|
PR RPLCMT/IRRIGATION VENTRICULAR CATHETER
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 62225
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$2,105.25 |
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: Aetna Medicare |
$558.04
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS MAPPO |
$558.04
|
| Rate for Payer: BCN Commercial |
$1,146.16
|
| Rate for Payer: BCN Medicare Advantage |
$558.04
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$803.58
|
| Rate for Payer: Cofinity Commercial |
$747.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.04
|
| Rate for Payer: Healthscope Commercial |
$669.65
|
| Rate for Payer: Healthscope Whirlpool |
$669.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.94
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$613.84
|
| Rate for Payer: Nomi Health Commercial |
$669.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$558.04
|
| Rate for Payer: PHP Medicare Advantage |
$558.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$963.60
|
| Rate for Payer: Priority Health Medicare |
$558.04
|
| Rate for Payer: Priority Health Narrow Network |
$963.60
|
| Rate for Payer: Railroad Medicare Medicare |
$558.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$916.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.04
|
| Rate for Payer: UHC Exchange |
$916.55
|
| Rate for Payer: UHC Medicaid |
$364.87
|
| Rate for Payer: UHCCP DNSP |
$558.04
|
| Rate for Payer: UHCCP Medicaid |
$364.87
|
|
|
PR RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 69717
|
| Min. Negotiated Rate |
$314.18 |
| Max. Negotiated Rate |
$1,909.68 |
| Rate for Payer: Aetna Commercial |
$643.68
|
| Rate for Payer: Aetna Medicare |
$480.36
|
| Rate for Payer: BCBS Complete |
$329.89
|
| Rate for Payer: BCBS MAPPO |
$480.36
|
| Rate for Payer: BCN Commercial |
$841.58
|
| Rate for Payer: BCN Medicare Advantage |
$480.36
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$691.72
|
| Rate for Payer: Cofinity Commercial |
$643.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.36
|
| Rate for Payer: Healthscope Commercial |
$576.43
|
| Rate for Payer: Healthscope Whirlpool |
$576.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$504.38
|
| Rate for Payer: Meridian Medicaid |
$329.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$528.40
|
| Rate for Payer: Nomi Health Commercial |
$576.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: PACE SWMI |
$480.36
|
| Rate for Payer: PHP Medicare Advantage |
$480.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$831.58
|
| Rate for Payer: Priority Health Medicare |
$480.36
|
| Rate for Payer: Priority Health Narrow Network |
$831.58
|
| Rate for Payer: Railroad Medicare Medicare |
$480.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,909.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.36
|
| Rate for Payer: UHC Exchange |
$1,909.68
|
| Rate for Payer: UHC Medicaid |
$314.18
|
| Rate for Payer: UHCCP DNSP |
$480.36
|
| Rate for Payer: UHCCP Medicaid |
$314.18
|
|
|
PR RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT
|
Professional
|
Both
|
$4,896.00
|
|
|
Service Code
|
HCPCS 33405
|
| Min. Negotiated Rate |
$1,355.75 |
| Max. Negotiated Rate |
$4,048.37 |
| Rate for Payer: Aetna Commercial |
$2,854.32
|
| Rate for Payer: Aetna Medicare |
$2,130.09
|
| Rate for Payer: BCBS Complete |
$1,423.54
|
| Rate for Payer: BCBS MAPPO |
$2,130.09
|
| Rate for Payer: BCN Commercial |
$3,335.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,130.09
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cofinity Commercial |
$3,067.33
|
| Rate for Payer: Cofinity Commercial |
$2,854.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,130.09
|
| Rate for Payer: Healthscope Commercial |
$2,556.11
|
| Rate for Payer: Healthscope Whirlpool |
$2,556.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,236.59
|
| Rate for Payer: Meridian Medicaid |
$1,423.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,343.10
|
| Rate for Payer: Nomi Health Commercial |
$2,556.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.00
|
| Rate for Payer: PACE SWMI |
$2,130.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,130.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,355.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,586.89
|
| Rate for Payer: Priority Health Medicare |
$2,130.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,586.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,130.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,048.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,130.09
|
| Rate for Payer: UHC Exchange |
$4,048.37
|
| Rate for Payer: UHC Medicaid |
$1,355.75
|
| Rate for Payer: UHCCP DNSP |
$2,130.09
|
| Rate for Payer: UHCCP Medicaid |
$1,355.75
|
|
|
PR RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS
|
Professional
|
Both
|
$3,662.00
|
|
|
Service Code
|
HCPCS 62230
|
| Min. Negotiated Rate |
$535.27 |
| Max. Negotiated Rate |
$2,746.50 |
| Rate for Payer: Aetna Commercial |
$1,112.43
|
| Rate for Payer: Aetna Medicare |
$830.17
|
| Rate for Payer: BCBS Complete |
$562.03
|
| Rate for Payer: BCBS MAPPO |
$830.17
|
| Rate for Payer: BCN Commercial |
$1,775.66
|
| Rate for Payer: BCN Medicare Advantage |
$830.17
|
| Rate for Payer: Cash Price |
$2,929.60
|
| Rate for Payer: Cash Price |
$2,929.60
|
| Rate for Payer: Cofinity Commercial |
$1,195.44
|
| Rate for Payer: Cofinity Commercial |
$1,112.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.17
|
| Rate for Payer: Healthscope Commercial |
$996.20
|
| Rate for Payer: Healthscope Whirlpool |
$996.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$871.68
|
| Rate for Payer: Meridian Medicaid |
$562.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$913.19
|
| Rate for Payer: Nomi Health Commercial |
$996.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,746.50
|
| Rate for Payer: PACE SWMI |
$830.17
|
| Rate for Payer: PHP Medicare Advantage |
$830.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,492.83
|
| Rate for Payer: Priority Health Medicare |
$830.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,492.83
|
| Rate for Payer: Railroad Medicare Medicare |
$830.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,476.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$830.17
|
| Rate for Payer: UHC Exchange |
$1,476.62
|
| Rate for Payer: UHC Medicaid |
$535.27
|
| Rate for Payer: UHCCP DNSP |
$830.17
|
| Rate for Payer: UHCCP Medicaid |
$535.27
|
|
|
PR RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP
|
Professional
|
Both
|
$4,042.00
|
|
|
Service Code
|
HCPCS 20822
|
| Min. Negotiated Rate |
$1,021.97 |
| Max. Negotiated Rate |
$3,114.37 |
| Rate for Payer: Aetna Commercial |
$2,115.38
|
| Rate for Payer: Aetna Medicare |
$1,578.64
|
| Rate for Payer: BCBS Complete |
$1,073.07
|
| Rate for Payer: BCBS MAPPO |
$1,578.64
|
| Rate for Payer: BCN Commercial |
$2,670.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,578.64
|
| Rate for Payer: Cash Price |
$3,233.60
|
| Rate for Payer: Cash Price |
$3,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,273.24
|
| Rate for Payer: Cofinity Commercial |
$2,115.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,578.64
|
| Rate for Payer: Healthscope Commercial |
$1,894.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,894.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,657.57
|
| Rate for Payer: Meridian Medicaid |
$1,073.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,736.50
|
| Rate for Payer: Nomi Health Commercial |
$1,894.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,031.50
|
| Rate for Payer: PACE SWMI |
$1,578.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,578.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,854.34
|
| Rate for Payer: Priority Health Medicare |
$1,578.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,854.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,578.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,114.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,578.64
|
| Rate for Payer: UHC Exchange |
$3,114.37
|
| Rate for Payer: UHC Medicaid |
$1,021.97
|
| Rate for Payer: UHCCP DNSP |
$1,578.64
|
| Rate for Payer: UHCCP Medicaid |
$1,021.97
|
|
|
PR RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 20 MIN
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: Aetna Medicare |
$26.15
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$26.15
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.15
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$37.66
|
| Rate for Payer: Cofinity Commercial |
$35.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.15
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Whirlpool |
$28.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.46
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.77
|
| Rate for Payer: Nomi Health Commercial |
$31.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PACE SWMI |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$26.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39.87
|
| Rate for Payer: Priority Health Medicare |
$26.15
|
| Rate for Payer: Priority Health Narrow Network |
$39.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.15
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$16.83
|
| Rate for Payer: UHCCP DNSP |
$26.15
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO EA ADDL 20
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: Aetna Medicare |
$26.15
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$26.15
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.15
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$37.66
|
| Rate for Payer: Cofinity Commercial |
$35.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.15
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Whirlpool |
$28.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.46
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.77
|
| Rate for Payer: Nomi Health Commercial |
$31.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$26.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39.87
|
| Rate for Payer: Priority Health Medicare |
$26.15
|
| Rate for Payer: Priority Health Narrow Network |
$39.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.15
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$16.83
|
| Rate for Payer: UHCCP DNSP |
$26.15
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$815.26 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$1,046.70
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,128.11
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$958.89
|
| Rate for Payer: BCN Commercial |
$958.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,128.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$1,046.70
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$953.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,019.02
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$815.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 49553
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,167.41 |
| Rate for Payer: Aetna Commercial |
$806.95
|
| Rate for Payer: Aetna Medicare |
$602.20
|
| Rate for Payer: BCBS Complete |
$407.71
|
| Rate for Payer: BCBS MAPPO |
$602.20
|
| Rate for Payer: BCN Commercial |
$958.11
|
| Rate for Payer: BCN Medicare Advantage |
$602.20
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$867.17
|
| Rate for Payer: Cofinity Commercial |
$806.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.20
|
| Rate for Payer: Healthscope Commercial |
$722.64
|
| Rate for Payer: Healthscope Whirlpool |
$722.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.31
|
| Rate for Payer: Meridian Medicaid |
$407.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.42
|
| Rate for Payer: Nomi Health Commercial |
$722.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$602.20
|
| Rate for Payer: PHP Medicare Advantage |
$602.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,167.41
|
| Rate for Payer: Priority Health Medicare |
$602.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,167.41
|
| Rate for Payer: Railroad Medicare Medicare |
$602.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.20
|
| Rate for Payer: UHC Exchange |
$1,121.43
|
| Rate for Payer: UHC Medicaid |
$388.30
|
| Rate for Payer: UHCCP DNSP |
$602.20
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$872.25 |
| Max. Negotiated Rate |
$1,163.00 |
| Rate for Payer: Aetna Commercial |
$1,046.70
|
| Rate for Payer: ASR ASR |
$1,128.11
|
| Rate for Payer: BCBS Trust/PPO |
$955.06
|
| Rate for Payer: BCN Commercial |
$955.06
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Healthscope Commercial |
$1,128.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.00
|
| Rate for Payer: Mclaren Commercial |
$1,046.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$953.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 49553
|
| Hospital Charge Code |
49553
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,167.41 |
| Rate for Payer: Aetna Commercial |
$806.95
|
| Rate for Payer: Aetna Medicare |
$602.20
|
| Rate for Payer: BCBS Complete |
$407.71
|
| Rate for Payer: BCBS MAPPO |
$602.20
|
| Rate for Payer: BCN Commercial |
$958.11
|
| Rate for Payer: BCN Medicare Advantage |
$602.20
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$867.17
|
| Rate for Payer: Cofinity Commercial |
$806.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.20
|
| Rate for Payer: Healthscope Commercial |
$722.64
|
| Rate for Payer: Healthscope Whirlpool |
$722.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.31
|
| Rate for Payer: Meridian Medicaid |
$407.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.42
|
| Rate for Payer: Nomi Health Commercial |
$722.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$602.20
|
| Rate for Payer: PHP Medicare Advantage |
$602.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,167.41
|
| Rate for Payer: Priority Health Medicare |
$602.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,167.41
|
| Rate for Payer: Railroad Medicare Medicare |
$602.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.20
|
| Rate for Payer: UHC Exchange |
$1,121.43
|
| Rate for Payer: UHC Medicaid |
$388.30
|
| Rate for Payer: UHCCP DNSP |
$602.20
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 49550
|
| Hospital Charge Code |
49550
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,069.12 |
| Rate for Payer: Aetna Commercial |
$739.61
|
| Rate for Payer: Aetna Medicare |
$551.95
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$551.95
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$551.95
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$794.81
|
| Rate for Payer: Cofinity Commercial |
$739.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.95
|
| Rate for Payer: Healthscope Commercial |
$662.34
|
| Rate for Payer: Healthscope Whirlpool |
$662.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.55
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$607.14
|
| Rate for Payer: Nomi Health Commercial |
$662.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$551.95
|
| Rate for Payer: PHP Medicare Advantage |
$551.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,069.12
|
| Rate for Payer: Priority Health Medicare |
$551.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.12
|
| Rate for Payer: Railroad Medicare Medicare |
$551.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,023.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.95
|
| Rate for Payer: UHC Exchange |
$1,023.36
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP DNSP |
$551.95
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$623.89 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$863.30
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$733.80
|
| Rate for Payer: BCN Commercial |
$733.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$836.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$863.30
|
| Rate for Payer: Healthscope Whirlpool |
$890.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$801.00
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.50
|
| Rate for Payer: Nomi Health Commercial |
$729.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$779.82
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$623.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$667.50 |
| Max. Negotiated Rate |
$890.00 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: ASR ASR |
$863.30
|
| Rate for Payer: BCBS Trust/PPO |
$730.87
|
| Rate for Payer: BCN Commercial |
$730.87
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$836.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$863.30
|
| Rate for Payer: Healthscope Whirlpool |
$890.00
|
| Rate for Payer: Mclaren Commercial |
$801.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.50
|
| Rate for Payer: Nomi Health Commercial |
$729.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 49550
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,069.12 |
| Rate for Payer: Aetna Commercial |
$739.61
|
| Rate for Payer: Aetna Medicare |
$551.95
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$551.95
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$551.95
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$739.61
|
| Rate for Payer: Cofinity Commercial |
$794.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.95
|
| Rate for Payer: Healthscope Commercial |
$662.34
|
| Rate for Payer: Healthscope Whirlpool |
$662.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.55
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$607.14
|
| Rate for Payer: Nomi Health Commercial |
$662.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$551.95
|
| Rate for Payer: PHP Medicare Advantage |
$551.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,069.12
|
| Rate for Payer: Priority Health Medicare |
$551.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.12
|
| Rate for Payer: Railroad Medicare Medicare |
$551.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,023.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.95
|
| Rate for Payer: UHC Exchange |
$1,023.36
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP DNSP |
$551.95
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR RPR 1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 49561
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: BCBS Complete |
$924.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$752.01
|
| Rate for Payer: Aetna Medicare |
$561.20
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$561.20
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: BCN Medicare Advantage |
$561.20
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$808.13
|
| Rate for Payer: Cofinity Commercial |
$752.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.20
|
| Rate for Payer: Healthscope Commercial |
$673.44
|
| Rate for Payer: Healthscope Whirlpool |
$673.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.26
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.32
|
| Rate for Payer: Nomi Health Commercial |
$673.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$561.20
|
| Rate for Payer: PHP Medicare Advantage |
$561.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,085.49
|
| Rate for Payer: Priority Health Medicare |
$561.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.49
|
| Rate for Payer: Railroad Medicare Medicare |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.20
|
| Rate for Payer: UHC Exchange |
$1,040.78
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP DNSP |
$561.20
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
IP
|
$1,715.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,286.25 |
| Max. Negotiated Rate |
$1,715.00 |
| Rate for Payer: Aetna Commercial |
$1,543.50
|
| Rate for Payer: ASR ASR |
$1,663.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,408.36
|
| Rate for Payer: BCN Commercial |
$1,408.36
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,612.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.00
|
| Rate for Payer: Healthscope Commercial |
$1,663.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,715.00
|
| Rate for Payer: Mclaren Commercial |
$1,543.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.75
|
| Rate for Payer: Nomi Health Commercial |
$1,406.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
OP
|
$1,715.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,202.21 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$1,543.50
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,663.55
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.02
|
| Rate for Payer: BCN Commercial |
$1,414.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,612.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,663.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,715.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$1,543.50
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.75
|
| Rate for Payer: Nomi Health Commercial |
$1,406.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,502.68
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,202.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$752.01
|
| Rate for Payer: Aetna Medicare |
$561.20
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$561.20
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: BCN Medicare Advantage |
$561.20
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$808.13
|
| Rate for Payer: Cofinity Commercial |
$752.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.20
|
| Rate for Payer: Healthscope Commercial |
$673.44
|
| Rate for Payer: Healthscope Whirlpool |
$673.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.26
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.32
|
| Rate for Payer: Nomi Health Commercial |
$673.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$561.20
|
| Rate for Payer: PHP Medicare Advantage |
$561.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,085.49
|
| Rate for Payer: Priority Health Medicare |
$561.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.49
|
| Rate for Payer: Railroad Medicare Medicare |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.20
|
| Rate for Payer: UHC Exchange |
$1,040.78
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP DNSP |
$561.20
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$671.57
|
| Rate for Payer: Aetna Medicare |
$501.17
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$501.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: BCN Medicare Advantage |
$501.17
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$721.68
|
| Rate for Payer: Cofinity Commercial |
$671.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.17
|
| Rate for Payer: Healthscope Commercial |
$601.40
|
| Rate for Payer: Healthscope Whirlpool |
$601.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.23
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.29
|
| Rate for Payer: Nomi Health Commercial |
$601.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE SWMI |
$501.17
|
| Rate for Payer: PHP Medicare Advantage |
$501.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$967.17
|
| Rate for Payer: Priority Health Medicare |
$501.17
|
| Rate for Payer: Priority Health Narrow Network |
$967.17
|
| Rate for Payer: Railroad Medicare Medicare |
$501.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$924.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$501.17
|
| Rate for Payer: UHC Exchange |
$924.10
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP DNSP |
$501.17
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,304.25 |
| Max. Negotiated Rate |
$1,739.00 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: ASR ASR |
$1,686.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.07
|
| Rate for Payer: BCN Commercial |
$1,428.07
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,634.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,739.00
|
| Rate for Payer: Mclaren Commercial |
$1,565.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Nomi Health Commercial |
$1,425.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,739.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,304.25 |
| Max. Negotiated Rate |
$5,516.51 |
| Rate for Payer: Aetna Commercial |
$1,565.10
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,686.83
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.81
|
| Rate for Payer: BCN Commercial |
$1,433.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,634.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,391.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,739.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$1,565.10
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,478.15
|
| Rate for Payer: Nomi Health Commercial |
$1,425.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,516.51
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$4,413.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$671.57
|
| Rate for Payer: Aetna Medicare |
$501.17
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$501.17
|
| Rate for Payer: BCN Commercial |
$793.78
|
| Rate for Payer: BCN Medicare Advantage |
$501.17
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$721.68
|
| Rate for Payer: Cofinity Commercial |
$671.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.17
|
| Rate for Payer: Healthscope Commercial |
$601.40
|
| Rate for Payer: Healthscope Whirlpool |
$601.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.23
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$551.29
|
| Rate for Payer: Nomi Health Commercial |
$601.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE SWMI |
$501.17
|
| Rate for Payer: PHP Medicare Advantage |
$501.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$967.17
|
| Rate for Payer: Priority Health Medicare |
$501.17
|
| Rate for Payer: Priority Health Narrow Network |
$967.17
|
| Rate for Payer: Railroad Medicare Medicare |
$501.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$924.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$501.17
|
| Rate for Payer: UHC Exchange |
$924.10
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP DNSP |
$501.17
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$374.03 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$776.70
|
| Rate for Payer: Aetna Medicare |
$579.63
|
| Rate for Payer: BCBS Complete |
$392.73
|
| Rate for Payer: BCBS MAPPO |
$579.63
|
| Rate for Payer: BCN Commercial |
$920.77
|
| Rate for Payer: BCN Medicare Advantage |
$579.63
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$834.67
|
| Rate for Payer: Cofinity Commercial |
$776.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.63
|
| Rate for Payer: Healthscope Commercial |
$695.56
|
| Rate for Payer: Healthscope Whirlpool |
$695.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.61
|
| Rate for Payer: Meridian Medicaid |
$392.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.59
|
| Rate for Payer: Nomi Health Commercial |
$695.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$579.63
|
| Rate for Payer: PHP Medicare Advantage |
$579.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,121.90
|
| Rate for Payer: Priority Health Medicare |
$579.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,121.90
|
| Rate for Payer: Railroad Medicare Medicare |
$579.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,074.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.63
|
| Rate for Payer: UHC Exchange |
$1,074.97
|
| Rate for Payer: UHC Medicaid |
$374.03
|
| Rate for Payer: UHCCP DNSP |
$579.63
|
| Rate for Payer: UHCCP Medicaid |
$374.03
|
|
