|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$381.06 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$790.43
|
| Rate for Payer: Aetna Medicare |
$832.50
|
| Rate for Payer: BCBS Complete |
$400.11
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$863.01
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Meridian Medicaid |
$400.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.13
|
| Rate for Payer: UHC Exchange |
$760.13
|
| Rate for Payer: UHCCP Medicaid |
$381.06
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$339.52 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$703.82
|
| Rate for Payer: Aetna Medicare |
$844.00
|
| Rate for Payer: BCBS Complete |
$356.50
|
| Rate for Payer: BCBS Trust/PPO |
$749.13
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Meridian Medicaid |
$356.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.81
|
| Rate for Payer: Priority Health Narrow Network |
$943.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$616.23
|
| Rate for Payer: UHC Exchange |
$616.23
|
| Rate for Payer: UHCCP Medicaid |
$339.52
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,097.20 |
| Max. Negotiated Rate |
$1,688.00 |
| Rate for Payer: Aetna Commercial |
$1,519.20
|
| Rate for Payer: ASR ASR |
$1,637.36
|
| Rate for Payer: ASR Commercial |
$1,637.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,375.55
|
| Rate for Payer: BCN Commercial |
$1,308.71
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,586.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Healthscope Commercial |
$1,688.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,637.36
|
| Rate for Payer: Mclaren Commercial |
$1,519.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: Nomi Health Commercial |
$1,384.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,485.44
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,097.20 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$1,519.20
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$1,637.36
|
| Rate for Payer: ASR Commercial |
$1,637.36
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,382.30
|
| Rate for Payer: BCN Commercial |
$1,308.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,586.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,688.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,637.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$1,519.20
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: Nomi Health Commercial |
$1,384.16
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,003.64
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$4,002.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,485.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$339.52 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$703.82
|
| Rate for Payer: Aetna Medicare |
$844.00
|
| Rate for Payer: BCBS Complete |
$356.50
|
| Rate for Payer: BCBS Trust/PPO |
$749.13
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Meridian Medicaid |
$356.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.81
|
| Rate for Payer: Priority Health Narrow Network |
$943.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$616.23
|
| Rate for Payer: UHC Exchange |
$616.23
|
| Rate for Payer: UHCCP Medicaid |
$339.52
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$393.84 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$818.16
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$413.53
|
| Rate for Payer: BCBS Trust/PPO |
$622.87
|
| Rate for Payer: BCN Commercial |
$890.86
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$413.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$715.79
|
| Rate for Payer: UHC Exchange |
$715.79
|
| Rate for Payer: UHCCP Medicaid |
$393.84
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$270.94 |
| Max. Negotiated Rate |
$885.30 |
| Rate for Payer: Aetna Commercial |
$557.36
|
| Rate for Payer: Aetna Medicare |
$681.00
|
| Rate for Payer: BCBS Complete |
$284.49
|
| Rate for Payer: BCBS Trust/PPO |
$542.04
|
| Rate for Payer: BCN Commercial |
$612.31
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Meridian Medicaid |
$284.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.09
|
| Rate for Payer: Priority Health Narrow Network |
$754.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$474.66
|
| Rate for Payer: UHC Exchange |
$474.66
|
| Rate for Payer: UHCCP Medicaid |
$270.94
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,799.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$399.59 |
| Max. Negotiated Rate |
$1,169.35 |
| Rate for Payer: Aetna Commercial |
$828.71
|
| Rate for Payer: Aetna Medicare |
$899.50
|
| Rate for Payer: BCBS Complete |
$419.57
|
| Rate for Payer: BCBS Trust/PPO |
$704.75
|
| Rate for Payer: BCN Commercial |
$903.08
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Meridian Medicaid |
$419.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$731.43
|
| Rate for Payer: UHC Exchange |
$731.43
|
| Rate for Payer: UHCCP Medicaid |
$399.59
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,514.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$984.10 |
| Rate for Payer: Aetna Commercial |
$551.37
|
| Rate for Payer: Aetna Medicare |
$757.00
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS Trust/PPO |
$878.03
|
| Rate for Payer: BCN Commercial |
$601.07
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.58
|
| Rate for Payer: Priority Health Narrow Network |
$738.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.40
|
| Rate for Payer: UHC Exchange |
$477.40
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$619.62 |
| Max. Negotiated Rate |
$1,725.95 |
| Rate for Payer: Aetna Commercial |
$1,296.36
|
| Rate for Payer: Aetna Medicare |
$949.50
|
| Rate for Payer: BCBS Complete |
$650.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.07
|
| Rate for Payer: BCN Commercial |
$1,404.95
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Meridian Medicaid |
$650.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,725.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,725.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,124.19
|
| Rate for Payer: UHC Exchange |
$1,124.19
|
| Rate for Payer: UHCCP Medicaid |
$619.62
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$201.81 |
| Max. Negotiated Rate |
$1,437.79 |
| Rate for Payer: Aetna Commercial |
$1,077.26
|
| Rate for Payer: Aetna Medicare |
$832.50
|
| Rate for Payer: BCBS Complete |
$542.13
|
| Rate for Payer: BCBS Trust/PPO |
$201.81
|
| Rate for Payer: BCN Commercial |
$1,170.87
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Meridian Medicaid |
$542.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,437.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,437.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.06
|
| Rate for Payer: UHC Exchange |
$940.06
|
| Rate for Payer: UHCCP Medicaid |
$516.31
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,302.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$1,067.17 |
| Rate for Payer: Aetna Commercial |
$519.92
|
| Rate for Payer: Aetna Medicare |
$651.00
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.17
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.66
|
| Rate for Payer: Priority Health Narrow Network |
$612.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.29
|
| Rate for Payer: UHC Exchange |
$523.29
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,215.62 |
| Rate for Payer: Aetna Commercial |
$504.08
|
| Rate for Payer: Aetna Medicare |
$666.00
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,215.62
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.84
|
| Rate for Payer: Priority Health Narrow Network |
$598.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.80
|
| Rate for Payer: UHC Exchange |
$528.80
|
| Rate for Payer: UHCCP Medicaid |
$240.90
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$657.74 |
| Max. Negotiated Rate |
$1,865.43 |
| Rate for Payer: Aetna Commercial |
$1,380.43
|
| Rate for Payer: Aetna Medicare |
$782.50
|
| Rate for Payer: BCBS Complete |
$690.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,865.43
|
| Rate for Payer: BCN Commercial |
$1,490.47
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Meridian Medicaid |
$690.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,825.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,825.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,409.65
|
| Rate for Payer: UHC Exchange |
$1,409.65
|
| Rate for Payer: UHCCP Medicaid |
$657.74
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$495.44 |
| Max. Negotiated Rate |
$1,376.34 |
| Rate for Payer: Aetna Commercial |
$1,039.20
|
| Rate for Payer: Aetna Medicare |
$793.00
|
| Rate for Payer: BCBS Complete |
$520.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.98
|
| Rate for Payer: BCN Commercial |
$1,122.50
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Meridian Medicaid |
$520.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,376.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,376.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,061.48
|
| Rate for Payer: UHC Exchange |
$1,061.48
|
| Rate for Payer: UHCCP Medicaid |
$495.44
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,855.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,205.75 |
| Max. Negotiated Rate |
$1,855.00 |
| Rate for Payer: Aetna Commercial |
$1,669.50
|
| Rate for Payer: ASR ASR |
$1,799.35
|
| Rate for Payer: ASR Commercial |
$1,799.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,511.64
|
| Rate for Payer: BCN Commercial |
$1,438.18
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$1,743.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.00
|
| Rate for Payer: Healthscope Commercial |
$1,855.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.35
|
| Rate for Payer: Mclaren Commercial |
$1,669.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.75
|
| Rate for Payer: Nomi Health Commercial |
$1,521.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,632.40
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,855.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,205.75 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$1,669.50
|
| Rate for Payer: Aetna Medicare |
$5,716.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: ASR ASR |
$1,799.35
|
| Rate for Payer: ASR Commercial |
$1,799.35
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,519.06
|
| Rate for Payer: BCN Commercial |
$1,438.18
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$1,743.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,855.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$1,669.50
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.75
|
| Rate for Payer: Nomi Health Commercial |
$1,521.10
|
| 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 |
$1,205.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,625.35
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.36
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,632.40
|
| 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 RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$477.97 |
| Max. Negotiated Rate |
$2,889.80 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: Aetna Medicare |
$927.50
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.80
|
| Rate for Payer: BCN Commercial |
$1,087.31
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,331.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,028.48
|
| Rate for Payer: UHC Exchange |
$1,028.48
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
49594
|
| Min. Negotiated Rate |
$477.97 |
| Max. Negotiated Rate |
$2,889.80 |
| Rate for Payer: Aetna Commercial |
$1,006.93
|
| Rate for Payer: Aetna Medicare |
$927.50
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.80
|
| Rate for Payer: BCN Commercial |
$1,087.31
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,331.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,028.48
|
| Rate for Payer: UHC Exchange |
$1,028.48
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,423.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$924.95 |
| Max. Negotiated Rate |
$9,476.05 |
| Rate for Payer: Aetna Commercial |
$1,280.70
|
| Rate for Payer: Aetna Medicare |
$6,113.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: ASR ASR |
$1,380.31
|
| Rate for Payer: ASR Commercial |
$1,380.31
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,165.29
|
| Rate for Payer: BCN Commercial |
$1,103.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,337.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$1,423.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,380.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$1,280.70
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: Nomi Health Commercial |
$1,166.86
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$6,724.94
|
| Rate for Payer: PHP Medicaid |
$3,276.88
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,246.83
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$997.52
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,252.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Exchange |
$9,476.05
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP DNSP |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,276.88
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$2,206.18 |
| Rate for Payer: Aetna Commercial |
$772.74
|
| Rate for Payer: Aetna Medicare |
$711.50
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,206.18
|
| Rate for Payer: BCN Commercial |
$835.15
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$789.56
|
| Rate for Payer: UHC Exchange |
$789.56
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 49593
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$2,206.18 |
| Rate for Payer: Aetna Commercial |
$772.74
|
| Rate for Payer: Aetna Medicare |
$711.50
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,206.18
|
| Rate for Payer: BCN Commercial |
$835.15
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$789.56
|
| Rate for Payer: UHC Exchange |
$789.56
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,423.00
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
49593
|
| Min. Negotiated Rate |
$924.95 |
| Max. Negotiated Rate |
$1,423.00 |
| Rate for Payer: Aetna Commercial |
$1,280.70
|
| Rate for Payer: ASR ASR |
$1,380.31
|
| Rate for Payer: ASR Commercial |
$1,380.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.60
|
| Rate for Payer: BCN Commercial |
$1,103.25
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,337.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Healthscope Commercial |
$1,423.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,380.31
|
| Rate for Payer: Mclaren Commercial |
$1,280.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: Nomi Health Commercial |
$1,166.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,252.24
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$2,151.77 |
| Rate for Payer: Aetna Commercial |
$641.53
|
| Rate for Payer: Aetna Medicare |
$591.00
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.77
|
| Rate for Payer: BCN Commercial |
$693.44
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$849.54
|
| Rate for Payer: Priority Health Narrow Network |
$849.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.60
|
| Rate for Payer: UHC Exchange |
$655.60
|
| Rate for Payer: UHCCP Medicaid |
$305.44
|
|
|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$768.30 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$1,063.80
|
| 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 |
$1,146.54
|
| Rate for Payer: ASR Commercial |
$1,146.54
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$967.94
|
| Rate for Payer: BCN Commercial |
$916.40
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,111.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,182.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,146.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$1,063.80
|
| 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 |
$1,004.70
|
| Rate for Payer: Nomi Health Commercial |
$969.24
|
| 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 |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,035.67
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$828.58
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.16
|
| 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
|
|
