|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$527.31 |
| Max. Negotiated Rate |
$1,888.90 |
| Rate for Payer: Aetna Commercial |
$706.60
|
| Rate for Payer: Aetna Medicare |
$548.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.60
|
| Rate for Payer: BCBS Complete |
$1,162.40
|
| Rate for Payer: BCBS MAPPO |
$527.31
|
| Rate for Payer: BCN Medicare Advantage |
$527.31
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cofinity Commercial |
$759.33
|
| Rate for Payer: Cofinity Commercial |
$706.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.68
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PACE SWMI |
$527.31
|
| Rate for Payer: PHP Commercial |
$738.23
|
| Rate for Payer: PHP Medicare Advantage |
$527.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.90
|
| Rate for Payer: Priority Health Medicare |
$527.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.31
|
| Rate for Payer: UHC Medicare Advantage |
$527.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,336.76
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$752.57 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$1,008.44
|
| Rate for Payer: Aetna Medicare |
$782.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.44
|
| Rate for Payer: BCBS Complete |
$872.40
|
| Rate for Payer: BCBS MAPPO |
$752.57
|
| Rate for Payer: BCN Medicare Advantage |
$752.57
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$1,083.70
|
| Rate for Payer: Cofinity Commercial |
$1,008.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.20
|
| Rate for Payer: Nomi Health Commercial |
$903.08
|
| Rate for Payer: PACE SWMI |
$752.57
|
| Rate for Payer: PHP Commercial |
$1,053.60
|
| Rate for Payer: PHP Medicare Advantage |
$752.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health Medicare |
$752.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.57
|
| Rate for Payer: UHC Medicare Advantage |
$752.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,003.26
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$849.30 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$613.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.32
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Commercial |
$825.71
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UMR Bronson Commercial |
$492.66
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$396.27 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$6,577.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: UMR Bronson Commercial |
$396.27
|
| Rate for Payer: VA VA |
$3,441.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: UMR Bronson Commercial |
$471.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$849.30 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$613.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.32
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Commercial |
$825.71
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UMR Bronson Commercial |
$492.66
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,481.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$592.40 |
| Max. Negotiated Rate |
$1,011.70 |
| Rate for Payer: Aetna Commercial |
$941.44
|
| Rate for Payer: Aetna Medicare |
$730.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.70
|
| Rate for Payer: BCBS Complete |
$592.40
|
| Rate for Payer: BCBS MAPPO |
$702.57
|
| Rate for Payer: BCN Medicare Advantage |
$702.57
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cofinity Commercial |
$941.44
|
| Rate for Payer: Cofinity Commercial |
$1,011.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.70
|
| Rate for Payer: Nomi Health Commercial |
$843.08
|
| Rate for Payer: PACE SWMI |
$702.57
|
| Rate for Payer: PHP Commercial |
$983.60
|
| Rate for Payer: PHP Medicare Advantage |
$702.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.65
|
| Rate for Payer: Priority Health Medicare |
$702.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$702.57
|
| Rate for Payer: UHC Medicare Advantage |
$702.57
|
| Rate for Payer: UMR Bronson Commercial |
$681.26
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.92
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.70
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$617.11 |
| Max. Negotiated Rate |
$1,118.65 |
| Rate for Payer: Aetna Commercial |
$826.93
|
| Rate for Payer: Aetna Medicare |
$641.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.93
|
| Rate for Payer: BCBS Complete |
$688.40
|
| Rate for Payer: BCBS MAPPO |
$617.11
|
| Rate for Payer: BCN Medicare Advantage |
$617.11
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$826.93
|
| Rate for Payer: Cofinity Commercial |
$888.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.97
|
| Rate for Payer: Nomi Health Commercial |
$740.53
|
| Rate for Payer: PACE SWMI |
$617.11
|
| Rate for Payer: PHP Commercial |
$863.95
|
| Rate for Payer: PHP Medicare Advantage |
$617.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health Medicare |
$617.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.11
|
| Rate for Payer: UHC Medicare Advantage |
$617.11
|
| Rate for Payer: UMR Bronson Commercial |
$791.66
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$617.11 |
| Max. Negotiated Rate |
$1,118.65 |
| Rate for Payer: Aetna Commercial |
$826.93
|
| Rate for Payer: Aetna Medicare |
$641.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.93
|
| Rate for Payer: BCBS Complete |
$688.40
|
| Rate for Payer: BCBS MAPPO |
$617.11
|
| Rate for Payer: BCN Medicare Advantage |
$617.11
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$826.93
|
| Rate for Payer: Cofinity Commercial |
$888.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.97
|
| Rate for Payer: Nomi Health Commercial |
$740.53
|
| Rate for Payer: PACE SWMI |
$617.11
|
| Rate for Payer: PHP Commercial |
$863.95
|
| Rate for Payer: PHP Medicare Advantage |
$617.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health Medicare |
$617.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.11
|
| Rate for Payer: UHC Medicare Advantage |
$617.11
|
| Rate for Payer: UMR Bronson Commercial |
$791.66
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$636.77 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna American Axle |
$1,118.65
|
| Rate for Payer: Aetna Commercial |
$1,462.85
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,204.70
|
| Rate for Payer: Cofinity Commercial |
$1,480.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,204.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,548.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,204.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,290.75
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$1,462.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$1,084.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$6,577.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: UMR Bronson Commercial |
$636.77
|
| Rate for Payer: VA VA |
$3,441.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,290.75
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$757.24 |
| Max. Negotiated Rate |
$1,548.90 |
| Rate for Payer: Aetna American Axle |
$1,118.65
|
| Rate for Payer: Aetna Commercial |
$1,462.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.65
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,204.70
|
| Rate for Payer: Cofinity Commercial |
$1,480.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,204.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Healthscope Commercial |
$1,548.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,204.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,290.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: PHP Commercial |
$1,462.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health SBD |
$1,084.23
|
| Rate for Payer: UMR Bronson Commercial |
$757.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,290.75
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$920.48 |
| Max. Negotiated Rate |
$1,882.80 |
| Rate for Payer: Aetna American Axle |
$1,359.80
|
| Rate for Payer: Aetna Commercial |
$1,778.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.80
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,464.40
|
| Rate for Payer: Cofinity Commercial |
$1,799.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Healthscope Commercial |
$1,882.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,464.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,569.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: PHP Commercial |
$1,778.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health SBD |
$1,317.96
|
| Rate for Payer: UMR Bronson Commercial |
$920.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,569.00
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$699.77 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$727.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.67
|
| Rate for Payer: BCBS Complete |
$836.80
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Commercial |
$979.68
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UMR Bronson Commercial |
$962.32
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$699.77 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$727.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.67
|
| Rate for Payer: BCBS Complete |
$836.80
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Commercial |
$979.68
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UMR Bronson Commercial |
$962.32
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$774.04 |
| Max. Negotiated Rate |
$17,130.07 |
| Rate for Payer: Aetna American Axle |
$1,359.80
|
| Rate for Payer: Aetna Commercial |
$1,778.20
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,464.40
|
| Rate for Payer: Cofinity Commercial |
$1,799.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$1,882.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,464.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,569.00
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$1,778.20
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$1,317.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Exchange |
$11,630.00
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,261.83
|
| Rate for Payer: UMR Bronson Commercial |
$774.04
|
| Rate for Payer: VA VA |
$6,085.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,569.00
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,469.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$1,256.66 |
| Max. Negotiated Rate |
$2,904.85 |
| Rate for Payer: Aetna Commercial |
$1,683.92
|
| Rate for Payer: Aetna Medicare |
$1,306.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.92
|
| Rate for Payer: BCBS Complete |
$1,787.60
|
| Rate for Payer: BCBS MAPPO |
$1,256.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.66
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,809.59
|
| Rate for Payer: Cofinity Commercial |
$1,683.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.49
|
| Rate for Payer: Nomi Health Commercial |
$1,507.99
|
| Rate for Payer: PACE SWMI |
$1,256.66
|
| Rate for Payer: PHP Commercial |
$1,759.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,904.85
|
| Rate for Payer: Priority Health Medicare |
$1,256.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,055.74
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,229.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$1,291.60 |
| Max. Negotiated Rate |
$2,142.56 |
| Rate for Payer: Aetna Commercial |
$1,993.77
|
| Rate for Payer: Aetna Medicare |
$1,547.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,142.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,993.77
|
| Rate for Payer: BCBS Complete |
$1,291.60
|
| Rate for Payer: BCBS MAPPO |
$1,487.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,487.89
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cofinity Commercial |
$2,142.56
|
| Rate for Payer: Cofinity Commercial |
$1,993.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,487.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,562.28
|
| Rate for Payer: Nomi Health Commercial |
$1,785.47
|
| Rate for Payer: PACE SWMI |
$1,487.89
|
| Rate for Payer: PHP Commercial |
$2,083.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,487.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,098.85
|
| Rate for Payer: Priority Health Medicare |
$1,487.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,487.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,487.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.34
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$716.18 |
| Max. Negotiated Rate |
$1,281.15 |
| Rate for Payer: Aetna Commercial |
$959.68
|
| Rate for Payer: Aetna Medicare |
$744.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.30
|
| Rate for Payer: BCBS Complete |
$788.40
|
| Rate for Payer: BCBS MAPPO |
$716.18
|
| Rate for Payer: BCN Medicare Advantage |
$716.18
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$959.68
|
| Rate for Payer: Cofinity Commercial |
$1,031.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.99
|
| Rate for Payer: Nomi Health Commercial |
$859.42
|
| Rate for Payer: PACE SWMI |
$716.18
|
| Rate for Payer: PHP Commercial |
$1,002.65
|
| Rate for Payer: PHP Medicare Advantage |
$716.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health Medicare |
$716.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.18
|
| Rate for Payer: UHC Medicare Advantage |
$716.18
|
| Rate for Payer: UMR Bronson Commercial |
$906.66
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$650.40 |
| Max. Negotiated Rate |
$1,056.90 |
| Rate for Payer: Aetna Medicare |
$813.00
|
| Rate for Payer: BCBS Complete |
$650.40
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
| Rate for Payer: UMR Bronson Commercial |
$747.96
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$7,886.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$1,018.95 |
| Max. Negotiated Rate |
$5,125.90 |
| Rate for Payer: Aetna Commercial |
$1,365.39
|
| Rate for Payer: Aetna Medicare |
$1,059.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.29
|
| Rate for Payer: BCBS Complete |
$3,154.40
|
| Rate for Payer: BCBS MAPPO |
$1,018.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,018.95
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,365.39
|
| Rate for Payer: Cofinity Commercial |
$1,467.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,018.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,069.90
|
| Rate for Payer: Nomi Health Commercial |
$1,222.74
|
| Rate for Payer: PACE SWMI |
$1,018.95
|
| Rate for Payer: PHP Commercial |
$1,426.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,018.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,125.90
|
| Rate for Payer: Priority Health Medicare |
$1,018.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,018.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,018.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,627.56
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$312.90 |
| Max. Negotiated Rate |
$814.45 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$325.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.29
|
| Rate for Payer: BCBS Complete |
$501.20
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.55
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Commercial |
$438.06
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health Medicare |
$312.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.90
|
| Rate for Payer: UHC Medicare Advantage |
$312.90
|
| Rate for Payer: UMR Bronson Commercial |
$576.38
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,254.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$501.60 |
| Max. Negotiated Rate |
$884.19 |
| Rate for Payer: Aetna Commercial |
$822.79
|
| Rate for Payer: Aetna Medicare |
$638.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.79
|
| Rate for Payer: BCBS Complete |
$501.60
|
| Rate for Payer: BCBS MAPPO |
$614.02
|
| Rate for Payer: BCN Medicare Advantage |
$614.02
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cofinity Commercial |
$884.19
|
| Rate for Payer: Cofinity Commercial |
$822.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.72
|
| Rate for Payer: Nomi Health Commercial |
$736.82
|
| Rate for Payer: PACE SWMI |
$614.02
|
| Rate for Payer: PHP Commercial |
$859.63
|
| Rate for Payer: PHP Medicare Advantage |
$614.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.10
|
| Rate for Payer: Priority Health Medicare |
$614.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.02
|
| Rate for Payer: UHC Medicare Advantage |
$614.02
|
| Rate for Payer: UMR Bronson Commercial |
$576.84
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25260
|
| Min. Negotiated Rate |
$614.65 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$823.63
|
| Rate for Payer: Aetna Medicare |
$639.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$885.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.63
|
| Rate for Payer: BCBS Complete |
$680.40
|
| Rate for Payer: BCBS MAPPO |
$614.65
|
| Rate for Payer: BCN Medicare Advantage |
$614.65
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$885.10
|
| Rate for Payer: Cofinity Commercial |
$823.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.38
|
| Rate for Payer: Nomi Health Commercial |
$737.58
|
| Rate for Payer: PACE SWMI |
$614.65
|
| Rate for Payer: PHP Commercial |
$860.51
|
| Rate for Payer: PHP Medicare Advantage |
$614.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health Medicare |
$614.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.65
|
| Rate for Payer: UHC Medicare Advantage |
$614.65
|
| Rate for Payer: UMR Bronson Commercial |
$782.46
|
|
