|
PR LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR
|
Professional
|
Both
|
$6,102.00
|
|
|
Service Code
|
HCPCS 45397
|
| Min. Negotiated Rate |
$121.51 |
| Max. Negotiated Rate |
$3,966.30 |
| Rate for Payer: Aetna Commercial |
$2,842.98
|
| Rate for Payer: Aetna Medicare |
$3,051.00
|
| Rate for Payer: BCBS Complete |
$1,413.47
|
| Rate for Payer: BCBS Trust/PPO |
$121.51
|
| Rate for Payer: BCN Commercial |
$3,073.29
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Meridian Medicaid |
$1,413.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,346.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,966.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,756.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,756.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,590.66
|
| Rate for Payer: UHC Exchange |
$2,590.66
|
| Rate for Payer: UHCCP Medicaid |
$1,346.16
|
|
|
PR LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE
|
Professional
|
Both
|
$1,211.00
|
|
|
Service Code
|
HCPCS 49652
|
| Min. Negotiated Rate |
$484.40 |
| Max. Negotiated Rate |
$787.15 |
| Rate for Payer: Aetna Medicare |
$605.50
|
| Rate for Payer: BCBS Complete |
$484.40
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.15
|
|
|
PR LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,444.00
|
|
|
Service Code
|
HCPCS 49655
|
| Min. Negotiated Rate |
$1,377.60 |
| Max. Negotiated Rate |
$2,238.60 |
| Rate for Payer: Aetna Medicare |
$1,722.00
|
| Rate for Payer: BCBS Complete |
$1,377.60
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,238.60
|
|
|
PR LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH
|
Professional
|
Both
|
$4,970.00
|
|
|
Service Code
|
HCPCS 43282
|
| Min. Negotiated Rate |
$835.24 |
| Max. Negotiated Rate |
$3,230.50 |
| Rate for Payer: Aetna Commercial |
$2,344.33
|
| Rate for Payer: Aetna Medicare |
$2,485.00
|
| Rate for Payer: BCBS Complete |
$1,162.09
|
| Rate for Payer: BCBS Trust/PPO |
$835.24
|
| Rate for Payer: BCN Commercial |
$2,517.17
|
| Rate for Payer: Cash Price |
$3,976.00
|
| Rate for Payer: Cash Price |
$3,976.00
|
| Rate for Payer: Meridian Medicaid |
$1,162.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,106.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,230.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,086.79
|
| Rate for Payer: Priority Health Narrow Network |
$3,086.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,213.39
|
| Rate for Payer: UHC Exchange |
$2,213.39
|
| Rate for Payer: UHCCP Medicaid |
$1,106.75
|
|
|
PR LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH
|
Professional
|
Both
|
$3,166.00
|
|
|
Service Code
|
HCPCS 43281
|
| Min. Negotiated Rate |
$936.15 |
| Max. Negotiated Rate |
$2,740.76 |
| Rate for Payer: Aetna Commercial |
$2,084.94
|
| Rate for Payer: Aetna Medicare |
$1,583.00
|
| Rate for Payer: BCBS Complete |
$1,031.03
|
| Rate for Payer: BCBS Trust/PPO |
$936.15
|
| Rate for Payer: BCN Commercial |
$2,238.14
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Meridian Medicaid |
$1,031.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$981.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,740.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,740.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,968.41
|
| Rate for Payer: UHC Exchange |
$1,968.41
|
| Rate for Payer: UHCCP Medicaid |
$981.93
|
|
|
PR LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED
|
Professional
|
Both
|
$4,082.00
|
|
|
Service Code
|
HCPCS 49657
|
| Min. Negotiated Rate |
$1,632.80 |
| Max. Negotiated Rate |
$2,653.30 |
| Rate for Payer: Aetna Medicare |
$2,041.00
|
| Rate for Payer: BCBS Complete |
$1,632.80
|
| Rate for Payer: Cash Price |
$3,265.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,653.30
|
|
|
PR LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,493.00
|
|
|
Service Code
|
HCPCS 49656
|
| Min. Negotiated Rate |
$597.20 |
| Max. Negotiated Rate |
$970.45 |
| Rate for Payer: Aetna Medicare |
$746.50
|
| Rate for Payer: BCBS Complete |
$597.20
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.45
|
|
|
PR LAPS SUPRACERVICAL HYSTERECTOMY >250
|
Professional
|
Both
|
$2,256.00
|
|
|
Service Code
|
HCPCS 58543
|
| Min. Negotiated Rate |
$362.94 |
| Max. Negotiated Rate |
$1,466.40 |
| Rate for Payer: Aetna Commercial |
$1,009.17
|
| Rate for Payer: Aetna Medicare |
$1,128.00
|
| Rate for Payer: BCBS Complete |
$566.96
|
| Rate for Payer: BCBS Trust/PPO |
$362.94
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Meridian Medicaid |
$566.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.10
|
| Rate for Payer: UHC Exchange |
$1,116.10
|
| Rate for Payer: UHCCP Medicaid |
$539.96
|
|
|
PR LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,458.00
|
|
|
Service Code
|
HCPCS 58544
|
| Min. Negotiated Rate |
$387.24 |
| Max. Negotiated Rate |
$1,597.70 |
| Rate for Payer: Aetna Commercial |
$1,086.55
|
| Rate for Payer: Aetna Medicare |
$1,229.00
|
| Rate for Payer: BCBS Complete |
$609.89
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$1,331.16
|
| Rate for Payer: Cash Price |
$1,966.40
|
| Rate for Payer: Cash Price |
$1,966.40
|
| Rate for Payer: Meridian Medicaid |
$609.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,597.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,354.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,206.79
|
| Rate for Payer: UHC Exchange |
$1,206.79
|
| Rate for Payer: UHCCP Medicaid |
$580.85
|
|
|
PR LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 58542
|
| Min. Negotiated Rate |
$383.55 |
| Max. Negotiated Rate |
$1,447.55 |
| Rate for Payer: Aetna Commercial |
$993.97
|
| Rate for Payer: Aetna Medicare |
$1,113.50
|
| Rate for Payer: BCBS Complete |
$558.67
|
| Rate for Payer: BCBS Trust/PPO |
$383.55
|
| Rate for Payer: BCN Commercial |
$1,218.27
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Meridian Medicaid |
$558.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,447.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,241.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,097.45
|
| Rate for Payer: UHC Exchange |
$1,097.45
|
| Rate for Payer: UHCCP Medicaid |
$532.07
|
|
|
PR LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY
|
Professional
|
Both
|
$1,554.00
|
|
|
Service Code
|
HCPCS 38571
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,316.18 |
| Rate for Payer: Aetna Commercial |
$820.26
|
| Rate for Payer: Aetna Medicare |
$777.00
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS Trust/PPO |
$459.62
|
| Rate for Payer: BCN Commercial |
$956.83
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Cash Price |
$1,243.20
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,316.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$954.14
|
| Rate for Payer: UHC Exchange |
$954.14
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR LAPS SURG CHOLECSTC W/EXPL COMMON DUCT
|
Professional
|
Both
|
$3,358.00
|
|
|
Service Code
|
HCPCS 47564
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,228.90 |
| Rate for Payer: Aetna Commercial |
$1,509.43
|
| Rate for Payer: Aetna Medicare |
$1,679.00
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,228.90
|
| Rate for Payer: BCN Commercial |
$1,633.65
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Cash Price |
$2,686.40
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,007.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.11
|
| Rate for Payer: UHC Exchange |
$1,042.11
|
| Rate for Payer: UHCCP Medicaid |
$721.43
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$969.23
|
| Rate for Payer: Aetna Medicare |
$1,396.00
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$905.69
|
| Rate for Payer: UHC Exchange |
$905.69
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
OP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,814.80 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$2,512.80
|
| 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 |
$2,708.24
|
| Rate for Payer: ASR Commercial |
$2,708.24
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,286.37
|
| Rate for Payer: BCN Commercial |
$2,164.64
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,624.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,792.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,708.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$2,512.80
|
| 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 |
$2,373.20
|
| Rate for Payer: Nomi Health Commercial |
$2,289.44
|
| 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 |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,446.35
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,957.19
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,456.96
|
| 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 LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,792.00
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
47563
|
| Min. Negotiated Rate |
$464.55 |
| Max. Negotiated Rate |
$1,814.80 |
| Rate for Payer: Aetna Commercial |
$969.23
|
| Rate for Payer: Aetna Medicare |
$1,396.00
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS Trust/PPO |
$584.28
|
| Rate for Payer: BCN Commercial |
$1,052.61
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$905.69
|
| Rate for Payer: UHC Exchange |
$905.69
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
|
|
PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Facility
|
IP
|
$2,792.00
|
|
|
Service Code
|
CPT 47563
|
| Hospital Charge Code |
47563
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,814.80 |
| Max. Negotiated Rate |
$2,792.00 |
| Rate for Payer: Aetna Commercial |
$2,512.80
|
| Rate for Payer: ASR ASR |
$2,708.24
|
| Rate for Payer: ASR Commercial |
$2,708.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,275.20
|
| Rate for Payer: BCN Commercial |
$2,164.64
|
| Rate for Payer: Cash Price |
$2,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,624.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,233.60
|
| Rate for Payer: Healthscope Commercial |
$2,792.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,708.24
|
| Rate for Payer: Mclaren Commercial |
$2,512.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,373.20
|
| Rate for Payer: Nomi Health Commercial |
$2,289.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,456.96
|
|
|
PR LAPS SURG ESOPG/GSTR FUNDOPLASTY
|
Professional
|
Both
|
$4,149.00
|
|
|
Service Code
|
HCPCS 43280
|
| Min. Negotiated Rate |
$692.04 |
| Max. Negotiated Rate |
$2,696.85 |
| Rate for Payer: Aetna Commercial |
$1,458.26
|
| Rate for Payer: Aetna Medicare |
$2,074.50
|
| Rate for Payer: BCBS Complete |
$726.64
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$1,571.58
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Meridian Medicaid |
$726.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,696.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,928.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.39
|
| Rate for Payer: UHC Exchange |
$1,313.39
|
| Rate for Payer: UHCCP Medicaid |
$692.04
|
|
|
PR LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 43653
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,491.10 |
| Rate for Payer: Aetna Commercial |
$777.16
|
| Rate for Payer: Aetna Medicare |
$1,147.00
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.13
|
| Rate for Payer: BCN Commercial |
$847.86
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$672.29
|
| Rate for Payer: UHC Exchange |
$672.29
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT
|
Professional
|
Both
|
$3,339.00
|
|
|
Service Code
|
HCPCS 55866
|
| Min. Negotiated Rate |
$761.69 |
| Max. Negotiated Rate |
$2,170.35 |
| Rate for Payer: Aetna Commercial |
$1,851.29
|
| Rate for Payer: Aetna Medicare |
$1,669.50
|
| Rate for Payer: BCBS Complete |
$799.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,132.22
|
| Rate for Payer: BCN Commercial |
$1,719.17
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Meridian Medicaid |
$799.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,892.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,110.05
|
| Rate for Payer: UHC Exchange |
$2,110.05
|
| Rate for Payer: UHCCP Medicaid |
$761.69
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Hospital Charge Code |
38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$637.62
|
| Rate for Payer: Aetna Medicare |
$490.50
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$619.47
|
| Rate for Payer: UHC Exchange |
$619.47
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 38570
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,033.90 |
| Rate for Payer: Aetna Commercial |
$637.62
|
| Rate for Payer: Aetna Medicare |
$490.50
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS Trust/PPO |
$453.28
|
| Rate for Payer: BCN Commercial |
$750.12
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$619.47
|
| Rate for Payer: UHC Exchange |
$619.47
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
IP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$637.65 |
| Max. Negotiated Rate |
$981.00 |
| Rate for Payer: Aetna Commercial |
$882.90
|
| Rate for Payer: ASR ASR |
$951.57
|
| Rate for Payer: ASR Commercial |
$951.57
|
| Rate for Payer: BCBS Trust/PPO |
$799.42
|
| Rate for Payer: BCN Commercial |
$760.57
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$922.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Healthscope Commercial |
$981.00
|
| Rate for Payer: Healthscope Whirlpool |
$951.57
|
| Rate for Payer: Mclaren Commercial |
$882.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.85
|
| Rate for Payer: Nomi Health Commercial |
$804.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$863.28
|
|
|
PR LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT
|
Facility
|
OP
|
$981.00
|
|
|
Service Code
|
CPT 38570
|
| Hospital Charge Code |
38570
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$637.65 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$882.90
|
| 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 |
$951.57
|
| Rate for Payer: ASR Commercial |
$951.57
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$803.34
|
| Rate for Payer: BCN Commercial |
$760.57
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$922.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$981.00
|
| Rate for Payer: Healthscope Whirlpool |
$951.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$882.90
|
| 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 |
$833.85
|
| Rate for Payer: Nomi Health Commercial |
$804.42
|
| 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 |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$859.55
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$687.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$863.28
|
| 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 LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Facility
|
OP
|
$2,071.00
|
|
|
Service Code
|
CPT 49651
|
| Hospital Charge Code |
49651
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,346.15 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$1,863.90
|
| 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 |
$2,008.87
|
| Rate for Payer: ASR Commercial |
$2,008.87
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,695.94
|
| Rate for Payer: BCN Commercial |
$1,605.65
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cofinity Commercial |
$1,946.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,008.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$1,863.90
|
| 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 |
$1,760.35
|
| Rate for Payer: Nomi Health Commercial |
$1,698.22
|
| 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 |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,814.61
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,451.77
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,822.48
|
| 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 LAPS SURG RPR RECURRENT INGUINAL HERNIA
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 49651
|
| Hospital Charge Code |
49651
|
| Min. Negotiated Rate |
$367.21 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$756.01
|
| Rate for Payer: Aetna Medicare |
$1,035.50
|
| Rate for Payer: BCBS Complete |
$385.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Cash Price |
$1,656.80
|
| Rate for Payer: Meridian Medicaid |
$385.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.49
|
| Rate for Payer: UHC Exchange |
$656.49
|
| Rate for Payer: UHCCP Medicaid |
$367.21
|
|
