|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$133.27 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.74
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Healthscope Commercial |
$133.27
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.60
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,726.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$2,290.40 |
| Max. Negotiated Rate |
$4,386.57 |
| Rate for Payer: Aetna Commercial |
$3,177.30
|
| Rate for Payer: Aetna Medicare |
$2,465.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,414.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,177.30
|
| Rate for Payer: BCBS Complete |
$2,290.40
|
| Rate for Payer: BCBS MAPPO |
$2,371.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,371.12
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cofinity Commercial |
$3,414.41
|
| Rate for Payer: Cofinity Commercial |
$3,177.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,371.12
|
| Rate for Payer: Healthscope Commercial |
$3,793.79
|
| Rate for Payer: Healthscope Commercial |
$4,386.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,489.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,721.90
|
| Rate for Payer: Nomi Health Commercial |
$2,845.34
|
| Rate for Payer: PACE SWMI |
$2,371.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,371.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,721.90
|
| Rate for Payer: Priority Health Medicare |
$2,371.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,371.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,371.12
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,419.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,367.60 |
| Max. Negotiated Rate |
$3,551.45 |
| Rate for Payer: Aetna Commercial |
$2,572.40
|
| Rate for Payer: Aetna Medicare |
$1,996.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,764.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,572.40
|
| Rate for Payer: BCBS Complete |
$1,367.60
|
| Rate for Payer: BCBS MAPPO |
$1,919.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,919.70
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cofinity Commercial |
$2,764.37
|
| Rate for Payer: Cofinity Commercial |
$2,572.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,919.70
|
| Rate for Payer: Healthscope Commercial |
$3,551.45
|
| Rate for Payer: Healthscope Commercial |
$3,071.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,015.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,222.35
|
| Rate for Payer: Nomi Health Commercial |
$2,303.64
|
| Rate for Payer: PACE SWMI |
$1,919.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,919.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.35
|
| Rate for Payer: Priority Health Medicare |
$1,919.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,919.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,919.70
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,133.00
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$408.97 |
| Max. Negotiated Rate |
$2,686.45 |
| Rate for Payer: Aetna Commercial |
$548.02
|
| Rate for Payer: Aetna Medicare |
$425.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.02
|
| Rate for Payer: BCBS Complete |
$1,653.20
|
| Rate for Payer: BCBS MAPPO |
$408.97
|
| Rate for Payer: BCN Medicare Advantage |
$408.97
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cofinity Commercial |
$588.92
|
| Rate for Payer: Cofinity Commercial |
$548.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.97
|
| Rate for Payer: Healthscope Commercial |
$654.35
|
| Rate for Payer: Healthscope Commercial |
$756.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,686.45
|
| Rate for Payer: Nomi Health Commercial |
$490.76
|
| Rate for Payer: PACE SWMI |
$408.97
|
| Rate for Payer: PHP Medicare Advantage |
$408.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,686.45
|
| Rate for Payer: Priority Health Medicare |
$408.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.97
|
| Rate for Payer: UHC Medicare Advantage |
$408.97
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$2,236.00 |
| Rate for Payer: Aetna Commercial |
$207.42
|
| Rate for Payer: Aetna Medicare |
$160.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.42
|
| Rate for Payer: BCBS Complete |
$1,376.00
|
| Rate for Payer: BCBS MAPPO |
$154.79
|
| Rate for Payer: BCN Medicare Advantage |
$154.79
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$222.90
|
| Rate for Payer: Cofinity Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.79
|
| Rate for Payer: Healthscope Commercial |
$286.36
|
| Rate for Payer: Healthscope Commercial |
$247.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,236.00
|
| Rate for Payer: Nomi Health Commercial |
$185.75
|
| Rate for Payer: PACE SWMI |
$154.79
|
| Rate for Payer: PHP Medicare Advantage |
$154.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.00
|
| Rate for Payer: Priority Health Medicare |
$154.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.79
|
| Rate for Payer: UHC Medicare Advantage |
$154.79
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 99424
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$131.16 |
| Rate for Payer: Aetna Commercial |
$95.01
|
| Rate for Payer: Aetna Medicare |
$73.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.10
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$70.90
|
| Rate for Payer: BCN Medicare Advantage |
$70.90
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$95.01
|
| Rate for Payer: Cofinity Commercial |
$102.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.90
|
| Rate for Payer: Healthscope Commercial |
$113.44
|
| Rate for Payer: Healthscope Commercial |
$131.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.90
|
| Rate for Payer: Nomi Health Commercial |
$85.08
|
| Rate for Payer: PACE SWMI |
$70.90
|
| Rate for Payer: PHP Medicare Advantage |
$70.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Medicare |
$70.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.90
|
| Rate for Payer: UHC Medicare Advantage |
$70.90
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 99426
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$86.39 |
| Rate for Payer: Aetna Commercial |
$62.58
|
| Rate for Payer: Aetna Medicare |
$48.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.58
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCBS MAPPO |
$46.70
|
| Rate for Payer: BCN Medicare Advantage |
$46.70
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$67.25
|
| Rate for Payer: Cofinity Commercial |
$62.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.70
|
| Rate for Payer: Healthscope Commercial |
$86.39
|
| Rate for Payer: Healthscope Commercial |
$74.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE SWMI |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health Medicare |
$46.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.70
|
| Rate for Payer: UHC Medicare Advantage |
$46.70
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$33.62 |
| Max. Negotiated Rate |
$63.05 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.05
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$33.62
|
| Rate for Payer: BCN Medicare Advantage |
$33.62
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$48.41
|
| Rate for Payer: Cofinity Commercial |
$45.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.62
|
| Rate for Payer: Healthscope Commercial |
$53.79
|
| Rate for Payer: Healthscope Commercial |
$62.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.05
|
| Rate for Payer: Nomi Health Commercial |
$40.34
|
| Rate for Payer: PACE SWMI |
$33.62
|
| Rate for Payer: PHP Medicare Advantage |
$33.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health Medicare |
$33.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.62
|
| Rate for Payer: UHC Medicare Advantage |
$33.62
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$89.13 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$50.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.56
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Healthscope Commercial |
$89.13
|
| Rate for Payer: Healthscope Commercial |
$77.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.00
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.18
|
| Rate for Payer: UHC Medicare Advantage |
$48.18
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$219.04 |
| Rate for Payer: Aetna Commercial |
$158.66
|
| Rate for Payer: Aetna Medicare |
$123.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.66
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: BCBS MAPPO |
$118.40
|
| Rate for Payer: BCN Medicare Advantage |
$118.40
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$170.50
|
| Rate for Payer: Cofinity Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$189.44
|
| Rate for Payer: Healthscope Commercial |
$219.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.60
|
| Rate for Payer: Nomi Health Commercial |
$142.08
|
| Rate for Payer: PACE SWMI |
$118.40
|
| Rate for Payer: PHP Medicare Advantage |
$118.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.60
|
| Rate for Payer: Priority Health Medicare |
$118.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.40
|
| Rate for Payer: UHC Medicare Advantage |
$118.40
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$2.43
|
| Rate for Payer: Aetna Medicare |
$1.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.43
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$1.81
|
| Rate for Payer: BCN Medicare Advantage |
$1.81
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$2.61
|
| Rate for Payer: Cofinity Commercial |
$2.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.81
|
| Rate for Payer: Healthscope Commercial |
$3.35
|
| Rate for Payer: Healthscope Commercial |
$2.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: PACE SWMI |
$1.81
|
| Rate for Payer: PHP Medicare Advantage |
$1.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$1.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.81
|
| Rate for Payer: UHC Medicare Advantage |
$1.81
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,082.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$1,005.44 |
| Max. Negotiated Rate |
$2,003.30 |
| Rate for Payer: Aetna Commercial |
$1,347.29
|
| Rate for Payer: Aetna Medicare |
$1,045.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.29
|
| Rate for Payer: BCBS Complete |
$1,232.80
|
| Rate for Payer: BCBS MAPPO |
$1,005.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.44
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,447.83
|
| Rate for Payer: Cofinity Commercial |
$1,347.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.44
|
| Rate for Payer: Healthscope Commercial |
$1,608.70
|
| Rate for Payer: Healthscope Commercial |
$1,860.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,003.30
|
| Rate for Payer: Nomi Health Commercial |
$1,206.53
|
| Rate for Payer: PACE SWMI |
$1,005.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.30
|
| Rate for Payer: Priority Health Medicare |
$1,005.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.44
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,658.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$663.20 |
| Max. Negotiated Rate |
$1,668.18 |
| Rate for Payer: Aetna Commercial |
$1,208.30
|
| Rate for Payer: Aetna Medicare |
$937.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,298.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,208.30
|
| Rate for Payer: BCBS Complete |
$663.20
|
| Rate for Payer: BCBS MAPPO |
$901.72
|
| Rate for Payer: BCN Medicare Advantage |
$901.72
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cofinity Commercial |
$1,298.48
|
| Rate for Payer: Cofinity Commercial |
$1,208.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.72
|
| Rate for Payer: Healthscope Commercial |
$1,668.18
|
| Rate for Payer: Healthscope Commercial |
$1,442.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$946.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.70
|
| Rate for Payer: Nomi Health Commercial |
$1,082.06
|
| Rate for Payer: PACE SWMI |
$901.72
|
| Rate for Payer: PHP Medicare Advantage |
$901.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.70
|
| Rate for Payer: Priority Health Medicare |
$901.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.72
|
| Rate for Payer: UHC Medicare Advantage |
$901.72
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,690.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$1,391.49 |
| Max. Negotiated Rate |
$2,574.26 |
| Rate for Payer: Aetna Commercial |
$1,864.60
|
| Rate for Payer: Aetna Medicare |
$1,447.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,003.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,864.60
|
| Rate for Payer: BCBS Complete |
$1,476.00
|
| Rate for Payer: BCBS MAPPO |
$1,391.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.49
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Cofinity Commercial |
$2,003.75
|
| Rate for Payer: Cofinity Commercial |
$1,864.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.49
|
| Rate for Payer: Healthscope Commercial |
$2,226.38
|
| Rate for Payer: Healthscope Commercial |
$2,574.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,461.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,398.50
|
| Rate for Payer: Nomi Health Commercial |
$1,669.79
|
| Rate for Payer: PACE SWMI |
$1,391.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,398.50
|
| Rate for Payer: Priority Health Medicare |
$1,391.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,391.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,391.49
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$574.48 |
| Max. Negotiated Rate |
$1,096.55 |
| Rate for Payer: Aetna Commercial |
$769.80
|
| Rate for Payer: Aetna Medicare |
$597.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$827.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.80
|
| Rate for Payer: BCBS Complete |
$674.80
|
| Rate for Payer: BCBS MAPPO |
$574.48
|
| Rate for Payer: BCN Medicare Advantage |
$574.48
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$827.25
|
| Rate for Payer: Cofinity Commercial |
$769.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.48
|
| Rate for Payer: Healthscope Commercial |
$919.17
|
| Rate for Payer: Healthscope Commercial |
$1,062.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.55
|
| Rate for Payer: Nomi Health Commercial |
$689.38
|
| Rate for Payer: PACE SWMI |
$574.48
|
| Rate for Payer: PHP Medicare Advantage |
$574.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health Medicare |
$574.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.48
|
| Rate for Payer: UHC Medicare Advantage |
$574.48
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$456.00 |
| Max. Negotiated Rate |
$1,019.53 |
| Rate for Payer: Aetna Commercial |
$738.47
|
| Rate for Payer: Aetna Medicare |
$573.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.47
|
| Rate for Payer: BCBS Complete |
$456.00
|
| Rate for Payer: BCBS MAPPO |
$551.10
|
| Rate for Payer: BCN Medicare Advantage |
$551.10
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$793.58
|
| Rate for Payer: Cofinity Commercial |
$738.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.10
|
| Rate for Payer: Healthscope Commercial |
$1,019.53
|
| Rate for Payer: Healthscope Commercial |
$881.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.00
|
| Rate for Payer: Nomi Health Commercial |
$661.32
|
| Rate for Payer: PACE SWMI |
$551.10
|
| Rate for Payer: PHP Medicare Advantage |
$551.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health Medicare |
$551.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.10
|
| Rate for Payer: UHC Medicare Advantage |
$551.10
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$124.11 |
| Max. Negotiated Rate |
$177.30 |
| Rate for Payer: Aetna Commercial |
$167.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.05
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$137.90
|
| Rate for Payer: Cofinity Commercial |
$169.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.60
|
| Rate for Payer: Healthscope Commercial |
$177.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.45
|
| Rate for Payer: PHP Commercial |
$167.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health SBD |
$124.11
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$128.05 |
| Rate for Payer: Aetna Commercial |
$62.22
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS MAPPO |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$46.43
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$66.86
|
| Rate for Payer: Cofinity Commercial |
$62.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.43
|
| Rate for Payer: Healthscope Commercial |
$85.90
|
| Rate for Payer: Healthscope Commercial |
$74.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.05
|
| Rate for Payer: Nomi Health Commercial |
$55.72
|
| Rate for Payer: PACE SWMI |
$46.43
|
| Rate for Payer: PHP Medicare Advantage |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health Medicare |
$46.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.43
|
| Rate for Payer: UHC Medicare Advantage |
$46.43
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$128.05 |
| Rate for Payer: Aetna Commercial |
$62.22
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.86
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS MAPPO |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$46.43
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$62.22
|
| Rate for Payer: Cofinity Commercial |
$66.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.43
|
| Rate for Payer: Healthscope Commercial |
$85.90
|
| Rate for Payer: Healthscope Commercial |
$74.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.05
|
| Rate for Payer: Nomi Health Commercial |
$55.72
|
| Rate for Payer: PACE SWMI |
$46.43
|
| Rate for Payer: PHP Medicare Advantage |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health Medicare |
$46.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.43
|
| Rate for Payer: UHC Medicare Advantage |
$46.43
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$124.11 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$167.45
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$169.42
|
| Rate for Payer: Cofinity Commercial |
$137.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$177.30
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.45
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$167.45
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$124.11
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$500.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR PROCTOSGMDSC RIGID ABLATION LESION
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 45320
|
| Min. Negotiated Rate |
$102.57 |
| Max. Negotiated Rate |
$313.30 |
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Medicare |
$106.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.44
|
| Rate for Payer: BCBS Complete |
$192.80
|
| Rate for Payer: BCBS MAPPO |
$102.57
|
| Rate for Payer: BCN Medicare Advantage |
$102.57
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$147.70
|
| Rate for Payer: Cofinity Commercial |
$137.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.57
|
| Rate for Payer: Healthscope Commercial |
$164.11
|
| Rate for Payer: Healthscope Commercial |
$189.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.30
|
| Rate for Payer: Nomi Health Commercial |
$123.08
|
| Rate for Payer: PACE SWMI |
$102.57
|
| Rate for Payer: PHP Medicare Advantage |
$102.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health Medicare |
$102.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.57
|
| Rate for Payer: UHC Medicare Advantage |
$102.57
|
|
|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$105.76 |
| Max. Negotiated Rate |
$293.80 |
| Rate for Payer: Aetna Commercial |
$141.72
|
| Rate for Payer: Aetna Medicare |
$109.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.72
|
| Rate for Payer: BCBS Complete |
$180.80
|
| Rate for Payer: BCBS MAPPO |
$105.76
|
| Rate for Payer: BCN Medicare Advantage |
$105.76
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cofinity Commercial |
$152.29
|
| Rate for Payer: Cofinity Commercial |
$141.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.76
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Healthscope Commercial |
$169.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.80
|
| Rate for Payer: Nomi Health Commercial |
$126.91
|
| Rate for Payer: PACE SWMI |
$105.76
|
| Rate for Payer: PHP Medicare Advantage |
$105.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.80
|
| Rate for Payer: Priority Health Medicare |
$105.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.76
|
| Rate for Payer: UHC Medicare Advantage |
$105.76
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$100.92 |
| Max. Negotiated Rate |
$254.80 |
| Rate for Payer: Aetna Commercial |
$135.23
|
| Rate for Payer: Aetna Medicare |
$104.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.23
|
| Rate for Payer: BCBS Complete |
$156.80
|
| Rate for Payer: BCBS MAPPO |
$100.92
|
| Rate for Payer: BCN Medicare Advantage |
$100.92
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$145.32
|
| Rate for Payer: Cofinity Commercial |
$135.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.92
|
| Rate for Payer: Healthscope Commercial |
$161.47
|
| Rate for Payer: Healthscope Commercial |
$186.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.80
|
| Rate for Payer: Nomi Health Commercial |
$121.10
|
| Rate for Payer: PACE SWMI |
$100.92
|
| Rate for Payer: PHP Medicare Advantage |
$100.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health Medicare |
$100.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.92
|
| Rate for Payer: UHC Medicare Advantage |
$100.92
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$82.06 |
| Max. Negotiated Rate |
$202.15 |
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.96
|
| Rate for Payer: BCBS Complete |
$124.40
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$118.17
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$151.81
|
| Rate for Payer: Healthscope Commercial |
$131.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.15
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.15
|
| Rate for Payer: Priority Health Medicare |
$82.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.06
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$87.23 |
| Max. Negotiated Rate |
$245.05 |
| Rate for Payer: Aetna Commercial |
$116.89
|
| Rate for Payer: Aetna Medicare |
$90.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.89
|
| Rate for Payer: BCBS Complete |
$150.80
|
| Rate for Payer: BCBS MAPPO |
$87.23
|
| Rate for Payer: BCN Medicare Advantage |
$87.23
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Cofinity Commercial |
$116.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.23
|
| Rate for Payer: Healthscope Commercial |
$139.57
|
| Rate for Payer: Healthscope Commercial |
$161.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.05
|
| Rate for Payer: Nomi Health Commercial |
$104.68
|
| Rate for Payer: PACE SWMI |
$87.23
|
| Rate for Payer: PHP Medicare Advantage |
$87.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health Medicare |
$87.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.23
|
| Rate for Payer: UHC Medicare Advantage |
$87.23
|
|
