|
PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,773.00
|
|
|
Service Code
|
HCPCS 63016
|
| Min. Negotiated Rate |
$313.28 |
| Max. Negotiated Rate |
$4,402.45 |
| Rate for Payer: Aetna Commercial |
$1,969.01
|
| Rate for Payer: Aetna Medicare |
$3,386.50
|
| Rate for Payer: BCBS Complete |
$1,042.66
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$2,480.52
|
| Rate for Payer: Cash Price |
$5,418.40
|
| Rate for Payer: Cash Price |
$5,418.40
|
| Rate for Payer: Meridian Medicaid |
$1,042.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$993.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,402.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,638.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,638.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,753.57
|
| Rate for Payer: UHC Exchange |
$1,753.57
|
| Rate for Payer: UHCCP Medicaid |
$993.01
|
|
|
PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS
|
Professional
|
Both
|
$5,784.00
|
|
|
Service Code
|
HCPCS 63185
|
| Min. Negotiated Rate |
$806.84 |
| Max. Negotiated Rate |
$4,716.13 |
| Rate for Payer: Aetna Commercial |
$1,466.36
|
| Rate for Payer: Aetna Medicare |
$2,892.00
|
| Rate for Payer: BCBS Complete |
$847.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,716.13
|
| Rate for Payer: BCN Commercial |
$1,680.08
|
| Rate for Payer: Cash Price |
$4,627.20
|
| Rate for Payer: Cash Price |
$4,627.20
|
| Rate for Payer: Meridian Medicaid |
$847.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$806.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,759.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,141.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,141.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,370.57
|
| Rate for Payer: UHC Exchange |
$1,370.57
|
| Rate for Payer: UHCCP Medicaid |
$806.84
|
|
|
PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR
|
Professional
|
Both
|
$6,155.00
|
|
|
Service Code
|
HCPCS 63012
|
| Min. Negotiated Rate |
$479.17 |
| Max. Negotiated Rate |
$4,000.75 |
| Rate for Payer: Aetna Commercial |
$1,539.11
|
| Rate for Payer: Aetna Medicare |
$3,077.50
|
| Rate for Payer: BCBS Complete |
$816.54
|
| Rate for Payer: BCBS Trust/PPO |
$479.17
|
| Rate for Payer: BCN Commercial |
$1,940.29
|
| Rate for Payer: Cash Price |
$4,924.00
|
| Rate for Payer: Cash Price |
$4,924.00
|
| Rate for Payer: Meridian Medicaid |
$816.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,000.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,065.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,065.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,375.19
|
| Rate for Payer: UHC Exchange |
$1,375.19
|
| Rate for Payer: UHCCP Medicaid |
$777.66
|
|
|
PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 63191
|
| Min. Negotiated Rate |
$243.55 |
| Max. Negotiated Rate |
$2,403.96 |
| Rate for Payer: Aetna Commercial |
$1,782.81
|
| Rate for Payer: Aetna Medicare |
$1,116.00
|
| Rate for Payer: BCBS Complete |
$950.73
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$2,045.12
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Meridian Medicaid |
$950.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$905.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,403.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,403.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.89
|
| Rate for Payer: UHC Exchange |
$1,352.89
|
| Rate for Payer: UHCCP Medicaid |
$905.46
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC
|
Professional
|
Both
|
$5,746.00
|
|
|
Service Code
|
HCPCS 63020
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$3,734.90 |
| Rate for Payer: Aetna Commercial |
$1,495.35
|
| Rate for Payer: Aetna Medicare |
$2,873.00
|
| Rate for Payer: BCBS Complete |
$754.59
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$1,778.33
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Cash Price |
$4,596.80
|
| Rate for Payer: Meridian Medicaid |
$754.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,734.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,899.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,899.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,345.00
|
| Rate for Payer: UHC Exchange |
$1,345.00
|
| Rate for Payer: UHCCP Medicaid |
$718.66
|
|
|
PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR
|
Professional
|
Both
|
$5,564.00
|
|
|
Service Code
|
HCPCS 63030
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$3,616.60 |
| Rate for Payer: Aetna Commercial |
$1,255.97
|
| Rate for Payer: Aetna Medicare |
$2,782.00
|
| Rate for Payer: BCBS Complete |
$627.56
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$1,146.75
|
| Rate for Payer: Cash Price |
$4,451.20
|
| Rate for Payer: Cash Price |
$4,451.20
|
| Rate for Payer: Meridian Medicaid |
$627.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,616.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,583.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,583.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,109.60
|
| Rate for Payer: UHC Exchange |
$1,109.60
|
| Rate for Payer: UHCCP Medicaid |
$597.68
|
|
|
PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63035
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$1,182.35 |
| Rate for Payer: Aetna Commercial |
$248.65
|
| Rate for Payer: Aetna Medicare |
$909.50
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.30
|
| Rate for Payer: BCN Commercial |
$375.03
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.97
|
| Rate for Payer: Priority Health Narrow Network |
$396.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.98
|
| Rate for Payer: UHC Exchange |
$230.98
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
|
|
PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ
|
Professional
|
Both
|
$8,543.00
|
|
|
Service Code
|
HCPCS 63051
|
| Min. Negotiated Rate |
$405.21 |
| Max. Negotiated Rate |
$5,552.95 |
| Rate for Payer: Aetna Commercial |
$2,195.15
|
| Rate for Payer: Aetna Medicare |
$4,271.50
|
| Rate for Payer: BCBS Complete |
$1,149.78
|
| Rate for Payer: BCBS Trust/PPO |
$405.21
|
| Rate for Payer: BCN Commercial |
$2,484.44
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Cash Price |
$6,834.40
|
| Rate for Payer: Meridian Medicaid |
$1,149.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,095.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,552.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,909.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,909.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,994.09
|
| Rate for Payer: UHC Exchange |
$1,994.09
|
| Rate for Payer: UHCCP Medicaid |
$1,095.03
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$6,673.00
|
|
|
Service Code
|
HCPCS 63040
|
| Min. Negotiated Rate |
$893.75 |
| Max. Negotiated Rate |
$4,337.45 |
| Rate for Payer: Aetna Commercial |
$1,795.55
|
| Rate for Payer: Aetna Medicare |
$3,336.50
|
| Rate for Payer: BCBS Complete |
$938.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$2,234.62
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Cash Price |
$5,338.40
|
| Rate for Payer: Meridian Medicaid |
$938.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,337.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,373.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,373.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,629.95
|
| Rate for Payer: UHC Exchange |
$1,629.95
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV
|
Professional
|
Both
|
$2,182.00
|
|
|
Service Code
|
HCPCS 63043
|
| Min. Negotiated Rate |
$191.17 |
| Max. Negotiated Rate |
$1,862.26 |
| Rate for Payer: Aetna Commercial |
$780.02
|
| Rate for Payer: Aetna Medicare |
$1,091.00
|
| Rate for Payer: BCBS Complete |
$200.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,862.26
|
| Rate for Payer: BCN Commercial |
$374.64
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Cash Price |
$1,745.60
|
| Rate for Payer: Meridian Medicaid |
$200.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.89
|
| Rate for Payer: UHC Exchange |
$362.89
|
| Rate for Payer: UHCCP Medicaid |
$191.17
|
|
|
PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 63042
|
| Min. Negotiated Rate |
$840.50 |
| Max. Negotiated Rate |
$2,234.49 |
| Rate for Payer: Aetna Commercial |
$1,671.08
|
| Rate for Payer: Aetna Medicare |
$1,346.50
|
| Rate for Payer: BCBS Complete |
$882.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.75
|
| Rate for Payer: BCN Commercial |
$2,094.72
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Meridian Medicaid |
$882.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,234.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,234.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,507.33
|
| Rate for Payer: UHC Exchange |
$1,507.33
|
| Rate for Payer: UHCCP Medicaid |
$840.50
|
|
|
PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 63044
|
| Min. Negotiated Rate |
$179.97 |
| Max. Negotiated Rate |
$1,908.75 |
| Rate for Payer: Aetna Commercial |
$741.31
|
| Rate for Payer: Aetna Medicare |
$1,062.50
|
| Rate for Payer: BCBS Complete |
$188.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,908.75
|
| Rate for Payer: BCN Commercial |
$374.64
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Meridian Medicaid |
$188.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,381.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.58
|
| Rate for Payer: Priority Health Narrow Network |
$985.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.64
|
| Rate for Payer: UHC Exchange |
$341.64
|
| Rate for Payer: UHCCP Medicaid |
$179.97
|
|
|
PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID
|
Professional
|
Both
|
$6,322.00
|
|
|
Service Code
|
HCPCS 63172
|
| Min. Negotiated Rate |
$925.27 |
| Max. Negotiated Rate |
$4,109.30 |
| Rate for Payer: Aetna Commercial |
$1,825.56
|
| Rate for Payer: Aetna Medicare |
$3,161.00
|
| Rate for Payer: BCBS Complete |
$971.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,470.40
|
| Rate for Payer: BCN Commercial |
$2,301.34
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Cash Price |
$5,057.60
|
| Rate for Payer: Meridian Medicaid |
$971.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,109.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,455.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,455.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,620.26
|
| Rate for Payer: UHC Exchange |
$1,620.26
|
| Rate for Payer: UHCCP Medicaid |
$925.27
|
|
|
PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL
|
Professional
|
Both
|
$6,858.00
|
|
|
Service Code
|
HCPCS 63173
|
| Min. Negotiated Rate |
$1,127.41 |
| Max. Negotiated Rate |
$4,457.70 |
| Rate for Payer: Aetna Commercial |
$2,229.76
|
| Rate for Payer: Aetna Medicare |
$3,429.00
|
| Rate for Payer: BCBS Complete |
$1,183.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,763.08
|
| Rate for Payer: BCN Commercial |
$2,549.92
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Cash Price |
$5,486.40
|
| Rate for Payer: Meridian Medicaid |
$1,183.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,127.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,457.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,997.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,997.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,994.60
|
| Rate for Payer: UHC Exchange |
$1,994.60
|
| Rate for Payer: UHCCP Medicaid |
$1,127.41
|
|
|
PR LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV
|
Professional
|
Both
|
$5,092.00
|
|
|
Service Code
|
HCPCS 63001
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$3,309.80 |
| Rate for Payer: Aetna Commercial |
$1,593.74
|
| Rate for Payer: Aetna Medicare |
$2,546.00
|
| Rate for Payer: BCBS Complete |
$844.28
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$2,002.17
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Meridian Medicaid |
$844.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,309.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,129.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,129.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,425.17
|
| Rate for Payer: UHC Exchange |
$1,425.17
|
| Rate for Payer: UHCCP Medicaid |
$804.08
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$389.58 |
| Max. Negotiated Rate |
$2,450.78 |
| Rate for Payer: Aetna Commercial |
$811.51
|
| Rate for Payer: Aetna Medicare |
$1,007.50
|
| Rate for Payer: BCBS Complete |
$409.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.78
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Meridian Medicaid |
$409.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$713.68
|
| Rate for Payer: UHC Exchange |
$713.68
|
| Rate for Payer: UHCCP Medicaid |
$389.58
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 44970
|
| Hospital Charge Code |
44970
|
| Min. Negotiated Rate |
$389.58 |
| Max. Negotiated Rate |
$2,450.78 |
| Rate for Payer: Aetna Commercial |
$811.51
|
| Rate for Payer: Aetna Medicare |
$1,007.50
|
| Rate for Payer: BCBS Complete |
$409.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.78
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Meridian Medicaid |
$409.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,084.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,084.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$713.68
|
| Rate for Payer: UHC Exchange |
$713.68
|
| Rate for Payer: UHCCP Medicaid |
$389.58
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$2,015.00 |
| Rate for Payer: Aetna Commercial |
$1,813.50
|
| Rate for Payer: ASR ASR |
$1,954.55
|
| Rate for Payer: ASR Commercial |
$1,954.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.02
|
| Rate for Payer: BCN Commercial |
$1,562.23
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,894.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$2,015.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.55
|
| Rate for Payer: Mclaren Commercial |
$1,813.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.20
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
44970
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$1,813.50
|
| Rate for Payer: Aetna Medicare |
$5,716.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: ASR ASR |
$1,954.55
|
| Rate for Payer: ASR Commercial |
$1,954.55
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.08
|
| Rate for Payer: BCN Commercial |
$1,562.23
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,894.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,015.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$1,813.50
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$6,288.03
|
| Rate for Payer: PHP Medicaid |
$3,063.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.54
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,412.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$8,860.40
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP DNSP |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR LAPAROSCOPIC SURGICAL SPLENECTOMY
|
Professional
|
Both
|
$4,026.00
|
|
|
Service Code
|
HCPCS 38120
|
| Min. Negotiated Rate |
$410.49 |
| Max. Negotiated Rate |
$2,616.90 |
| Rate for Payer: Aetna Commercial |
$1,317.62
|
| Rate for Payer: Aetna Medicare |
$2,013.00
|
| Rate for Payer: BCBS Complete |
$716.35
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$1,545.19
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Cash Price |
$3,220.80
|
| Rate for Payer: Meridian Medicaid |
$716.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,616.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,119.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,119.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,164.12
|
| Rate for Payer: UHC Exchange |
$1,164.12
|
| Rate for Payer: UHCCP Medicaid |
$682.24
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$533.05 |
| Max. Negotiated Rate |
$1,921.36 |
| Rate for Payer: Aetna Commercial |
$1,544.16
|
| Rate for Payer: Aetna Medicare |
$1,107.50
|
| Rate for Payer: BCBS Complete |
$804.25
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$1,729.43
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Meridian Medicaid |
$804.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,921.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,921.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,364.29
|
| Rate for Payer: UHC Exchange |
$1,364.29
|
| Rate for Payer: UHCCP Medicaid |
$765.95
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,626.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$979.80 |
| Max. Negotiated Rate |
$2,732.40 |
| Rate for Payer: Aetna Commercial |
$2,065.92
|
| Rate for Payer: Aetna Medicare |
$1,813.00
|
| Rate for Payer: BCBS Complete |
$1,028.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.45
|
| Rate for Payer: BCN Commercial |
$2,229.34
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Cash Price |
$2,900.80
|
| Rate for Payer: Meridian Medicaid |
$1,028.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$979.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,356.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,732.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,732.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,869.21
|
| Rate for Payer: UHC Exchange |
$1,869.21
|
| Rate for Payer: UHCCP Medicaid |
$979.80
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$540.98 |
| Max. Negotiated Rate |
$1,451.43 |
| Rate for Payer: Aetna Commercial |
$1,163.50
|
| Rate for Payer: Aetna Medicare |
$1,012.50
|
| Rate for Payer: BCBS Complete |
$654.18
|
| Rate for Payer: BCBS Trust/PPO |
$540.98
|
| Rate for Payer: BCN Commercial |
$1,422.05
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Meridian Medicaid |
$654.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,451.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,451.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.45
|
| Rate for Payer: UHC Exchange |
$1,116.45
|
| Rate for Payer: UHCCP Medicaid |
$623.03
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
OP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,511.25 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$2,092.50
|
| Rate for Payer: Aetna Medicare |
$5,716.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: ASR ASR |
$2,255.25
|
| Rate for Payer: ASR Commercial |
$2,255.25
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,903.94
|
| Rate for Payer: BCN Commercial |
$1,802.57
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$2,185.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,325.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,255.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$2,092.50
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: Nomi Health Commercial |
$1,906.50
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$6,288.03
|
| Rate for Payer: PHP Medicaid |
$3,063.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.16
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,629.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,046.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$8,860.40
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP DNSP |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 44180
|
| Hospital Charge Code |
44180
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$1,647.79 |
| Rate for Payer: Aetna Commercial |
$1,241.34
|
| Rate for Payer: Aetna Medicare |
$1,162.50
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS Trust/PPO |
$952.00
|
| Rate for Payer: BCN Commercial |
$1,341.91
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,647.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.31
|
| Rate for Payer: UHC Exchange |
$1,112.31
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
|
