|
PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ
|
Professional
|
Both
|
$8,799.00
|
|
|
Service Code
|
HCPCS 63051
|
| Min. Negotiated Rate |
$1,004.30 |
| Max. Negotiated Rate |
$6,599.25 |
| Rate for Payer: Aetna Commercial |
$2,096.54
|
| Rate for Payer: Aetna Medicare |
$1,564.58
|
| Rate for Payer: BCBS Complete |
$1,054.52
|
| Rate for Payer: BCBS MAPPO |
$1,564.58
|
| Rate for Payer: BCN Commercial |
$2,560.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,564.58
|
| Rate for Payer: Cash Price |
$7,039.20
|
| Rate for Payer: Cash Price |
$7,039.20
|
| Rate for Payer: Cofinity Commercial |
$2,253.00
|
| Rate for Payer: Cofinity Commercial |
$2,096.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,564.58
|
| Rate for Payer: Healthscope Commercial |
$1,877.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,877.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,642.81
|
| Rate for Payer: Meridian Medicaid |
$1,054.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,721.04
|
| Rate for Payer: Nomi Health Commercial |
$1,877.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,599.25
|
| Rate for Payer: PACE SWMI |
$1,564.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,564.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,004.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,973.53
|
| Rate for Payer: Priority Health Medicare |
$1,564.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,973.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,564.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,010.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,564.58
|
| Rate for Payer: UHC Exchange |
$3,010.55
|
| Rate for Payer: UHC Medicaid |
$1,004.30
|
| Rate for Payer: UHCCP DNSP |
$1,564.58
|
| Rate for Payer: UHCCP Medicaid |
$1,004.30
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$6,873.00
|
|
|
Service Code
|
HCPCS 63040
|
| Min. Negotiated Rate |
$821.33 |
| Max. Negotiated Rate |
$5,154.75 |
| Rate for Payer: Aetna Commercial |
$1,712.24
|
| Rate for Payer: Aetna Medicare |
$1,277.79
|
| Rate for Payer: BCBS Complete |
$862.40
|
| Rate for Payer: BCBS MAPPO |
$1,277.79
|
| Rate for Payer: BCN Commercial |
$2,295.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.79
|
| Rate for Payer: Cash Price |
$5,498.40
|
| Rate for Payer: Cash Price |
$5,498.40
|
| Rate for Payer: Cofinity Commercial |
$1,840.02
|
| Rate for Payer: Cofinity Commercial |
$1,712.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.79
|
| Rate for Payer: Healthscope Commercial |
$1,533.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,533.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.68
|
| Rate for Payer: Meridian Medicaid |
$862.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,405.57
|
| Rate for Payer: Nomi Health Commercial |
$1,533.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,154.75
|
| Rate for Payer: PACE SWMI |
$1,277.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,426.95
|
| Rate for Payer: Priority Health Medicare |
$1,277.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,426.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,277.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,454.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,277.79
|
| Rate for Payer: UHC Exchange |
$2,454.90
|
| Rate for Payer: UHC Medicaid |
$821.33
|
| Rate for Payer: UHCCP DNSP |
$1,277.79
|
| Rate for Payer: UHCCP Medicaid |
$821.33
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV
|
Professional
|
Both
|
$2,247.00
|
|
|
Service Code
|
HCPCS 63043
|
| Min. Negotiated Rate |
$191.17 |
| Max. Negotiated Rate |
$1,685.25 |
| Rate for Payer: Aetna Commercial |
$780.02
|
| Rate for Payer: BCBS Complete |
$200.73
|
| Rate for Payer: BCN Commercial |
$378.69
|
| Rate for Payer: Cash Price |
$1,797.60
|
| Rate for Payer: Cash Price |
$1,797.60
|
| Rate for Payer: Meridian Medicaid |
$200.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,685.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,059.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,059.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.83
|
| Rate for Payer: UHC Exchange |
$540.83
|
| Rate for Payer: UHC Medicaid |
$191.17
|
| Rate for Payer: UHCCP Medicaid |
$191.17
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 63042
|
| Min. Negotiated Rate |
$777.88 |
| Max. Negotiated Rate |
$2,284.60 |
| Rate for Payer: Aetna Commercial |
$1,616.72
|
| Rate for Payer: Aetna Medicare |
$1,206.51
|
| Rate for Payer: BCBS Complete |
$816.77
|
| Rate for Payer: BCBS MAPPO |
$1,206.51
|
| Rate for Payer: BCN Commercial |
$2,158.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,206.51
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,737.37
|
| Rate for Payer: Cofinity Commercial |
$1,616.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,206.51
|
| Rate for Payer: Healthscope Commercial |
$1,447.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,447.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,266.84
|
| Rate for Payer: Meridian Medicaid |
$816.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,327.16
|
| Rate for Payer: Nomi Health Commercial |
$1,447.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,080.50
|
| Rate for Payer: PACE SWMI |
$1,206.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,206.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,282.34
|
| Rate for Payer: Priority Health Medicare |
$1,206.51
|
| Rate for Payer: Priority Health Narrow Network |
$2,282.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,206.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,284.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,206.51
|
| Rate for Payer: UHC Exchange |
$2,284.60
|
| Rate for Payer: UHC Medicaid |
$777.88
|
| Rate for Payer: UHCCP DNSP |
$1,206.51
|
| Rate for Payer: UHCCP Medicaid |
$777.88
|
|
|
PR LAMOT W/DCMPRN NRV RT EA ADDL NTRSPC CRV/LMBR
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 63035
|
| Min. Negotiated Rate |
$131.63 |
| Max. Negotiated Rate |
$1,405.50 |
| Rate for Payer: Aetna Commercial |
$278.49
|
| Rate for Payer: Aetna Medicare |
$207.83
|
| Rate for Payer: BCBS Complete |
$138.21
|
| Rate for Payer: BCBS MAPPO |
$207.83
|
| Rate for Payer: BCN Commercial |
$381.85
|
| Rate for Payer: BCN Medicare Advantage |
$207.83
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cofinity Commercial |
$299.28
|
| Rate for Payer: Cofinity Commercial |
$278.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.83
|
| Rate for Payer: Healthscope Commercial |
$249.40
|
| Rate for Payer: Healthscope Whirlpool |
$249.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.22
|
| Rate for Payer: Meridian Medicaid |
$138.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$228.61
|
| Rate for Payer: Nomi Health Commercial |
$249.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.50
|
| Rate for Payer: PACE SWMI |
$207.83
|
| Rate for Payer: PHP Medicare Advantage |
$207.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$403.72
|
| Rate for Payer: Priority Health Medicare |
$207.83
|
| Rate for Payer: Priority Health Narrow Network |
$403.72
|
| Rate for Payer: Railroad Medicare Medicare |
$207.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$207.83
|
| Rate for Payer: UHC Exchange |
$340.45
|
| Rate for Payer: UHC Medicaid |
$131.63
|
| Rate for Payer: UHCCP DNSP |
$207.83
|
| Rate for Payer: UHCCP Medicaid |
$131.63
|
|
|
PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR
|
Professional
|
Both
|
$2,189.00
|
|
|
Service Code
|
HCPCS 63044
|
| Min. Negotiated Rate |
$179.97 |
| Max. Negotiated Rate |
$1,641.75 |
| Rate for Payer: Aetna Commercial |
$741.31
|
| Rate for Payer: BCBS Complete |
$188.97
|
| Rate for Payer: BCN Commercial |
$378.69
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Meridian Medicaid |
$188.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,006.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$509.14
|
| Rate for Payer: UHC Exchange |
$509.14
|
| Rate for Payer: UHC Medicaid |
$179.97
|
| Rate for Payer: UHCCP Medicaid |
$179.97
|
|
|
PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID
|
Professional
|
Both
|
$6,512.00
|
|
|
Service Code
|
HCPCS 63172
|
| Min. Negotiated Rate |
$892.04 |
| Max. Negotiated Rate |
$4,884.00 |
| Rate for Payer: Aetna Commercial |
$1,864.99
|
| Rate for Payer: Aetna Medicare |
$1,391.78
|
| Rate for Payer: BCBS Complete |
$936.64
|
| Rate for Payer: BCBS MAPPO |
$1,391.78
|
| Rate for Payer: BCN Commercial |
$2,376.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.78
|
| Rate for Payer: Cash Price |
$5,209.60
|
| Rate for Payer: Cash Price |
$5,209.60
|
| Rate for Payer: Cofinity Commercial |
$2,004.16
|
| Rate for Payer: Cofinity Commercial |
$1,864.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.78
|
| Rate for Payer: Healthscope Commercial |
$1,670.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,670.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,461.37
|
| Rate for Payer: Meridian Medicaid |
$936.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,530.96
|
| Rate for Payer: Nomi Health Commercial |
$1,670.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,884.00
|
| Rate for Payer: PACE SWMI |
$1,391.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$892.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,512.55
|
| Rate for Payer: Priority Health Medicare |
$1,391.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,512.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,391.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,439.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,391.78
|
| Rate for Payer: UHC Exchange |
$2,439.41
|
| Rate for Payer: UHC Medicaid |
$892.04
|
| Rate for Payer: UHCCP DNSP |
$1,391.78
|
| Rate for Payer: UHCCP Medicaid |
$892.04
|
|
|
PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL
|
Professional
|
Both
|
$7,064.00
|
|
|
Service Code
|
HCPCS 63173
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$5,298.00 |
| Rate for Payer: Aetna Commercial |
$2,265.42
|
| Rate for Payer: Aetna Medicare |
$1,690.61
|
| Rate for Payer: BCBS Complete |
$1,136.36
|
| Rate for Payer: BCBS MAPPO |
$1,690.61
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,690.61
|
| Rate for Payer: Cash Price |
$5,651.20
|
| Rate for Payer: Cash Price |
$5,651.20
|
| Rate for Payer: Cofinity Commercial |
$2,434.48
|
| Rate for Payer: Cofinity Commercial |
$2,265.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,690.61
|
| Rate for Payer: Healthscope Commercial |
$2,028.73
|
| Rate for Payer: Healthscope Whirlpool |
$2,028.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,775.14
|
| Rate for Payer: Meridian Medicaid |
$1,136.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,859.67
|
| Rate for Payer: Nomi Health Commercial |
$2,028.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,298.00
|
| Rate for Payer: PACE SWMI |
$1,690.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,690.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,061.45
|
| Rate for Payer: Priority Health Medicare |
$1,690.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,061.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,690.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,037.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,690.61
|
| Rate for Payer: UHC Exchange |
$3,037.92
|
| Rate for Payer: UHC Medicaid |
$1,082.25
|
| Rate for Payer: UHCCP DNSP |
$1,690.61
|
| Rate for Payer: UHCCP Medicaid |
$1,082.25
|
|
|
PR LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV
|
Professional
|
Both
|
$5,245.00
|
|
|
Service Code
|
HCPCS 63001
|
| Min. Negotiated Rate |
$761.26 |
| Max. Negotiated Rate |
$3,933.75 |
| Rate for Payer: Aetna Commercial |
$1,589.67
|
| Rate for Payer: Aetna Medicare |
$1,186.32
|
| Rate for Payer: BCBS Complete |
$799.32
|
| Rate for Payer: BCBS MAPPO |
$1,186.32
|
| Rate for Payer: BCN Commercial |
$2,065.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,186.32
|
| Rate for Payer: Cash Price |
$4,196.00
|
| Rate for Payer: Cash Price |
$4,196.00
|
| Rate for Payer: Cofinity Commercial |
$1,708.30
|
| Rate for Payer: Cofinity Commercial |
$1,589.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,186.32
|
| Rate for Payer: Healthscope Commercial |
$1,423.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,423.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,245.64
|
| Rate for Payer: Meridian Medicaid |
$799.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,304.95
|
| Rate for Payer: Nomi Health Commercial |
$1,423.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,933.75
|
| Rate for Payer: PACE SWMI |
$1,186.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,186.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,183.44
|
| Rate for Payer: Priority Health Medicare |
$1,186.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,183.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,186.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,177.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,186.32
|
| Rate for Payer: UHC Exchange |
$2,177.21
|
| Rate for Payer: UHC Medicaid |
$761.26
|
| Rate for Payer: UHCCP DNSP |
$1,186.32
|
| Rate for Payer: UHCCP Medicaid |
$761.26
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,075.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,556.25 |
| Rate for Payer: Aetna Commercial |
$766.21
|
| Rate for Payer: Aetna Medicare |
$571.80
|
| Rate for Payer: BCBS Complete |
$387.13
|
| Rate for Payer: BCBS MAPPO |
$571.80
|
| Rate for Payer: BCN Commercial |
$910.81
|
| Rate for Payer: BCN Medicare Advantage |
$571.80
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$823.39
|
| Rate for Payer: Cofinity Commercial |
$766.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.80
|
| Rate for Payer: Healthscope Commercial |
$686.16
|
| Rate for Payer: Healthscope Whirlpool |
$686.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.39
|
| Rate for Payer: Meridian Medicaid |
$387.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$628.98
|
| Rate for Payer: Nomi Health Commercial |
$686.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: PACE SWMI |
$571.80
|
| Rate for Payer: PHP Medicare Advantage |
$571.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,109.76
|
| Rate for Payer: Priority Health Medicare |
$571.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.76
|
| Rate for Payer: Railroad Medicare Medicare |
$571.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$571.80
|
| Rate for Payer: UHC Exchange |
$1,067.09
|
| Rate for Payer: UHC Medicaid |
$368.70
|
| Rate for Payer: UHCCP DNSP |
$571.80
|
| Rate for Payer: UHCCP Medicaid |
$368.70
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
IP
|
$2,075.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,556.25 |
| Max. Negotiated Rate |
$2,075.00 |
| Rate for Payer: Aetna Commercial |
$1,867.50
|
| Rate for Payer: ASR ASR |
$2,012.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.99
|
| Rate for Payer: BCN Commercial |
$1,703.99
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,950.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.00
|
| Rate for Payer: Healthscope Commercial |
$2,012.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,075.00
|
| Rate for Payer: Mclaren Commercial |
$1,867.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.75
|
| Rate for Payer: Nomi Health Commercial |
$1,701.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,075.00
|
|
|
Service Code
|
HCPCS 44970
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,556.25 |
| Rate for Payer: Aetna Commercial |
$766.21
|
| Rate for Payer: Aetna Medicare |
$571.80
|
| Rate for Payer: BCBS Complete |
$387.13
|
| Rate for Payer: BCBS MAPPO |
$571.80
|
| Rate for Payer: BCN Commercial |
$910.81
|
| Rate for Payer: BCN Medicare Advantage |
$571.80
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$823.39
|
| Rate for Payer: Cofinity Commercial |
$766.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.80
|
| Rate for Payer: Healthscope Commercial |
$686.16
|
| Rate for Payer: Healthscope Whirlpool |
$686.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.39
|
| Rate for Payer: Meridian Medicaid |
$387.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$628.98
|
| Rate for Payer: Nomi Health Commercial |
$686.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: PACE SWMI |
$571.80
|
| Rate for Payer: PHP Medicare Advantage |
$571.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,109.76
|
| Rate for Payer: Priority Health Medicare |
$571.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.76
|
| Rate for Payer: Railroad Medicare Medicare |
$571.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$571.80
|
| Rate for Payer: UHC Exchange |
$1,067.09
|
| Rate for Payer: UHC Medicaid |
$368.70
|
| Rate for Payer: UHCCP DNSP |
$571.80
|
| Rate for Payer: UHCCP Medicaid |
$368.70
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
OP
|
$2,075.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,454.58 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$1,867.50
|
| Rate for Payer: Aetna Medicare |
$6,023.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: ASR ASR |
$2,012.75
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,710.84
|
| Rate for Payer: BCN Commercial |
$1,710.84
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,950.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,012.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,075.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$1,867.50
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$3,308.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.75
|
| Rate for Payer: Nomi Health Commercial |
$1,701.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$6,626.17
|
| Rate for Payer: PHP Medicaid |
$3,228.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,818.12
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,454.58
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP DNSP |
$6,023.79
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
PR LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$4,147.00
|
|
|
Service Code
|
HCPCS 38120
|
| Min. Negotiated Rate |
$636.87 |
| Max. Negotiated Rate |
$3,110.25 |
| Rate for Payer: Aetna Commercial |
$1,327.59
|
| Rate for Payer: Aetna Medicare |
$990.74
|
| Rate for Payer: BCBS Complete |
$668.71
|
| Rate for Payer: BCBS MAPPO |
$990.74
|
| Rate for Payer: BCN Commercial |
$1,595.04
|
| Rate for Payer: BCN Medicare Advantage |
$990.74
|
| Rate for Payer: Cash Price |
$3,317.60
|
| Rate for Payer: Cash Price |
$3,317.60
|
| Rate for Payer: Cofinity Commercial |
$1,426.67
|
| Rate for Payer: Cofinity Commercial |
$1,327.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$990.74
|
| Rate for Payer: Healthscope Commercial |
$1,188.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,040.28
|
| Rate for Payer: Meridian Medicaid |
$668.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,089.81
|
| Rate for Payer: Nomi Health Commercial |
$1,188.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,110.25
|
| Rate for Payer: PACE SWMI |
$990.74
|
| Rate for Payer: PHP Medicare Advantage |
$990.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,122.32
|
| Rate for Payer: Priority Health Medicare |
$990.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,122.32
|
| Rate for Payer: Railroad Medicare Medicare |
$990.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,874.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$990.74
|
| Rate for Payer: UHC Exchange |
$1,874.68
|
| Rate for Payer: UHC Medicaid |
$636.87
|
| Rate for Payer: UHCCP DNSP |
$990.74
|
| Rate for Payer: UHCCP Medicaid |
$636.87
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,281.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$703.97 |
| Max. Negotiated Rate |
$2,121.74 |
| Rate for Payer: Aetna Commercial |
$1,473.71
|
| Rate for Payer: Aetna Medicare |
$1,099.78
|
| Rate for Payer: BCBS Complete |
$739.17
|
| Rate for Payer: BCBS MAPPO |
$1,099.78
|
| Rate for Payer: BCN Commercial |
$1,790.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.78
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Cofinity Commercial |
$1,583.68
|
| Rate for Payer: Cofinity Commercial |
$1,473.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.78
|
| Rate for Payer: Healthscope Commercial |
$1,319.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,319.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.77
|
| Rate for Payer: Meridian Medicaid |
$739.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,209.76
|
| Rate for Payer: Nomi Health Commercial |
$1,319.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,710.75
|
| Rate for Payer: PACE SWMI |
$1,099.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,941.77
|
| Rate for Payer: Priority Health Medicare |
$1,099.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,941.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,099.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,121.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,099.78
|
| Rate for Payer: UHC Exchange |
$2,121.74
|
| Rate for Payer: UHC Medicaid |
$703.97
|
| Rate for Payer: UHCCP DNSP |
$1,099.78
|
| Rate for Payer: UHCCP Medicaid |
$703.97
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,735.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$901.20 |
| Max. Negotiated Rate |
$2,801.25 |
| Rate for Payer: Aetna Commercial |
$1,884.82
|
| Rate for Payer: Aetna Medicare |
$1,406.58
|
| Rate for Payer: BCBS Complete |
$946.26
|
| Rate for Payer: BCBS MAPPO |
$1,406.58
|
| Rate for Payer: BCN Commercial |
$2,290.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,406.58
|
| Rate for Payer: Cash Price |
$2,988.00
|
| Rate for Payer: Cash Price |
$2,988.00
|
| Rate for Payer: Cofinity Commercial |
$2,025.48
|
| Rate for Payer: Cofinity Commercial |
$1,884.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,406.58
|
| Rate for Payer: Healthscope Commercial |
$1,687.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,687.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,476.91
|
| Rate for Payer: Meridian Medicaid |
$946.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,547.24
|
| Rate for Payer: Nomi Health Commercial |
$1,687.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,801.25
|
| Rate for Payer: PACE SWMI |
$1,406.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,406.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$901.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,791.09
|
| Rate for Payer: Priority Health Medicare |
$1,406.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,791.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,406.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,406.58
|
| Rate for Payer: UHC Exchange |
$2,738.57
|
| Rate for Payer: UHC Medicaid |
$901.20
|
| Rate for Payer: UHCCP DNSP |
$1,406.58
|
| Rate for Payer: UHCCP Medicaid |
$901.20
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$1,730.62 |
| Rate for Payer: Aetna Commercial |
$1,143.45
|
| Rate for Payer: Aetna Medicare |
$853.32
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCBS MAPPO |
$853.32
|
| Rate for Payer: BCN Commercial |
$1,456.60
|
| Rate for Payer: BCN Medicare Advantage |
$853.32
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cofinity Commercial |
$1,228.78
|
| Rate for Payer: Cofinity Commercial |
$1,143.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.32
|
| Rate for Payer: Healthscope Commercial |
$1,023.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,023.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.99
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$938.65
|
| Rate for Payer: Nomi Health Commercial |
$1,023.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: PACE SWMI |
$853.32
|
| Rate for Payer: PHP Medicare Advantage |
$853.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,475.22
|
| Rate for Payer: Priority Health Medicare |
$853.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,475.22
|
| Rate for Payer: Railroad Medicare Medicare |
$853.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,730.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$853.32
|
| Rate for Payer: UHC Exchange |
$1,730.62
|
| Rate for Payer: UHC Medicaid |
$548.48
|
| Rate for Payer: UHCCP DNSP |
$853.32
|
| Rate for Payer: UHCCP Medicaid |
$548.48
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 44180
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$1,796.25 |
| Rate for Payer: Aetna Commercial |
$1,152.16
|
| Rate for Payer: Aetna Medicare |
$859.82
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$859.82
|
| Rate for Payer: BCN Commercial |
$1,384.39
|
| Rate for Payer: BCN Medicare Advantage |
$859.82
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$1,238.14
|
| Rate for Payer: Cofinity Commercial |
$1,152.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.82
|
| Rate for Payer: Healthscope Commercial |
$1,031.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$902.81
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$945.80
|
| Rate for Payer: Nomi Health Commercial |
$1,031.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,796.25
|
| Rate for Payer: PACE SWMI |
$859.82
|
| Rate for Payer: PHP Medicare Advantage |
$859.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,686.78
|
| Rate for Payer: Priority Health Medicare |
$859.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,686.78
|
| Rate for Payer: Railroad Medicare Medicare |
$859.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,639.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$859.82
|
| Rate for Payer: UHC Exchange |
$1,639.38
|
| Rate for Payer: UHC Medicaid |
$551.24
|
| Rate for Payer: UHCCP DNSP |
$859.82
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$2,395.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,796.25 |
| Max. Negotiated Rate |
$2,395.00 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.77
|
| Rate for Payer: BCN Commercial |
$1,966.77
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Healthscope Commercial |
$2,323.15
|
| Rate for Payer: Healthscope Whirlpool |
$2,395.00
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,796.25
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$2,395.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,678.89 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$2,155.50
|
| Rate for Payer: Aetna Medicare |
$6,023.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: ASR ASR |
$2,323.15
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,974.68
|
| Rate for Payer: BCN Commercial |
$1,974.68
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$2,251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,323.15
|
| Rate for Payer: Healthscope Whirlpool |
$2,395.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$2,155.50
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$3,308.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,035.75
|
| Rate for Payer: Nomi Health Commercial |
$1,963.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,796.25
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$6,626.17
|
| Rate for Payer: PHP Medicaid |
$3,228.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,098.50
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,678.89
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP DNSP |
$6,023.79
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,395.00
|
|
|
Service Code
|
HCPCS 44180
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$551.24 |
| Max. Negotiated Rate |
$1,796.25 |
| Rate for Payer: Aetna Commercial |
$1,152.16
|
| Rate for Payer: Aetna Medicare |
$859.82
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$859.82
|
| Rate for Payer: BCN Commercial |
$1,384.39
|
| Rate for Payer: BCN Medicare Advantage |
$859.82
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cash Price |
$1,916.00
|
| Rate for Payer: Cofinity Commercial |
$1,238.14
|
| Rate for Payer: Cofinity Commercial |
$1,152.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.82
|
| Rate for Payer: Healthscope Commercial |
$1,031.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$902.81
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$945.80
|
| Rate for Payer: Nomi Health Commercial |
$1,031.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,796.25
|
| Rate for Payer: PACE SWMI |
$859.82
|
| Rate for Payer: PHP Medicare Advantage |
$859.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,686.78
|
| Rate for Payer: Priority Health Medicare |
$859.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,686.78
|
| Rate for Payer: Railroad Medicare Medicare |
$859.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,639.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$859.82
|
| Rate for Payer: UHC Exchange |
$1,639.38
|
| Rate for Payer: UHC Medicaid |
$551.24
|
| Rate for Payer: UHCCP DNSP |
$859.82
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
|
|
PR LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 58670
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,143.00 |
| Rate for Payer: Aetna Commercial |
$439.69
|
| Rate for Payer: Aetna Medicare |
$328.13
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$328.13
|
| Rate for Payer: BCN Commercial |
$558.74
|
| Rate for Payer: BCN Medicare Advantage |
$328.13
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cofinity Commercial |
$472.51
|
| Rate for Payer: Cofinity Commercial |
$439.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.13
|
| Rate for Payer: Healthscope Commercial |
$393.76
|
| Rate for Payer: Healthscope Whirlpool |
$393.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.54
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.94
|
| Rate for Payer: Nomi Health Commercial |
$393.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,143.00
|
| Rate for Payer: PACE SWMI |
$328.13
|
| Rate for Payer: PHP Medicare Advantage |
$328.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$565.88
|
| Rate for Payer: Priority Health Medicare |
$328.13
|
| Rate for Payer: Priority Health Narrow Network |
$565.88
|
| Rate for Payer: Railroad Medicare Medicare |
$328.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$650.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$328.13
|
| Rate for Payer: UHC Exchange |
$650.67
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP DNSP |
$328.13
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT
|
Professional
|
Both
|
$3,098.00
|
|
|
Service Code
|
HCPCS 50546
|
| Min. Negotiated Rate |
$688.20 |
| Max. Negotiated Rate |
$2,323.50 |
| Rate for Payer: Aetna Commercial |
$1,431.92
|
| Rate for Payer: Aetna Medicare |
$1,068.60
|
| Rate for Payer: BCBS Complete |
$722.61
|
| Rate for Payer: BCBS MAPPO |
$1,068.60
|
| Rate for Payer: BCN Commercial |
$1,794.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,068.60
|
| Rate for Payer: Cash Price |
$2,478.40
|
| Rate for Payer: Cash Price |
$2,478.40
|
| Rate for Payer: Cofinity Commercial |
$1,538.78
|
| Rate for Payer: Cofinity Commercial |
$1,431.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,068.60
|
| Rate for Payer: Healthscope Commercial |
$1,282.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,282.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,122.03
|
| Rate for Payer: Meridian Medicaid |
$722.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,175.46
|
| Rate for Payer: Nomi Health Commercial |
$1,282.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,323.50
|
| Rate for Payer: PACE SWMI |
$1,068.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,068.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,955.04
|
| Rate for Payer: Priority Health Medicare |
$1,068.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,955.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,068.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,129.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,068.60
|
| Rate for Payer: UHC Exchange |
$2,129.59
|
| Rate for Payer: UHC Medicaid |
$688.20
|
| Rate for Payer: UHCCP DNSP |
$1,068.60
|
| Rate for Payer: UHCCP Medicaid |
$688.20
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY
|
Professional
|
Both
|
$2,670.00
|
|
|
Service Code
|
HCPCS 50548
|
| Min. Negotiated Rate |
$759.56 |
| Max. Negotiated Rate |
$2,384.90 |
| Rate for Payer: Aetna Commercial |
$1,584.62
|
| Rate for Payer: Aetna Medicare |
$1,182.55
|
| Rate for Payer: BCBS Complete |
$797.54
|
| Rate for Payer: BCBS MAPPO |
$1,182.55
|
| Rate for Payer: BCN Commercial |
$1,993.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.55
|
| Rate for Payer: Cash Price |
$2,136.00
|
| Rate for Payer: Cash Price |
$2,136.00
|
| Rate for Payer: Cofinity Commercial |
$1,702.87
|
| Rate for Payer: Cofinity Commercial |
$1,584.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.55
|
| Rate for Payer: Healthscope Commercial |
$1,419.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,419.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.68
|
| Rate for Payer: Meridian Medicaid |
$797.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,300.81
|
| Rate for Payer: Nomi Health Commercial |
$1,419.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,002.50
|
| Rate for Payer: PACE SWMI |
$1,182.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,172.02
|
| Rate for Payer: Priority Health Medicare |
$1,182.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,172.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,182.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,384.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,182.55
|
| Rate for Payer: UHC Exchange |
$2,384.90
|
| Rate for Payer: UHC Medicaid |
$759.56
|
| Rate for Payer: UHCCP DNSP |
$1,182.55
|
| Rate for Payer: UHCCP Medicaid |
$759.56
|
|
|
PR LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$2,363.00
|
|
|
Service Code
|
HCPCS 54692
|
| Min. Negotiated Rate |
$434.09 |
| Max. Negotiated Rate |
$1,772.25 |
| Rate for Payer: Aetna Commercial |
$901.61
|
| Rate for Payer: Aetna Medicare |
$672.84
|
| Rate for Payer: BCBS Complete |
$455.79
|
| Rate for Payer: BCBS MAPPO |
$672.84
|
| Rate for Payer: BCN Commercial |
$1,130.42
|
| Rate for Payer: BCN Medicare Advantage |
$672.84
|
| Rate for Payer: Cash Price |
$1,890.40
|
| Rate for Payer: Cash Price |
$1,890.40
|
| Rate for Payer: Cofinity Commercial |
$968.89
|
| Rate for Payer: Cofinity Commercial |
$901.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.84
|
| Rate for Payer: Healthscope Commercial |
$807.41
|
| Rate for Payer: Healthscope Whirlpool |
$807.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.48
|
| Rate for Payer: Meridian Medicaid |
$455.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$740.12
|
| Rate for Payer: Nomi Health Commercial |
$807.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,772.25
|
| Rate for Payer: PACE SWMI |
$672.84
|
| Rate for Payer: PHP Medicare Advantage |
$672.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,231.40
|
| Rate for Payer: Priority Health Medicare |
$672.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.40
|
| Rate for Payer: Railroad Medicare Medicare |
$672.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.84
|
| Rate for Payer: UHC Exchange |
$1,340.01
|
| Rate for Payer: UHC Medicaid |
$434.09
|
| Rate for Payer: UHCCP DNSP |
$672.84
|
| Rate for Payer: UHCCP Medicaid |
$434.09
|
|
