|
PR RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS
|
Professional
|
Both
|
$3,555.00
|
|
|
Service Code
|
HCPCS 62230
|
| Min. Negotiated Rate |
$549.75 |
| Max. Negotiated Rate |
$2,310.75 |
| Rate for Payer: Aetna Commercial |
$1,113.20
|
| Rate for Payer: Aetna Medicare |
$863.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.28
|
| Rate for Payer: BCBS Complete |
$577.24
|
| Rate for Payer: BCBS MAPPO |
$830.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: BCN Commercial |
$1,726.70
|
| Rate for Payer: BCN Medicare Advantage |
$830.75
|
| Rate for Payer: Cash Price |
$2,844.00
|
| Rate for Payer: Cash Price |
$2,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,113.20
|
| Rate for Payer: Cofinity Commercial |
$1,196.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.29
|
| Rate for Payer: Meridian Medicaid |
$577.24
|
| Rate for Payer: Nomi Health Commercial |
$996.90
|
| Rate for Payer: PACE SWMI |
$830.75
|
| Rate for Payer: PHP Commercial |
$1,163.05
|
| Rate for Payer: PHP Medicare Advantage |
$830.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,310.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,462.73
|
| Rate for Payer: Priority Health Medicare |
$830.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,462.73
|
| Rate for Payer: Priority Health SBD |
$1,462.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.75
|
| Rate for Payer: UHC Medicare Advantage |
$830.75
|
| Rate for Payer: UHCCP Medicaid |
$549.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,635.30
|
|
|
PR RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP
|
Professional
|
Both
|
$3,924.00
|
|
|
Service Code
|
HCPCS 20822
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,709.18 |
| Rate for Payer: Aetna Commercial |
$2,281.78
|
| Rate for Payer: Aetna Medicare |
$1,770.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,281.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,452.06
|
| Rate for Payer: BCBS Complete |
$1,199.22
|
| Rate for Payer: BCBS MAPPO |
$1,702.82
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,584.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.82
|
| Rate for Payer: Cash Price |
$3,139.20
|
| Rate for Payer: Cash Price |
$3,139.20
|
| Rate for Payer: Cofinity Commercial |
$2,281.78
|
| Rate for Payer: Cofinity Commercial |
$2,452.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.96
|
| Rate for Payer: Meridian Medicaid |
$1,199.22
|
| Rate for Payer: Nomi Health Commercial |
$2,043.38
|
| Rate for Payer: PACE SWMI |
$1,702.82
|
| Rate for Payer: PHP Commercial |
$2,383.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,142.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,550.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,709.18
|
| Rate for Payer: Priority Health Medicare |
$1,702.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,709.18
|
| Rate for Payer: Priority Health SBD |
$2,709.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.82
|
| Rate for Payer: UHCCP Medicaid |
$1,142.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,805.04
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$417.73 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$733.85
|
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.09
|
| Rate for Payer: BCN Commercial |
$2,642.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$790.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$711.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.93
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$619.94
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$417.73
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 49553
|
| Hospital Charge Code |
49553
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,814.71 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$640.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.44
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$616.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.71
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$616.28
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$887.44
|
| Rate for Payer: Cofinity Commercial |
$825.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.09
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Nomi Health Commercial |
$739.54
|
| Rate for Payer: PACE SWMI |
$616.28
|
| Rate for Payer: PHP Commercial |
$862.79
|
| Rate for Payer: PHP Medicare Advantage |
$616.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.49
|
| Rate for Payer: Priority Health Medicare |
$616.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,139.49
|
| Rate for Payer: Priority Health SBD |
$1,139.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.28
|
| Rate for Payer: UHC Medicare Advantage |
$616.28
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
| Rate for Payer: UMR Bronson Commercial |
$519.34
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 49553
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,814.71 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$640.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.44
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$616.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.71
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$616.28
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$825.82
|
| Rate for Payer: Cofinity Commercial |
$887.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.09
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Nomi Health Commercial |
$739.54
|
| Rate for Payer: PACE SWMI |
$616.28
|
| Rate for Payer: PHP Commercial |
$862.79
|
| Rate for Payer: PHP Medicare Advantage |
$616.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.49
|
| Rate for Payer: Priority Health Medicare |
$616.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,139.49
|
| Rate for Payer: Priority Health SBD |
$1,139.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.28
|
| Rate for Payer: UHC Medicare Advantage |
$616.28
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
| Rate for Payer: UMR Bronson Commercial |
$519.34
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$496.76 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Aetna American Axle |
$733.85
|
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$790.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health SBD |
$711.27
|
| Rate for Payer: UMR Bronson Commercial |
$496.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$864.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$319.68 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$561.60
|
| Rate for Payer: Aetna Commercial |
$734.40
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$561.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.09
|
| Rate for Payer: BCN Commercial |
$2,642.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$604.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$777.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$604.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.00
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.40
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$734.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$544.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.39
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$566.72
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$319.68
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.00
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$864.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$380.16 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Aetna American Axle |
$561.60
|
| Rate for Payer: Aetna Commercial |
$734.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$561.60
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$604.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.20
|
| Rate for Payer: Healthscope Commercial |
$777.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$604.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.40
|
| Rate for Payer: PHP Commercial |
$734.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health SBD |
$544.32
|
| Rate for Payer: UMR Bronson Commercial |
$380.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.00
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 49550
|
| Hospital Charge Code |
49550
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$6,312.66 |
| Rate for Payer: PHP Commercial |
$789.84
|
| Rate for Payer: Aetna Commercial |
$755.99
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.40
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,312.66
|
| Rate for Payer: BCN Commercial |
$848.35
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$812.40
|
| Rate for Payer: Cofinity Commercial |
$755.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Nomi Health Commercial |
$677.00
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.25
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.25
|
| Rate for Payer: Priority Health SBD |
$1,042.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
| Rate for Payer: UMR Bronson Commercial |
$397.44
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 49550
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$6,312.66 |
| Rate for Payer: Aetna Commercial |
$755.99
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.40
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,312.66
|
| Rate for Payer: BCN Commercial |
$848.35
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$755.99
|
| Rate for Payer: Cofinity Commercial |
$812.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Nomi Health Commercial |
$677.00
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Commercial |
$789.84
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.25
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.25
|
| Rate for Payer: Priority Health SBD |
$1,042.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
| Rate for Payer: UMR Bronson Commercial |
$397.44
|
|
|
PR RPR 1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 49561
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$1,457.95 |
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,031.78
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$732.60 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna American Axle |
$1,082.25
|
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,165.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health SBD |
$1,048.95
|
| Rate for Payer: UMR Bronson Commercial |
$732.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$576.13 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$1,082.25
|
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,078.53
|
| Rate for Payer: BCN Commercial |
$4,078.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,165.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,048.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.74
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$576.13
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$616.05
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$381.06 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$767.03
|
| Rate for Payer: Aetna Medicare |
$595.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.27
|
| Rate for Payer: BCBS Complete |
$400.11
|
| Rate for Payer: BCBS MAPPO |
$572.41
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$863.01
|
| Rate for Payer: BCN Medicare Advantage |
$572.41
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$824.27
|
| Rate for Payer: Cofinity Commercial |
$767.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.03
|
| Rate for Payer: Meridian Medicaid |
$400.11
|
| Rate for Payer: Nomi Health Commercial |
$686.89
|
| Rate for Payer: PACE SWMI |
$572.41
|
| Rate for Payer: PHP Commercial |
$801.37
|
| Rate for Payer: PHP Medicare Advantage |
$572.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.15
|
| Rate for Payer: Priority Health Medicare |
$572.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.15
|
| Rate for Payer: Priority Health SBD |
$1,060.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.41
|
| Rate for Payer: UHC Medicare Advantage |
$572.41
|
| Rate for Payer: UHCCP Medicaid |
$381.06
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$381.06 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$767.03
|
| Rate for Payer: Aetna Medicare |
$595.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.27
|
| Rate for Payer: BCBS Complete |
$400.11
|
| Rate for Payer: BCBS MAPPO |
$572.41
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$863.01
|
| Rate for Payer: BCN Medicare Advantage |
$572.41
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$824.27
|
| Rate for Payer: Cofinity Commercial |
$767.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.03
|
| Rate for Payer: Meridian Medicaid |
$400.11
|
| Rate for Payer: Nomi Health Commercial |
$686.89
|
| Rate for Payer: PACE SWMI |
$572.41
|
| Rate for Payer: PHP Commercial |
$801.37
|
| Rate for Payer: PHP Medicare Advantage |
$572.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.15
|
| Rate for Payer: Priority Health Medicare |
$572.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.15
|
| Rate for Payer: Priority Health SBD |
$1,060.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.41
|
| Rate for Payer: UHC Medicare Advantage |
$572.41
|
| Rate for Payer: UHCCP Medicaid |
$381.06
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$742.72 |
| Max. Negotiated Rate |
$1,519.20 |
| Rate for Payer: Aetna American Axle |
$1,097.20
|
| Rate for Payer: Aetna Commercial |
$1,434.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.20
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,181.60
|
| Rate for Payer: Cofinity Commercial |
$1,451.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,181.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Healthscope Commercial |
$1,519.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,181.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,266.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: PHP Commercial |
$1,434.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health SBD |
$1,063.44
|
| Rate for Payer: UMR Bronson Commercial |
$742.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,266.00
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$339.52 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$682.72
|
| Rate for Payer: Aetna Medicare |
$529.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.67
|
| Rate for Payer: BCBS Complete |
$356.50
|
| Rate for Payer: BCBS MAPPO |
$509.49
|
| Rate for Payer: BCBS Trust/PPO |
$749.13
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$509.49
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$733.67
|
| Rate for Payer: Cofinity Commercial |
$682.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.96
|
| Rate for Payer: Meridian Medicaid |
$356.50
|
| Rate for Payer: Nomi Health Commercial |
$611.39
|
| Rate for Payer: PACE SWMI |
$509.49
|
| Rate for Payer: PHP Commercial |
$713.29
|
| Rate for Payer: PHP Medicare Advantage |
$509.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.81
|
| Rate for Payer: Priority Health Medicare |
$509.49
|
| Rate for Payer: Priority Health Narrow Network |
$943.81
|
| Rate for Payer: Priority Health SBD |
$943.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.49
|
| Rate for Payer: UHC Medicare Advantage |
$509.49
|
| Rate for Payer: UHCCP Medicaid |
$339.52
|
| Rate for Payer: UMR Bronson Commercial |
$776.48
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$512.35 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$1,097.20
|
| Rate for Payer: Aetna Commercial |
$1,434.80
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,816.08
|
| Rate for Payer: BCN Commercial |
$3,816.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,181.60
|
| Rate for Payer: Cofinity Commercial |
$1,451.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,181.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,519.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,181.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,266.00
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,434.80
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,063.44
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.58
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$512.35
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$624.56
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,266.00
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$339.52 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$682.72
|
| Rate for Payer: Aetna Medicare |
$529.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.67
|
| Rate for Payer: BCBS Complete |
$356.50
|
| Rate for Payer: BCBS MAPPO |
$509.49
|
| Rate for Payer: BCBS Trust/PPO |
$749.13
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$509.49
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$682.72
|
| Rate for Payer: Cofinity Commercial |
$733.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.96
|
| Rate for Payer: Meridian Medicaid |
$356.50
|
| Rate for Payer: Nomi Health Commercial |
$611.39
|
| Rate for Payer: PACE SWMI |
$509.49
|
| Rate for Payer: PHP Commercial |
$713.29
|
| Rate for Payer: PHP Medicare Advantage |
$509.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.81
|
| Rate for Payer: Priority Health Medicare |
$509.49
|
| Rate for Payer: Priority Health Narrow Network |
$943.81
|
| Rate for Payer: Priority Health SBD |
$943.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.49
|
| Rate for Payer: UHC Medicare Advantage |
$509.49
|
| Rate for Payer: UHCCP Medicaid |
$339.52
|
| Rate for Payer: UMR Bronson Commercial |
$776.48
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$393.84 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$793.36
|
| Rate for Payer: Aetna Medicare |
$615.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.57
|
| Rate for Payer: BCBS Complete |
$413.53
|
| Rate for Payer: BCBS MAPPO |
$592.06
|
| Rate for Payer: BCBS Trust/PPO |
$622.87
|
| Rate for Payer: BCN Commercial |
$890.86
|
| Rate for Payer: BCN Medicare Advantage |
$592.06
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$793.36
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.66
|
| Rate for Payer: Meridian Medicaid |
$413.53
|
| Rate for Payer: Nomi Health Commercial |
$710.47
|
| Rate for Payer: PACE SWMI |
$592.06
|
| Rate for Payer: PHP Commercial |
$828.88
|
| Rate for Payer: PHP Medicare Advantage |
$592.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.76
|
| Rate for Payer: Priority Health Medicare |
$592.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.76
|
| Rate for Payer: Priority Health SBD |
$1,094.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$592.06
|
| Rate for Payer: UHC Medicare Advantage |
$592.06
|
| Rate for Payer: UHCCP Medicaid |
$393.84
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$270.94 |
| Max. Negotiated Rate |
$885.30 |
| Rate for Payer: Aetna Commercial |
$541.49
|
| Rate for Payer: Aetna Medicare |
$420.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.90
|
| Rate for Payer: BCBS Complete |
$284.49
|
| Rate for Payer: BCBS MAPPO |
$404.10
|
| Rate for Payer: BCBS Trust/PPO |
$542.04
|
| Rate for Payer: BCN Commercial |
$612.31
|
| Rate for Payer: BCN Medicare Advantage |
$404.10
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$541.49
|
| Rate for Payer: Cofinity Commercial |
$581.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.30
|
| Rate for Payer: Meridian Medicaid |
$284.49
|
| Rate for Payer: Nomi Health Commercial |
$484.92
|
| Rate for Payer: PACE SWMI |
$404.10
|
| Rate for Payer: PHP Commercial |
$565.74
|
| Rate for Payer: PHP Medicare Advantage |
$404.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.09
|
| Rate for Payer: Priority Health Medicare |
$404.10
|
| Rate for Payer: Priority Health Narrow Network |
$754.09
|
| Rate for Payer: Priority Health SBD |
$754.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.10
|
| Rate for Payer: UHC Medicare Advantage |
$404.10
|
| Rate for Payer: UHCCP Medicaid |
$270.94
|
| Rate for Payer: UMR Bronson Commercial |
$626.52
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,799.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$399.59 |
| Max. Negotiated Rate |
$1,169.35 |
| Rate for Payer: Aetna Commercial |
$804.25
|
| Rate for Payer: Aetna Medicare |
$624.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.27
|
| Rate for Payer: BCBS Complete |
$419.57
|
| Rate for Payer: BCBS MAPPO |
$600.19
|
| Rate for Payer: BCBS Trust/PPO |
$704.75
|
| Rate for Payer: BCN Commercial |
$903.08
|
| Rate for Payer: BCN Medicare Advantage |
$600.19
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cofinity Commercial |
$804.25
|
| Rate for Payer: Cofinity Commercial |
$864.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.20
|
| Rate for Payer: Meridian Medicaid |
$419.57
|
| Rate for Payer: Nomi Health Commercial |
$720.23
|
| Rate for Payer: PACE SWMI |
$600.19
|
| Rate for Payer: PHP Commercial |
$840.27
|
| Rate for Payer: PHP Medicare Advantage |
$600.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.46
|
| Rate for Payer: Priority Health Medicare |
$600.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.46
|
| Rate for Payer: Priority Health SBD |
$1,111.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.19
|
| Rate for Payer: UHC Medicare Advantage |
$600.19
|
| Rate for Payer: UHCCP Medicaid |
$399.59
|
| Rate for Payer: UMR Bronson Commercial |
$827.54
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,514.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$984.10 |
| Rate for Payer: Aetna Commercial |
$534.66
|
| Rate for Payer: Aetna Medicare |
$414.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.56
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS MAPPO |
$399.00
|
| Rate for Payer: BCBS Trust/PPO |
$878.03
|
| Rate for Payer: BCN Commercial |
$601.07
|
| Rate for Payer: BCN Medicare Advantage |
$399.00
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cofinity Commercial |
$534.66
|
| Rate for Payer: Cofinity Commercial |
$574.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.95
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Nomi Health Commercial |
$478.80
|
| Rate for Payer: PACE SWMI |
$399.00
|
| Rate for Payer: PHP Commercial |
$558.60
|
| Rate for Payer: PHP Medicare Advantage |
$399.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.58
|
| Rate for Payer: Priority Health Medicare |
$399.00
|
| Rate for Payer: Priority Health Narrow Network |
$738.58
|
| Rate for Payer: Priority Health SBD |
$738.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.00
|
| Rate for Payer: UHC Medicare Advantage |
$399.00
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
| Rate for Payer: UMR Bronson Commercial |
$696.44
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$619.62 |
| Max. Negotiated Rate |
$1,725.95 |
| Rate for Payer: Aetna Commercial |
$1,252.71
|
| Rate for Payer: Aetna Medicare |
$972.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.20
|
| Rate for Payer: BCBS Complete |
$650.60
|
| Rate for Payer: BCBS MAPPO |
$934.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.07
|
| Rate for Payer: BCN Commercial |
$1,404.95
|
| Rate for Payer: BCN Medicare Advantage |
$934.86
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cofinity Commercial |
$1,252.71
|
| Rate for Payer: Cofinity Commercial |
$1,346.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.60
|
| Rate for Payer: Meridian Medicaid |
$650.60
|
| Rate for Payer: Nomi Health Commercial |
$1,121.83
|
| Rate for Payer: PACE SWMI |
$934.86
|
| Rate for Payer: PHP Commercial |
$1,308.80
|
| Rate for Payer: PHP Medicare Advantage |
$934.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,725.95
|
| Rate for Payer: Priority Health Medicare |
$934.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,725.95
|
| Rate for Payer: Priority Health SBD |
$1,725.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.86
|
| Rate for Payer: UHC Medicare Advantage |
$934.86
|
| Rate for Payer: UHCCP Medicaid |
$619.62
|
| Rate for Payer: UMR Bronson Commercial |
$873.54
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$201.81 |
| Max. Negotiated Rate |
$1,437.79 |
| Rate for Payer: Aetna Commercial |
$1,041.61
|
| Rate for Payer: Aetna Medicare |
$808.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,041.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.34
|
| Rate for Payer: BCBS Complete |
$542.13
|
| Rate for Payer: BCBS MAPPO |
$777.32
|
| Rate for Payer: BCBS Trust/PPO |
$201.81
|
| Rate for Payer: BCN Commercial |
$1,170.87
|
| Rate for Payer: BCN Medicare Advantage |
$777.32
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,041.61
|
| Rate for Payer: Cofinity Commercial |
$1,119.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.19
|
| Rate for Payer: Meridian Medicaid |
$542.13
|
| Rate for Payer: Nomi Health Commercial |
$932.78
|
| Rate for Payer: PACE SWMI |
$777.32
|
| Rate for Payer: PHP Commercial |
$1,088.25
|
| Rate for Payer: PHP Medicare Advantage |
$777.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,437.79
|
| Rate for Payer: Priority Health Medicare |
$777.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,437.79
|
| Rate for Payer: Priority Health SBD |
$1,437.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.32
|
| Rate for Payer: UHC Medicare Advantage |
$777.32
|
| Rate for Payer: UHCCP Medicaid |
$516.31
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
|
