|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
IP
|
$1,715.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$754.60 |
| Max. Negotiated Rate |
$1,543.50 |
| Rate for Payer: Aetna American Axle |
$1,114.75
|
| Rate for Payer: Aetna Commercial |
$1,457.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,114.75
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Advantage |
$1,200.50
|
| Rate for Payer: Cofinity Commercial |
$1,474.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.00
|
| Rate for Payer: Healthscope Commercial |
$1,543.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,200.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,286.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PHP Commercial |
$1,457.75
|
| Rate for Payer: Priority Health SBD |
$1,080.45
|
| Rate for Payer: UMR Bronson Commercial |
$754.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,286.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$752.01
|
| Rate for Payer: Aetna Medicare |
$583.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.13
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$561.20
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: BCN Medicare Advantage |
$561.20
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$752.01
|
| Rate for Payer: Cofinity Commercial |
$808.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.26
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.32
|
| Rate for Payer: Nomi Health Commercial |
$673.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$561.20
|
| Rate for Payer: PHP Commercial |
$785.68
|
| Rate for Payer: PHP Medicare Advantage |
$561.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.49
|
| Rate for Payer: Priority Health Medicare |
$561.20
|
| Rate for Payer: Priority Health SBD |
$1,085.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.49
|
| Rate for Payer: Railroad Medicare Medicare |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.78
|
| Rate for Payer: UHC Core |
$1,040.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.20
|
| Rate for Payer: UHC Exchange |
$1,040.78
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$788.90
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$752.01
|
| Rate for Payer: Aetna Medicare |
$583.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.13
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$561.20
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: BCN Medicare Advantage |
$561.20
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$808.13
|
| Rate for Payer: Cofinity Commercial |
$752.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.26
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.32
|
| Rate for Payer: Nomi Health Commercial |
$673.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$561.20
|
| Rate for Payer: PHP Commercial |
$785.68
|
| Rate for Payer: PHP Medicare Advantage |
$561.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.49
|
| Rate for Payer: Priority Health Medicare |
$561.20
|
| Rate for Payer: Priority Health SBD |
$1,085.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.49
|
| Rate for Payer: Railroad Medicare Medicare |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.78
|
| Rate for Payer: UHC Core |
$1,040.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.20
|
| Rate for Payer: UHC Exchange |
$1,040.78
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$788.90
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$671.57
|
| Rate for Payer: Aetna Medicare |
$521.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.68
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$501.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: BCN Medicare Advantage |
$501.17
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$671.57
|
| Rate for Payer: Cofinity Commercial |
$721.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.23
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.29
|
| Rate for Payer: Nomi Health Commercial |
$601.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE SWMI |
$501.17
|
| Rate for Payer: PHP Commercial |
$701.64
|
| Rate for Payer: PHP Medicare Advantage |
$501.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.17
|
| Rate for Payer: Priority Health Medicare |
$501.17
|
| Rate for Payer: Priority Health SBD |
$967.17
|
| Rate for Payer: Priority Health Tiered Network |
$967.17
|
| Rate for Payer: Railroad Medicare Medicare |
$501.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$924.10
|
| Rate for Payer: UHC Core |
$924.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$501.17
|
| Rate for Payer: UHC Exchange |
$924.10
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
| Rate for Payer: UMR Bronson Commercial |
$799.94
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$643.43 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$1,130.35
|
| Rate for Payer: Aetna Commercial |
$1,478.15
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,130.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,610.18
|
| Rate for Payer: BCN Commercial |
$4,610.18
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Advantage |
$1,217.30
|
| Rate for Payer: Cofinity Commercial |
$1,495.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,565.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,217.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,304.25
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$1,478.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$1,095.57
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$643.43
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,304.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$671.57
|
| Rate for Payer: Aetna Medicare |
$521.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.68
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$501.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: BCN Medicare Advantage |
$501.17
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$671.57
|
| Rate for Payer: Cofinity Commercial |
$721.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.23
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.29
|
| Rate for Payer: Nomi Health Commercial |
$601.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE SWMI |
$501.17
|
| Rate for Payer: PHP Commercial |
$701.64
|
| Rate for Payer: PHP Medicare Advantage |
$501.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.17
|
| Rate for Payer: Priority Health Medicare |
$501.17
|
| Rate for Payer: Priority Health SBD |
$967.17
|
| Rate for Payer: Priority Health Tiered Network |
$967.17
|
| Rate for Payer: Railroad Medicare Medicare |
$501.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$924.10
|
| Rate for Payer: UHC Core |
$924.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$501.17
|
| Rate for Payer: UHC Exchange |
$924.10
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
| Rate for Payer: UMR Bronson Commercial |
$799.94
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$765.16 |
| Max. Negotiated Rate |
$1,565.10 |
| Rate for Payer: Aetna American Axle |
$1,130.35
|
| Rate for Payer: Aetna Commercial |
$1,478.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,130.35
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Advantage |
$1,217.30
|
| Rate for Payer: Cofinity Commercial |
$1,495.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Healthscope Commercial |
$1,565.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,217.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,304.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PHP Commercial |
$1,478.15
|
| Rate for Payer: Priority Health SBD |
$1,095.57
|
| Rate for Payer: UMR Bronson Commercial |
$765.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,304.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$374.03 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$776.70
|
| Rate for Payer: Aetna Medicare |
$602.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.67
|
| Rate for Payer: BCBS Complete |
$392.73
|
| Rate for Payer: BCBS MAPPO |
$579.63
|
| Rate for Payer: BCN Commercial |
$920.77
|
| Rate for Payer: BCN Medicare Advantage |
$579.63
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$776.70
|
| Rate for Payer: Cofinity Commercial |
$834.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.61
|
| Rate for Payer: Meridian Medicaid |
$392.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.59
|
| Rate for Payer: Nomi Health Commercial |
$695.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$579.63
|
| Rate for Payer: PHP Commercial |
$811.48
|
| Rate for Payer: PHP Medicare Advantage |
$579.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,121.90
|
| Rate for Payer: Priority Health Medicare |
$579.63
|
| Rate for Payer: Priority Health SBD |
$1,121.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,121.90
|
| Rate for Payer: Railroad Medicare Medicare |
$579.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.97
|
| Rate for Payer: UHC Core |
$1,074.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.63
|
| Rate for Payer: UHC Exchange |
$1,074.97
|
| Rate for Payer: UHC Medicaid |
$374.03
|
| Rate for Payer: UHCCP Medicaid |
$374.03
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,403.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$263.06 |
| Max. Negotiated Rate |
$1,052.25 |
| Rate for Payer: Aetna Commercial |
$541.41
|
| Rate for Payer: Aetna Medicare |
$420.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.82
|
| Rate for Payer: BCBS Complete |
$276.21
|
| Rate for Payer: BCBS MAPPO |
$404.04
|
| Rate for Payer: BCN Commercial |
$633.43
|
| Rate for Payer: BCN Medicare Advantage |
$404.04
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Cofinity Commercial |
$541.41
|
| Rate for Payer: Cofinity Commercial |
$581.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.24
|
| Rate for Payer: Meridian Medicaid |
$276.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$444.44
|
| Rate for Payer: Nomi Health Commercial |
$484.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,052.25
|
| Rate for Payer: PACE SWMI |
$404.04
|
| Rate for Payer: PHP Commercial |
$565.66
|
| Rate for Payer: PHP Medicare Advantage |
$404.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$771.80
|
| Rate for Payer: Priority Health Medicare |
$404.04
|
| Rate for Payer: Priority Health SBD |
$771.80
|
| Rate for Payer: Priority Health Tiered Network |
$771.80
|
| Rate for Payer: Railroad Medicare Medicare |
$404.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.58
|
| Rate for Payer: UHC Core |
$727.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$404.04
|
| Rate for Payer: UHC Exchange |
$727.58
|
| Rate for Payer: UHC Medicaid |
$263.06
|
| Rate for Payer: UHCCP Medicaid |
$263.06
|
| Rate for Payer: UMR Bronson Commercial |
$645.38
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$380.21 |
| Max. Negotiated Rate |
$1,389.75 |
| Rate for Payer: Aetna Commercial |
$788.94
|
| Rate for Payer: Aetna Medicare |
$612.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$847.81
|
| Rate for Payer: BCBS Complete |
$399.22
|
| Rate for Payer: BCBS MAPPO |
$588.76
|
| Rate for Payer: BCN Commercial |
$934.21
|
| Rate for Payer: BCN Medicare Advantage |
$588.76
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$788.94
|
| Rate for Payer: Cofinity Commercial |
$847.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.20
|
| Rate for Payer: Meridian Medicaid |
$399.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$647.64
|
| Rate for Payer: Nomi Health Commercial |
$706.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,389.75
|
| Rate for Payer: PACE SWMI |
$588.76
|
| Rate for Payer: PHP Commercial |
$824.26
|
| Rate for Payer: PHP Medicare Advantage |
$588.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,138.28
|
| Rate for Payer: Priority Health Medicare |
$588.76
|
| Rate for Payer: Priority Health SBD |
$1,138.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,138.28
|
| Rate for Payer: Railroad Medicare Medicare |
$588.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.71
|
| Rate for Payer: UHC Core |
$1,089.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$588.76
|
| Rate for Payer: UHC Exchange |
$1,089.71
|
| Rate for Payer: UHC Medicaid |
$380.21
|
| Rate for Payer: UHCCP Medicaid |
$380.21
|
| Rate for Payer: UMR Bronson Commercial |
$852.38
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,559.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$1,169.25 |
| Rate for Payer: Aetna Commercial |
$527.95
|
| Rate for Payer: Aetna Medicare |
$409.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.35
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCBS MAPPO |
$393.99
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: BCN Medicare Advantage |
$393.99
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cofinity Commercial |
$527.95
|
| Rate for Payer: Cofinity Commercial |
$567.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.69
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.39
|
| Rate for Payer: Nomi Health Commercial |
$472.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,169.25
|
| Rate for Payer: PACE SWMI |
$393.99
|
| Rate for Payer: PHP Commercial |
$551.59
|
| Rate for Payer: PHP Medicare Advantage |
$393.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$757.23
|
| Rate for Payer: Priority Health Medicare |
$393.99
|
| Rate for Payer: Priority Health SBD |
$757.23
|
| Rate for Payer: Priority Health Tiered Network |
$757.23
|
| Rate for Payer: Railroad Medicare Medicare |
$393.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.19
|
| Rate for Payer: UHC Core |
$724.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.99
|
| Rate for Payer: UHC Exchange |
$724.19
|
| Rate for Payer: UHC Medicaid |
$254.75
|
| Rate for Payer: UHCCP Medicaid |
$254.75
|
| Rate for Payer: UMR Bronson Commercial |
$717.14
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$1,765.06 |
| Rate for Payer: Aetna Commercial |
$1,212.18
|
| Rate for Payer: Aetna Medicare |
$940.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.64
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCBS MAPPO |
$904.61
|
| Rate for Payer: BCN Commercial |
$1,448.62
|
| Rate for Payer: BCN Medicare Advantage |
$904.61
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cofinity Commercial |
$1,212.18
|
| Rate for Payer: Cofinity Commercial |
$1,302.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.84
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$995.07
|
| Rate for Payer: Nomi Health Commercial |
$1,085.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,467.00
|
| Rate for Payer: PACE SWMI |
$904.61
|
| Rate for Payer: PHP Commercial |
$1,266.45
|
| Rate for Payer: PHP Medicare Advantage |
$904.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,765.06
|
| Rate for Payer: Priority Health Medicare |
$904.61
|
| Rate for Payer: Priority Health SBD |
$1,765.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,765.06
|
| Rate for Payer: Railroad Medicare Medicare |
$904.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,706.96
|
| Rate for Payer: UHC Core |
$1,706.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$904.61
|
| Rate for Payer: UHC Exchange |
$1,706.96
|
| Rate for Payer: UHC Medicaid |
$581.06
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
| Rate for Payer: UMR Bronson Commercial |
$899.76
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,470.78 |
| Rate for Payer: Aetna Commercial |
$1,013.64
|
| Rate for Payer: Aetna Medicare |
$786.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.29
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$756.45
|
| Rate for Payer: BCN Commercial |
$1,207.10
|
| Rate for Payer: BCN Medicare Advantage |
$756.45
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,013.64
|
| Rate for Payer: Cofinity Commercial |
$1,089.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.27
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$832.10
|
| Rate for Payer: Nomi Health Commercial |
$907.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$756.45
|
| Rate for Payer: PHP Commercial |
$1,059.03
|
| Rate for Payer: PHP Medicare Advantage |
$756.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,470.78
|
| Rate for Payer: Priority Health Medicare |
$756.45
|
| Rate for Payer: Priority Health SBD |
$1,470.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,470.78
|
| Rate for Payer: Railroad Medicare Medicare |
$756.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.05
|
| Rate for Payer: UHC Core |
$1,416.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.45
|
| Rate for Payer: UHC Exchange |
$1,416.05
|
| Rate for Payer: UHC Medicaid |
$487.13
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
| Rate for Payer: UMR Bronson Commercial |
$788.90
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$1,005.75 |
| Rate for Payer: Aetna Commercial |
$461.13
|
| Rate for Payer: Aetna Medicare |
$357.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.55
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$344.13
|
| Rate for Payer: BCN Commercial |
$575.17
|
| Rate for Payer: BCN Medicare Advantage |
$344.13
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cofinity Commercial |
$461.13
|
| Rate for Payer: Cofinity Commercial |
$495.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.34
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.54
|
| Rate for Payer: Nomi Health Commercial |
$412.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.75
|
| Rate for Payer: PACE SWMI |
$344.13
|
| Rate for Payer: PHP Commercial |
$481.78
|
| Rate for Payer: PHP Medicare Advantage |
$344.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$618.52
|
| Rate for Payer: Priority Health Medicare |
$344.13
|
| Rate for Payer: Priority Health SBD |
$618.52
|
| Rate for Payer: Priority Health Tiered Network |
$618.52
|
| Rate for Payer: Railroad Medicare Medicare |
$344.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.30
|
| Rate for Payer: UHC Core |
$681.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.13
|
| Rate for Payer: UHC Exchange |
$681.30
|
| Rate for Payer: UHC Medicaid |
$222.16
|
| Rate for Payer: UHCCP Medicaid |
$222.16
|
| Rate for Payer: UMR Bronson Commercial |
$616.86
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$217.69 |
| Max. Negotiated Rate |
$1,029.00 |
| Rate for Payer: Aetna Commercial |
$453.16
|
| Rate for Payer: Aetna Medicare |
$351.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.98
|
| Rate for Payer: BCBS Complete |
$228.57
|
| Rate for Payer: BCBS MAPPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$563.22
|
| Rate for Payer: BCN Medicare Advantage |
$338.18
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cofinity Commercial |
$453.16
|
| Rate for Payer: Cofinity Commercial |
$486.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.09
|
| Rate for Payer: Meridian Medicaid |
$228.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$372.00
|
| Rate for Payer: Nomi Health Commercial |
$405.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.00
|
| Rate for Payer: PACE SWMI |
$338.18
|
| Rate for Payer: PHP Commercial |
$473.45
|
| Rate for Payer: PHP Medicare Advantage |
$338.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$605.67
|
| Rate for Payer: Priority Health Medicare |
$338.18
|
| Rate for Payer: Priority Health SBD |
$605.67
|
| Rate for Payer: Priority Health Tiered Network |
$605.67
|
| Rate for Payer: Railroad Medicare Medicare |
$338.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.32
|
| Rate for Payer: UHC Core |
$665.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$338.18
|
| Rate for Payer: UHC Exchange |
$665.32
|
| Rate for Payer: UHC Medicaid |
$217.69
|
| Rate for Payer: UHCCP Medicaid |
$217.69
|
| Rate for Payer: UMR Bronson Commercial |
$631.12
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,875.39 |
| Rate for Payer: Aetna Commercial |
$1,262.40
|
| Rate for Payer: Aetna Medicare |
$979.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.61
|
| Rate for Payer: BCBS Complete |
$627.11
|
| Rate for Payer: BCBS MAPPO |
$942.09
|
| Rate for Payer: BCN Commercial |
$1,537.77
|
| Rate for Payer: BCN Medicare Advantage |
$942.09
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$1,262.40
|
| Rate for Payer: Cofinity Commercial |
$1,356.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$942.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.19
|
| Rate for Payer: Meridian Medicaid |
$627.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.30
|
| Rate for Payer: Nomi Health Commercial |
$1,130.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.00
|
| Rate for Payer: PACE SWMI |
$942.09
|
| Rate for Payer: PHP Commercial |
$1,318.93
|
| Rate for Payer: PHP Medicare Advantage |
$942.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,873.67
|
| Rate for Payer: Priority Health Medicare |
$942.09
|
| Rate for Payer: Priority Health SBD |
$1,873.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,873.67
|
| Rate for Payer: Railroad Medicare Medicare |
$942.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,875.39
|
| Rate for Payer: UHC Core |
$1,875.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$942.09
|
| Rate for Payer: UHC Exchange |
$1,875.39
|
| Rate for Payer: UHC Medicaid |
$597.25
|
| Rate for Payer: UHCCP Medicaid |
$597.25
|
| Rate for Payer: UMR Bronson Commercial |
$741.52
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$449.22 |
| Max. Negotiated Rate |
$1,411.78 |
| Rate for Payer: Aetna Commercial |
$948.28
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.28
|
| Rate for Payer: BCBS Complete |
$471.68
|
| Rate for Payer: BCBS MAPPO |
$707.67
|
| Rate for Payer: BCN Commercial |
$1,158.31
|
| Rate for Payer: BCN Medicare Advantage |
$707.67
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$1,019.04
|
| Rate for Payer: Cofinity Commercial |
$948.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.05
|
| Rate for Payer: Meridian Medicaid |
$471.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.44
|
| Rate for Payer: Nomi Health Commercial |
$849.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$707.67
|
| Rate for Payer: PHP Commercial |
$990.74
|
| Rate for Payer: PHP Medicare Advantage |
$707.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,411.32
|
| Rate for Payer: Priority Health Medicare |
$707.67
|
| Rate for Payer: Priority Health SBD |
$1,411.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,411.32
|
| Rate for Payer: Railroad Medicare Medicare |
$707.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,411.78
|
| Rate for Payer: UHC Core |
$1,411.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.67
|
| Rate for Payer: UHC Exchange |
$1,411.78
|
| Rate for Payer: UHC Medicaid |
$449.22
|
| Rate for Payer: UHCCP Medicaid |
$449.22
|
| Rate for Payer: UMR Bronson Commercial |
$751.64
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$919.28
|
| Rate for Payer: Aetna Medicare |
$713.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.88
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$686.03
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: BCN Medicare Advantage |
$686.03
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$987.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.33
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.63
|
| Rate for Payer: Nomi Health Commercial |
$823.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE SWMI |
$686.03
|
| Rate for Payer: PHP Commercial |
$960.44
|
| Rate for Payer: PHP Medicare Advantage |
$686.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,361.57
|
| Rate for Payer: Priority Health Medicare |
$686.03
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,361.57
|
| Rate for Payer: Railroad Medicare Medicare |
$686.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.64
|
| Rate for Payer: UHC Core |
$1,367.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.03
|
| Rate for Payer: UHC Exchange |
$1,367.64
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
| Rate for Payer: UMR Bronson Commercial |
$879.06
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$707.07 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna American Axle |
$1,242.15
|
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,740.03
|
| Rate for Payer: BCN Commercial |
$4,740.03
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Advantage |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: UMR Bronson Commercial |
$707.07
|
| Rate for Payer: VA VA |
$6,023.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,911.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$840.84 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna American Axle |
$1,242.15
|
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Advantage |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,624.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
| Rate for Payer: UMR Bronson Commercial |
$840.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,433.25 |
| Rate for Payer: Aetna Commercial |
$919.28
|
| Rate for Payer: Aetna Medicare |
$713.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.88
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$686.03
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: BCN Medicare Advantage |
$686.03
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$987.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.33
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.63
|
| Rate for Payer: Nomi Health Commercial |
$823.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,433.25
|
| Rate for Payer: PACE SWMI |
$686.03
|
| Rate for Payer: PHP Commercial |
$960.44
|
| Rate for Payer: PHP Medicare Advantage |
$686.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,361.57
|
| Rate for Payer: Priority Health Medicare |
$686.03
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,361.57
|
| Rate for Payer: Railroad Medicare Medicare |
$686.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.64
|
| Rate for Payer: UHC Core |
$1,367.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.03
|
| Rate for Payer: UHC Exchange |
$1,367.64
|
| Rate for Payer: UHC Medicaid |
$435.16
|
| Rate for Payer: UHCCP Medicaid |
$435.16
|
| Rate for Payer: UMR Bronson Commercial |
$879.06
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 49593
|
| Min. Negotiated Rate |
$334.84 |
| Max. Negotiated Rate |
$1,099.50 |
| Rate for Payer: Aetna Commercial |
$706.54
|
| Rate for Payer: Aetna Medicare |
$548.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.27
|
| Rate for Payer: BCBS Complete |
$351.58
|
| Rate for Payer: BCBS MAPPO |
$527.27
|
| Rate for Payer: BCN Commercial |
$859.02
|
| Rate for Payer: BCN Medicare Advantage |
$527.27
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cofinity Commercial |
$706.54
|
| Rate for Payer: Cofinity Commercial |
$759.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.63
|
| Rate for Payer: Meridian Medicaid |
$351.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.00
|
| Rate for Payer: Nomi Health Commercial |
$632.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,099.50
|
| Rate for Payer: PACE SWMI |
$527.27
|
| Rate for Payer: PHP Commercial |
$738.18
|
| Rate for Payer: PHP Medicare Advantage |
$527.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,046.66
|
| Rate for Payer: Priority Health Medicare |
$527.27
|
| Rate for Payer: Priority Health SBD |
$1,046.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,046.66
|
| Rate for Payer: Railroad Medicare Medicare |
$527.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.81
|
| Rate for Payer: UHC Core |
$1,049.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$527.27
|
| Rate for Payer: UHC Exchange |
$1,049.81
|
| Rate for Payer: UHC Medicaid |
$334.84
|
| Rate for Payer: UHCCP Medicaid |
$334.84
|
| Rate for Payer: UMR Bronson Commercial |
$674.36
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 49592
|
| Min. Negotiated Rate |
$278.60 |
| Max. Negotiated Rate |
$912.75 |
| Rate for Payer: Aetna Commercial |
$587.50
|
| Rate for Payer: Aetna Medicare |
$455.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.34
|
| Rate for Payer: BCBS Complete |
$292.53
|
| Rate for Payer: BCBS MAPPO |
$438.43
|
| Rate for Payer: BCN Commercial |
$714.11
|
| Rate for Payer: BCN Medicare Advantage |
$438.43
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$587.50
|
| Rate for Payer: Cofinity Commercial |
$631.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.35
|
| Rate for Payer: Meridian Medicaid |
$292.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$482.27
|
| Rate for Payer: Nomi Health Commercial |
$526.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.75
|
| Rate for Payer: PACE SWMI |
$438.43
|
| Rate for Payer: PHP Commercial |
$613.80
|
| Rate for Payer: PHP Medicare Advantage |
$438.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$870.09
|
| Rate for Payer: Priority Health Medicare |
$438.43
|
| Rate for Payer: Priority Health SBD |
$870.09
|
| Rate for Payer: Priority Health Tiered Network |
$870.09
|
| Rate for Payer: Railroad Medicare Medicare |
$438.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.46
|
| Rate for Payer: UHC Core |
$871.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.43
|
| Rate for Payer: UHC Exchange |
$871.46
|
| Rate for Payer: UHC Medicaid |
$278.60
|
| Rate for Payer: UHCCP Medicaid |
$278.60
|
| Rate for Payer: UMR Bronson Commercial |
$559.82
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$895.00
|
|
|
Service Code
|
HCPCS 49591
|
| Min. Negotiated Rate |
$201.29 |
| Max. Negotiated Rate |
$671.25 |
| Rate for Payer: Aetna Commercial |
$423.19
|
| Rate for Payer: Aetna Medicare |
$328.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.77
|
| Rate for Payer: BCBS Complete |
$211.35
|
| Rate for Payer: BCBS MAPPO |
$315.81
|
| Rate for Payer: BCN Commercial |
$513.42
|
| Rate for Payer: BCN Medicare Advantage |
$315.81
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cash Price |
$716.00
|
| Rate for Payer: Cofinity Commercial |
$423.19
|
| Rate for Payer: Cofinity Commercial |
$454.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.60
|
| Rate for Payer: Meridian Medicaid |
$211.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.39
|
| Rate for Payer: Nomi Health Commercial |
$378.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.25
|
| Rate for Payer: PACE SWMI |
$315.81
|
| Rate for Payer: PHP Commercial |
$442.13
|
| Rate for Payer: PHP Medicare Advantage |
$315.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$625.56
|
| Rate for Payer: Priority Health Medicare |
$315.81
|
| Rate for Payer: Priority Health SBD |
$625.56
|
| Rate for Payer: Priority Health Tiered Network |
$625.56
|
| Rate for Payer: Railroad Medicare Medicare |
$315.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.53
|
| Rate for Payer: UHC Core |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.81
|
| Rate for Payer: UHC Exchange |
$625.53
|
| Rate for Payer: UHC Medicaid |
$201.29
|
| Rate for Payer: UHCCP Medicaid |
$201.29
|
| Rate for Payer: UMR Bronson Commercial |
$411.70
|
|
|
PR RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,256.00
|
|
|
Service Code
|
HCPCS 49618
|
| Min. Negotiated Rate |
$721.64 |
| Max. Negotiated Rate |
$2,442.00 |
| Rate for Payer: Aetna Commercial |
$1,525.51
|
| Rate for Payer: Aetna Medicare |
$1,183.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,525.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.35
|
| Rate for Payer: BCBS Complete |
$757.72
|
| Rate for Payer: BCBS MAPPO |
$1,138.44
|
| Rate for Payer: BCN Commercial |
$1,863.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.44
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cofinity Commercial |
$1,525.51
|
| Rate for Payer: Cofinity Commercial |
$1,639.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,195.36
|
| Rate for Payer: Meridian Medicaid |
$757.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,252.28
|
| Rate for Payer: Nomi Health Commercial |
$1,366.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.00
|
| Rate for Payer: PACE SWMI |
$1,138.44
|
| Rate for Payer: PHP Commercial |
$1,593.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,271.09
|
| Rate for Payer: Priority Health Medicare |
$1,138.44
|
| Rate for Payer: Priority Health SBD |
$2,271.09
|
| Rate for Payer: Priority Health Tiered Network |
$2,271.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.10
|
| Rate for Payer: UHC Core |
$2,273.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,138.44
|
| Rate for Payer: UHC Exchange |
$2,273.10
|
| Rate for Payer: UHC Medicaid |
$721.64
|
| Rate for Payer: UHCCP Medicaid |
$721.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,497.76
|
|
