|
PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 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
|
IP
|
$1,182.00
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
49592
|
| Min. Negotiated Rate |
$768.30 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: Aetna Commercial |
$1,063.80
|
| Rate for Payer: ASR ASR |
$1,146.54
|
| Rate for Payer: ASR Commercial |
$1,146.54
|
| Rate for Payer: BCBS Trust/PPO |
$963.21
|
| Rate for Payer: BCN Commercial |
$916.40
|
| 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: Healthscope Commercial |
$1,182.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,146.54
|
| Rate for Payer: Mclaren Commercial |
$1,063.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,004.70
|
| Rate for Payer: Nomi Health Commercial |
$969.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.16
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
OP
|
$869.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$564.85 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$782.10
|
| 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 |
$842.93
|
| Rate for Payer: ASR Commercial |
$842.93
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$711.62
|
| Rate for Payer: BCN Commercial |
$673.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$816.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$869.00
|
| Rate for Payer: Healthscope Whirlpool |
$842.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$782.10
|
| 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 |
$738.65
|
| Rate for Payer: Nomi Health Commercial |
$712.58
|
| 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 |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$761.42
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$609.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.72
|
| 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 AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 49591
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$460.31
|
| Rate for Payer: Aetna Medicare |
$434.50
|
| Rate for Payer: BCBS Complete |
$230.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Meridian Medicaid |
$230.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.51
|
| Rate for Payer: Priority Health Narrow Network |
$611.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.79
|
| Rate for Payer: UHC Exchange |
$470.79
|
| Rate for Payer: UHCCP Medicaid |
$219.60
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$1,842.18 |
| Rate for Payer: Aetna Commercial |
$460.31
|
| Rate for Payer: Aetna Medicare |
$434.50
|
| Rate for Payer: BCBS Complete |
$230.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.18
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Meridian Medicaid |
$230.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.51
|
| Rate for Payer: Priority Health Narrow Network |
$611.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.79
|
| Rate for Payer: UHC Exchange |
$470.79
|
| Rate for Payer: UHCCP Medicaid |
$219.60
|
|
|
PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
IP
|
$869.00
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
49591
|
| Min. Negotiated Rate |
$564.85 |
| Max. Negotiated Rate |
$869.00 |
| Rate for Payer: Aetna Commercial |
$782.10
|
| Rate for Payer: ASR ASR |
$842.93
|
| Rate for Payer: ASR Commercial |
$842.93
|
| Rate for Payer: BCBS Trust/PPO |
$708.15
|
| Rate for Payer: BCN Commercial |
$673.74
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$816.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Healthscope Commercial |
$869.00
|
| Rate for Payer: Healthscope Whirlpool |
$842.93
|
| Rate for Payer: Mclaren Commercial |
$782.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.65
|
| Rate for Payer: Nomi Health Commercial |
$712.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.72
|
|
|
PR RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$3,161.00
|
|
|
Service Code
|
HCPCS 49618
|
| Min. Negotiated Rate |
$797.26 |
| Max. Negotiated Rate |
$2,982.78 |
| Rate for Payer: Aetna Commercial |
$1,673.34
|
| Rate for Payer: Aetna Medicare |
$1,580.50
|
| Rate for Payer: BCBS Complete |
$837.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,982.78
|
| Rate for Payer: BCN Commercial |
$1,806.16
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Meridian Medicaid |
$837.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,054.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,212.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,212.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,708.56
|
| Rate for Payer: UHC Exchange |
$1,708.56
|
| Rate for Payer: UHCCP Medicaid |
$797.26
|
|
|
PR RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,848.00
|
|
|
Service Code
|
HCPCS 49617
|
| Min. Negotiated Rate |
$569.14 |
| Max. Negotiated Rate |
$1,579.18 |
| Rate for Payer: Aetna Commercial |
$1,193.22
|
| Rate for Payer: Aetna Medicare |
$924.00
|
| Rate for Payer: BCBS Complete |
$597.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.13
|
| Rate for Payer: BCN Commercial |
$1,289.14
|
| Rate for Payer: Cash Price |
$1,478.40
|
| Rate for Payer: Cash Price |
$1,478.40
|
| Rate for Payer: Meridian Medicaid |
$597.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,579.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,579.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,218.84
|
| Rate for Payer: UHC Exchange |
$1,218.84
|
| Rate for Payer: UHCCP Medicaid |
$569.14
|
|
|
PR RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 49616
|
| Min. Negotiated Rate |
$549.97 |
| Max. Negotiated Rate |
$1,532.66 |
| Rate for Payer: Aetna Commercial |
$1,159.17
|
| Rate for Payer: Aetna Medicare |
$875.50
|
| Rate for Payer: BCBS Complete |
$577.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.07
|
| Rate for Payer: BCN Commercial |
$1,251.51
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Meridian Medicaid |
$577.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,183.85
|
| Rate for Payer: UHC Exchange |
$1,183.85
|
| Rate for Payer: UHCCP Medicaid |
$549.97
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,589.00
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$1,032.85 |
| Max. Negotiated Rate |
$9,476.05 |
| Rate for Payer: Aetna Commercial |
$1,430.10
|
| 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 |
$1,541.33
|
| Rate for Payer: ASR Commercial |
$1,541.33
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.23
|
| Rate for Payer: BCN Commercial |
$1,231.95
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,493.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$1,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,541.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$1,430.10
|
| 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 |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| 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 |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.28
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.89
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,398.32
|
| 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 RECR 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,589.00
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$1,032.85 |
| Max. Negotiated Rate |
$1,589.00 |
| Rate for Payer: Aetna Commercial |
$1,430.10
|
| Rate for Payer: ASR ASR |
$1,541.33
|
| Rate for Payer: ASR Commercial |
$1,541.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.88
|
| Rate for Payer: BCN Commercial |
$1,231.95
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,493.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Healthscope Commercial |
$1,589.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,541.33
|
| Rate for Payer: Mclaren Commercial |
$1,430.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$1,302.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,398.32
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$862.33
|
| Rate for Payer: Aetna Medicare |
$794.50
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$881.08
|
| Rate for Payer: UHC Exchange |
$881.08
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$862.33
|
| Rate for Payer: Aetna Medicare |
$794.50
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$881.08
|
| Rate for Payer: UHC Exchange |
$881.08
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$771.03
|
| Rate for Payer: Aetna Medicare |
$582.50
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$787.78
|
| Rate for Payer: UHC Exchange |
$787.78
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$757.25 |
| Max. Negotiated Rate |
$1,165.00 |
| Rate for Payer: Aetna Commercial |
$1,048.50
|
| Rate for Payer: ASR ASR |
$1,130.05
|
| Rate for Payer: ASR Commercial |
$1,130.05
|
| Rate for Payer: BCBS Trust/PPO |
$949.36
|
| Rate for Payer: BCN Commercial |
$903.22
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,095.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Healthscope Commercial |
$1,165.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,130.05
|
| Rate for Payer: Mclaren Commercial |
$1,048.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.25
|
| Rate for Payer: Nomi Health Commercial |
$955.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.20
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$771.03
|
| Rate for Payer: Aetna Medicare |
$582.50
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$787.78
|
| Rate for Payer: UHC Exchange |
$787.78
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$757.25 |
| Max. Negotiated Rate |
$8,860.40 |
| Rate for Payer: Aetna Commercial |
$1,048.50
|
| 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 |
$1,130.05
|
| Rate for Payer: ASR Commercial |
$1,130.05
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$954.02
|
| Rate for Payer: BCN Commercial |
$903.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,095.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,165.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,130.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,716.39
|
| Rate for Payer: Mclaren Commercial |
$1,048.50
|
| 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 |
$990.25
|
| Rate for Payer: Nomi Health Commercial |
$955.30
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$6,288.03
|
| Rate for Payer: PHP Medicaid |
$3,063.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.77
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$816.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$8,860.40
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP DNSP |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Professional
|
Both
|
$857.00
|
|
|
Service Code
|
HCPCS 49613
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$2,199.84 |
| Rate for Payer: Aetna Commercial |
$567.44
|
| Rate for Payer: Aetna Medicare |
$428.50
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,199.84
|
| Rate for Payer: BCN Commercial |
$614.26
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.50
|
| Rate for Payer: Priority Health Narrow Network |
$753.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.21
|
| Rate for Payer: UHC Exchange |
$580.21
|
| Rate for Payer: UHCCP Medicaid |
$270.08
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 35190
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,185.44 |
| Rate for Payer: Aetna Commercial |
$1,022.68
|
| Rate for Payer: Aetna Medicare |
$770.50
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS Trust/PPO |
$706.87
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,185.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,185.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$994.24
|
| Rate for Payer: UHC Exchange |
$994.24
|
| Rate for Payer: UHCCP Medicaid |
$474.14
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,240.00
|
|
|
Service Code
|
HCPCS 35188
|
| Min. Negotiated Rate |
$836.88 |
| Max. Negotiated Rate |
$2,756.00 |
| Rate for Payer: Aetna Commercial |
$1,718.98
|
| Rate for Payer: Aetna Medicare |
$2,120.00
|
| Rate for Payer: BCBS Complete |
$878.72
|
| Rate for Payer: BCBS Trust/PPO |
$933.51
|
| Rate for Payer: BCN Commercial |
$1,893.13
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Meridian Medicaid |
$878.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,080.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,080.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,136.79
|
| Rate for Payer: UHC Exchange |
$1,136.79
|
| Rate for Payer: UHCCP Medicaid |
$836.88
|
|
|
PR RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26350
|
| Min. Negotiated Rate |
$329.13 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Commercial |
$986.19
|
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS Trust/PPO |
$329.13
|
| Rate for Payer: BCN Commercial |
$1,111.25
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.08
|
| Rate for Payer: UHC Exchange |
$781.08
|
| Rate for Payer: UHCCP Medicaid |
$481.17
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$641.34 |
| Max. Negotiated Rate |
$1,760.85 |
| Rate for Payer: Aetna Commercial |
$1,314.43
|
| Rate for Payer: Aetna Medicare |
$1,354.50
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,522.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,018.21
|
| Rate for Payer: UHC Exchange |
$1,018.21
|
| Rate for Payer: UHCCP Medicaid |
$641.34
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 26356
|
| Min. Negotiated Rate |
$521.21 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$1,057.09
|
| Rate for Payer: Aetna Medicare |
$1,328.50
|
| Rate for Payer: BCBS Complete |
$547.27
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$1,176.25
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Meridian Medicaid |
$547.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,192.14
|
| Rate for Payer: UHC Exchange |
$1,192.14
|
| Rate for Payer: UHCCP Medicaid |
$521.21
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 26357
|
| Min. Negotiated Rate |
$511.92 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,188.68
|
| Rate for Payer: Aetna Medicare |
$1,387.50
|
| Rate for Payer: BCBS Complete |
$611.24
|
| Rate for Payer: BCBS Trust/PPO |
$511.92
|
| Rate for Payer: BCN Commercial |
$1,316.50
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Meridian Medicaid |
$611.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$960.92
|
| Rate for Payer: UHC Exchange |
$960.92
|
| Rate for Payer: UHCCP Medicaid |
$582.13
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 26370
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$1,045.85
|
| Rate for Payer: Aetna Medicare |
$1,170.00
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS Trust/PPO |
$732.75
|
| Rate for Payer: BCN Commercial |
$1,166.96
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,210.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,210.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$845.51
|
| Rate for Payer: UHC Exchange |
$845.51
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
|
