|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Facility
|
IP
|
$837.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$544.05 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna Commercial |
$753.30
|
| Rate for Payer: ASR ASR |
$811.89
|
| Rate for Payer: ASR Commercial |
$811.89
|
| Rate for Payer: BCBS Trust/PPO |
$682.07
|
| Rate for Payer: BCN Commercial |
$648.93
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$786.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.60
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Healthscope Whirlpool |
$811.89
|
| Rate for Payer: Mclaren Commercial |
$753.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.45
|
| Rate for Payer: Nomi Health Commercial |
$686.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.56
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Facility
|
OP
|
$837.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$544.05 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$753.30
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$811.89
|
| Rate for Payer: ASR Commercial |
$811.89
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$685.42
|
| Rate for Payer: BCN Commercial |
$648.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$786.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Healthscope Whirlpool |
$811.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$753.30
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.45
|
| Rate for Payer: Nomi Health Commercial |
$686.34
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$733.38
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$586.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 11451
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$355.34
|
| Rate for Payer: Aetna Medicare |
$418.50
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.42
|
| Rate for Payer: Priority Health Narrow Network |
$452.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.68
|
| Rate for Payer: UHC Exchange |
$327.68
|
| Rate for Payer: UHCCP Medicaid |
$215.98
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$355.34
|
| Rate for Payer: Aetna Medicare |
$418.50
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.42
|
| Rate for Payer: Priority Health Narrow Network |
$452.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.68
|
| Rate for Payer: UHC Exchange |
$327.68
|
| Rate for Payer: UHCCP Medicaid |
$215.98
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$733.00
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$170.83 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$278.60
|
| Rate for Payer: Aetna Medicare |
$366.50
|
| Rate for Payer: BCBS Complete |
$179.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: BCN Commercial |
$636.26
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Meridian Medicaid |
$179.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.50
|
| Rate for Payer: Priority Health Narrow Network |
$358.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.80
|
| Rate for Payer: UHC Exchange |
$250.80
|
| Rate for Payer: UHCCP Medicaid |
$170.83
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
IP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$412.75 |
| Max. Negotiated Rate |
$635.00 |
| Rate for Payer: Aetna Commercial |
$571.50
|
| Rate for Payer: ASR ASR |
$615.95
|
| Rate for Payer: ASR Commercial |
$615.95
|
| Rate for Payer: BCBS Trust/PPO |
$517.46
|
| Rate for Payer: BCN Commercial |
$492.32
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$596.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Healthscope Commercial |
$635.00
|
| Rate for Payer: Healthscope Whirlpool |
$615.95
|
| Rate for Payer: Mclaren Commercial |
$571.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.80
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$214.70 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: Aetna Medicare |
$317.50
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.68
|
| Rate for Payer: Priority Health Narrow Network |
$454.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.71
|
| Rate for Payer: UHC Exchange |
$332.71
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
OP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$412.75 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$571.50
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$615.95
|
| Rate for Payer: ASR Commercial |
$615.95
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$520.00
|
| Rate for Payer: BCN Commercial |
$492.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$596.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$635.00
|
| Rate for Payer: Healthscope Whirlpool |
$615.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$571.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.39
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$445.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$214.70 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: Aetna Medicare |
$317.50
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.68
|
| Rate for Payer: Priority Health Narrow Network |
$454.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.71
|
| Rate for Payer: UHC Exchange |
$332.71
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$615.25 |
| Rate for Payer: Aetna Commercial |
$264.03
|
| Rate for Payer: Aetna Medicare |
$236.50
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.34
|
| Rate for Payer: Priority Health Narrow Network |
$341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.90
|
| Rate for Payer: UHC Exchange |
$240.90
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$307.45 |
| Max. Negotiated Rate |
$473.00 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: ASR ASR |
$458.81
|
| Rate for Payer: ASR Commercial |
$458.81
|
| Rate for Payer: BCBS Trust/PPO |
$385.45
|
| Rate for Payer: BCN Commercial |
$366.72
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Healthscope Commercial |
$473.00
|
| Rate for Payer: Healthscope Whirlpool |
$458.81
|
| Rate for Payer: Mclaren Commercial |
$425.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: Nomi Health Commercial |
$387.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.24
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$615.25 |
| Rate for Payer: Aetna Commercial |
$264.03
|
| Rate for Payer: Aetna Medicare |
$236.50
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.34
|
| Rate for Payer: Priority Health Narrow Network |
$341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.90
|
| Rate for Payer: UHC Exchange |
$240.90
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$307.45 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$458.81
|
| Rate for Payer: ASR Commercial |
$458.81
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$387.34
|
| Rate for Payer: BCN Commercial |
$366.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$473.00
|
| Rate for Payer: Healthscope Whirlpool |
$458.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$425.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: Nomi Health Commercial |
$387.86
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.44
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$331.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$640.90 |
| Max. Negotiated Rate |
$986.00 |
| Rate for Payer: Aetna Commercial |
$887.40
|
| Rate for Payer: ASR ASR |
$956.42
|
| Rate for Payer: ASR Commercial |
$956.42
|
| Rate for Payer: BCBS Trust/PPO |
$803.49
|
| Rate for Payer: BCN Commercial |
$764.45
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$926.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Healthscope Commercial |
$986.00
|
| Rate for Payer: Healthscope Whirlpool |
$956.42
|
| Rate for Payer: Mclaren Commercial |
$887.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.68
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$640.90 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$887.40
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$956.42
|
| Rate for Payer: ASR Commercial |
$956.42
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$807.44
|
| Rate for Payer: BCN Commercial |
$764.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$926.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$986.00
|
| Rate for Payer: Healthscope Whirlpool |
$956.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$887.40
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$863.93
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$691.19
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$796.55 |
| Rate for Payer: Aetna Commercial |
$377.56
|
| Rate for Payer: Aetna Medicare |
$493.00
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.51
|
| Rate for Payer: Priority Health Narrow Network |
$479.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.41
|
| Rate for Payer: UHC Exchange |
$353.41
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$796.55 |
| Rate for Payer: Aetna Commercial |
$377.56
|
| Rate for Payer: Aetna Medicare |
$493.00
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.51
|
| Rate for Payer: Priority Health Narrow Network |
$479.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.41
|
| Rate for Payer: UHC Exchange |
$353.41
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$673.89 |
| Rate for Payer: Aetna Commercial |
$305.63
|
| Rate for Payer: Aetna Medicare |
$455.00
|
| Rate for Payer: BCBS Complete |
$195.92
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$673.89
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Meridian Medicaid |
$195.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.92
|
| Rate for Payer: Priority Health Narrow Network |
$391.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.01
|
| Rate for Payer: UHC Exchange |
$283.01
|
| Rate for Payer: UHCCP Medicaid |
$186.59
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.83
|
| Rate for Payer: Aetna Medicare |
$921.50
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.66
|
| Rate for Payer: Priority Health Narrow Network |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$609.45
|
| Rate for Payer: UHC Exchange |
$609.45
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,197.95 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$1,658.70
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$1,787.71
|
| Rate for Payer: ASR Commercial |
$1,787.71
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.23
|
| Rate for Payer: BCN Commercial |
$1,428.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,732.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,843.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$1,658.70
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,614.84
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,621.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.83
|
| Rate for Payer: Aetna Medicare |
$921.50
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.66
|
| Rate for Payer: Priority Health Narrow Network |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$609.45
|
| Rate for Payer: UHC Exchange |
$609.45
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
IP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,197.95 |
| Max. Negotiated Rate |
$1,843.00 |
| Rate for Payer: Aetna Commercial |
$1,658.70
|
| Rate for Payer: ASR ASR |
$1,787.71
|
| Rate for Payer: ASR Commercial |
$1,787.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.86
|
| Rate for Payer: BCN Commercial |
$1,428.88
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,732.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Healthscope Commercial |
$1,843.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.71
|
| Rate for Payer: Mclaren Commercial |
$1,658.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,621.84
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$433.14
|
| Rate for Payer: Aetna Medicare |
$628.00
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$403.51
|
| Rate for Payer: UHC Exchange |
$403.51
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$1,130.40
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$1,218.32
|
| Rate for Payer: ASR Commercial |
$1,218.32
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.54
|
| Rate for Payer: BCN Commercial |
$973.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,180.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,256.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$1,130.40
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.51
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$880.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$1,256.00 |
| Rate for Payer: Aetna Commercial |
$1,130.40
|
| Rate for Payer: ASR ASR |
$1,218.32
|
| Rate for Payer: ASR Commercial |
$1,218.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.51
|
| Rate for Payer: BCN Commercial |
$973.78
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,180.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Healthscope Commercial |
$1,256.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.32
|
| Rate for Payer: Mclaren Commercial |
$1,130.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.28
|
|
