Advantage |
$796.36
|
| Rate for Payer: UHCCP Medicaid |
$532.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.42
|
|
|
PR LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY
|
Professional
|
Both
|
$1,554.00
|
|
|
Service Code
|
HCPCS 38571
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,316.18 |
| Rate for Payer: Aetna Commercial |
$849.40
|
| Rate for Payer: Aetna Medicare |
$659.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.79
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$633.88
|
| Rate for Payer: BCBS Trust/PPO |
$459.62
|
| Rate for Payer: BCN Commercial |
$956.83
|
| Rate for Payer: BCN Medicare Advantage |
$633.88
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cofinity Commercial |
$849.40
|
| Rate for Payer: Cofinity Commercial |
$912.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.57
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Nomi Health Commercial |
$760.66
|
| Rate for Payer: PACE SWMI |
$633.88
|
| Rate for Payer: PHP Commercial |
$887.43
|
| Rate for Payer: PHP Medicare Advantage |
$633.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.18
|
| Rate for Payer: Priority Health Medicare |
$633.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,316.18
|
| Rate for Payer: Priority Health SBD |
$1,316.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.88
|
| Rate for Payer: UHC Medicare Advantage |
$633.88
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
| Rate for Payer: UMR Bronson Commercial |
$714.84
|
|
|
PR LAPS SURG CHOLECSTC W/EXPL COMMON DUCT
|
Professional
|
Both
|
$3,358.00
|
|
|
Service Code
|
HCPCS 47564
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,228.90 |
| Rate for Payer: Aetna Commercial |
$1,458.17
|
| Rate for Payer: Aetna Medicare |
$1,131.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.99
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS MAPPO |
$1,088.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,228.90
|
| Rate for Payer: BCN Commercial |
$1,633.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,088.19
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Cofinity Commercial |
$1,458.17
|
| Rate for Payer: Cofinity Commercial |
$1,566.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,088.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,142.60
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Nomi Health Commercial |
$1,305.83
|
| Rate for Payer: PACE SWMI |
$1,088.19
|
| Rate for Payer: PHP Commercial |
$1,523.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,088.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.53
|
| Rate for Payer: Priority Health Medicare |
$1,088.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,007.53
|
| Rate for Payer: Priority Health SBD |
$2,007.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,088.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,088.19
|
| Rate for Payer: UHCCP Medicaid |
$721.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,544.68
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
OP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$704.04 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$1,814.80
|
| Rate for Payer: Aetna Commercial |
$2,373.20
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.80
|
| 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 |
$5,490.95
|
| Rate for Payer: BCN Commercial |
$5,490.95
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$1,954.40
|
| Rate for Payer: Cofinity Commercial |
$2,401.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,954.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,512.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,954.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,094.00
|
| 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 |
$2,373.20
|
| 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 |
$2,373.20
|
| 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 |
$1,814.80
|
| 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 |
$1,758.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$774.44
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$704.04
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,033.04
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,094.00
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$938.27
|
| Rate for Payer: Aetna Medicare |
$728.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.27
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$700.20
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: BCN Medicare Advantage |
$700.20
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$1,008.29
|
| Rate for Payer: Cofinity Commercial |
$938.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.21
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Nomi Health Commercial |
$840.24
|
| Rate for Payer: PACE SWMI |
$700.20
|
| Rate for Payer: PHP Commercial |
$980.28
|
| Rate for Payer: PHP Medicare Advantage |
$700.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.62
|
| Rate for Payer: Priority Health Medicare |
$700.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.62
|
| Rate for Payer: Priority Health SBD |
$1,291.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.20
|
| Rate for Payer: UHC Medicare Advantage |
$700.20
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,284.32
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
IP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,228.48 |
| Max. Negotiated Rate |
$2,512.80 |
| Rate for Payer: Aetna American Axle |
$1,814.80
|
| Rate for Payer: Aetna Commercial |
$2,373.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,814.80
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$1,954.40
|
| Rate for Payer: Cofinity Commercial |
$2,401.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,954.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Healthscope Commercial |
$2,512.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,954.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,094.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.20
|
| Rate for Payer: PHP Commercial |
$2,373.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health SBD |
$1,758.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,228.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,094.00
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$938.27
|
| Rate for Payer: Aetna Medicare |
$728.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.27
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$700.20
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: BCN Medicare Advantage |
$700.20
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$938.27
|
| Rate for Payer: Cofinity Commercial |
$1,008.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.21
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Nomi Health Commercial |
$840.24
|
| Rate for Payer: PACE SWMI |
$700.20
|
| Rate for Payer: PHP Commercial |
$980.28
|
| Rate for Payer: PHP Medicare Advantage |
$700.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.62
|
| Rate for Payer: Priority Health Medicare |
$700.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.62
|
| Rate for Payer: Priority Health SBD |
$1,291.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$700.20
|
| Rate for Payer: UHC Medicare Advantage |
$700.20
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,284.32
|
|
|
PR LAPS SURG ESOPG/GSTR FUNDOPLASTY
|
Professional
|
Both
|
$4,149.00
|
|
|
Service Code
|
HCPCS 43280
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$2,696.85 |
| Rate for Payer: Aetna Commercial |
$1,403.85
|
| Rate for Payer: Aetna Medicare |
$1,089.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,508.62
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS MAPPO |
$1,047.65
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.65
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cofinity Commercial |
$1,403.85
|
| Rate for Payer: Cofinity Commercial |
$1,508.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.03
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Nomi Health Commercial |
$1,257.18
|
| Rate for Payer: PACE SWMI |
$1,047.65
|
| Rate for Payer: PHP Commercial |
$1,466.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,696.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.19
|
| Rate for Payer: Priority Health Medicare |
$1,047.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,928.19
|
| Rate for Payer: Priority Health SBD |
$1,928.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.65
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,908.54
|
|
|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,491.10 |
| Rate for Payer: Aetna Commercial |
$751.86
|
| Rate for Payer: Aetna Medicare |
$583.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.97
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$561.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.13
|
| Rate for Payer: BCN Commercial |
$847.86
|
| Rate for Payer: BCN Medicare Advantage |
$561.09
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cofinity Commercial |
$751.86
|
| Rate for Payer: Cofinity Commercial |
$807.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.14
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Nomi Health Commercial |
$673.31
|
| Rate for Payer: PACE SWMI |
$561.09
|
| Rate for Payer: PHP Commercial |
$785.53
|
| Rate for Payer: PHP Medicare Advantage |
$561.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.85
|
| Rate for Payer: Priority Health Medicare |
$561.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.85
|
| Rate for Payer: Priority Health SBD |
$1,042.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.09
|
| Rate for Payer: UHC Medicare Advantage |
$561.09
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.24
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT
|
Professional
|
Both
|
$3,339.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$761.69 |
| Max. Negotiated Rate |
$2,170.35 |
| Rate for Payer: Aetna Commercial |
$1,529.80
|
| Rate for Payer: Aetna Medicare |
$1,187.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,643.96
|
| Rate for Payer: BCBS Complete |
$799.77
|
| Rate for Payer: BCBS MAPPO |
$1,141.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.22
|
| Rate for Payer: BCN Commercial |
$1,719.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.64
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cofinity Commercial |
$1,529.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.72
|
| Rate for Payer: Meridian Medicaid |
$799.77
|
| Rate for Payer: Nomi Health Commercial |
$1,369.97
|
| Rate for Payer: PACE SWMI |
$1,141.64
|
| Rate for Payer: PHP Commercial |
$1,598.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.32
|
| Rate for Payer: Priority Health Medicare |
$1,141.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,892.32
|
| Rate for Payer: Priority Health SBD |
$1,892.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,141.64
|
| Rate for Payer: UHCCP Medicaid |
$761.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,535.94
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$362.97 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$637.65
|
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.65
|
| 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 |
$3,391.27
|
| Rate for Payer: BCN Commercial |
$3,391.27
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Cofinity Commercial |
$686.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$686.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.75
|
| 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 |
$833.85
|
| 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 |
$833.85
|
| 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 |
$637.65
|
| 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 |
$618.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.86
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$500.78
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$362.97
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.75
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.67
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Commercial |
$694.82
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$496.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: Priority Health SBD |
$1,033.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
| Rate for Payer: UMR Bronson Commercial |
$451.26
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$431.64 |
| Max. Negotiated Rate |
$882.90 |
| Rate for Payer: Aetna American Axle |
$637.65
|
| Rate for Payer: Aetna Commercial |
$833.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.65
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$686.70
|
| Rate for Payer: Cofinity Commercial |
$843.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$686.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Healthscope Commercial |
$882.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$686.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.85
|
| Rate for Payer: PHP Commercial |
$833.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health SBD |
$618.03
|
| Rate for Payer: UMR Bronson Commercial |
$431.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.75
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$665.04
|
| Rate for Payer: Aetna Medicare |
$516.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.67
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$496.30
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$496.30
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$665.04
|
| Rate for Payer: Cofinity Commercial |
$714.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.12
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Nomi Health Commercial |
$595.56
|
| Rate for Payer: PACE SWMI |
$496.30
|
| Rate for Payer: PHP Commercial |
$694.82
|
| Rate for Payer: PHP Medicare Advantage |
$496.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Medicare |
$496.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: Priority Health SBD |
$1,033.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.30
|
| Rate for Payer: UHC Medicare Advantage |
$496.30
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
| Rate for Payer: UMR Bronson Commercial |
$451.26
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$553.38 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$1,346.15
|
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.15
|
| 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 |
$5,891.94
|
| Rate for Payer: BCN Commercial |
$5,891.94
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,449.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,449.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,449.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,553.25
|
| 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 |
$1,760.35
|
| 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 |
$1,760.35
|
| 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 |
$1,346.15
|
| 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 |
$1,304.73
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.72
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$553.38
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$766.27
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,553.25
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
IP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$911.24 |
| Max. Negotiated Rate |
$1,863.90 |
| Rate for Payer: Aetna American Axle |
$1,346.15
|
| Rate for Payer: Aetna Commercial |
$1,760.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.15
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,449.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,449.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Healthscope Commercial |
$1,863.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,449.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,553.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,760.35
|
| Rate for Payer: PHP Commercial |
$1,760.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health SBD |
$1,304.73
|
| Rate for Payer: UMR Bronson Commercial |
$911.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,553.25
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.16
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Commercial |
$770.15
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$550.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.37
|
| Rate for Payer: Priority Health SBD |
$1,021.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
| Rate for Payer: UMR Bronson Commercial |
$952.66
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$737.15
|
| Rate for Payer: Aetna Medicare |
$572.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.16
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS MAPPO |
$550.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.11
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$792.16
|
| Rate for Payer: Cofinity Commercial |
$737.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.62
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Nomi Health Commercial |
$660.13
|
| Rate for Payer: PACE SWMI |
$550.11
|
| Rate for Payer: PHP Commercial |
$770.15
|
| Rate for Payer: PHP Medicare Advantage |
$550.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.37
|
| Rate for Payer: Priority Health Medicare |
$550.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.37
|
| Rate for Payer: Priority Health SBD |
$1,021.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.11
|
| Rate for Payer: UHC Medicare Advantage |
$550.11
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
| Rate for Payer: UMR Bronson Commercial |
$952.66
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 43652
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$1,378.72 |
| Rate for Payer: Aetna Commercial |
$999.95
|
| Rate for Payer: Aetna Medicare |
$776.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.95
|
| Rate for Payer: BCBS Complete |
$519.99
|
| Rate for Payer: BCBS MAPPO |
$746.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.56
|
| Rate for Payer: BCN Commercial |
$1,121.52
|
| Rate for Payer: BCN Medicare Advantage |
$746.23
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,074.57
|
| Rate for Payer: Cofinity Commercial |
$999.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.54
|
| Rate for Payer: Meridian Medicaid |
$519.99
|
| Rate for Payer: Nomi Health Commercial |
$895.48
|
| Rate for Payer: PACE SWMI |
$746.23
|
| Rate for Payer: PHP Commercial |
$1,044.72
|
| Rate for Payer: PHP Medicare Advantage |
$746.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,378.72
|
| Rate for Payer: Priority Health Medicare |
$746.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,378.72
|
| Rate for Payer: Priority Health SBD |
$1,378.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.23
|
| Rate for Payer: UHC Medicare Advantage |
$746.23
|
| Rate for Payer: UHCCP Medicaid |
$495.23
|
| Rate for Payer: UMR Bronson Commercial |
$733.70
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV TRUNCAL
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 43651
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$1,681.55 |
| Rate for Payer: Aetna Commercial |
$858.23
|
| Rate for Payer: Aetna Medicare |
$666.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.28
|
| Rate for Payer: BCBS Complete |
$447.30
|
| Rate for Payer: BCBS MAPPO |
$640.47
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$640.47
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$858.23
|
| Rate for Payer: Cofinity Commercial |
$922.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.49
|
| Rate for Payer: Meridian Medicaid |
$447.30
|
| Rate for Payer: Nomi Health Commercial |
$768.56
|
| Rate for Payer: PACE SWMI |
$640.47
|
| Rate for Payer: PHP Commercial |
$896.66
|
| Rate for Payer: PHP Medicare Advantage |
$640.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.84
|
| Rate for Payer: Priority Health Medicare |
$640.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.84
|
| Rate for Payer: Priority Health SBD |
$1,184.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.47
|
| Rate for Payer: UHC Medicare Advantage |
$640.47
|
| Rate for Payer: UHCCP Medicaid |
$426.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,190.02
|
|
|
PR LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 49322
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$1,014.65 |
| Rate for Payer: Aetna Commercial |
$487.02
|
| Rate for Payer: Aetna Medicare |
$377.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.37
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$363.45
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$363.45
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$487.02
|
| Rate for Payer: Cofinity Commercial |
$523.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.62
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Nomi Health Commercial |
$436.14
|
| Rate for Payer: PACE SWMI |
$363.45
|
| Rate for Payer: PHP Commercial |
$508.83
|
| Rate for Payer: PHP Medicare Advantage |
$363.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.15
|
| Rate for Payer: Priority Health Medicare |
$363.45
|
| Rate for Payer: Priority Health Narrow Network |
$674.15
|
| Rate for Payer: Priority Health SBD |
$674.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.45
|
| Rate for Payer: UHC Medicare Advantage |
$363.45
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
| Rate for Payer: UMR Bronson Commercial |
$718.06
|
|
|
PR LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 49323
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$1,264.25 |
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Aetna Commercial |
$831.97
|
| Rate for Payer: Aetna Medicare |
$645.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.05
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$620.87
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$930.93
|
| Rate for Payer: BCN Medicare Advantage |
$620.87
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$831.97
|
| Rate for Payer: Cofinity Commercial |
$894.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.91
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Nomi Health Commercial |
$745.04
|
| Rate for Payer: PACE SWMI |
$620.87
|
| Rate for Payer: PHP Commercial |
$869.22
|
| Rate for Payer: PHP Medicare Advantage |
$620.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.44
|
| Rate for Payer: Priority Health Medicare |
$620.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.44
|
| Rate for Payer: Priority Health SBD |
$1,148.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.87
|
| Rate for Payer: UHC Medicare Advantage |
$620.87
|
| Rate for Payer: UHCCP Medicaid |
$413.22
|
| Rate for Payer: UMR Bronson Commercial |
$894.70
|
|
