|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Facility
|
IP
|
$2,325.00
|
|
|
Service Code
|
CPT 44180
|
| Hospital Charge Code |
44180
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,511.25 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna Commercial |
$2,092.50
|
| Rate for Payer: ASR ASR |
$2,255.25
|
| Rate for Payer: ASR Commercial |
$2,255.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.64
|
| Rate for Payer: BCN Commercial |
$1,802.57
|
| 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: Healthscope Commercial |
$2,325.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,255.25
|
| Rate for Payer: Mclaren Commercial |
$2,092.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.25
|
| Rate for Payer: Nomi Health Commercial |
$1,906.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,046.00
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 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
|
|
|
PR LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 58670
|
| Min. Negotiated Rate |
$238.99 |
| Max. Negotiated Rate |
$962.00 |
| Rate for Payer: Aetna Commercial |
$442.77
|
| Rate for Payer: Aetna Medicare |
$740.00
|
| Rate for Payer: BCBS Complete |
$250.94
|
| Rate for Payer: BCBS Trust/PPO |
$373.07
|
| Rate for Payer: BCN Commercial |
$546.34
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Meridian Medicaid |
$250.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.05
|
| Rate for Payer: Priority Health Narrow Network |
$558.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.35
|
| Rate for Payer: UHC Exchange |
$416.35
|
| Rate for Payer: UHCCP Medicaid |
$238.99
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT
|
Professional
|
Both
|
$3,008.00
|
|
|
Service Code
|
HCPCS 50546
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$1,955.20 |
| Rate for Payer: Aetna Commercial |
$1,546.92
|
| Rate for Payer: Aetna Medicare |
$1,504.00
|
| Rate for Payer: BCBS Complete |
$806.03
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$1,731.88
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Meridian Medicaid |
$806.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,907.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,907.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,447.99
|
| Rate for Payer: UHC Exchange |
$1,447.99
|
| Rate for Payer: UHCCP Medicaid |
$767.65
|
|
|
PR LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY
|
Professional
|
Both
|
$2,592.00
|
|
|
Service Code
|
HCPCS 50548
|
| Min. Negotiated Rate |
$852.85 |
| Max. Negotiated Rate |
$2,995.46 |
| Rate for Payer: Aetna Commercial |
$1,729.50
|
| Rate for Payer: Aetna Medicare |
$1,296.00
|
| Rate for Payer: BCBS Complete |
$895.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,995.46
|
| Rate for Payer: BCN Commercial |
$1,925.39
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Meridian Medicaid |
$895.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,120.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,120.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,637.95
|
| Rate for Payer: UHC Exchange |
$1,637.95
|
| Rate for Payer: UHCCP Medicaid |
$852.85
|
|
|
PR LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 54692
|
| Min. Negotiated Rate |
$483.51 |
| Max. Negotiated Rate |
$1,686.86 |
| Rate for Payer: Aetna Commercial |
$972.39
|
| Rate for Payer: Aetna Medicare |
$1,147.00
|
| Rate for Payer: BCBS Complete |
$507.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,686.86
|
| Rate for Payer: BCN Commercial |
$1,088.77
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Meridian Medicaid |
$507.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$919.25
|
| Rate for Payer: UHC Exchange |
$919.25
|
| Rate for Payer: UHCCP Medicaid |
$483.51
|
|
|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE
|
Professional
|
Both
|
$3,345.00
|
|
|
Service Code
|
HCPCS 45400
|
| Min. Negotiated Rate |
$721.86 |
| Max. Negotiated Rate |
$2,758.78 |
| Rate for Payer: Aetna Commercial |
$1,512.32
|
| Rate for Payer: Aetna Medicare |
$1,672.50
|
| Rate for Payer: BCBS Complete |
$757.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.78
|
| Rate for Payer: BCN Commercial |
$1,640.98
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Cash Price |
$2,676.00
|
| Rate for Payer: Meridian Medicaid |
$757.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,174.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,014.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,014.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,390.83
|
| Rate for Payer: UHC Exchange |
$1,390.83
|
| Rate for Payer: UHCCP Medicaid |
$721.86
|
|
|
PR LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ
|
Professional
|
Both
|
$4,663.00
|
|
|
Service Code
|
HCPCS 45402
|
| Min. Negotiated Rate |
$964.68 |
| Max. Negotiated Rate |
$3,030.95 |
| Rate for Payer: Aetna Commercial |
$2,023.67
|
| Rate for Payer: Aetna Medicare |
$2,331.50
|
| Rate for Payer: BCBS Complete |
$1,012.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,142.26
|
| Rate for Payer: BCN Commercial |
$2,197.59
|
| Rate for Payer: Cash Price |
$3,730.40
|
| Rate for Payer: Cash Price |
$3,730.40
|
| Rate for Payer: Meridian Medicaid |
$1,012.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,030.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,693.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,693.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,856.61
|
| Rate for Payer: UHC Exchange |
$1,856.61
|
| Rate for Payer: UHCCP Medicaid |
$964.68
|
|
|
PR LAPAROSCOPY RADICAL NEPHRECTOMY
|
Professional
|
Both
|
$4,089.00
|
|
|
Service Code
|
HCPCS 50545
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$2,657.85 |
| Rate for Payer: Aetna Commercial |
$1,716.91
|
| Rate for Payer: Aetna Medicare |
$2,044.50
|
| Rate for Payer: BCBS Complete |
$891.25
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$1,915.13
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Meridian Medicaid |
$891.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$848.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,657.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,109.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,109.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,628.24
|
| Rate for Payer: UHC Exchange |
$1,628.24
|
| Rate for Payer: UHCCP Medicaid |
$848.81
|
|
|
PR LAPAROSCOPY SALPINGOSTOMY
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 58673
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$2,026.05 |
| Rate for Payer: Aetna Commercial |
$953.91
|
| Rate for Payer: Aetna Medicare |
$1,558.50
|
| Rate for Payer: BCBS Complete |
$532.96
|
| Rate for Payer: BCBS Trust/PPO |
$94.66
|
| Rate for Payer: BCN Commercial |
$1,162.57
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Meridian Medicaid |
$532.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,184.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$919.97
|
| Rate for Payer: UHC Exchange |
$919.97
|
| Rate for Payer: UHCCP Medicaid |
$507.58
|
|
|
PR LAPAROSCOPY SLING OPERATION STRESS INCONT
|
Professional
|
Both
|
$1,724.00
|
|
|
Service Code
|
HCPCS 51992
|
| Min. Negotiated Rate |
$534.42 |
| Max. Negotiated Rate |
$1,505.66 |
| Rate for Payer: Aetna Commercial |
$1,079.36
|
| Rate for Payer: Aetna Medicare |
$862.00
|
| Rate for Payer: BCBS Complete |
$561.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.66
|
| Rate for Payer: BCN Commercial |
$1,210.95
|
| Rate for Payer: Cash Price |
$1,379.20
|
| Rate for Payer: Cash Price |
$1,379.20
|
| Rate for Payer: Meridian Medicaid |
$561.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,334.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,334.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$988.55
|
| Rate for Payer: UHC Exchange |
$988.55
|
| Rate for Payer: UHCCP Medicaid |
$534.42
|
|
|
PR LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 44203
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,325.50 |
| Rate for Payer: Aetna Commercial |
$324.29
|
| Rate for Payer: Aetna Medicare |
$533.00
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.50
|
| Rate for Payer: BCN Commercial |
$349.89
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$424.78
|
| Rate for Payer: Priority Health Narrow Network |
$424.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.78
|
| Rate for Payer: UHC Exchange |
$299.78
|
| Rate for Payer: UHCCP Medicaid |
$152.30
|
|
|
PR LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 58541
|
| Min. Negotiated Rate |
$187.02 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$871.92
|
| Rate for Payer: Aetna Medicare |
$1,012.50
|
| Rate for Payer: BCBS Complete |
$492.70
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$1,070.70
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Meridian Medicaid |
$492.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,093.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,093.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$981.81
|
| Rate for Payer: UHC Exchange |
$981.81
|
| Rate for Payer: UHCCP Medicaid |
$469.24
|
|
|
PR LAPAROSCOPY SURG ABLATION RENAL CYSTS
|
Professional
|
Both
|
$1,762.00
|
|
|
Service Code
|
HCPCS 50541
|
| Min. Negotiated Rate |
$585.11 |
| Max. Negotiated Rate |
$2,280.67 |
| Rate for Payer: Aetna Commercial |
$1,179.65
|
| Rate for Payer: Aetna Medicare |
$881.00
|
| Rate for Payer: BCBS Complete |
$614.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,280.67
|
| Rate for Payer: BCN Commercial |
$1,319.92
|
| Rate for Payer: Cash Price |
$1,409.60
|
| Rate for Payer: Cash Price |
$1,409.60
|
| Rate for Payer: Meridian Medicaid |
$614.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$585.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,145.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,453.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,453.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.54
|
| Rate for Payer: UHC Exchange |
$1,112.54
|
| Rate for Payer: UHCCP Medicaid |
$585.11
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
IP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,957.15 |
| Max. Negotiated Rate |
$3,011.00 |
| Rate for Payer: Aetna Commercial |
$2,709.90
|
| Rate for Payer: ASR ASR |
$2,920.67
|
| Rate for Payer: ASR Commercial |
$2,920.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,453.66
|
| Rate for Payer: BCN Commercial |
$2,334.43
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,830.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Healthscope Commercial |
$3,011.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,920.67
|
| Rate for Payer: Mclaren Commercial |
$2,709.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,559.35
|
| Rate for Payer: Nomi Health Commercial |
$2,469.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,649.68
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Facility
|
OP
|
$3,011.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
47562
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,957.15 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$2,709.90
|
| 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 |
$2,920.67
|
| Rate for Payer: ASR Commercial |
$2,920.67
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,465.71
|
| Rate for Payer: BCN Commercial |
$2,334.43
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,830.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,408.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$3,011.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,920.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$2,709.90
|
| 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 |
$2,559.35
|
| Rate for Payer: Nomi Health Commercial |
$2,469.02
|
| 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 |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,638.24
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,110.71
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,649.68
|
| 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 SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,011.00
|
|
|
Service Code
|
HCPCS 47562
|
| Min. Negotiated Rate |
$427.28 |
| Max. Negotiated Rate |
$1,957.15 |
| Rate for Payer: Aetna Commercial |
$890.52
|
| Rate for Payer: Aetna Medicare |
$1,505.50
|
| Rate for Payer: BCBS Complete |
$448.64
|
| Rate for Payer: BCBS Trust/PPO |
$481.23
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Meridian Medicaid |
$448.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,188.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,188.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$890.05
|
| Rate for Payer: UHC Exchange |
$890.05
|
| Rate for Payer: UHCCP Medicaid |
$427.28
|
|
|
PR LAPAROSCOPY SURG CHOLECYSTECTOMY
|
Professional
|
Both
|
$3,011.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
47562
|
| Min. Negotiated Rate |
$427.28 |
| Max. Negotiated Rate |
$1,957.15 |
| Rate for Payer: Aetna Commercial |
$890.52
|
| Rate for Payer: Aetna Medicare |
$1,505.50
|
| Rate for Payer: BCBS Complete |
$448.64
|
| Rate for Payer: BCBS Trust/PPO |
$481.23
|
| Rate for Payer: BCN Commercial |
$965.63
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Meridian Medicaid |
$448.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,188.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,188.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$890.05
|
| Rate for Payer: UHC Exchange |
$890.05
|
| Rate for Payer: UHCCP Medicaid |
$427.28
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,762.00
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$2,164.44 |
| Rate for Payer: Aetna Commercial |
$1,636.86
|
| Rate for Payer: Aetna Medicare |
$1,381.00
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$1,768.04
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,164.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,164.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,463.61
|
| Rate for Payer: UHC Exchange |
$1,463.61
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Facility
|
IP
|
$2,762.00
|
|
|
Service Code
|
CPT 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$1,795.30 |
| Max. Negotiated Rate |
$2,762.00 |
| Rate for Payer: Aetna Commercial |
$2,485.80
|
| Rate for Payer: ASR ASR |
$2,679.14
|
| Rate for Payer: ASR Commercial |
$2,679.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,250.75
|
| Rate for Payer: BCN Commercial |
$2,141.38
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$2,596.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,209.60
|
| Rate for Payer: Healthscope Commercial |
$2,762.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,679.14
|
| Rate for Payer: Mclaren Commercial |
$2,485.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,347.70
|
| Rate for Payer: Nomi Health Commercial |
$2,264.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,430.56
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Professional
|
Both
|
$2,762.00
|
|
|
Service Code
|
HCPCS 44188
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$2,164.44 |
| Rate for Payer: Aetna Commercial |
$1,636.86
|
| Rate for Payer: Aetna Medicare |
$1,381.00
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.13
|
| Rate for Payer: BCN Commercial |
$1,768.04
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,164.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,164.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,463.61
|
| Rate for Payer: UHC Exchange |
$1,463.61
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY
|
Facility
|
OP
|
$2,762.00
|
|
|
Service Code
|
CPT 44188
|
| Hospital Charge Code |
44188
|
| Min. Negotiated Rate |
$1,104.80 |
| Max. Negotiated Rate |
$2,762.00 |
| Rate for Payer: Aetna Commercial |
$2,485.80
|
| Rate for Payer: Aetna Medicare |
$1,381.00
|
| Rate for Payer: ASR ASR |
$2,679.14
|
| Rate for Payer: ASR Commercial |
$2,679.14
|
| Rate for Payer: BCBS Complete |
$1,104.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,261.80
|
| Rate for Payer: BCN Commercial |
$2,141.38
|
| Rate for Payer: Cash Price |
$2,209.60
|
| Rate for Payer: Cofinity Commercial |
$2,596.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,209.60
|
| Rate for Payer: Healthscope Commercial |
$2,762.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,679.14
|
| Rate for Payer: Mclaren Commercial |
$2,485.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,347.70
|
| Rate for Payer: Nomi Health Commercial |
$2,264.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,420.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,936.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,430.56
|
|
|
PR LAPAROSCOPY SURGICAL JEJUNOSTOMY
|
Professional
|
Both
|
$1,998.00
|
|
|
Service Code
|
HCPCS 44186
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$1,298.70 |
| Rate for Payer: Aetna Commercial |
$878.77
|
| Rate for Payer: Aetna Medicare |
$999.00
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.47
|
| Rate for Payer: BCN Commercial |
$951.95
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,298.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,170.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.93
|
| Rate for Payer: UHC Exchange |
$785.93
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR LAPAROSCOPY SURGICAL ORCHIECTOMY
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 54690
|
| Min. Negotiated Rate |
$420.25 |
| Max. Negotiated Rate |
$2,517.35 |
| Rate for Payer: Aetna Commercial |
$842.34
|
| Rate for Payer: Aetna Medicare |
$663.50
|
| Rate for Payer: BCBS Complete |
$441.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.35
|
| Rate for Payer: BCN Commercial |
$945.10
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Meridian Medicaid |
$441.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.61
|
| Rate for Payer: UHC Exchange |
$821.61
|
| Rate for Payer: UHCCP Medicaid |
$420.25
|
|
|
PR LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$3,023.00
|
|
|
Service Code
|
HCPCS 44187
|
| Min. Negotiated Rate |
$696.08 |
| Max. Negotiated Rate |
$1,964.95 |
| Rate for Payer: Aetna Commercial |
$1,467.80
|
| Rate for Payer: Aetna Medicare |
$1,511.50
|
| Rate for Payer: BCBS Complete |
$730.88
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,587.72
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Meridian Medicaid |
$730.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,964.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,943.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,319.24
|
| Rate for Payer: UHC Exchange |
$1,319.24
|
| Rate for Payer: UHCCP Medicaid |
$696.08
|
|
