|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
OP
|
$2,737.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,915.90 |
| Max. Negotiated Rate |
$6,411.01 |
| Rate for Payer: Aetna Commercial |
$2,463.30
|
| Rate for Payer: Aetna Medicare |
$5,128.81
|
| 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: ASR ASR |
$2,654.89
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,122.00
|
| Rate for Payer: BCN Commercial |
$2,122.00
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$2,572.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$2,737.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,654.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
| Rate for Payer: Mclaren Commercial |
$2,463.30
|
| 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 |
$2,326.45
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$5,641.69
|
| Rate for Payer: PHP Medicaid |
$2,805.46
|
| 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 |
$1,915.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,490.67
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.27
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,408.56
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
IP
|
$2,737.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,915.90 |
| Max. Negotiated Rate |
$2,737.00 |
| Rate for Payer: Aetna Commercial |
$2,463.30
|
| Rate for Payer: ASR ASR |
$2,654.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,122.00
|
| Rate for Payer: BCN Commercial |
$2,122.00
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$2,572.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.60
|
| Rate for Payer: Healthscope Commercial |
$2,737.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,654.89
|
| Rate for Payer: Mclaren Commercial |
$2,463.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,326.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,915.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,408.56
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
47563
|
| Min. Negotiated Rate |
$461.15 |
| Max. Negotiated Rate |
$1,915.90 |
| Rate for Payer: Aetna Commercial |
$958.61
|
| Rate for Payer: Aetna Medicare |
$715.38
|
| Rate for Payer: BCBS Complete |
$484.21
|
| Rate for Payer: BCBS MAPPO |
$715.38
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: BCN Medicare Advantage |
$715.38
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$958.61
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.38
|
| Rate for Payer: Healthscope Commercial |
$858.46
|
| Rate for Payer: Healthscope Whirlpool |
$858.46
|
| Rate for Payer: Meridian Medicaid |
$484.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$751.15
|
| Rate for Payer: PACE SWMI |
$715.38
|
| Rate for Payer: PHP Medicare Advantage |
$715.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,915.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,266.49
|
| Rate for Payer: Priority Health Medicare |
$715.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,266.49
|
| Rate for Payer: UHC Medicare Advantage |
$736.84
|
|
|
PR LAPS SURG ESOPG/GSTR FUNDOPLASTY
|
Professional
|
Both
|
$4,068.00
|
|
|
Service Code
|
HCPCS 43280
|
| Min. Negotiated Rate |
$688.42 |
| Max. Negotiated Rate |
$2,847.60 |
| Rate for Payer: Aetna Commercial |
$1,436.72
|
| Rate for Payer: Aetna Medicare |
$1,072.18
|
| Rate for Payer: BCBS Complete |
$722.84
|
| Rate for Payer: BCBS MAPPO |
$1,072.18
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.18
|
| Rate for Payer: Cash Price |
$3,254.40
|
| Rate for Payer: Cash Price |
$3,254.40
|
| Rate for Payer: Cofinity Commercial |
$1,436.72
|
| Rate for Payer: Cofinity Commercial |
$1,543.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.18
|
| Rate for Payer: Healthscope Commercial |
$1,286.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,286.62
|
| Rate for Payer: Meridian Medicaid |
$722.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,125.79
|
| Rate for Payer: PACE SWMI |
$1,072.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,847.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,890.92
|
| Rate for Payer: Priority Health Medicare |
$1,072.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,890.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,104.35
|
|
|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,249.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$372.32 |
| Max. Negotiated Rate |
$1,574.30 |
| Rate for Payer: Aetna Commercial |
$767.58
|
| Rate for Payer: Aetna Medicare |
$572.82
|
| Rate for Payer: BCBS Complete |
$390.94
|
| Rate for Payer: BCBS MAPPO |
$572.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.13
|
| Rate for Payer: BCN Commercial |
$847.86
|
| Rate for Payer: BCN Medicare Advantage |
$572.82
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cofinity Commercial |
$824.86
|
| Rate for Payer: Cofinity Commercial |
$767.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.82
|
| Rate for Payer: Healthscope Commercial |
$687.38
|
| Rate for Payer: Healthscope Whirlpool |
$687.38
|
| Rate for Payer: Meridian Medicaid |
$390.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$601.46
|
| Rate for Payer: PACE SWMI |
$572.82
|
| Rate for Payer: PHP Medicare Advantage |
$572.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.13
|
| Rate for Payer: Priority Health Medicare |
$572.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.13
|
| Rate for Payer: UHC Medicare Advantage |
$590.00
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT
|
Professional
|
Both
|
$3,274.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$756.79 |
| Max. Negotiated Rate |
$2,291.80 |
| Rate for Payer: Aetna Commercial |
$1,566.15
|
| Rate for Payer: Aetna Medicare |
$1,168.77
|
| Rate for Payer: BCBS Complete |
$794.63
|
| Rate for Payer: BCBS MAPPO |
$1,168.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.22
|
| Rate for Payer: BCN Commercial |
$1,719.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,168.77
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cash Price |
$2,619.20
|
| Rate for Payer: Cofinity Commercial |
$1,566.15
|
| Rate for Payer: Cofinity Commercial |
$1,683.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,168.77
|
| Rate for Payer: Healthscope Commercial |
$1,402.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,402.52
|
| Rate for Payer: Meridian Medicaid |
$794.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,227.21
|
| Rate for Payer: PACE SWMI |
$1,168.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,168.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$756.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,291.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,900.98
|
| Rate for Payer: Priority Health Medicare |
$1,168.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,900.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,203.83
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$330.79 |
| Max. Negotiated Rate |
$1,111.87 |
| Rate for Payer: Aetna Commercial |
$680.17
|
| Rate for Payer: Aetna Medicare |
$507.59
|
| Rate for Payer: BCBS Complete |
$347.33
|
| Rate for Payer: BCBS MAPPO |
$507.59
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$507.59
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$680.17
|
| Rate for Payer: Cofinity Commercial |
$730.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.59
|
| Rate for Payer: Healthscope Commercial |
$609.11
|
| Rate for Payer: Healthscope Whirlpool |
$609.11
|
| Rate for Payer: Meridian Medicaid |
$347.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$532.97
|
| Rate for Payer: PACE SWMI |
$507.59
|
| Rate for Payer: PHP Medicare Advantage |
$507.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.87
|
| Rate for Payer: Priority Health Medicare |
$507.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.87
|
| Rate for Payer: UHC Medicare Advantage |
$522.82
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$330.79 |
| Max. Negotiated Rate |
$1,111.87 |
| Rate for Payer: Aetna Commercial |
$680.17
|
| Rate for Payer: Aetna Medicare |
$507.59
|
| Rate for Payer: BCBS Complete |
$347.33
|
| Rate for Payer: BCBS MAPPO |
$507.59
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: BCN Medicare Advantage |
$507.59
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$680.17
|
| Rate for Payer: Cofinity Commercial |
$730.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.59
|
| Rate for Payer: Healthscope Commercial |
$609.11
|
| Rate for Payer: Healthscope Whirlpool |
$609.11
|
| Rate for Payer: Meridian Medicaid |
$347.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$532.97
|
| Rate for Payer: PACE SWMI |
$507.59
|
| Rate for Payer: PHP Medicare Advantage |
$507.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.87
|
| Rate for Payer: Priority Health Medicare |
$507.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.87
|
| Rate for Payer: UHC Medicare Advantage |
$522.82
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$962.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$673.40 |
| Max. Negotiated Rate |
$962.00 |
| Rate for Payer: Aetna Commercial |
$865.80
|
| Rate for Payer: ASR ASR |
$933.14
|
| Rate for Payer: BCBS Trust/PPO |
$745.84
|
| Rate for Payer: BCN Commercial |
$745.84
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$904.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.60
|
| Rate for Payer: Healthscope Commercial |
$962.00
|
| Rate for Payer: Healthscope Whirlpool |
$933.14
|
| Rate for Payer: Mclaren Commercial |
$865.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$817.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$846.56
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$962.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$673.40 |
| Max. Negotiated Rate |
$6,411.01 |
| Rate for Payer: Aetna Commercial |
$865.80
|
| Rate for Payer: Aetna Medicare |
$5,128.81
|
| 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: ASR ASR |
$933.14
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$745.84
|
| Rate for Payer: BCN Commercial |
$745.84
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$904.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$962.00
|
| Rate for Payer: Healthscope Whirlpool |
$933.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
| Rate for Payer: Mclaren Commercial |
$865.80
|
| 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 |
$817.70
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$5,641.69
|
| Rate for Payer: PHP Medicaid |
$2,805.46
|
| 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 |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$875.42
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$683.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$846.56
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$751.87
|
| Rate for Payer: Aetna Medicare |
$561.10
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS MAPPO |
$561.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$561.10
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$807.98
|
| Rate for Payer: Cofinity Commercial |
$751.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.10
|
| Rate for Payer: Healthscope Commercial |
$673.32
|
| Rate for Payer: Healthscope Whirlpool |
$673.32
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$589.16
|
| Rate for Payer: PACE SWMI |
$561.10
|
| Rate for Payer: PHP Medicare Advantage |
$561.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,421.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.37
|
| Rate for Payer: Priority Health Medicare |
$561.10
|
| Rate for Payer: Priority Health Narrow Network |
$998.37
|
| Rate for Payer: UHC Medicare Advantage |
$577.93
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 49651
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$751.87
|
| Rate for Payer: Aetna Medicare |
$561.10
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS MAPPO |
$561.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$561.10
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$807.98
|
| Rate for Payer: Cofinity Commercial |
$751.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.10
|
| Rate for Payer: Healthscope Commercial |
$673.32
|
| Rate for Payer: Healthscope Whirlpool |
$673.32
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$589.16
|
| Rate for Payer: PACE SWMI |
$561.10
|
| Rate for Payer: PHP Medicare Advantage |
$561.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,421.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.37
|
| Rate for Payer: Priority Health Medicare |
$561.10
|
| Rate for Payer: Priority Health Narrow Network |
$998.37
|
| Rate for Payer: UHC Medicare Advantage |
$577.93
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
IP
|
$2,030.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$2,030.00 |
| Rate for Payer: Aetna Commercial |
$1,827.00
|
| Rate for Payer: ASR ASR |
$1,969.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.86
|
| Rate for Payer: BCN Commercial |
$1,573.86
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$1,908.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,624.00
|
| Rate for Payer: Healthscope Commercial |
$2,030.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,969.10
|
| Rate for Payer: Mclaren Commercial |
$1,827.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,725.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,421.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,786.40
|
|
|
PR LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,030.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$6,411.01 |
| Rate for Payer: Aetna Commercial |
$1,827.00
|
| Rate for Payer: Aetna Medicare |
$5,128.81
|
| 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: ASR ASR |
$1,969.10
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.86
|
| Rate for Payer: BCN Commercial |
$1,573.86
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$1,908.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,624.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$2,030.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,969.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
| Rate for Payer: Mclaren Commercial |
$1,827.00
|
| 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 |
$1,725.50
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$5,641.69
|
| Rate for Payer: PHP Medicaid |
$2,805.46
|
| 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 |
$1,421.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,847.30
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,441.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,786.40
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 43652
|
| Min. Negotiated Rate |
$492.24 |
| Max. Negotiated Rate |
$1,349.40 |
| Rate for Payer: Aetna Commercial |
$1,021.19
|
| Rate for Payer: Aetna Medicare |
$762.08
|
| Rate for Payer: BCBS Complete |
$516.85
|
| Rate for Payer: BCBS MAPPO |
$762.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.56
|
| Rate for Payer: BCN Commercial |
$1,121.52
|
| Rate for Payer: BCN Medicare Advantage |
$762.08
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,097.40
|
| Rate for Payer: Cofinity Commercial |
$1,021.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.08
|
| Rate for Payer: Healthscope Commercial |
$914.50
|
| Rate for Payer: Healthscope Whirlpool |
$914.50
|
| Rate for Payer: Meridian Medicaid |
$516.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$800.18
|
| Rate for Payer: PACE SWMI |
$762.08
|
| Rate for Payer: PHP Medicare Advantage |
$762.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,094.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,349.40
|
| Rate for Payer: Priority Health Medicare |
$762.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,349.40
|
| Rate for Payer: UHC Medicare Advantage |
$784.94
|
|
|
PR LAPS SURG TRNSXJ VAGUS NRV TRUNCAL
|
Professional
|
Both
|
$2,536.00
|
|
|
Service Code
|
HCPCS 43651
|
| Min. Negotiated Rate |
$423.02 |
| Max. Negotiated Rate |
$1,775.20 |
| Rate for Payer: Aetna Commercial |
$874.42
|
| Rate for Payer: Aetna Medicare |
$652.55
|
| Rate for Payer: BCBS Complete |
$444.17
|
| Rate for Payer: BCBS MAPPO |
$652.55
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$962.20
|
| Rate for Payer: BCN Medicare Advantage |
$652.55
|
| Rate for Payer: Cash Price |
$2,028.80
|
| Rate for Payer: Cash Price |
$2,028.80
|
| Rate for Payer: Cofinity Commercial |
$939.67
|
| Rate for Payer: Cofinity Commercial |
$874.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.55
|
| Rate for Payer: Healthscope Commercial |
$783.06
|
| Rate for Payer: Healthscope Whirlpool |
$783.06
|
| Rate for Payer: Meridian Medicaid |
$444.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$685.18
|
| Rate for Payer: PACE SWMI |
$652.55
|
| Rate for Payer: PHP Medicare Advantage |
$652.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.72
|
| Rate for Payer: Priority Health Medicare |
$652.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.72
|
| Rate for Payer: UHC Medicare Advantage |
$672.13
|
|
|
PR LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 49322
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$499.03
|
| Rate for Payer: Aetna Medicare |
$372.41
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$372.41
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$372.41
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$536.27
|
| Rate for Payer: Cofinity Commercial |
$499.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.41
|
| Rate for Payer: Healthscope Commercial |
$446.89
|
| Rate for Payer: Healthscope Whirlpool |
$446.89
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.03
|
| Rate for Payer: PACE SWMI |
$372.41
|
| Rate for Payer: PHP Medicare Advantage |
$372.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$660.29
|
| Rate for Payer: Priority Health Medicare |
$372.41
|
| Rate for Payer: Priority Health Narrow Network |
$660.29
|
| Rate for Payer: UHC Medicare Advantage |
$383.58
|
|
|
PR LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY
|
Professional
|
Both
|
$1,907.00
|
|
|
Service Code
|
HCPCS 49323
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$1,334.90 |
| Rate for Payer: Aetna Commercial |
$846.48
|
| Rate for Payer: Aetna Medicare |
$631.70
|
| Rate for Payer: BCBS Complete |
$430.53
|
| Rate for Payer: BCBS MAPPO |
$631.70
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$930.93
|
| Rate for Payer: BCN Medicare Advantage |
$631.70
|
| Rate for Payer: Cash Price |
$1,525.60
|
| Rate for Payer: Cash Price |
$1,525.60
|
| Rate for Payer: Cofinity Commercial |
$909.65
|
| Rate for Payer: Cofinity Commercial |
$846.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.70
|
| Rate for Payer: Healthscope Commercial |
$758.04
|
| Rate for Payer: Healthscope Whirlpool |
$758.04
|
| Rate for Payer: Meridian Medicaid |
$430.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$663.28
|
| Rate for Payer: PACE SWMI |
$631.70
|
| Rate for Payer: PHP Medicare Advantage |
$631.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.09
|
| Rate for Payer: Priority Health Medicare |
$631.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.09
|
| Rate for Payer: UHC Medicare Advantage |
$650.65
|
|
|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,718.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,204.32
|
| Rate for Payer: Aetna Medicare |
$898.75
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$898.75
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$1,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$898.75
|
| Rate for Payer: Cash Price |
$2,174.40
|
| Rate for Payer: Cash Price |
$2,174.40
|
| Rate for Payer: Cofinity Commercial |
$1,294.20
|
| Rate for Payer: Cofinity Commercial |
$1,204.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.75
|
| Rate for Payer: Healthscope Commercial |
$1,078.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,078.50
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$943.69
|
| Rate for Payer: PACE SWMI |
$898.75
|
| Rate for Payer: PHP Medicare Advantage |
$898.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.71
|
| Rate for Payer: Priority Health Medicare |
$898.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.71
|
| Rate for Payer: UHC Medicare Advantage |
$925.71
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$284.23 |
| Max. Negotiated Rate |
$1,167.45 |
| Rate for Payer: Aetna Commercial |
$1,065.35
|
| Rate for Payer: Aetna Medicare |
$795.04
|
| Rate for Payer: BCBS Complete |
$537.21
|
| Rate for Payer: BCBS MAPPO |
$795.04
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$795.04
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,144.86
|
| Rate for Payer: Cofinity Commercial |
$1,065.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.04
|
| Rate for Payer: Healthscope Commercial |
$954.05
|
| Rate for Payer: Healthscope Whirlpool |
$954.05
|
| Rate for Payer: Meridian Medicaid |
$537.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$834.79
|
| Rate for Payer: PACE SWMI |
$795.04
|
| Rate for Payer: PHP Medicare Advantage |
$795.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.03
|
| Rate for Payer: Priority Health Medicare |
$795.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.03
|
| Rate for Payer: UHC Medicare Advantage |
$818.89
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$1,142.04 |
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: Aetna Medicare |
$778.00
|
| Rate for Payer: BCBS Complete |
$525.58
|
| Rate for Payer: BCBS MAPPO |
$778.00
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$1,142.04
|
| Rate for Payer: BCN Medicare Advantage |
$778.00
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$1,120.32
|
| Rate for Payer: Cofinity Commercial |
$1,042.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.00
|
| Rate for Payer: Healthscope Commercial |
$933.60
|
| Rate for Payer: Healthscope Whirlpool |
$933.60
|
| Rate for Payer: Meridian Medicaid |
$525.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.90
|
| Rate for Payer: PACE SWMI |
$778.00
|
| Rate for Payer: PHP Medicare Advantage |
$778.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.46
|
| Rate for Payer: Priority Health Medicare |
$778.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,103.46
|
| Rate for Payer: UHC Medicare Advantage |
$801.34
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,833.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$875.43 |
| Max. Negotiated Rate |
$5,304.13 |
| Rate for Payer: Aetna Commercial |
$1,808.66
|
| Rate for Payer: Aetna Medicare |
$1,349.75
|
| Rate for Payer: BCBS Complete |
$919.20
|
| Rate for Payer: BCBS MAPPO |
$1,349.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.13
|
| Rate for Payer: BCN Commercial |
$1,985.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.75
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cofinity Commercial |
$1,808.66
|
| Rate for Payer: Cofinity Commercial |
$1,943.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.75
|
| Rate for Payer: Healthscope Commercial |
$1,619.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,619.70
|
| Rate for Payer: Meridian Medicaid |
$919.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.24
|
| Rate for Payer: PACE SWMI |
$1,349.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$875.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,983.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,196.02
|
| Rate for Payer: Priority Health Medicare |
$1,349.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,196.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.24
|
|
|
PR LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 50948
|
| Min. Negotiated Rate |
$802.80 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$1,665.47
|
| Rate for Payer: Aetna Medicare |
$1,242.89
|
| Rate for Payer: BCBS Complete |
$842.94
|
| Rate for Payer: BCBS MAPPO |
$1,242.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.89
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,789.76
|
| Rate for Payer: Cofinity Commercial |
$1,665.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.89
|
| Rate for Payer: Healthscope Commercial |
$1,491.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.47
|
| Rate for Payer: Meridian Medicaid |
$842.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,305.03
|
| Rate for Payer: PACE SWMI |
$1,242.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$802.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,021.48
|
| Rate for Payer: Priority Health Medicare |
$1,242.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,021.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,280.18
|
|
|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,167.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$2,216.90 |
| Rate for Payer: Aetna Commercial |
$1,735.88
|
| Rate for Payer: Aetna Medicare |
$1,295.43
|
| Rate for Payer: BCBS Complete |
$878.05
|
| Rate for Payer: BCBS MAPPO |
$1,295.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,295.43
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cofinity Commercial |
$1,735.88
|
| Rate for Payer: Cofinity Commercial |
$1,865.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,295.43
|
| Rate for Payer: Healthscope Commercial |
$1,554.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,554.52
|
| Rate for Payer: Meridian Medicaid |
$878.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,360.20
|
| Rate for Payer: PACE SWMI |
$1,295.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,295.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,847.30
|
| Rate for Payer: Priority Health Medicare |
$1,295.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,847.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,334.29
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,468.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$395.17 |
| Max. Negotiated Rate |
$1,727.60 |
| Rate for Payer: Aetna Commercial |
$1,173.77
|
| Rate for Payer: Aetna Medicare |
$875.95
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$875.95
|
| Rate for Payer: BCBS Trust/PPO |
$395.17
|
| Rate for Payer: BCN Commercial |
$1,292.55
|
| Rate for Payer: BCN Medicare Advantage |
$875.95
|
| Rate for Payer: Cash Price |
$1,974.40
|
| Rate for Payer: Cash Price |
$1,974.40
|
| Rate for Payer: Cofinity Commercial |
$1,261.37
|
| Rate for Payer: Cofinity Commercial |
$1,173.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.95
|
| Rate for Payer: Healthscope Commercial |
$1,051.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.14
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.75
|
| Rate for Payer: PACE SWMI |
$875.95
|
| Rate for Payer: PHP Medicare Advantage |
$875.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,252.21
|
| Rate for Payer: Priority Health Medicare |
$875.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,252.21
|
| Rate for Payer: UHC Medicare Advantage |
$902.23
|
|
