|
PR LAPAROSCOPY W/LYSIS OF ADHESIONS
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 58660
|
| Min. Negotiated Rate |
$400.23 |
| Max. Negotiated Rate |
$2,076.00 |
| Rate for Payer: Aetna Commercial |
$834.74
|
| Rate for Payer: Aetna Medicare |
$622.94
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS MAPPO |
$622.94
|
| Rate for Payer: BCN Commercial |
$1,030.82
|
| Rate for Payer: BCN Medicare Advantage |
$622.94
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$897.03
|
| Rate for Payer: Cofinity Commercial |
$834.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.94
|
| Rate for Payer: Healthscope Commercial |
$747.53
|
| Rate for Payer: Healthscope Whirlpool |
$747.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.09
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.23
|
| Rate for Payer: Nomi Health Commercial |
$747.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,076.00
|
| Rate for Payer: PACE SWMI |
$622.94
|
| Rate for Payer: PHP Medicare Advantage |
$622.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,043.99
|
| Rate for Payer: Priority Health Medicare |
$622.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.99
|
| Rate for Payer: Railroad Medicare Medicare |
$622.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,201.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$622.94
|
| Rate for Payer: UHC Exchange |
$1,201.37
|
| Rate for Payer: UHC Medicaid |
$400.23
|
| Rate for Payer: UHCCP DNSP |
$622.94
|
| Rate for Payer: UHCCP Medicaid |
$400.23
|
|
|
PR LAPAROSCOPY W/OMENTOPEXY
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 49326
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$340.38 |
| Rate for Payer: Aetna Commercial |
$229.15
|
| Rate for Payer: Aetna Medicare |
$171.01
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$171.01
|
| Rate for Payer: BCN Commercial |
$279.37
|
| Rate for Payer: BCN Medicare Advantage |
$171.01
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$246.25
|
| Rate for Payer: Cofinity Commercial |
$229.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.01
|
| Rate for Payer: Healthscope Commercial |
$205.21
|
| Rate for Payer: Healthscope Whirlpool |
$205.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.56
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.11
|
| Rate for Payer: Nomi Health Commercial |
$205.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.50
|
| Rate for Payer: PACE SWMI |
$171.01
|
| Rate for Payer: PHP Medicare Advantage |
$171.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.38
|
| Rate for Payer: Priority Health Medicare |
$171.01
|
| Rate for Payer: Priority Health Narrow Network |
$340.38
|
| Rate for Payer: Railroad Medicare Medicare |
$171.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.01
|
| Rate for Payer: UHC Exchange |
$340.27
|
| Rate for Payer: UHC Medicaid |
$107.99
|
| Rate for Payer: UHCCP DNSP |
$171.01
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
|
|
PR LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 58671
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,179.00 |
| 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 |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| 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 |
$1,179.00
|
| 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 |
$649.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$328.13
|
| Rate for Payer: UHC Exchange |
$649.47
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP DNSP |
$328.13
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,826.00
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
58661
|
| Min. Negotiated Rate |
$373.82 |
| Max. Negotiated Rate |
$2,119.50 |
| Rate for Payer: Aetna Commercial |
$780.84
|
| Rate for Payer: Aetna Medicare |
$582.72
|
| Rate for Payer: BCBS Complete |
$392.51
|
| Rate for Payer: BCBS MAPPO |
$582.72
|
| Rate for Payer: BCN Commercial |
$978.53
|
| Rate for Payer: BCN Medicare Advantage |
$582.72
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Commercial |
$839.12
|
| Rate for Payer: Cofinity Commercial |
$780.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.72
|
| Rate for Payer: Healthscope Commercial |
$699.26
|
| Rate for Payer: Healthscope Whirlpool |
$699.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.86
|
| Rate for Payer: Meridian Medicaid |
$392.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$640.99
|
| Rate for Payer: Nomi Health Commercial |
$699.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| Rate for Payer: PACE SWMI |
$582.72
|
| Rate for Payer: PHP Medicare Advantage |
$582.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$991.04
|
| Rate for Payer: Priority Health Medicare |
$582.72
|
| Rate for Payer: Priority Health Narrow Network |
$991.04
|
| Rate for Payer: Railroad Medicare Medicare |
$582.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,153.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$582.72
|
| Rate for Payer: UHC Exchange |
$1,153.74
|
| Rate for Payer: UHC Medicaid |
$373.82
|
| Rate for Payer: UHCCP DNSP |
$582.72
|
| Rate for Payer: UHCCP Medicaid |
$373.82
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
IP
|
$2,826.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,119.50 |
| Max. Negotiated Rate |
$2,826.00 |
| Rate for Payer: Aetna Commercial |
$2,543.40
|
| Rate for Payer: ASR ASR |
$2,741.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,320.71
|
| Rate for Payer: BCN Commercial |
$2,320.71
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Commercial |
$2,656.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,260.80
|
| Rate for Payer: Healthscope Commercial |
$2,741.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,826.00
|
| Rate for Payer: Mclaren Commercial |
$2,543.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.10
|
| Rate for Payer: Nomi Health Commercial |
$2,317.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
|
|
PR LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES
|
Facility
|
OP
|
$2,826.00
|
|
|
Service Code
|
CPT 58661
|
| Hospital Charge Code |
58661
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,981.03 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$2,543.40
|
| 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 |
$2,741.22
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,330.04
|
| Rate for Payer: BCN Commercial |
$2,330.04
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Commercial |
$2,656.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,260.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,741.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,826.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$2,543.40
|
| 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 |
$2,402.10
|
| Rate for Payer: Nomi Health Commercial |
$2,317.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| 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 |
$2,476.14
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,981.03
|
| 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 W/RMVL ADNEXAL STRUCTURES
|
Professional
|
Both
|
$2,826.00
|
|
|
Service Code
|
HCPCS 58661
|
| Min. Negotiated Rate |
$373.82 |
| Max. Negotiated Rate |
$2,119.50 |
| Rate for Payer: Aetna Commercial |
$780.84
|
| Rate for Payer: Aetna Medicare |
$582.72
|
| Rate for Payer: BCBS Complete |
$392.51
|
| Rate for Payer: BCBS MAPPO |
$582.72
|
| Rate for Payer: BCN Commercial |
$978.53
|
| Rate for Payer: BCN Medicare Advantage |
$582.72
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cash Price |
$2,260.80
|
| Rate for Payer: Cofinity Commercial |
$839.12
|
| Rate for Payer: Cofinity Commercial |
$780.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.72
|
| Rate for Payer: Healthscope Commercial |
$699.26
|
| Rate for Payer: Healthscope Whirlpool |
$699.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.86
|
| Rate for Payer: Meridian Medicaid |
$392.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$640.99
|
| Rate for Payer: Nomi Health Commercial |
$699.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,119.50
|
| Rate for Payer: PACE SWMI |
$582.72
|
| Rate for Payer: PHP Medicare Advantage |
$582.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$991.04
|
| Rate for Payer: Priority Health Medicare |
$582.72
|
| Rate for Payer: Priority Health Narrow Network |
$991.04
|
| Rate for Payer: Railroad Medicare Medicare |
$582.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,153.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$582.72
|
| Rate for Payer: UHC Exchange |
$1,153.74
|
| Rate for Payer: UHC Medicaid |
$373.82
|
| Rate for Payer: UHCCP DNSP |
$582.72
|
| Rate for Payer: UHCCP Medicaid |
$373.82
|
|
|
PR LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,549.00
|
|
|
Service Code
|
HCPCS 58570
|
| Min. Negotiated Rate |
$463.70 |
| Max. Negotiated Rate |
$1,911.75 |
| Rate for Payer: Aetna Commercial |
$964.30
|
| Rate for Payer: Aetna Medicare |
$719.63
|
| Rate for Payer: BCBS Complete |
$486.88
|
| Rate for Payer: BCBS MAPPO |
$719.63
|
| Rate for Payer: BCN Commercial |
$1,213.58
|
| Rate for Payer: BCN Medicare Advantage |
$719.63
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cofinity Commercial |
$964.30
|
| Rate for Payer: Cofinity Commercial |
$1,036.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.63
|
| Rate for Payer: Healthscope Commercial |
$863.56
|
| Rate for Payer: Healthscope Whirlpool |
$863.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.61
|
| Rate for Payer: Meridian Medicaid |
$486.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.59
|
| Rate for Payer: Nomi Health Commercial |
$863.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,911.75
|
| Rate for Payer: PACE SWMI |
$719.63
|
| Rate for Payer: PHP Medicare Advantage |
$719.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,229.09
|
| Rate for Payer: Priority Health Medicare |
$719.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,229.09
|
| Rate for Payer: Railroad Medicare Medicare |
$719.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,403.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.63
|
| Rate for Payer: UHC Exchange |
$1,403.24
|
| Rate for Payer: UHC Medicaid |
$463.70
|
| Rate for Payer: UHCCP DNSP |
$719.63
|
| Rate for Payer: UHCCP Medicaid |
$463.70
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 49654
|
| Min. Negotiated Rate |
$1,162.40 |
| Max. Negotiated Rate |
$2,179.50 |
| Rate for Payer: BCBS Complete |
$1,162.40
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,179.50
|
|
|
PR LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,209.00
|
|
|
Service Code
|
HCPCS 49653
|
| Min. Negotiated Rate |
$1,283.60 |
| Max. Negotiated Rate |
$2,406.75 |
| Rate for Payer: BCBS Complete |
$1,283.60
|
| Rate for Payer: Cash Price |
$2,567.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,406.75
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,449.00
|
|
|
Service Code
|
HCPCS 49320
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$1,086.75 |
| Rate for Payer: Aetna Commercial |
$418.37
|
| Rate for Payer: Aetna Medicare |
$312.22
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$312.22
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$312.22
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$418.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.22
|
| Rate for Payer: Healthscope Commercial |
$374.66
|
| Rate for Payer: Healthscope Whirlpool |
$374.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.83
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.44
|
| Rate for Payer: Nomi Health Commercial |
$374.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PACE SWMI |
$312.22
|
| Rate for Payer: PHP Medicare Advantage |
$312.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$608.59
|
| Rate for Payer: Priority Health Medicare |
$312.22
|
| Rate for Payer: Priority Health Narrow Network |
$608.59
|
| Rate for Payer: Railroad Medicare Medicare |
$312.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$581.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.22
|
| Rate for Payer: UHC Exchange |
$581.60
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP DNSP |
$312.22
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,086.75 |
| Max. Negotiated Rate |
$1,449.00 |
| Rate for Payer: Aetna Commercial |
$1,304.10
|
| Rate for Payer: ASR ASR |
$1,405.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.92
|
| Rate for Payer: BCN Commercial |
$1,189.92
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.20
|
| Rate for Payer: Healthscope Commercial |
$1,405.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,449.00
|
| Rate for Payer: Mclaren Commercial |
$1,304.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.65
|
| Rate for Payer: Nomi Health Commercial |
$1,188.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Professional
|
Both
|
$1,449.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
49320
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$1,086.75 |
| Rate for Payer: Aetna Commercial |
$418.37
|
| Rate for Payer: Aetna Medicare |
$312.22
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$312.22
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$312.22
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$418.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.22
|
| Rate for Payer: Healthscope Commercial |
$374.66
|
| Rate for Payer: Healthscope Whirlpool |
$374.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.83
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.44
|
| Rate for Payer: Nomi Health Commercial |
$374.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| Rate for Payer: PACE SWMI |
$312.22
|
| Rate for Payer: PHP Medicare Advantage |
$312.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$608.59
|
| Rate for Payer: Priority Health Medicare |
$312.22
|
| Rate for Payer: Priority Health Narrow Network |
$608.59
|
| Rate for Payer: Railroad Medicare Medicare |
$312.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$581.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.22
|
| Rate for Payer: UHC Exchange |
$581.60
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP DNSP |
$312.22
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT 49320
|
| Hospital Charge Code |
49320
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,015.75 |
| Max. Negotiated Rate |
$7,529.74 |
| Rate for Payer: Aetna Commercial |
$1,304.10
|
| 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 |
$1,405.53
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.70
|
| Rate for Payer: BCN Commercial |
$1,194.70
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$1,405.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,449.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,023.79
|
| Rate for Payer: Mclaren Commercial |
$1,304.10
|
| 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 |
$1,231.65
|
| Rate for Payer: Nomi Health Commercial |
$1,188.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.75
|
| 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 |
$1,269.61
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,015.75
|
| 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 LAPS ABLTJ RENAL MASS LESION W/INTRAOP US
|
Professional
|
Both
|
$2,178.00
|
|
|
Service Code
|
HCPCS 50542
|
| Min. Negotiated Rate |
$666.26 |
| Max. Negotiated Rate |
$2,060.98 |
| Rate for Payer: Aetna Commercial |
$1,385.61
|
| Rate for Payer: Aetna Medicare |
$1,034.04
|
| Rate for Payer: BCBS Complete |
$699.57
|
| Rate for Payer: BCBS MAPPO |
$1,034.04
|
| Rate for Payer: BCN Commercial |
$1,736.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,742.40
|
| Rate for Payer: Cash Price |
$1,742.40
|
| Rate for Payer: Cofinity Commercial |
$1,489.02
|
| Rate for Payer: Cofinity Commercial |
$1,385.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,034.04
|
| Rate for Payer: Healthscope Commercial |
$1,240.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,240.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.74
|
| Rate for Payer: Meridian Medicaid |
$699.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,137.44
|
| Rate for Payer: Nomi Health Commercial |
$1,240.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,633.50
|
| Rate for Payer: PACE SWMI |
$1,034.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,034.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,892.12
|
| Rate for Payer: Priority Health Medicare |
$1,034.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,892.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,034.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,060.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,034.04
|
| Rate for Payer: UHC Exchange |
$2,060.98
|
| Rate for Payer: UHC Medicaid |
$666.26
|
| Rate for Payer: UHCCP DNSP |
$1,034.04
|
| Rate for Payer: UHCCP Medicaid |
$666.26
|
|
|
PR LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 38572
|
| Min. Negotiated Rate |
$526.54 |
| Max. Negotiated Rate |
$1,788.36 |
| Rate for Payer: Aetna Commercial |
$1,097.59
|
| Rate for Payer: Aetna Medicare |
$819.10
|
| Rate for Payer: BCBS Complete |
$552.87
|
| Rate for Payer: BCBS MAPPO |
$819.10
|
| Rate for Payer: BCN Commercial |
$1,344.05
|
| Rate for Payer: BCN Medicare Advantage |
$819.10
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,179.50
|
| Rate for Payer: Cofinity Commercial |
$1,097.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.10
|
| Rate for Payer: Healthscope Commercial |
$982.92
|
| Rate for Payer: Healthscope Whirlpool |
$982.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.05
|
| Rate for Payer: Meridian Medicaid |
$552.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$901.01
|
| Rate for Payer: Nomi Health Commercial |
$982.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,443.75
|
| Rate for Payer: PACE SWMI |
$819.10
|
| Rate for Payer: PHP Medicare Advantage |
$819.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,788.36
|
| Rate for Payer: Priority Health Medicare |
$819.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,788.36
|
| Rate for Payer: Railroad Medicare Medicare |
$819.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,608.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$819.10
|
| Rate for Payer: UHC Exchange |
$1,608.02
|
| Rate for Payer: UHC Medicaid |
$526.54
|
| Rate for Payer: UHCCP DNSP |
$819.10
|
| Rate for Payer: UHCCP Medicaid |
$526.54
|
|
|
PR LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$3,948.00
|
|
|
Service Code
|
HCPCS 44227
|
| Min. Negotiated Rate |
$968.94 |
| Max. Negotiated Rate |
$3,007.09 |
| Rate for Payer: Aetna Commercial |
$2,027.45
|
| Rate for Payer: Aetna Medicare |
$1,513.02
|
| Rate for Payer: BCBS Complete |
$1,017.39
|
| Rate for Payer: BCBS MAPPO |
$1,513.02
|
| Rate for Payer: BCN Commercial |
$2,468.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,513.02
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cofinity Commercial |
$2,178.75
|
| Rate for Payer: Cofinity Commercial |
$2,027.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,513.02
|
| Rate for Payer: Healthscope Commercial |
$1,815.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,815.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,588.67
|
| Rate for Payer: Meridian Medicaid |
$1,017.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,664.32
|
| Rate for Payer: Nomi Health Commercial |
$1,815.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,961.00
|
| Rate for Payer: PACE SWMI |
$1,513.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,513.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$968.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,007.09
|
| Rate for Payer: Priority Health Medicare |
$1,513.02
|
| Rate for Payer: Priority Health Narrow Network |
$3,007.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,513.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,966.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,513.02
|
| Rate for Payer: UHC Exchange |
$2,966.13
|
| Rate for Payer: UHC Medicaid |
$968.94
|
| Rate for Payer: UHCCP DNSP |
$1,513.02
|
| Rate for Payer: UHCCP Medicaid |
$968.94
|
|
|
PR LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS
|
Professional
|
Both
|
$6,498.00
|
|
|
Service Code
|
HCPCS 44211
|
| Min. Negotiated Rate |
$1,229.01 |
| Max. Negotiated Rate |
$4,873.50 |
| Rate for Payer: Aetna Commercial |
$2,548.75
|
| Rate for Payer: Aetna Medicare |
$1,902.05
|
| Rate for Payer: BCBS Complete |
$1,290.46
|
| Rate for Payer: BCBS MAPPO |
$1,902.05
|
| Rate for Payer: BCN Commercial |
$3,131.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,902.05
|
| Rate for Payer: Cash Price |
$5,198.40
|
| Rate for Payer: Cash Price |
$5,198.40
|
| Rate for Payer: Cofinity Commercial |
$2,738.95
|
| Rate for Payer: Cofinity Commercial |
$2,548.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,902.05
|
| Rate for Payer: Healthscope Commercial |
$2,282.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,282.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,997.15
|
| Rate for Payer: Meridian Medicaid |
$1,290.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,092.26
|
| Rate for Payer: Nomi Health Commercial |
$2,282.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,873.50
|
| Rate for Payer: PACE SWMI |
$1,902.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,902.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,229.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,815.89
|
| Rate for Payer: Priority Health Medicare |
$1,902.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,815.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,902.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,740.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,902.05
|
| Rate for Payer: UHC Exchange |
$3,740.20
|
| Rate for Payer: UHC Medicaid |
$1,229.01
|
| Rate for Payer: UHCCP DNSP |
$1,902.05
|
| Rate for Payer: UHCCP Medicaid |
$1,229.01
|
|
|
PR LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST
|
Professional
|
Both
|
$4,801.00
|
|
|
Service Code
|
HCPCS 44208
|
| Min. Negotiated Rate |
$1,149.14 |
| Max. Negotiated Rate |
$3,600.75 |
| Rate for Payer: Aetna Commercial |
$2,398.49
|
| Rate for Payer: Aetna Medicare |
$1,789.92
|
| Rate for Payer: BCBS Complete |
$1,206.60
|
| Rate for Payer: BCBS MAPPO |
$1,789.92
|
| Rate for Payer: BCN Commercial |
$2,924.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,789.92
|
| Rate for Payer: Cash Price |
$3,840.80
|
| Rate for Payer: Cash Price |
$3,840.80
|
| Rate for Payer: Cofinity Commercial |
$2,577.48
|
| Rate for Payer: Cofinity Commercial |
$2,398.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,789.92
|
| Rate for Payer: Healthscope Commercial |
$2,147.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,147.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,879.42
|
| Rate for Payer: Meridian Medicaid |
$1,206.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,968.91
|
| Rate for Payer: Nomi Health Commercial |
$2,147.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,600.75
|
| Rate for Payer: PACE SWMI |
$1,789.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,789.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,149.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,563.49
|
| Rate for Payer: Priority Health Medicare |
$1,789.92
|
| Rate for Payer: Priority Health Narrow Network |
$3,563.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,789.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,512.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,789.92
|
| Rate for Payer: UHC Exchange |
$3,512.29
|
| Rate for Payer: UHC Medicaid |
$1,149.14
|
| Rate for Payer: UHCCP DNSP |
$1,789.92
|
| Rate for Payer: UHCCP Medicaid |
$1,149.14
|
|
|
PR LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$6,450.00
|
|
|
Service Code
|
HCPCS 44212
|
| Min. Negotiated Rate |
$1,187.48 |
| Max. Negotiated Rate |
$4,837.50 |
| Rate for Payer: Aetna Commercial |
$2,467.64
|
| Rate for Payer: Aetna Medicare |
$1,841.52
|
| Rate for Payer: BCBS Complete |
$1,246.85
|
| Rate for Payer: BCBS MAPPO |
$1,841.52
|
| Rate for Payer: BCN Commercial |
$3,013.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,841.52
|
| Rate for Payer: Cash Price |
$5,160.00
|
| Rate for Payer: Cash Price |
$5,160.00
|
| Rate for Payer: Cofinity Commercial |
$2,651.79
|
| Rate for Payer: Cofinity Commercial |
$2,467.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,841.52
|
| Rate for Payer: Healthscope Commercial |
$2,209.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,209.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,933.60
|
| Rate for Payer: Meridian Medicaid |
$1,246.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,025.67
|
| Rate for Payer: Nomi Health Commercial |
$2,209.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,837.50
|
| Rate for Payer: PACE SWMI |
$1,841.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,841.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,187.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,672.10
|
| Rate for Payer: Priority Health Medicare |
$1,841.52
|
| Rate for Payer: Priority Health Narrow Network |
$3,672.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,841.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,606.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,841.52
|
| Rate for Payer: UHC Exchange |
$3,606.31
|
| Rate for Payer: UHC Medicaid |
$1,187.48
|
| Rate for Payer: UHCCP DNSP |
$1,841.52
|
| Rate for Payer: UHCCP Medicaid |
$1,187.48
|
|
|
PR LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST
|
Professional
|
Both
|
$4,730.00
|
|
|
Service Code
|
HCPCS 44207
|
| Min. Negotiated Rate |
$1,051.79 |
| Max. Negotiated Rate |
$3,547.50 |
| Rate for Payer: Aetna Commercial |
$2,200.49
|
| Rate for Payer: Aetna Medicare |
$1,642.16
|
| Rate for Payer: BCBS Complete |
$1,104.38
|
| Rate for Payer: BCBS MAPPO |
$1,642.16
|
| Rate for Payer: BCN Commercial |
$2,690.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,642.16
|
| Rate for Payer: Cash Price |
$3,784.00
|
| Rate for Payer: Cash Price |
$3,784.00
|
| Rate for Payer: Cofinity Commercial |
$2,364.71
|
| Rate for Payer: Cofinity Commercial |
$2,200.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,642.16
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,970.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,724.27
|
| Rate for Payer: Meridian Medicaid |
$1,104.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,806.38
|
| Rate for Payer: Nomi Health Commercial |
$1,970.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.50
|
| Rate for Payer: PACE SWMI |
$1,642.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,642.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,278.31
|
| Rate for Payer: Priority Health Medicare |
$1,642.16
|
| Rate for Payer: Priority Health Narrow Network |
$3,278.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,642.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,230.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,642.16
|
| Rate for Payer: UHC Exchange |
$3,230.34
|
| Rate for Payer: UHC Medicaid |
$1,051.79
|
| Rate for Payer: UHCCP DNSP |
$1,642.16
|
| Rate for Payer: UHCCP Medicaid |
$1,051.79
|
|
|
PR LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM
|
Professional
|
Both
|
$4,878.00
|
|
|
Service Code
|
HCPCS 44206
|
| Min. Negotiated Rate |
$1,020.70 |
| Max. Negotiated Rate |
$3,658.50 |
| Rate for Payer: Aetna Commercial |
$2,134.70
|
| Rate for Payer: Aetna Medicare |
$1,593.06
|
| Rate for Payer: BCBS Complete |
$1,071.73
|
| Rate for Payer: BCBS MAPPO |
$1,593.06
|
| Rate for Payer: BCN Commercial |
$2,589.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,593.06
|
| Rate for Payer: Cash Price |
$3,902.40
|
| Rate for Payer: Cash Price |
$3,902.40
|
| Rate for Payer: Cofinity Commercial |
$2,294.01
|
| Rate for Payer: Cofinity Commercial |
$2,134.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,593.06
|
| Rate for Payer: Healthscope Commercial |
$1,911.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,672.71
|
| Rate for Payer: Meridian Medicaid |
$1,071.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,752.37
|
| Rate for Payer: Nomi Health Commercial |
$1,911.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,658.50
|
| Rate for Payer: PACE SWMI |
$1,593.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,593.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,154.52
|
| Rate for Payer: Priority Health Medicare |
$1,593.06
|
| Rate for Payer: Priority Health Narrow Network |
$3,154.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,593.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,110.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,593.06
|
| Rate for Payer: UHC Exchange |
$3,110.18
|
| Rate for Payer: UHC Medicaid |
$1,020.70
|
| Rate for Payer: UHCCP DNSP |
$1,593.06
|
| Rate for Payer: UHCCP Medicaid |
$1,020.70
|
|
|
PR LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM
|
Professional
|
Both
|
$4,325.00
|
|
|
Service Code
|
HCPCS 44205
|
| Min. Negotiated Rate |
$781.92 |
| Max. Negotiated Rate |
$3,243.75 |
| Rate for Payer: Aetna Commercial |
$1,633.45
|
| Rate for Payer: Aetna Medicare |
$1,218.99
|
| Rate for Payer: BCBS Complete |
$821.02
|
| Rate for Payer: BCBS MAPPO |
$1,218.99
|
| Rate for Payer: BCN Commercial |
$1,989.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.99
|
| Rate for Payer: Cash Price |
$3,460.00
|
| Rate for Payer: Cash Price |
$3,460.00
|
| Rate for Payer: Cofinity Commercial |
$1,755.35
|
| Rate for Payer: Cofinity Commercial |
$1,633.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.99
|
| Rate for Payer: Healthscope Commercial |
$1,462.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,462.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.94
|
| Rate for Payer: Meridian Medicaid |
$821.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,340.89
|
| Rate for Payer: Nomi Health Commercial |
$1,462.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,243.75
|
| Rate for Payer: PACE SWMI |
$1,218.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,423.99
|
| Rate for Payer: Priority Health Medicare |
$1,218.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,218.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,377.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,218.99
|
| Rate for Payer: UHC Exchange |
$2,377.66
|
| Rate for Payer: UHC Medicaid |
$781.92
|
| Rate for Payer: UHCCP DNSP |
$1,218.99
|
| Rate for Payer: UHCCP Medicaid |
$781.92
|
|
|
PR LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$5,440.00
|
|
|
Service Code
|
HCPCS 44210
|
| Min. Negotiated Rate |
$1,037.95 |
| Max. Negotiated Rate |
$4,080.00 |
| Rate for Payer: Aetna Commercial |
$2,158.98
|
| Rate for Payer: Aetna Medicare |
$1,611.18
|
| Rate for Payer: BCBS Complete |
$1,089.85
|
| Rate for Payer: BCBS MAPPO |
$1,611.18
|
| Rate for Payer: BCN Commercial |
$2,628.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,611.18
|
| Rate for Payer: Cash Price |
$4,352.00
|
| Rate for Payer: Cash Price |
$4,352.00
|
| Rate for Payer: Cofinity Commercial |
$2,320.10
|
| Rate for Payer: Cofinity Commercial |
$2,158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,611.18
|
| Rate for Payer: Healthscope Commercial |
$1,933.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,933.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,691.74
|
| Rate for Payer: Meridian Medicaid |
$1,089.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,772.30
|
| Rate for Payer: Nomi Health Commercial |
$1,933.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,080.00
|
| Rate for Payer: PACE SWMI |
$1,611.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,611.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,037.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,203.07
|
| Rate for Payer: Priority Health Medicare |
$1,611.18
|
| Rate for Payer: Priority Health Narrow Network |
$3,203.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,611.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,138.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,611.18
|
| Rate for Payer: UHC Exchange |
$3,138.42
|
| Rate for Payer: UHC Medicaid |
$1,037.95
|
| Rate for Payer: UHCCP DNSP |
$1,611.18
|
| Rate for Payer: UHCCP Medicaid |
$1,037.95
|
|
|
PR LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 44202
|
| Min. Negotiated Rate |
$821.97 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$1,719.78
|
| Rate for Payer: Aetna Medicare |
$1,283.42
|
| Rate for Payer: BCBS Complete |
$863.07
|
| Rate for Payer: BCBS MAPPO |
$1,283.42
|
| Rate for Payer: BCN Commercial |
$2,077.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.42
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cofinity Commercial |
$1,848.12
|
| Rate for Payer: Cofinity Commercial |
$1,719.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.42
|
| Rate for Payer: Healthscope Commercial |
$1,540.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.59
|
| Rate for Payer: Meridian Medicaid |
$863.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,411.76
|
| Rate for Payer: Nomi Health Commercial |
$1,540.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: PACE SWMI |
$1,283.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,530.78
|
| Rate for Payer: Priority Health Medicare |
$1,283.42
|
| Rate for Payer: Priority Health Narrow Network |
$2,530.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,283.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,470.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,283.42
|
| Rate for Payer: UHC Exchange |
$2,470.56
|
| Rate for Payer: UHC Medicaid |
$821.97
|
| Rate for Payer: UHCCP DNSP |
$1,283.42
|
| Rate for Payer: UHCCP Medicaid |
$821.97
|
|
