|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,849.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$353.79 |
| Max. Negotiated Rate |
$1,994.30 |
| Rate for Payer: Aetna Commercial |
$723.41
|
| Rate for Payer: Aetna Medicare |
$539.86
|
| Rate for Payer: BCBS Complete |
$371.48
|
| Rate for Payer: BCBS MAPPO |
$539.86
|
| Rate for Payer: BCBS Trust/PPO |
$620.09
|
| Rate for Payer: BCN Commercial |
$803.87
|
| Rate for Payer: BCN Medicare Advantage |
$539.86
|
| Rate for Payer: Cash Price |
$2,279.20
|
| Rate for Payer: Cash Price |
$2,279.20
|
| Rate for Payer: Cofinity Commercial |
$777.40
|
| Rate for Payer: Cofinity Commercial |
$723.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.86
|
| Rate for Payer: Healthscope Commercial |
$647.83
|
| Rate for Payer: Healthscope Whirlpool |
$647.83
|
| Rate for Payer: Meridian Medicaid |
$371.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.85
|
| Rate for Payer: PACE SWMI |
$539.86
|
| Rate for Payer: PHP Medicare Advantage |
$539.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,994.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.01
|
| Rate for Payer: Priority Health Medicare |
$539.86
|
| Rate for Payer: Priority Health Narrow Network |
$840.01
|
| Rate for Payer: UHC Medicare Advantage |
$556.06
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$1,496.60 |
| Rate for Payer: Aetna Commercial |
$1,051.65
|
| Rate for Payer: Aetna Medicare |
$784.81
|
| Rate for Payer: BCBS Complete |
$543.69
|
| Rate for Payer: BCBS MAPPO |
$784.81
|
| Rate for Payer: BCBS Trust/PPO |
$89.28
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$784.81
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cofinity Commercial |
$1,051.65
|
| Rate for Payer: Cofinity Commercial |
$1,130.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.81
|
| Rate for Payer: Healthscope Commercial |
$941.77
|
| Rate for Payer: Healthscope Whirlpool |
$941.77
|
| Rate for Payer: Meridian Medicaid |
$543.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$824.05
|
| Rate for Payer: PACE SWMI |
$784.81
|
| Rate for Payer: PHP Medicare Advantage |
$784.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.92
|
| Rate for Payer: Priority Health Medicare |
$784.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.92
|
| Rate for Payer: UHC Medicare Advantage |
$808.35
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,050.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$735.00 |
| Max. Negotiated Rate |
$1,050.00 |
| Rate for Payer: Aetna Commercial |
$945.00
|
| Rate for Payer: ASR ASR |
$1,018.50
|
| Rate for Payer: BCBS Trust/PPO |
$814.06
|
| Rate for Payer: BCN Commercial |
$814.06
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$987.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$840.00
|
| Rate for Payer: Healthscope Commercial |
$1,050.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.50
|
| Rate for Payer: Mclaren Commercial |
$945.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$892.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$924.00
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$807.28
|
| Rate for Payer: Aetna Medicare |
$602.45
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS MAPPO |
$602.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: BCN Medicare Advantage |
$602.45
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$867.53
|
| Rate for Payer: Cofinity Commercial |
$807.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.45
|
| Rate for Payer: Healthscope Commercial |
$722.94
|
| Rate for Payer: Healthscope Whirlpool |
$722.94
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$632.57
|
| Rate for Payer: PACE SWMI |
$602.45
|
| Rate for Payer: PHP Medicare Advantage |
$602.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.35
|
| Rate for Payer: Priority Health Medicare |
$602.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.35
|
| Rate for Payer: UHC Medicare Advantage |
$620.52
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$807.28
|
| Rate for Payer: Aetna Medicare |
$602.45
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS MAPPO |
$602.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: BCN Medicare Advantage |
$602.45
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$807.28
|
| Rate for Payer: Cofinity Commercial |
$867.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.45
|
| Rate for Payer: Healthscope Commercial |
$722.94
|
| Rate for Payer: Healthscope Whirlpool |
$722.94
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$632.57
|
| Rate for Payer: PACE SWMI |
$602.45
|
| Rate for Payer: PHP Medicare Advantage |
$602.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.35
|
| Rate for Payer: Priority Health Medicare |
$602.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.35
|
| Rate for Payer: UHC Medicare Advantage |
$620.52
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,050.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$735.00 |
| Max. Negotiated Rate |
$3,844.02 |
| Rate for Payer: Aetna Commercial |
$945.00
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$1,018.50
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$814.06
|
| Rate for Payer: BCN Commercial |
$814.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$987.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$840.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,050.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$945.00
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$892.50
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.50
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$745.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$924.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$464.34 |
| Max. Negotiated Rate |
$1,663.62 |
| Rate for Payer: Aetna Commercial |
$966.56
|
| Rate for Payer: Aetna Medicare |
$721.31
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS MAPPO |
$721.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: BCN Commercial |
$1,060.92
|
| Rate for Payer: BCN Medicare Advantage |
$721.31
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cofinity Commercial |
$1,038.69
|
| Rate for Payer: Cofinity Commercial |
$966.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$721.31
|
| Rate for Payer: Healthscope Commercial |
$865.57
|
| Rate for Payer: Healthscope Whirlpool |
$865.57
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$757.38
|
| Rate for Payer: PACE SWMI |
$721.31
|
| Rate for Payer: PHP Medicare Advantage |
$721.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.49
|
| Rate for Payer: Priority Health Medicare |
$721.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,276.49
|
| Rate for Payer: UHC Medicare Advantage |
$742.95
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,040.00 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: BCBS Complete |
$1,040.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,250.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: BCBS Complete |
$900.00
|
| Rate for Payer: Cash Price |
$1,800.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,575.00
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,180.90 |
| Rate for Payer: Aetna Commercial |
$844.79
|
| Rate for Payer: Aetna Medicare |
$630.44
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS MAPPO |
$630.44
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$630.44
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$907.83
|
| Rate for Payer: Cofinity Commercial |
$844.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.44
|
| Rate for Payer: Healthscope Commercial |
$756.53
|
| Rate for Payer: Healthscope Whirlpool |
$756.53
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.96
|
| Rate for Payer: PACE SWMI |
$630.44
|
| Rate for Payer: PHP Medicare Advantage |
$630.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.15
|
| Rate for Payer: Priority Health Medicare |
$630.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.15
|
| Rate for Payer: UHC Medicare Advantage |
$649.35
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,180.90 |
| Rate for Payer: Aetna Commercial |
$844.79
|
| Rate for Payer: Aetna Medicare |
$630.44
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS MAPPO |
$630.44
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$630.44
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$907.83
|
| Rate for Payer: Cofinity Commercial |
$844.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.44
|
| Rate for Payer: Healthscope Commercial |
$756.53
|
| Rate for Payer: Healthscope Whirlpool |
$756.53
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.96
|
| Rate for Payer: PACE SWMI |
$630.44
|
| Rate for Payer: PHP Medicare Advantage |
$630.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.15
|
| Rate for Payer: Priority Health Medicare |
$630.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.15
|
| Rate for Payer: UHC Medicare Advantage |
$649.35
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,687.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,180.90 |
| Max. Negotiated Rate |
$3,844.02 |
| Rate for Payer: Aetna Commercial |
$1,518.30
|
| Rate for Payer: Aetna Medicare |
$3,075.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: ASR ASR |
$1,636.39
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.93
|
| Rate for Payer: BCN Commercial |
$1,307.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$1,585.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,687.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,636.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,075.22
|
| Rate for Payer: Mclaren Commercial |
$1,518.30
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.95
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,382.74
|
| Rate for Payer: PHP Medicaid |
$1,682.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,535.17
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,197.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,687.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,180.90 |
| Max. Negotiated Rate |
$1,687.00 |
| Rate for Payer: Aetna Commercial |
$1,518.30
|
| Rate for Payer: ASR ASR |
$1,636.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.93
|
| Rate for Payer: BCN Commercial |
$1,307.93
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$1,585.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.60
|
| Rate for Payer: Healthscope Commercial |
$1,687.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,636.39
|
| Rate for Payer: Mclaren Commercial |
$1,518.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.56
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,051.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,435.70 |
| Max. Negotiated Rate |
$8,406.09 |
| Rate for Payer: Aetna Commercial |
$1,845.90
|
| Rate for Payer: Aetna Medicare |
$6,724.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,406.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,406.09
|
| Rate for Payer: ASR ASR |
$1,989.47
|
| Rate for Payer: BCBS Complete |
$3,862.77
|
| Rate for Payer: BCBS MAPPO |
$6,724.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.14
|
| Rate for Payer: BCN Commercial |
$1,590.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,724.87
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,927.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,724.87
|
| Rate for Payer: Healthscope Commercial |
$2,051.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,989.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,724.87
|
| Rate for Payer: Mclaren Commercial |
$1,845.90
|
| Rate for Payer: Mclaren Medicaid |
$3,678.50
|
| Rate for Payer: Mclaren Medicare |
$6,724.87
|
| Rate for Payer: Meridian Medicaid |
$3,862.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,061.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.35
|
| Rate for Payer: PACE Medicare |
$6,388.63
|
| Rate for Payer: PACE SWMI |
$6,724.87
|
| Rate for Payer: PHP Commercial |
$7,397.36
|
| Rate for Payer: PHP Medicaid |
$3,678.50
|
| Rate for Payer: PHP Medicare Advantage |
$6,724.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,678.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,866.41
|
| Rate for Payer: Priority Health Medicare |
$6,724.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,456.21
|
| Rate for Payer: Railroad Medicare Medicare |
$6,724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,804.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,926.62
|
| Rate for Payer: VA VA |
$6,724.87
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$1,435.70 |
| Rate for Payer: Aetna Commercial |
$956.92
|
| Rate for Payer: Aetna Medicare |
$714.12
|
| Rate for Payer: BCBS Complete |
$483.54
|
| Rate for Payer: BCBS MAPPO |
$714.12
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: BCN Medicare Advantage |
$714.12
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$956.92
|
| Rate for Payer: Cofinity Commercial |
$1,028.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.12
|
| Rate for Payer: Healthscope Commercial |
$856.94
|
| Rate for Payer: Healthscope Whirlpool |
$856.94
|
| Rate for Payer: Meridian Medicaid |
$483.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$749.83
|
| Rate for Payer: PACE SWMI |
$714.12
|
| Rate for Payer: PHP Medicare Advantage |
$714.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.13
|
| Rate for Payer: Priority Health Medicare |
$714.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.13
|
| Rate for Payer: UHC Medicare Advantage |
$735.54
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$1,435.70 |
| Rate for Payer: Aetna Commercial |
$956.92
|
| Rate for Payer: Aetna Medicare |
$714.12
|
| Rate for Payer: BCBS Complete |
$483.54
|
| Rate for Payer: BCBS MAPPO |
$714.12
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: BCN Medicare Advantage |
$714.12
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$956.92
|
| Rate for Payer: Cofinity Commercial |
$1,028.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.12
|
| Rate for Payer: Healthscope Commercial |
$856.94
|
| Rate for Payer: Healthscope Whirlpool |
$856.94
|
| Rate for Payer: Meridian Medicaid |
$483.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$749.83
|
| Rate for Payer: PACE SWMI |
$714.12
|
| Rate for Payer: PHP Medicare Advantage |
$714.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.13
|
| Rate for Payer: Priority Health Medicare |
$714.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.13
|
| Rate for Payer: UHC Medicare Advantage |
$735.54
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,051.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,435.70 |
| Max. Negotiated Rate |
$2,051.00 |
| Rate for Payer: Aetna Commercial |
$1,845.90
|
| Rate for Payer: ASR ASR |
$1,989.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.14
|
| Rate for Payer: BCN Commercial |
$1,590.14
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,927.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.80
|
| Rate for Payer: Healthscope Commercial |
$2,051.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,989.47
|
| Rate for Payer: Mclaren Commercial |
$1,845.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,804.88
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,381.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$710.04 |
| Max. Negotiated Rate |
$3,066.70 |
| Rate for Payer: Aetna Commercial |
$1,723.11
|
| Rate for Payer: Aetna Medicare |
$1,285.90
|
| Rate for Payer: BCBS Complete |
$865.30
|
| Rate for Payer: BCBS MAPPO |
$1,285.90
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$1,882.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,285.90
|
| Rate for Payer: Cash Price |
$3,504.80
|
| Rate for Payer: Cash Price |
$3,504.80
|
| Rate for Payer: Cofinity Commercial |
$1,723.11
|
| Rate for Payer: Cofinity Commercial |
$1,851.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,285.90
|
| Rate for Payer: Healthscope Commercial |
$1,543.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,543.08
|
| Rate for Payer: Meridian Medicaid |
$865.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,350.20
|
| Rate for Payer: PACE SWMI |
$1,285.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,285.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,066.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,790.15
|
| Rate for Payer: Priority Health Medicare |
$1,285.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,790.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.48
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,932.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$472.43 |
| Max. Negotiated Rate |
$2,035.01 |
| Rate for Payer: Aetna Commercial |
$980.48
|
| Rate for Payer: Aetna Medicare |
$731.70
|
| Rate for Payer: BCBS Complete |
$496.05
|
| Rate for Payer: BCBS MAPPO |
$731.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$1,077.53
|
| Rate for Payer: BCN Medicare Advantage |
$731.70
|
| Rate for Payer: Cash Price |
$1,545.60
|
| Rate for Payer: Cash Price |
$1,545.60
|
| Rate for Payer: Cofinity Commercial |
$980.48
|
| Rate for Payer: Cofinity Commercial |
$1,053.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.70
|
| Rate for Payer: Healthscope Commercial |
$878.04
|
| Rate for Payer: Healthscope Whirlpool |
$878.04
|
| Rate for Payer: Meridian Medicaid |
$496.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.28
|
| Rate for Payer: PACE SWMI |
$731.70
|
| Rate for Payer: PHP Medicare Advantage |
$731.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,352.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,296.48
|
| Rate for Payer: Priority Health Medicare |
$731.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,296.48
|
| Rate for Payer: UHC Medicare Advantage |
$753.65
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,594.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$637.60 |
| Max. Negotiated Rate |
$1,115.80 |
| Rate for Payer: BCBS Complete |
$637.60
|
| Rate for Payer: Cash Price |
$1,275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.80
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$7,731.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$672.02 |
| Max. Negotiated Rate |
$5,411.70 |
| Rate for Payer: Aetna Commercial |
$1,375.91
|
| Rate for Payer: Aetna Medicare |
$1,026.80
|
| Rate for Payer: BCBS Complete |
$705.62
|
| Rate for Payer: BCBS MAPPO |
$1,026.80
|
| Rate for Payer: BCBS Trust/PPO |
$957.28
|
| Rate for Payer: BCN Commercial |
$1,513.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,026.80
|
| Rate for Payer: Cash Price |
$6,184.80
|
| Rate for Payer: Cash Price |
$6,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,478.59
|
| Rate for Payer: Cofinity Commercial |
$1,375.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.80
|
| Rate for Payer: Healthscope Commercial |
$1,232.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.16
|
| Rate for Payer: Meridian Medicaid |
$705.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,078.14
|
| Rate for Payer: PACE SWMI |
$1,026.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,026.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,411.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.29
|
| Rate for Payer: Priority Health Medicare |
$1,026.80
|
| Rate for Payer: Priority Health Narrow Network |
$2,243.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,057.60
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$1,084.07 |
| Rate for Payer: Aetna Commercial |
$427.37
|
| Rate for Payer: Aetna Medicare |
$318.93
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$318.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.07
|
| Rate for Payer: BCN Commercial |
$719.83
|
| Rate for Payer: BCN Medicare Advantage |
$318.93
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$459.26
|
| Rate for Payer: Cofinity Commercial |
$427.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.93
|
| Rate for Payer: Healthscope Commercial |
$382.72
|
| Rate for Payer: Healthscope Whirlpool |
$382.72
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.88
|
| Rate for Payer: PACE SWMI |
$318.93
|
| Rate for Payer: PHP Medicare Advantage |
$318.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.91
|
| Rate for Payer: Priority Health Medicare |
$318.93
|
| Rate for Payer: Priority Health Narrow Network |
$498.91
|
| Rate for Payer: UHC Medicare Advantage |
$328.50
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$413.22 |
| Max. Negotiated Rate |
$3,601.42 |
| Rate for Payer: Aetna Commercial |
$838.81
|
| Rate for Payer: Aetna Medicare |
$625.98
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$625.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,601.42
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: BCN Medicare Advantage |
$625.98
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$838.81
|
| Rate for Payer: Cofinity Commercial |
$901.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.98
|
| Rate for Payer: Healthscope Commercial |
$751.18
|
| Rate for Payer: Healthscope Whirlpool |
$751.18
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.28
|
| Rate for Payer: PACE SWMI |
$625.98
|
| Rate for Payer: PHP Medicare Advantage |
$625.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$860.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$980.44
|
| Rate for Payer: Priority Health Medicare |
$625.98
|
| Rate for Payer: Priority Health Narrow Network |
$980.44
|
| Rate for Payer: UHC Medicare Advantage |
$644.76
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 25260
|
| Min. Negotiated Rate |
$413.22 |
| Max. Negotiated Rate |
$1,459.69 |
| Rate for Payer: Aetna Commercial |
$839.87
|
| Rate for Payer: Aetna Medicare |
$626.77
|
| Rate for Payer: BCBS Complete |
$433.88
|
| Rate for Payer: BCBS MAPPO |
$626.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,459.69
|
| Rate for Payer: BCN Commercial |
$940.22
|
| Rate for Payer: BCN Medicare Advantage |
$626.77
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$902.55
|
| Rate for Payer: Cofinity Commercial |
$839.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.77
|
| Rate for Payer: Healthscope Commercial |
$752.12
|
| Rate for Payer: Healthscope Whirlpool |
$752.12
|
| Rate for Payer: Meridian Medicaid |
$433.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.11
|
| Rate for Payer: PACE SWMI |
$626.77
|
| Rate for Payer: PHP Medicare Advantage |
$626.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.49
|
| Rate for Payer: Priority Health Medicare |
$626.77
|
| Rate for Payer: Priority Health Narrow Network |
$982.49
|
| Rate for Payer: UHC Medicare Advantage |
$645.57
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 25270
|
| Min. Negotiated Rate |
$322.91 |
| Max. Negotiated Rate |
$3,579.76 |
| Rate for Payer: Aetna Commercial |
$653.99
|
| Rate for Payer: Aetna Medicare |
$488.05
|
| Rate for Payer: BCBS Complete |
$339.06
|
| Rate for Payer: BCBS MAPPO |
$488.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,579.76
|
| Rate for Payer: BCN Commercial |
$733.02
|
| Rate for Payer: BCN Medicare Advantage |
$488.05
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$702.79
|
| Rate for Payer: Cofinity Commercial |
$653.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.05
|
| Rate for Payer: Healthscope Commercial |
$585.66
|
| Rate for Payer: Healthscope Whirlpool |
$585.66
|
| Rate for Payer: Meridian Medicaid |
$339.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$512.45
|
| Rate for Payer: PACE SWMI |
$488.05
|
| Rate for Payer: PHP Medicare Advantage |
$488.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.98
|
| Rate for Payer: Priority Health Medicare |
$488.05
|
| Rate for Payer: Priority Health Narrow Network |
$765.98
|
| Rate for Payer: UHC Medicare Advantage |
$502.69
|
|
