|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,690.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$183.85 |
| Max. Negotiated Rate |
$1,883.00 |
| Rate for Payer: Aetna Commercial |
$780.25
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,883.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$926.01
|
| Rate for Payer: Priority Health Narrow Network |
$926.01
|
| Rate for Payer: Priority Health SBD |
$926.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,237.40
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
OP
|
$2,690.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$643.42 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$1,748.50
|
| Rate for Payer: Aetna Commercial |
$2,286.50
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,748.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,611.86
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Cofinity Commercial |
$2,313.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$2,421.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,883.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,017.50
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,286.50
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$2,286.50
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,883.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$1,694.70
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$707.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$643.42
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$995.30
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,017.50
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
IP
|
$2,690.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,183.60 |
| Max. Negotiated Rate |
$2,421.00 |
| Rate for Payer: Aetna American Axle |
$1,748.50
|
| Rate for Payer: Aetna Commercial |
$2,286.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,748.50
|
| Rate for Payer: Cash Price |
$2,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Cofinity Commercial |
$2,313.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,152.00
|
| Rate for Payer: Healthscope Commercial |
$2,421.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,883.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,017.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,286.50
|
| Rate for Payer: PHP Commercial |
$2,286.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,883.00
|
| Rate for Payer: Priority Health SBD |
$1,694.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,183.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,017.50
|
|
|
PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,426.00
|
|
|
Service Code
|
HCPCS 58570
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$1,698.20 |
| Rate for Payer: Aetna Commercial |
$956.81
|
| Rate for Payer: BCBS Complete |
$544.81
|
| Rate for Payer: BCBS Trust/PPO |
$2.14
|
| Rate for Payer: Cash Price |
$1,940.80
|
| Rate for Payer: Cash Price |
$1,940.80
|
| Rate for Payer: Meridian Medicaid |
$544.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,698.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.11
|
| Rate for Payer: Priority Health SBD |
$1,147.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,115.96
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,055.00
|
|
|
Service Code
|
HCPCS 49653
|
| Min. Negotiated Rate |
$1,222.00 |
| Max. Negotiated Rate |
$2,138.50 |
| Rate for Payer: BCBS Complete |
$1,222.00
|
| Rate for Payer: Cash Price |
$2,444.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,138.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,405.30
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 49654
|
| Min. Negotiated Rate |
$1,106.40 |
| Max. Negotiated Rate |
$1,936.20 |
| Rate for Payer: BCBS Complete |
$1,106.40
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,936.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,272.36
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
OP
|
$1,379.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$325.48 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$896.35
|
| Rate for Payer: Aetna Commercial |
$1,172.15
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,949.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cofinity Commercial |
$965.30
|
| Rate for Payer: Cofinity Commercial |
$1,185.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$1,241.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$965.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.25
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,172.15
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$1,172.15
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$965.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$868.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$325.48
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$510.23
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.25
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
49320
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$1,309.66 |
| Rate for Payer: Aetna Commercial |
$441.92
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.66
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$965.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.57
|
| Rate for Payer: Priority Health Narrow Network |
$578.57
|
| Rate for Payer: Priority Health SBD |
$578.57
|
| Rate for Payer: UMR Bronson Commercial |
$634.34
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 49320
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$1,309.66 |
| Rate for Payer: Aetna Commercial |
$441.92
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.66
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$965.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.57
|
| Rate for Payer: Priority Health Narrow Network |
$578.57
|
| Rate for Payer: Priority Health SBD |
$578.57
|
| Rate for Payer: UMR Bronson Commercial |
$634.34
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
IP
|
$1,379.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$606.76 |
| Max. Negotiated Rate |
$1,241.10 |
| Rate for Payer: Aetna American Axle |
$896.35
|
| Rate for Payer: Aetna Commercial |
$1,172.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.35
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cofinity Commercial |
$1,185.94
|
| Rate for Payer: Cofinity Commercial |
$965.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.20
|
| Rate for Payer: Healthscope Commercial |
$1,241.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$965.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,172.15
|
| Rate for Payer: PHP Commercial |
$1,172.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$965.30
|
| Rate for Payer: Priority Health SBD |
$868.77
|
| Rate for Payer: UMR Bronson Commercial |
$606.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.25
|
|
|
PR LAPS ABLTJ RENAL MASS LESION W/INTRAOP US
|
Professional
|
Both
|
$2,074.00
|
|
|
Service Code
|
HCPCS 50542
|
| Min. Negotiated Rate |
$735.28 |
| Max. Negotiated Rate |
$3,188.29 |
| Rate for Payer: Aetna Commercial |
$1,499.49
|
| Rate for Payer: BCBS Complete |
$772.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,188.29
|
| Rate for Payer: Cash Price |
$1,659.20
|
| Rate for Payer: Cash Price |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$772.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,856.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,856.14
|
| Rate for Payer: Priority Health SBD |
$1,856.14
|
| Rate for Payer: UMR Bronson Commercial |
$954.04
|
|
|
PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1
|
Professional
|
Both
|
$1,832.00
|
|
|
Service Code
|
HCPCS 38572
|
| Min. Negotiated Rate |
$503.47 |
| Max. Negotiated Rate |
$1,950.65 |
| Rate for Payer: Aetna Commercial |
$1,126.54
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Cash Price |
$1,465.60
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,282.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,950.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,950.65
|
| Rate for Payer: Priority Health SBD |
$1,950.65
|
| Rate for Payer: UMR Bronson Commercial |
$842.72
|
|
|
PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$3,758.00
|
|
|
Service Code
|
HCPCS 44227
|
| Min. Negotiated Rate |
$1,051.58 |
| Max. Negotiated Rate |
$2,894.01 |
| Rate for Payer: Aetna Commercial |
$2,238.05
|
| Rate for Payer: BCBS Complete |
$1,104.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.81
|
| Rate for Payer: Cash Price |
$3,006.40
|
| Rate for Payer: Cash Price |
$3,006.40
|
| Rate for Payer: Meridian Medicaid |
$1,104.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,630.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,894.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,894.01
|
| Rate for Payer: Priority Health SBD |
$2,894.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,728.68
|
|
|
PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS
|
Professional
|
Both
|
$6,185.00
|
|
|
Service Code
|
HCPCS 44211
|
| Min. Negotiated Rate |
$1,335.51 |
| Max. Negotiated Rate |
$4,329.50 |
| Rate for Payer: Aetna Commercial |
$2,816.64
|
| Rate for Payer: BCBS Complete |
$1,402.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.09
|
| Rate for Payer: Cash Price |
$4,948.00
|
| Rate for Payer: Cash Price |
$4,948.00
|
| Rate for Payer: Meridian Medicaid |
$1,402.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,335.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,329.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,674.24
|
| Rate for Payer: Priority Health Narrow Network |
$3,674.24
|
| Rate for Payer: Priority Health SBD |
$3,674.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,845.10
|
|
|
PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST
|
Professional
|
Both
|
$4,570.00
|
|
|
Service Code
|
HCPCS 44208
|
| Min. Negotiated Rate |
$1,248.61 |
| Max. Negotiated Rate |
$3,433.76 |
| Rate for Payer: Aetna Commercial |
$2,648.24
|
| Rate for Payer: BCBS Complete |
$1,311.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,882.86
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Meridian Medicaid |
$1,311.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,433.76
|
| Rate for Payer: Priority Health Narrow Network |
$3,433.76
|
| Rate for Payer: Priority Health SBD |
$3,433.76
|
| Rate for Payer: UMR Bronson Commercial |
$2,102.20
|
|
|
PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$6,139.00
|
|
|
Service Code
|
HCPCS 44212
|
| Min. Negotiated Rate |
$994.79 |
| Max. Negotiated Rate |
$4,297.30 |
| Rate for Payer: Aetna Commercial |
$2,718.21
|
| Rate for Payer: BCBS Complete |
$1,344.81
|
| Rate for Payer: BCBS Trust/PPO |
$994.79
|
| Rate for Payer: Cash Price |
$4,911.20
|
| Rate for Payer: Cash Price |
$4,911.20
|
| Rate for Payer: Meridian Medicaid |
$1,344.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,280.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,297.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,520.20
|
| Rate for Payer: Priority Health Narrow Network |
$3,520.20
|
| Rate for Payer: Priority Health SBD |
$3,520.20
|
| Rate for Payer: UMR Bronson Commercial |
$2,823.94
|
|
|
PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST
|
Professional
|
Both
|
$4,502.00
|
|
|
Service Code
|
HCPCS 44207
|
| Min. Negotiated Rate |
$1,146.79 |
| Max. Negotiated Rate |
$3,154.48 |
| Rate for Payer: Aetna Commercial |
$2,434.39
|
| Rate for Payer: BCBS Complete |
$1,204.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,992.75
|
| Rate for Payer: Cash Price |
$3,601.60
|
| Rate for Payer: Cash Price |
$3,601.60
|
| Rate for Payer: Meridian Medicaid |
$1,204.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,146.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,151.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,154.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,154.48
|
| Rate for Payer: Priority Health SBD |
$3,154.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,070.92
|
|
|
PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM
|
Professional
|
Both
|
$4,643.00
|
|
|
Service Code
|
HCPCS 44206
|
| Min. Negotiated Rate |
$1,105.04 |
| Max. Negotiated Rate |
$3,250.10 |
| Rate for Payer: Aetna Commercial |
$2,349.86
|
| Rate for Payer: BCBS Complete |
$1,160.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: Cash Price |
$3,714.40
|
| Rate for Payer: Cash Price |
$3,714.40
|
| Rate for Payer: Meridian Medicaid |
$1,160.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,105.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,250.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,038.64
|
| Rate for Payer: Priority Health Narrow Network |
$3,038.64
|
| Rate for Payer: Priority Health SBD |
$3,038.64
|
| Rate for Payer: UMR Bronson Commercial |
$2,135.78
|
|
|
PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM
|
Professional
|
Both
|
$4,117.00
|
|
|
Service Code
|
HCPCS 44205
|
| Min. Negotiated Rate |
$846.89 |
| Max. Negotiated Rate |
$2,881.90 |
| Rate for Payer: Aetna Commercial |
$1,793.71
|
| Rate for Payer: BCBS Complete |
$889.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,868.07
|
| Rate for Payer: Cash Price |
$3,293.60
|
| Rate for Payer: Cash Price |
$3,293.60
|
| Rate for Payer: Meridian Medicaid |
$889.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,329.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,329.55
|
| Rate for Payer: Priority Health SBD |
$2,329.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,893.82
|
|
|
PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$5,178.00
|
|
|
Service Code
|
HCPCS 44210
|
| Min. Negotiated Rate |
$1,121.66 |
| Max. Negotiated Rate |
$3,624.60 |
| Rate for Payer: Aetna Commercial |
$2,365.94
|
| Rate for Payer: BCBS Complete |
$1,177.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,790.41
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Meridian Medicaid |
$1,177.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,121.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,624.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,085.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,085.09
|
| Rate for Payer: Priority Health SBD |
$3,085.09
|
| Rate for Payer: UMR Bronson Commercial |
$2,381.88
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Facility
|
OP
|
$4,561.00
|
|
|
Service Code
|
CPT 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$1,358.88 |
| Max. Negotiated Rate |
$4,839.16 |
| Rate for Payer: Aetna American Axle |
$2,964.65
|
| Rate for Payer: Aetna Commercial |
$3,876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,964.65
|
| Rate for Payer: BCBS Complete |
$1,824.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,839.16
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Cofinity Commercial |
$3,192.70
|
| Rate for Payer: Cofinity Commercial |
$3,922.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,648.80
|
| Rate for Payer: Healthscope Commercial |
$4,104.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,192.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,420.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,876.85
|
| Rate for Payer: PHP Commercial |
$3,876.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.70
|
| Rate for Payer: Priority Health SBD |
$2,873.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,494.77
|
| Rate for Payer: UHC Exchange |
$1,358.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,687.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,420.75
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,561.00
|
|
|
Service Code
|
HCPCS 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$764.98 |
| Max. Negotiated Rate |
$3,192.70 |
| Rate for Payer: Aetna Commercial |
$1,868.47
|
| Rate for Payer: BCBS Complete |
$928.15
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Meridian Medicaid |
$928.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,430.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,430.10
|
| Rate for Payer: Priority Health SBD |
$2,430.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,098.06
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,561.00
|
|
|
Service Code
|
HCPCS 44202
|
| Min. Negotiated Rate |
$764.98 |
| Max. Negotiated Rate |
$3,192.70 |
| Rate for Payer: Aetna Commercial |
$1,868.47
|
| Rate for Payer: BCBS Complete |
$928.15
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Meridian Medicaid |
$928.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,430.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,430.10
|
| Rate for Payer: Priority Health SBD |
$2,430.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,098.06
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Facility
|
IP
|
$4,561.00
|
|
|
Service Code
|
CPT 44202
|
| Hospital Charge Code |
44202
|
| Min. Negotiated Rate |
$2,006.84 |
| Max. Negotiated Rate |
$4,104.90 |
| Rate for Payer: Aetna American Axle |
$2,964.65
|
| Rate for Payer: Aetna Commercial |
$3,876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,964.65
|
| Rate for Payer: Cash Price |
$3,648.80
|
| Rate for Payer: Cofinity Commercial |
$3,192.70
|
| Rate for Payer: Cofinity Commercial |
$3,922.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,648.80
|
| Rate for Payer: Healthscope Commercial |
$4,104.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,192.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,420.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,876.85
|
| Rate for Payer: PHP Commercial |
$3,876.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.70
|
| Rate for Payer: Priority Health SBD |
$2,873.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,006.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,420.75
|
|
|
PR LAPS ESOPHAGEAL LENGTHENING ADDL
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 43283
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$868.53 |
| Rate for Payer: Aetna Commercial |
$214.16
|
| Rate for Payer: BCBS Complete |
$104.44
|
| Rate for Payer: BCBS Trust/PPO |
$868.53
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Meridian Medicaid |
$104.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.42
|
| Rate for Payer: Priority Health Narrow Network |
$273.42
|
| Rate for Payer: Priority Health SBD |
$273.42
|
| Rate for Payer: UMR Bronson Commercial |
$132.48
|
|
