|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$5,876.00
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$2,350.40 |
| Max. Negotiated Rate |
$4,216.51 |
| Rate for Payer: Aetna Commercial |
$3,923.69
|
| Rate for Payer: Aetna Medicare |
$2,928.13
|
| Rate for Payer: BCBS Complete |
$2,350.40
|
| Rate for Payer: BCBS MAPPO |
$2,928.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,928.13
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Cash Price |
$4,700.80
|
| Rate for Payer: Cofinity Commercial |
$4,216.51
|
| Rate for Payer: Cofinity Commercial |
$3,923.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,928.13
|
| Rate for Payer: Healthscope Commercial |
$3,513.76
|
| Rate for Payer: Healthscope Whirlpool |
$3,513.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,074.54
|
| Rate for Payer: Nomi Health Commercial |
$3,513.76
|
| Rate for Payer: PACE SWMI |
$2,928.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,928.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,819.40
|
| Rate for Payer: Priority Health Medicare |
$2,928.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,928.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,928.13
|
| Rate for Payer: UHCCP DNSP |
$2,928.13
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$1,951.00
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$467.38 |
| Max. Negotiated Rate |
$1,268.15 |
| Rate for Payer: Aetna Commercial |
$626.29
|
| Rate for Payer: Aetna Medicare |
$467.38
|
| Rate for Payer: BCBS Complete |
$780.40
|
| Rate for Payer: BCBS MAPPO |
$467.38
|
| Rate for Payer: BCN Medicare Advantage |
$467.38
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Cash Price |
$1,560.80
|
| Rate for Payer: Cofinity Commercial |
$673.03
|
| Rate for Payer: Cofinity Commercial |
$626.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.38
|
| Rate for Payer: Healthscope Commercial |
$560.86
|
| Rate for Payer: Healthscope Whirlpool |
$560.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.75
|
| Rate for Payer: Nomi Health Commercial |
$560.86
|
| Rate for Payer: PACE SWMI |
$467.38
|
| Rate for Payer: PHP Medicare Advantage |
$467.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,268.15
|
| Rate for Payer: Priority Health Medicare |
$467.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.38
|
| Rate for Payer: UHC Medicare Advantage |
$467.38
|
| Rate for Payer: UHCCP DNSP |
$467.38
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$418.40 |
| Max. Negotiated Rate |
$923.53 |
| Rate for Payer: Aetna Commercial |
$859.40
|
| Rate for Payer: Aetna Medicare |
$641.34
|
| Rate for Payer: BCBS Complete |
$418.40
|
| Rate for Payer: BCBS MAPPO |
$641.34
|
| Rate for Payer: BCN Medicare Advantage |
$641.34
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$923.53
|
| Rate for Payer: Cofinity Commercial |
$859.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.34
|
| Rate for Payer: Healthscope Commercial |
$769.61
|
| Rate for Payer: Healthscope Whirlpool |
$769.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.41
|
| Rate for Payer: Nomi Health Commercial |
$769.61
|
| Rate for Payer: PACE SWMI |
$641.34
|
| Rate for Payer: PHP Medicare Advantage |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.90
|
| Rate for Payer: Priority Health Medicare |
$641.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.34
|
| Rate for Payer: UHC Medicare Advantage |
$641.34
|
| Rate for Payer: UHCCP DNSP |
$641.34
|
|
|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$653.14 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$875.21
|
| Rate for Payer: Aetna Medicare |
$653.14
|
| Rate for Payer: BCBS Complete |
$761.20
|
| Rate for Payer: BCBS MAPPO |
$653.14
|
| Rate for Payer: BCN Medicare Advantage |
$653.14
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$940.52
|
| Rate for Payer: Cofinity Commercial |
$875.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.14
|
| Rate for Payer: Healthscope Commercial |
$783.77
|
| Rate for Payer: Healthscope Whirlpool |
$783.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.80
|
| Rate for Payer: Nomi Health Commercial |
$783.77
|
| Rate for Payer: PACE SWMI |
$653.14
|
| Rate for Payer: PHP Medicare Advantage |
$653.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health Medicare |
$653.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.14
|
| Rate for Payer: UHC Medicare Advantage |
$653.14
|
| Rate for Payer: UHCCP DNSP |
$653.14
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,906.00
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$527.31 |
| Max. Negotiated Rate |
$1,888.90 |
| Rate for Payer: Aetna Commercial |
$706.60
|
| Rate for Payer: Aetna Medicare |
$527.31
|
| Rate for Payer: BCBS Complete |
$1,162.40
|
| Rate for Payer: BCBS MAPPO |
$527.31
|
| Rate for Payer: BCN Medicare Advantage |
$527.31
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cash Price |
$2,324.80
|
| Rate for Payer: Cofinity Commercial |
$759.33
|
| Rate for Payer: Cofinity Commercial |
$706.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.31
|
| Rate for Payer: Healthscope Commercial |
$632.77
|
| Rate for Payer: Healthscope Whirlpool |
$632.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.68
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PACE SWMI |
$527.31
|
| Rate for Payer: PHP Medicare Advantage |
$527.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,888.90
|
| Rate for Payer: Priority Health Medicare |
$527.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.31
|
| Rate for Payer: UHC Medicare Advantage |
$527.31
|
| Rate for Payer: UHCCP DNSP |
$527.31
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$752.57 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$1,008.44
|
| Rate for Payer: Aetna Medicare |
$752.57
|
| Rate for Payer: BCBS Complete |
$872.40
|
| Rate for Payer: BCBS MAPPO |
$752.57
|
| Rate for Payer: BCN Medicare Advantage |
$752.57
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$1,083.70
|
| Rate for Payer: Cofinity Commercial |
$1,008.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.57
|
| Rate for Payer: Healthscope Commercial |
$903.08
|
| Rate for Payer: Healthscope Whirlpool |
$903.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.20
|
| Rate for Payer: Nomi Health Commercial |
$903.08
|
| Rate for Payer: PACE SWMI |
$752.57
|
| Rate for Payer: PHP Medicare Advantage |
$752.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health Medicare |
$752.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.57
|
| Rate for Payer: UHC Medicare Advantage |
$752.57
|
| Rate for Payer: UHCCP DNSP |
$752.57
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$849.30 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$589.79
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Healthscope Commercial |
$707.75
|
| Rate for Payer: Healthscope Whirlpool |
$707.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UHCCP DNSP |
$589.79
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Hospital Charge Code |
49555
|
| Min. Negotiated Rate |
$428.40 |
| Max. Negotiated Rate |
$849.30 |
| Rate for Payer: Aetna Commercial |
$790.32
|
| Rate for Payer: Aetna Medicare |
$589.79
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$589.79
|
| Rate for Payer: BCN Medicare Advantage |
$589.79
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$849.30
|
| Rate for Payer: Cofinity Commercial |
$790.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.79
|
| Rate for Payer: Healthscope Commercial |
$707.75
|
| Rate for Payer: Healthscope Whirlpool |
$707.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.28
|
| Rate for Payer: Nomi Health Commercial |
$707.75
|
| Rate for Payer: PACE SWMI |
$589.79
|
| Rate for Payer: PHP Medicare Advantage |
$589.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health Medicare |
$589.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.79
|
| Rate for Payer: UHC Medicare Advantage |
$589.79
|
| Rate for Payer: UHCCP DNSP |
$589.79
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$696.15 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,038.87
|
| Rate for Payer: ASR Commercial |
$1,038.87
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$877.04
|
| Rate for Payer: BCN Commercial |
$830.35
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$1,006.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$963.90
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: Nomi Health Commercial |
$878.22
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$938.41
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$750.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$696.15 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: ASR ASR |
$1,038.87
|
| Rate for Payer: ASR Commercial |
$1,038.87
|
| Rate for Payer: BCBS Trust/PPO |
$872.76
|
| Rate for Payer: BCN Commercial |
$830.35
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$1,006.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.87
|
| Rate for Payer: Mclaren Commercial |
$963.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: Nomi Health Commercial |
$878.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,481.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$592.40 |
| Max. Negotiated Rate |
$1,011.70 |
| Rate for Payer: Aetna Commercial |
$941.44
|
| Rate for Payer: Aetna Medicare |
$702.57
|
| Rate for Payer: BCBS Complete |
$592.40
|
| Rate for Payer: BCBS MAPPO |
$702.57
|
| Rate for Payer: BCN Medicare Advantage |
$702.57
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cofinity Commercial |
$941.44
|
| Rate for Payer: Cofinity Commercial |
$1,011.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.57
|
| Rate for Payer: Healthscope Commercial |
$843.08
|
| Rate for Payer: Healthscope Whirlpool |
$843.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.70
|
| Rate for Payer: Nomi Health Commercial |
$843.08
|
| Rate for Payer: PACE SWMI |
$702.57
|
| Rate for Payer: PHP Medicare Advantage |
$702.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.65
|
| Rate for Payer: Priority Health Medicare |
$702.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$702.57
|
| Rate for Payer: UHC Medicare Advantage |
$702.57
|
| Rate for Payer: UHCCP DNSP |
$702.57
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,118.65 |
| Max. Negotiated Rate |
$1,721.00 |
| Rate for Payer: Aetna Commercial |
$1,548.90
|
| Rate for Payer: ASR ASR |
$1,669.37
|
| Rate for Payer: ASR Commercial |
$1,669.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,402.44
|
| Rate for Payer: BCN Commercial |
$1,334.29
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Healthscope Commercial |
$1,721.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.37
|
| Rate for Payer: Mclaren Commercial |
$1,548.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: Nomi Health Commercial |
$1,411.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.48
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$617.11 |
| Max. Negotiated Rate |
$1,118.65 |
| Rate for Payer: Aetna Commercial |
$826.93
|
| Rate for Payer: Aetna Medicare |
$617.11
|
| Rate for Payer: BCBS Complete |
$688.40
|
| Rate for Payer: BCBS MAPPO |
$617.11
|
| Rate for Payer: BCN Medicare Advantage |
$617.11
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$888.64
|
| Rate for Payer: Cofinity Commercial |
$826.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.11
|
| Rate for Payer: Healthscope Commercial |
$740.53
|
| Rate for Payer: Healthscope Whirlpool |
$740.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.97
|
| Rate for Payer: Nomi Health Commercial |
$740.53
|
| Rate for Payer: PACE SWMI |
$617.11
|
| Rate for Payer: PHP Medicare Advantage |
$617.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health Medicare |
$617.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.11
|
| Rate for Payer: UHC Medicare Advantage |
$617.11
|
| Rate for Payer: UHCCP DNSP |
$617.11
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$617.11 |
| Max. Negotiated Rate |
$1,118.65 |
| Rate for Payer: Aetna Commercial |
$826.93
|
| Rate for Payer: Aetna Medicare |
$617.11
|
| Rate for Payer: BCBS Complete |
$688.40
|
| Rate for Payer: BCBS MAPPO |
$617.11
|
| Rate for Payer: BCN Medicare Advantage |
$617.11
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$888.64
|
| Rate for Payer: Cofinity Commercial |
$826.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.11
|
| Rate for Payer: Healthscope Commercial |
$740.53
|
| Rate for Payer: Healthscope Whirlpool |
$740.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.97
|
| Rate for Payer: Nomi Health Commercial |
$740.53
|
| Rate for Payer: PACE SWMI |
$617.11
|
| Rate for Payer: PHP Medicare Advantage |
$617.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health Medicare |
$617.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$617.11
|
| Rate for Payer: UHC Medicare Advantage |
$617.11
|
| Rate for Payer: UHCCP DNSP |
$617.11
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,118.65 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$1,548.90
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,669.37
|
| Rate for Payer: ASR Commercial |
$1,669.37
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.33
|
| Rate for Payer: BCN Commercial |
$1,334.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,721.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$1,548.90
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: Nomi Health Commercial |
$1,411.22
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,507.94
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,359.80 |
| Max. Negotiated Rate |
$2,092.00 |
| Rate for Payer: Aetna Commercial |
$1,882.80
|
| Rate for Payer: ASR ASR |
$2,029.24
|
| Rate for Payer: ASR Commercial |
$2,029.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.77
|
| Rate for Payer: BCN Commercial |
$1,621.93
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,966.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Healthscope Commercial |
$2,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,029.24
|
| Rate for Payer: Mclaren Commercial |
$1,882.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: Nomi Health Commercial |
$1,715.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.96
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$699.77 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$699.77
|
| Rate for Payer: BCBS Complete |
$836.80
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Healthscope Commercial |
$839.72
|
| Rate for Payer: Healthscope Whirlpool |
$839.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UHCCP DNSP |
$699.77
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$699.77 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$699.77
|
| Rate for Payer: BCBS Complete |
$836.80
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Healthscope Commercial |
$839.72
|
| Rate for Payer: Healthscope Whirlpool |
$839.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UHCCP DNSP |
$699.77
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,359.80 |
| Max. Negotiated Rate |
$9,432.52 |
| Rate for Payer: Aetna Commercial |
$1,882.80
|
| Rate for Payer: Aetna Medicare |
$6,085.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: ASR ASR |
$2,029.24
|
| Rate for Payer: ASR Commercial |
$2,029.24
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,713.14
|
| Rate for Payer: BCN Commercial |
$1,621.93
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,966.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$2,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,029.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,085.50
|
| Rate for Payer: Mclaren Commercial |
$1,882.80
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: Nomi Health Commercial |
$1,715.44
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$6,694.05
|
| Rate for Payer: PHP Medicaid |
$3,261.83
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,833.01
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.49
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Exchange |
$9,432.52
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP DNSP |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,261.83
|
| Rate for Payer: VA VA |
$6,085.50
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,469.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$1,256.66 |
| Max. Negotiated Rate |
$2,904.85 |
| Rate for Payer: Aetna Commercial |
$1,683.92
|
| Rate for Payer: Aetna Medicare |
$1,256.66
|
| Rate for Payer: BCBS Complete |
$1,787.60
|
| Rate for Payer: BCBS MAPPO |
$1,256.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.66
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,809.59
|
| Rate for Payer: Cofinity Commercial |
$1,683.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.66
|
| Rate for Payer: Healthscope Commercial |
$1,507.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,507.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.49
|
| Rate for Payer: Nomi Health Commercial |
$1,507.99
|
| Rate for Payer: PACE SWMI |
$1,256.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,904.85
|
| Rate for Payer: Priority Health Medicare |
$1,256.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.66
|
| Rate for Payer: UHCCP DNSP |
$1,256.66
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,229.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$1,291.60 |
| Max. Negotiated Rate |
$2,142.56 |
| Rate for Payer: Aetna Commercial |
$1,993.77
|
| Rate for Payer: Aetna Medicare |
$1,487.89
|
| Rate for Payer: BCBS Complete |
$1,291.60
|
| Rate for Payer: BCBS MAPPO |
$1,487.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,487.89
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cofinity Commercial |
$2,142.56
|
| Rate for Payer: Cofinity Commercial |
$1,993.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,487.89
|
| Rate for Payer: Healthscope Commercial |
$1,785.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,785.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,562.28
|
| Rate for Payer: Nomi Health Commercial |
$1,785.47
|
| Rate for Payer: PACE SWMI |
$1,487.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,487.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,098.85
|
| Rate for Payer: Priority Health Medicare |
$1,487.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,487.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,487.89
|
| Rate for Payer: UHCCP DNSP |
$1,487.89
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$716.18 |
| Max. Negotiated Rate |
$1,281.15 |
| Rate for Payer: Aetna Commercial |
$959.68
|
| Rate for Payer: Aetna Medicare |
$716.18
|
| Rate for Payer: BCBS Complete |
$788.40
|
| Rate for Payer: BCBS MAPPO |
$716.18
|
| Rate for Payer: BCN Medicare Advantage |
$716.18
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$959.68
|
| Rate for Payer: Cofinity Commercial |
$1,031.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.18
|
| Rate for Payer: Healthscope Commercial |
$859.42
|
| Rate for Payer: Healthscope Whirlpool |
$859.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.99
|
| Rate for Payer: Nomi Health Commercial |
$859.42
|
| Rate for Payer: PACE SWMI |
$716.18
|
| Rate for Payer: PHP Medicare Advantage |
$716.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health Medicare |
$716.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.18
|
| Rate for Payer: UHC Medicare Advantage |
$716.18
|
| Rate for Payer: UHCCP DNSP |
$716.18
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$650.40 |
| Max. Negotiated Rate |
$1,056.90 |
| Rate for Payer: Aetna Medicare |
$813.00
|
| Rate for Payer: BCBS Complete |
$650.40
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
|
