|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE
|
Professional
|
Both
|
$3,445.00
|
|
|
Service Code
|
HCPCS 45400
|
| Min. Negotiated Rate |
$666.05 |
| Max. Negotiated Rate |
$2,583.75 |
| Rate for Payer: Aetna Commercial |
$1,384.07
|
| Rate for Payer: Aetna Medicare |
$1,032.89
|
| Rate for Payer: BCBS Complete |
$699.35
|
| Rate for Payer: BCBS MAPPO |
$1,032.89
|
| Rate for Payer: BCN Commercial |
$1,687.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,032.89
|
| Rate for Payer: Cash Price |
$2,756.00
|
| Rate for Payer: Cash Price |
$2,756.00
|
| Rate for Payer: Cofinity Commercial |
$1,487.36
|
| Rate for Payer: Cofinity Commercial |
$1,384.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,032.89
|
| Rate for Payer: Healthscope Commercial |
$1,239.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.53
|
| Rate for Payer: Meridian Medicaid |
$699.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,136.18
|
| Rate for Payer: Nomi Health Commercial |
$1,239.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,583.75
|
| Rate for Payer: PACE SWMI |
$1,032.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,032.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,056.30
|
| Rate for Payer: Priority Health Medicare |
$1,032.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,056.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,032.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,009.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,032.89
|
| Rate for Payer: UHC Exchange |
$2,009.25
|
| Rate for Payer: UHC Medicaid |
$666.05
|
| Rate for Payer: UHCCP DNSP |
$1,032.89
|
| Rate for Payer: UHCCP Medicaid |
$666.05
|
|
|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ
|
Professional
|
Both
|
$4,803.00
|
|
|
Service Code
|
HCPCS 45402
|
| Min. Negotiated Rate |
$888.21 |
| Max. Negotiated Rate |
$3,602.25 |
| Rate for Payer: Aetna Commercial |
$1,853.09
|
| Rate for Payer: Aetna Medicare |
$1,382.90
|
| Rate for Payer: BCBS Complete |
$932.62
|
| Rate for Payer: BCBS MAPPO |
$1,382.90
|
| Rate for Payer: BCN Commercial |
$2,255.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.90
|
| Rate for Payer: Cash Price |
$3,842.40
|
| Rate for Payer: Cash Price |
$3,842.40
|
| Rate for Payer: Cofinity Commercial |
$1,991.38
|
| Rate for Payer: Cofinity Commercial |
$1,853.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.90
|
| Rate for Payer: Healthscope Commercial |
$1,659.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,659.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,452.05
|
| Rate for Payer: Meridian Medicaid |
$932.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,521.19
|
| Rate for Payer: Nomi Health Commercial |
$1,659.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,602.25
|
| Rate for Payer: PACE SWMI |
$1,382.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,748.00
|
| Rate for Payer: Priority Health Medicare |
$1,382.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,748.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,382.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,686.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,382.90
|
| Rate for Payer: UHC Exchange |
$2,686.66
|
| Rate for Payer: UHC Medicaid |
$888.21
|
| Rate for Payer: UHCCP DNSP |
$1,382.90
|
| Rate for Payer: UHCCP Medicaid |
$888.21
|
|
|
PR LAPAROSCOPY RADICAL NEPHRECTOMY
|
Professional
|
Both
|
$4,212.00
|
|
|
Service Code
|
HCPCS 50545
|
| Min. Negotiated Rate |
$756.58 |
| Max. Negotiated Rate |
$3,159.00 |
| Rate for Payer: Aetna Commercial |
$1,577.34
|
| Rate for Payer: Aetna Medicare |
$1,177.12
|
| Rate for Payer: BCBS Complete |
$794.41
|
| Rate for Payer: BCBS MAPPO |
$1,177.12
|
| Rate for Payer: BCN Commercial |
$1,984.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,177.12
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Cofinity Commercial |
$1,695.05
|
| Rate for Payer: Cofinity Commercial |
$1,577.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,177.12
|
| Rate for Payer: Healthscope Commercial |
$1,412.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,412.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.98
|
| Rate for Payer: Meridian Medicaid |
$794.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,294.83
|
| Rate for Payer: Nomi Health Commercial |
$1,412.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,159.00
|
| Rate for Payer: PACE SWMI |
$1,177.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$756.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,161.72
|
| Rate for Payer: Priority Health Medicare |
$1,177.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,161.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,370.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,177.12
|
| Rate for Payer: UHC Exchange |
$2,370.56
|
| Rate for Payer: UHC Medicaid |
$756.58
|
| Rate for Payer: UHCCP DNSP |
$1,177.12
|
| Rate for Payer: UHCCP Medicaid |
$756.58
|
|
|
PR LAPAROSCOPY SALPINGOSTOMY
|
Professional
|
Both
|
$3,211.00
|
|
|
Service Code
|
HCPCS 58673
|
| Min. Negotiated Rate |
$446.24 |
| Max. Negotiated Rate |
$2,408.25 |
| Rate for Payer: Aetna Commercial |
$932.60
|
| Rate for Payer: Aetna Medicare |
$695.97
|
| Rate for Payer: BCBS Complete |
$468.55
|
| Rate for Payer: BCBS MAPPO |
$695.97
|
| Rate for Payer: BCN Commercial |
$1,186.69
|
| Rate for Payer: BCN Medicare Advantage |
$695.97
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cofinity Commercial |
$932.60
|
| Rate for Payer: Cofinity Commercial |
$1,002.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$835.16
|
| Rate for Payer: Healthscope Whirlpool |
$835.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.77
|
| Rate for Payer: Meridian Medicaid |
$468.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$765.57
|
| Rate for Payer: Nomi Health Commercial |
$835.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.25
|
| Rate for Payer: PACE SWMI |
$695.97
|
| Rate for Payer: PHP Medicare Advantage |
$695.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,201.86
|
| Rate for Payer: Priority Health Medicare |
$695.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,201.86
|
| Rate for Payer: Railroad Medicare Medicare |
$695.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$695.97
|
| Rate for Payer: UHC Exchange |
$1,416.71
|
| Rate for Payer: UHC Medicaid |
$446.24
|
| Rate for Payer: UHCCP DNSP |
$695.97
|
| Rate for Payer: UHCCP Medicaid |
$446.24
|
|
|
PR LAPAROSCOPY SLING OPERATION STRESS INCONT
|
Professional
|
Both
|
$1,776.00
|
|
|
Service Code
|
HCPCS 51992
|
| Min. Negotiated Rate |
$476.06 |
| Max. Negotiated Rate |
$1,486.80 |
| Rate for Payer: Aetna Commercial |
$992.77
|
| Rate for Payer: Aetna Medicare |
$740.87
|
| Rate for Payer: BCBS Complete |
$499.86
|
| Rate for Payer: BCBS MAPPO |
$740.87
|
| Rate for Payer: BCN Commercial |
$1,249.43
|
| Rate for Payer: BCN Medicare Advantage |
$740.87
|
| Rate for Payer: Cash Price |
$1,420.80
|
| Rate for Payer: Cash Price |
$1,420.80
|
| Rate for Payer: Cofinity Commercial |
$992.77
|
| Rate for Payer: Cofinity Commercial |
$1,066.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.87
|
| Rate for Payer: Healthscope Commercial |
$889.04
|
| Rate for Payer: Healthscope Whirlpool |
$889.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.91
|
| Rate for Payer: Meridian Medicaid |
$499.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.96
|
| Rate for Payer: Nomi Health Commercial |
$889.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.00
|
| Rate for Payer: PACE SWMI |
$740.87
|
| Rate for Payer: PHP Medicare Advantage |
$740.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,361.03
|
| Rate for Payer: Priority Health Medicare |
$740.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.03
|
| Rate for Payer: Railroad Medicare Medicare |
$740.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,486.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.87
|
| Rate for Payer: UHC Exchange |
$1,486.80
|
| Rate for Payer: UHC Medicaid |
$476.06
|
| Rate for Payer: UHCCP DNSP |
$740.87
|
| Rate for Payer: UHCCP Medicaid |
$476.06
|
|
|
PR LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44203
|
| Min. Negotiated Rate |
$137.81 |
| Max. Negotiated Rate |
$823.50 |
| Rate for Payer: Aetna Commercial |
$291.58
|
| Rate for Payer: Aetna Medicare |
$217.60
|
| Rate for Payer: BCBS Complete |
$144.70
|
| Rate for Payer: BCBS MAPPO |
$217.60
|
| Rate for Payer: BCN Commercial |
$356.06
|
| Rate for Payer: BCN Medicare Advantage |
$217.60
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$313.34
|
| Rate for Payer: Cofinity Commercial |
$291.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.60
|
| Rate for Payer: Healthscope Commercial |
$261.12
|
| Rate for Payer: Healthscope Whirlpool |
$261.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.48
|
| Rate for Payer: Meridian Medicaid |
$144.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.36
|
| Rate for Payer: Nomi Health Commercial |
$261.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$823.50
|
| Rate for Payer: PACE SWMI |
$217.60
|
| Rate for Payer: PHP Medicare Advantage |
$217.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$433.84
|
| Rate for Payer: Priority Health Medicare |
$217.60
|
| Rate for Payer: Priority Health Narrow Network |
$433.84
|
| Rate for Payer: Railroad Medicare Medicare |
$217.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.60
|
| Rate for Payer: UHC Exchange |
$430.96
|
| Rate for Payer: UHC Medicaid |
$137.81
|
| Rate for Payer: UHCCP DNSP |
$217.60
|
| Rate for Payer: UHCCP Medicaid |
$137.81
|
|
|
PR LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<
|
Professional
|
Both
|
$2,086.00
|
|
|
Service Code
|
HCPCS 58541
|
| Min. Negotiated Rate |
$413.65 |
| Max. Negotiated Rate |
$1,564.50 |
| Rate for Payer: Aetna Commercial |
$859.17
|
| Rate for Payer: Aetna Medicare |
$641.17
|
| Rate for Payer: BCBS Complete |
$434.33
|
| Rate for Payer: BCBS MAPPO |
$641.17
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: BCN Medicare Advantage |
$641.17
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cash Price |
$1,668.80
|
| Rate for Payer: Cofinity Commercial |
$923.28
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.17
|
| Rate for Payer: Healthscope Commercial |
$769.40
|
| Rate for Payer: Healthscope Whirlpool |
$769.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.23
|
| Rate for Payer: Meridian Medicaid |
$434.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.29
|
| Rate for Payer: Nomi Health Commercial |
$769.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,564.50
|
| Rate for Payer: PACE SWMI |
$641.17
|
| Rate for Payer: PHP Medicare Advantage |
$641.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,111.07
|
| Rate for Payer: Priority Health Medicare |
$641.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.07
|
| Rate for Payer: Railroad Medicare Medicare |
$641.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,285.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.17
|
| Rate for Payer: UHC Exchange |
$1,285.48
|
| Rate for Payer: UHC Medicaid |
$413.65
|
| Rate for Payer: UHCCP DNSP |
$641.17
|
| Rate for Payer: UHCCP Medicaid |
$413.65
|
|
|
PR LAPAROSCOPY SURG ABLATION RENAL CYSTS
|
Professional
|
Both
|
$1,815.00
|
|
|
Service Code
|
HCPCS 50541
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,622.97 |
| Rate for Payer: Aetna Commercial |
$1,089.22
|
| Rate for Payer: Aetna Medicare |
$812.85
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS MAPPO |
$812.85
|
| Rate for Payer: BCN Commercial |
$1,367.95
|
| Rate for Payer: BCN Medicare Advantage |
$812.85
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cash Price |
$1,452.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.50
|
| Rate for Payer: Cofinity Commercial |
$1,089.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.85
|
| Rate for Payer: Healthscope Commercial |
$975.42
|
| Rate for Payer: Healthscope Whirlpool |
$975.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.49
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$894.13
|
| Rate for Payer: Nomi Health Commercial |
$975.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,361.25
|
| Rate for Payer: PACE SWMI |
$812.85
|
| Rate for Payer: PHP Medicare Advantage |
$812.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,490.15
|
| Rate for Payer: Priority Health Medicare |
$812.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,490.15
|
| Rate for Payer: Railroad Medicare Medicare |
$812.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,622.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.85
|
| Rate for Payer: UHC Exchange |
$1,622.97
|
| Rate for Payer: UHC Medicaid |
$523.55
|
| Rate for Payer: UHCCP DNSP |
$812.85
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
IP
|
$3,101.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,325.75 |
| Max. Negotiated Rate |
$3,101.00 |
| Rate for Payer: Aetna Commercial |
$2,790.90
|
| Rate for Payer: ASR ASR |
$3,007.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,546.54
|
| Rate for Payer: BCN Commercial |
$2,546.54
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$2,914.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,480.80
|
| Rate for Payer: Healthscope Commercial |
$3,007.97
|
| Rate for Payer: Healthscope Whirlpool |
$3,101.00
|
| Rate for Payer: Mclaren Commercial |
$2,790.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,635.85
|
| Rate for Payer: Nomi Health Commercial |
$2,542.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 47562
|
| Min. Negotiated Rate |
$403.00 |
| Max. Negotiated Rate |
$2,325.75 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: Aetna Medicare |
$625.90
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS MAPPO |
$625.90
|
| Rate for Payer: BCN Commercial |
$998.95
|
| Rate for Payer: BCN Medicare Advantage |
$625.90
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$901.30
|
| Rate for Payer: Cofinity Commercial |
$838.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.90
|
| Rate for Payer: Healthscope Commercial |
$751.08
|
| Rate for Payer: Healthscope Whirlpool |
$751.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.20
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.49
|
| Rate for Payer: Nomi Health Commercial |
$751.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PACE SWMI |
$625.90
|
| Rate for Payer: PHP Medicare Advantage |
$625.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,217.15
|
| Rate for Payer: Priority Health Medicare |
$625.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.15
|
| Rate for Payer: Railroad Medicare Medicare |
$625.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,171.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.90
|
| Rate for Payer: UHC Exchange |
$1,171.70
|
| Rate for Payer: UHC Medicaid |
$403.00
|
| Rate for Payer: UHCCP DNSP |
$625.90
|
| Rate for Payer: UHCCP Medicaid |
$403.00
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,101.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$403.00 |
| Max. Negotiated Rate |
$2,325.75 |
| Rate for Payer: Aetna Commercial |
$838.71
|
| Rate for Payer: Aetna Medicare |
$625.90
|
| Rate for Payer: BCBS Complete |
$423.15
|
| Rate for Payer: BCBS MAPPO |
$625.90
|
| Rate for Payer: BCN Commercial |
$998.95
|
| Rate for Payer: BCN Medicare Advantage |
$625.90
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$901.30
|
| Rate for Payer: Cofinity Commercial |
$838.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.90
|
| Rate for Payer: Healthscope Commercial |
$751.08
|
| Rate for Payer: Healthscope Whirlpool |
$751.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.20
|
| Rate for Payer: Meridian Medicaid |
$423.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.49
|
| Rate for Payer: Nomi Health Commercial |
$751.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| Rate for Payer: PACE SWMI |
$625.90
|
| Rate for Payer: PHP Medicare Advantage |
$625.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,217.15
|
| Rate for Payer: Priority Health Medicare |
$625.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.15
|
| Rate for Payer: Railroad Medicare Medicare |
$625.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,171.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.90
|
| Rate for Payer: UHC Exchange |
$1,171.70
|
| Rate for Payer: UHC Medicaid |
$403.00
|
| Rate for Payer: UHCCP DNSP |
$625.90
|
| Rate for Payer: UHCCP Medicaid |
$403.00
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
OP
|
$3,101.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,173.80 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$2,790.90
|
| 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 |
$3,007.97
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,556.77
|
| Rate for Payer: BCN Commercial |
$2,556.77
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cash Price |
$2,480.80
|
| Rate for Payer: Cofinity Commercial |
$2,914.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,480.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$3,007.97
|
| Rate for Payer: Healthscope Whirlpool |
$3,101.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$2,790.90
|
| 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 |
$2,635.85
|
| Rate for Payer: Nomi Health Commercial |
$2,542.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,325.75
|
| 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 |
$2,717.10
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,173.80
|
| 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 SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,845.00
|
|
|
Service Code
|
HCPCS 44188
|
| Min. Negotiated Rate |
$726.76 |
| Max. Negotiated Rate |
$2,207.99 |
| Rate for Payer: Aetna Commercial |
$1,508.44
|
| Rate for Payer: Aetna Medicare |
$1,125.70
|
| Rate for Payer: BCBS Complete |
$763.10
|
| Rate for Payer: BCBS MAPPO |
$1,125.70
|
| Rate for Payer: BCN Commercial |
$1,812.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,125.70
|
| Rate for Payer: Cash Price |
$2,276.00
|
| Rate for Payer: Cash Price |
$2,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,621.01
|
| Rate for Payer: Cofinity Commercial |
$1,508.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,125.70
|
| Rate for Payer: Healthscope Commercial |
$1,350.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,350.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,181.98
|
| Rate for Payer: Meridian Medicaid |
$763.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,238.27
|
| Rate for Payer: Nomi Health Commercial |
$1,350.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,133.75
|
| Rate for Payer: PACE SWMI |
$1,125.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,125.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,207.99
|
| Rate for Payer: Priority Health Medicare |
$1,125.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,207.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,125.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,160.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,125.70
|
| Rate for Payer: UHC Exchange |
$2,160.85
|
| Rate for Payer: UHC Medicaid |
$726.76
|
| Rate for Payer: UHCCP DNSP |
$1,125.70
|
| Rate for Payer: UHCCP Medicaid |
$726.76
|
|
|
PR LAPAROSCOPY SURGICAL JEJUNOSTOMY
|
Professional
|
Both
|
$2,058.00
|
|
|
Service Code
|
HCPCS 44186
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$1,543.50 |
| Rate for Payer: Aetna Commercial |
$829.00
|
| Rate for Payer: Aetna Medicare |
$618.66
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$618.66
|
| Rate for Payer: BCN Commercial |
$981.52
|
| Rate for Payer: BCN Medicare Advantage |
$618.66
|
| Rate for Payer: Cash Price |
$1,646.40
|
| Rate for Payer: Cash Price |
$1,646.40
|
| Rate for Payer: Cofinity Commercial |
$890.87
|
| Rate for Payer: Cofinity Commercial |
$829.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$618.66
|
| Rate for Payer: Healthscope Commercial |
$742.39
|
| Rate for Payer: Healthscope Whirlpool |
$742.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$649.59
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$680.53
|
| Rate for Payer: Nomi Health Commercial |
$742.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,543.50
|
| Rate for Payer: PACE SWMI |
$618.66
|
| Rate for Payer: PHP Medicare Advantage |
$618.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,195.92
|
| Rate for Payer: Priority Health Medicare |
$618.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,195.92
|
| Rate for Payer: Railroad Medicare Medicare |
$618.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,158.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$618.66
|
| Rate for Payer: UHC Exchange |
$1,158.94
|
| Rate for Payer: UHC Medicaid |
$398.52
|
| Rate for Payer: UHCCP DNSP |
$618.66
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR LAPAROSCOPY SURGICAL ORCHIECTOMY
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 54690
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$1,157.67 |
| Rate for Payer: Aetna Commercial |
$784.28
|
| Rate for Payer: Aetna Medicare |
$585.28
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS MAPPO |
$585.28
|
| Rate for Payer: BCN Commercial |
$982.52
|
| Rate for Payer: BCN Medicare Advantage |
$585.28
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$842.80
|
| Rate for Payer: Cofinity Commercial |
$784.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.28
|
| Rate for Payer: Healthscope Commercial |
$702.34
|
| Rate for Payer: Healthscope Whirlpool |
$702.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.54
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$643.81
|
| Rate for Payer: Nomi Health Commercial |
$702.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$585.28
|
| Rate for Payer: PHP Medicare Advantage |
$585.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,070.29
|
| Rate for Payer: Priority Health Medicare |
$585.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,070.29
|
| Rate for Payer: Railroad Medicare Medicare |
$585.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,157.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$585.28
|
| Rate for Payer: UHC Exchange |
$1,157.67
|
| Rate for Payer: UHC Medicaid |
$378.29
|
| Rate for Payer: UHCCP DNSP |
$585.28
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$3,114.00
|
|
|
Service Code
|
HCPCS 44187
|
| Min. Negotiated Rate |
$653.48 |
| Max. Negotiated Rate |
$2,335.50 |
| Rate for Payer: Aetna Commercial |
$1,352.64
|
| Rate for Payer: Aetna Medicare |
$1,009.43
|
| Rate for Payer: BCBS Complete |
$686.15
|
| Rate for Payer: BCBS MAPPO |
$1,009.43
|
| Rate for Payer: BCN Commercial |
$1,627.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,009.43
|
| Rate for Payer: Cash Price |
$2,491.20
|
| Rate for Payer: Cash Price |
$2,491.20
|
| Rate for Payer: Cofinity Commercial |
$1,453.58
|
| Rate for Payer: Cofinity Commercial |
$1,352.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,009.43
|
| Rate for Payer: Healthscope Commercial |
$1,211.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,211.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,059.90
|
| Rate for Payer: Meridian Medicaid |
$686.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,110.37
|
| Rate for Payer: Nomi Health Commercial |
$1,211.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.50
|
| Rate for Payer: PACE SWMI |
$1,009.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,009.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,982.88
|
| Rate for Payer: Priority Health Medicare |
$1,009.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,982.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,009.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,937.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,009.43
|
| Rate for Payer: UHC Exchange |
$1,937.77
|
| Rate for Payer: UHC Medicaid |
$653.48
|
| Rate for Payer: UHCCP DNSP |
$1,009.43
|
| Rate for Payer: UHCCP Medicaid |
$653.48
|
|
|
PR LAPAROSCOPY SURG PARTIAL NEPHRECTOMY
|
Professional
|
Both
|
$2,938.00
|
|
|
Service Code
|
HCPCS 50543
|
| Min. Negotiated Rate |
$847.95 |
| Max. Negotiated Rate |
$2,633.68 |
| Rate for Payer: Aetna Commercial |
$1,764.26
|
| Rate for Payer: Aetna Medicare |
$1,316.61
|
| Rate for Payer: BCBS Complete |
$890.35
|
| Rate for Payer: BCBS MAPPO |
$1,316.61
|
| Rate for Payer: BCN Commercial |
$2,217.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,316.61
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,895.92
|
| Rate for Payer: Cofinity Commercial |
$1,764.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,316.61
|
| Rate for Payer: Healthscope Commercial |
$1,579.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,579.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,382.44
|
| Rate for Payer: Meridian Medicaid |
$890.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,448.27
|
| Rate for Payer: Nomi Health Commercial |
$1,579.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,203.50
|
| Rate for Payer: PACE SWMI |
$1,316.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,316.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,415.05
|
| Rate for Payer: Priority Health Medicare |
$1,316.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,415.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,316.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,633.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,316.61
|
| Rate for Payer: UHC Exchange |
$2,633.68
|
| Rate for Payer: UHC Medicaid |
$847.95
|
| Rate for Payer: UHCCP DNSP |
$1,316.61
|
| Rate for Payer: UHCCP Medicaid |
$847.95
|
|
|
PR LAPAROSCOPY SURG PYELOPLASTY
|
Professional
|
Both
|
$2,469.00
|
|
|
Service Code
|
HCPCS 50544
|
| Min. Negotiated Rate |
$703.54 |
| Max. Negotiated Rate |
$2,205.24 |
| Rate for Payer: Aetna Commercial |
$1,466.98
|
| Rate for Payer: Aetna Medicare |
$1,094.76
|
| Rate for Payer: BCBS Complete |
$738.72
|
| Rate for Payer: BCBS MAPPO |
$1,094.76
|
| Rate for Payer: BCN Commercial |
$1,844.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.76
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cofinity Commercial |
$1,576.45
|
| Rate for Payer: Cofinity Commercial |
$1,466.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.76
|
| Rate for Payer: Healthscope Commercial |
$1,313.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,313.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,149.50
|
| Rate for Payer: Meridian Medicaid |
$738.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,204.24
|
| Rate for Payer: Nomi Health Commercial |
$1,313.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,851.75
|
| Rate for Payer: PACE SWMI |
$1,094.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,008.74
|
| Rate for Payer: Priority Health Medicare |
$1,094.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,008.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,094.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,205.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,094.76
|
| Rate for Payer: UHC Exchange |
$2,205.24
|
| Rate for Payer: UHC Medicaid |
$703.54
|
| Rate for Payer: UHCCP DNSP |
$1,094.76
|
| Rate for Payer: UHCCP Medicaid |
$703.54
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 49650
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Medicare |
$417.06
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$417.06
|
| Rate for Payer: BCN Commercial |
$658.33
|
| Rate for Payer: BCN Medicare Advantage |
$417.06
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$600.57
|
| Rate for Payer: Cofinity Commercial |
$558.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.06
|
| Rate for Payer: Healthscope Commercial |
$500.47
|
| Rate for Payer: Healthscope Whirlpool |
$500.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.91
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.77
|
| Rate for Payer: Nomi Health Commercial |
$500.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE SWMI |
$417.06
|
| Rate for Payer: PHP Medicare Advantage |
$417.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$802.13
|
| Rate for Payer: Priority Health Medicare |
$417.06
|
| Rate for Payer: Priority Health Narrow Network |
$802.13
|
| Rate for Payer: Railroad Medicare Medicare |
$417.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.06
|
| Rate for Payer: UHC Exchange |
$760.14
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP DNSP |
$417.06
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,127.21 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| 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 |
$1,559.76
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.80
|
| Rate for Payer: BCN Commercial |
$1,325.80
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,511.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,559.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,608.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$1,447.20
|
| 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 |
$1,366.80
|
| Rate for Payer: Nomi Health Commercial |
$1,318.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| 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 |
$1,408.93
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.21
|
| 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 SURG RPR INITIAL INGUINAL HERNIA
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 49650
|
| Hospital Charge Code |
49650
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,206.00 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$1,447.20
|
| Rate for Payer: ASR ASR |
$1,559.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.49
|
| Rate for Payer: BCN Commercial |
$1,320.49
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,511.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.40
|
| Rate for Payer: Healthscope Commercial |
$1,559.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,608.00
|
| Rate for Payer: Mclaren Commercial |
$1,447.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,366.80
|
| Rate for Payer: Nomi Health Commercial |
$1,318.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
|
|
PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 49650
|
| Hospital Charge Code |
49650
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$558.86
|
| Rate for Payer: Aetna Medicare |
$417.06
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$417.06
|
| Rate for Payer: BCN Commercial |
$658.33
|
| Rate for Payer: BCN Medicare Advantage |
$417.06
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$600.57
|
| Rate for Payer: Cofinity Commercial |
$558.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.06
|
| Rate for Payer: Healthscope Commercial |
$500.47
|
| Rate for Payer: Healthscope Whirlpool |
$500.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.91
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.77
|
| Rate for Payer: Nomi Health Commercial |
$500.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.00
|
| Rate for Payer: PACE SWMI |
$417.06
|
| Rate for Payer: PHP Medicare Advantage |
$417.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$802.13
|
| Rate for Payer: Priority Health Medicare |
$417.06
|
| Rate for Payer: Priority Health Narrow Network |
$802.13
|
| Rate for Payer: Railroad Medicare Medicare |
$417.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.06
|
| Rate for Payer: UHC Exchange |
$760.14
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP DNSP |
$417.06
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 49321
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$1,212.75 |
| Rate for Payer: Aetna Commercial |
$435.73
|
| Rate for Payer: Aetna Medicare |
$325.17
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$325.17
|
| Rate for Payer: BCN Commercial |
$520.39
|
| Rate for Payer: BCN Medicare Advantage |
$325.17
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$468.24
|
| Rate for Payer: Cofinity Commercial |
$435.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.17
|
| Rate for Payer: Healthscope Commercial |
$390.20
|
| Rate for Payer: Healthscope Whirlpool |
$390.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.43
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$357.69
|
| Rate for Payer: Nomi Health Commercial |
$390.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,212.75
|
| Rate for Payer: PACE SWMI |
$325.17
|
| Rate for Payer: PHP Medicare Advantage |
$325.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$634.06
|
| Rate for Payer: Priority Health Medicare |
$325.17
|
| Rate for Payer: Priority Health Narrow Network |
$634.06
|
| Rate for Payer: Railroad Medicare Medicare |
$325.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$611.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$325.17
|
| Rate for Payer: UHC Exchange |
$611.00
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP DNSP |
$325.17
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM
|
Professional
|
Both
|
$3,059.00
|
|
|
Service Code
|
HCPCS 58572
|
| Min. Negotiated Rate |
$603.00 |
| Max. Negotiated Rate |
$2,294.25 |
| Rate for Payer: Aetna Commercial |
$1,257.63
|
| Rate for Payer: Aetna Medicare |
$938.53
|
| Rate for Payer: BCBS Complete |
$633.15
|
| Rate for Payer: BCBS MAPPO |
$938.53
|
| Rate for Payer: BCN Commercial |
$1,562.17
|
| Rate for Payer: BCN Medicare Advantage |
$938.53
|
| Rate for Payer: Cash Price |
$2,447.20
|
| Rate for Payer: Cash Price |
$2,447.20
|
| Rate for Payer: Cofinity Commercial |
$1,351.48
|
| Rate for Payer: Cofinity Commercial |
$1,257.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.53
|
| Rate for Payer: Healthscope Commercial |
$1,126.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,126.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.46
|
| Rate for Payer: Meridian Medicaid |
$633.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,032.38
|
| Rate for Payer: Nomi Health Commercial |
$1,126.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,294.25
|
| Rate for Payer: PACE SWMI |
$938.53
|
| Rate for Payer: PHP Medicare Advantage |
$938.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,582.14
|
| Rate for Payer: Priority Health Medicare |
$938.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,582.14
|
| Rate for Payer: Railroad Medicare Medicare |
$938.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,825.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$938.53
|
| Rate for Payer: UHC Exchange |
$1,825.47
|
| Rate for Payer: UHC Medicaid |
$603.00
|
| Rate for Payer: UHCCP DNSP |
$938.53
|
| Rate for Payer: UHCCP Medicaid |
$603.00
|
|
|
PR LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR
|
Professional
|
Both
|
$3,569.00
|
|
|
Service Code
|
HCPCS 58573
|
| Min. Negotiated Rate |
$705.03 |
| Max. Negotiated Rate |
$2,676.75 |
| Rate for Payer: Aetna Commercial |
$1,471.05
|
| Rate for Payer: Aetna Medicare |
$1,097.80
|
| Rate for Payer: BCBS Complete |
$740.28
|
| Rate for Payer: BCBS MAPPO |
$1,097.80
|
| Rate for Payer: BCN Commercial |
$1,826.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.80
|
| Rate for Payer: Cash Price |
$2,855.20
|
| Rate for Payer: Cash Price |
$2,855.20
|
| Rate for Payer: Cofinity Commercial |
$1,580.83
|
| Rate for Payer: Cofinity Commercial |
$1,471.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.80
|
| Rate for Payer: Healthscope Commercial |
$1,317.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,317.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.69
|
| Rate for Payer: Meridian Medicaid |
$740.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,207.58
|
| Rate for Payer: Nomi Health Commercial |
$1,317.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,676.75
|
| Rate for Payer: PACE SWMI |
$1,097.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,849.94
|
| Rate for Payer: Priority Health Medicare |
$1,097.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,849.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,140.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.80
|
| Rate for Payer: UHC Exchange |
$2,140.93
|
| Rate for Payer: UHC Medicaid |
$705.03
|
| Rate for Payer: UHCCP DNSP |
$1,097.80
|
| Rate for Payer: UHCCP Medicaid |
$705.03
|
|
