|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$532.35 |
| Rate for Payer: Aetna Medicare |
$409.50
|
| Rate for Payer: BCBS Complete |
$327.60
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$22,140.00 |
| Rate for Payer: Aetna Commercial |
$159.47
|
| Rate for Payer: Aetna Medicare |
$123.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.37
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$119.01
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$119.01
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$159.47
|
| Rate for Payer: Cofinity Commercial |
$171.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.01
|
| Rate for Payer: Healthscope Commercial |
$190.42
|
| Rate for Payer: Healthscope Commercial |
$220.17
|
| Rate for Payer: Mclaren Medicaid |
$79.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.96
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,140.00
|
| Rate for Payer: Nomi Health Commercial |
$142.81
|
| Rate for Payer: PACE SWMI |
$119.01
|
| Rate for Payer: PHP Medicare Advantage |
$119.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.13
|
| Rate for Payer: Priority Health Medicare |
$119.01
|
| Rate for Payer: Priority Health Narrow Network |
$198.13
|
| Rate for Payer: Priority Health SBD |
$198.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.01
|
| Rate for Payer: UHC Exchange |
$182.90
|
| Rate for Payer: UHC Medicare Advantage |
$119.01
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$134,802.00 |
| Rate for Payer: Aetna Commercial |
$982.61
|
| Rate for Payer: Aetna Medicare |
$762.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.61
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$733.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.99
|
| Rate for Payer: BCN Commercial |
$1,101.48
|
| Rate for Payer: BCN Medicare Advantage |
$733.29
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$982.61
|
| Rate for Payer: Cofinity Commercial |
$1,055.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.29
|
| Rate for Payer: Healthscope Commercial |
$1,356.59
|
| Rate for Payer: Healthscope Commercial |
$1,173.26
|
| Rate for Payer: Mclaren Medicaid |
$486.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.95
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,802.00
|
| Rate for Payer: Nomi Health Commercial |
$879.95
|
| Rate for Payer: PACE SWMI |
$733.29
|
| Rate for Payer: PHP Medicare Advantage |
$733.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,104.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.54
|
| Rate for Payer: Priority Health Medicare |
$733.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.54
|
| Rate for Payer: Priority Health SBD |
$1,209.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.29
|
| Rate for Payer: UHC Exchange |
$850.00
|
| Rate for Payer: UHC Medicare Advantage |
$733.29
|
| Rate for Payer: UHCCP Medicaid |
$486.71
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$185.74 |
| Max. Negotiated Rate |
$51,498.00 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: Aetna Medicare |
$289.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.37
|
| Rate for Payer: BCBS Complete |
$195.03
|
| Rate for Payer: BCBS MAPPO |
$278.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.82
|
| Rate for Payer: BCN Commercial |
$522.88
|
| Rate for Payer: BCN Medicare Advantage |
$278.73
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$401.37
|
| Rate for Payer: Cofinity Commercial |
$373.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.73
|
| Rate for Payer: Healthscope Commercial |
$515.65
|
| Rate for Payer: Healthscope Commercial |
$445.97
|
| Rate for Payer: Mclaren Medicaid |
$185.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.67
|
| Rate for Payer: Meridian Medicaid |
$195.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,498.00
|
| Rate for Payer: Nomi Health Commercial |
$334.48
|
| Rate for Payer: PACE SWMI |
$278.73
|
| Rate for Payer: PHP Medicare Advantage |
$278.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.23
|
| Rate for Payer: Priority Health Medicare |
$278.73
|
| Rate for Payer: Priority Health Narrow Network |
$461.23
|
| Rate for Payer: Priority Health SBD |
$461.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.73
|
| Rate for Payer: UHC Exchange |
$431.79
|
| Rate for Payer: UHC Medicare Advantage |
$278.73
|
| Rate for Payer: UHCCP Medicaid |
$185.74
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$452.20 |
| Max. Negotiated Rate |
$132,070.00 |
| Rate for Payer: Aetna Commercial |
$902.37
|
| Rate for Payer: Aetna Medicare |
$700.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.71
|
| Rate for Payer: BCBS Complete |
$474.81
|
| Rate for Payer: BCBS MAPPO |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.57
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: BCN Medicare Advantage |
$673.41
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$969.71
|
| Rate for Payer: Cofinity Commercial |
$902.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.41
|
| Rate for Payer: Healthscope Commercial |
$1,245.81
|
| Rate for Payer: Healthscope Commercial |
$1,077.46
|
| Rate for Payer: Mclaren Medicaid |
$452.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.08
|
| Rate for Payer: Meridian Medicaid |
$474.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,070.00
|
| Rate for Payer: Nomi Health Commercial |
$808.09
|
| Rate for Payer: PACE SWMI |
$673.41
|
| Rate for Payer: PHP Medicare Advantage |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,124.32
|
| Rate for Payer: Priority Health Medicare |
$673.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.32
|
| Rate for Payer: Priority Health SBD |
$1,124.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.41
|
| Rate for Payer: UHC Exchange |
$873.52
|
| Rate for Payer: UHC Medicare Advantage |
$673.41
|
| Rate for Payer: UHCCP Medicaid |
$452.20
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$59,670.00 |
| Rate for Payer: Aetna Commercial |
$434.24
|
| Rate for Payer: Aetna Medicare |
$337.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.65
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$324.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.40
|
| Rate for Payer: BCN Commercial |
$595.70
|
| Rate for Payer: BCN Medicare Advantage |
$324.06
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cofinity Commercial |
$466.65
|
| Rate for Payer: Cofinity Commercial |
$434.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.06
|
| Rate for Payer: Healthscope Commercial |
$599.51
|
| Rate for Payer: Healthscope Commercial |
$518.50
|
| Rate for Payer: Mclaren Medicaid |
$215.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.26
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,670.00
|
| Rate for Payer: Nomi Health Commercial |
$388.87
|
| Rate for Payer: PACE SWMI |
$324.06
|
| Rate for Payer: PHP Medicare Advantage |
$324.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.26
|
| Rate for Payer: Priority Health Medicare |
$324.06
|
| Rate for Payer: Priority Health Narrow Network |
$535.26
|
| Rate for Payer: Priority Health SBD |
$535.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.06
|
| Rate for Payer: UHC Exchange |
$1,034.95
|
| Rate for Payer: UHC Medicare Advantage |
$324.06
|
| Rate for Payer: UHCCP Medicaid |
$215.77
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$60,451.00 |
| Rate for Payer: Aetna Commercial |
$439.32
|
| Rate for Payer: Aetna Medicare |
$340.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.10
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$327.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.46
|
| Rate for Payer: BCN Commercial |
$606.45
|
| Rate for Payer: BCN Medicare Advantage |
$327.85
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$472.10
|
| Rate for Payer: Cofinity Commercial |
$439.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.85
|
| Rate for Payer: Healthscope Commercial |
$606.52
|
| Rate for Payer: Healthscope Commercial |
$524.56
|
| Rate for Payer: Mclaren Medicaid |
$218.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.24
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,451.00
|
| Rate for Payer: Nomi Health Commercial |
$393.42
|
| Rate for Payer: PACE SWMI |
$327.85
|
| Rate for Payer: PHP Medicare Advantage |
$327.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.19
|
| Rate for Payer: Priority Health Medicare |
$327.85
|
| Rate for Payer: Priority Health Narrow Network |
$542.19
|
| Rate for Payer: Priority Health SBD |
$542.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.85
|
| Rate for Payer: UHC Exchange |
$1,073.35
|
| Rate for Payer: UHC Medicare Advantage |
$327.85
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$908.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$68,935.00 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$388.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.16
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCBS Trust/PPO |
$287.92
|
| Rate for Payer: BCN Commercial |
$687.57
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Healthscope Commercial |
$691.38
|
| Rate for Payer: Healthscope Commercial |
$597.95
|
| Rate for Payer: Mclaren Medicaid |
$248.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,935.00
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.41
|
| Rate for Payer: Priority Health Medicare |
$373.72
|
| Rate for Payer: Priority Health Narrow Network |
$619.41
|
| Rate for Payer: Priority Health SBD |
$619.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Exchange |
$1,021.10
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$55,039.00 |
| Rate for Payer: Aetna Commercial |
$398.76
|
| Rate for Payer: Aetna Medicare |
$309.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.52
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$297.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,834.93
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$297.58
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$428.52
|
| Rate for Payer: Cofinity Commercial |
$398.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.58
|
| Rate for Payer: Healthscope Commercial |
$550.52
|
| Rate for Payer: Healthscope Commercial |
$476.13
|
| Rate for Payer: Mclaren Medicaid |
$198.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.46
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,039.00
|
| Rate for Payer: Nomi Health Commercial |
$357.10
|
| Rate for Payer: PACE SWMI |
$297.58
|
| Rate for Payer: PHP Medicare Advantage |
$297.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.18
|
| Rate for Payer: Priority Health Medicare |
$297.58
|
| Rate for Payer: Priority Health Narrow Network |
$493.18
|
| Rate for Payer: Priority Health SBD |
$493.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$989.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.58
|
| Rate for Payer: UHC Exchange |
$989.04
|
| Rate for Payer: UHC Medicare Advantage |
$297.58
|
| Rate for Payer: UHCCP Medicaid |
$198.30
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$85,829.00 |
| Rate for Payer: Aetna Commercial |
$623.96
|
| Rate for Payer: Aetna Medicare |
$484.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.52
|
| Rate for Payer: BCBS Complete |
$325.18
|
| Rate for Payer: BCBS MAPPO |
$465.64
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$465.64
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$670.52
|
| Rate for Payer: Cofinity Commercial |
$623.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.64
|
| Rate for Payer: Healthscope Commercial |
$861.43
|
| Rate for Payer: Healthscope Commercial |
$745.02
|
| Rate for Payer: Mclaren Medicaid |
$309.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.92
|
| Rate for Payer: Meridian Medicaid |
$325.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,829.00
|
| Rate for Payer: Nomi Health Commercial |
$558.77
|
| Rate for Payer: PACE SWMI |
$465.64
|
| Rate for Payer: PHP Medicare Advantage |
$465.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.67
|
| Rate for Payer: Priority Health Medicare |
$465.64
|
| Rate for Payer: Priority Health Narrow Network |
$770.67
|
| Rate for Payer: Priority Health SBD |
$770.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.64
|
| Rate for Payer: UHC Exchange |
$549.07
|
| Rate for Payer: UHC Medicare Advantage |
$465.64
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$611.24 |
| Max. Negotiated Rate |
$186,433.00 |
| Rate for Payer: Aetna Commercial |
$1,356.37
|
| Rate for Payer: Aetna Medicare |
$1,052.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,457.60
|
| Rate for Payer: BCBS Complete |
$702.71
|
| Rate for Payer: BCBS MAPPO |
$1,012.22
|
| Rate for Payer: BCBS Trust/PPO |
$611.24
|
| Rate for Payer: BCN Commercial |
$1,518.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.22
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$1,457.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.22
|
| Rate for Payer: Healthscope Commercial |
$1,872.61
|
| Rate for Payer: Healthscope Commercial |
$1,619.55
|
| Rate for Payer: Mclaren Medicaid |
$669.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,062.83
|
| Rate for Payer: Meridian Medicaid |
$702.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186,433.00
|
| Rate for Payer: Nomi Health Commercial |
$1,214.66
|
| Rate for Payer: PACE SWMI |
$1,012.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,863.76
|
| Rate for Payer: Priority Health Medicare |
$1,012.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,863.76
|
| Rate for Payer: Priority Health SBD |
$1,863.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,012.22
|
| Rate for Payer: UHC Exchange |
$806.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,012.22
|
| Rate for Payer: UHCCP Medicaid |
$669.25
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$31,824.00 |
| Rate for Payer: Aetna Commercial |
$234.53
|
| Rate for Payer: Aetna Medicare |
$182.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.03
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS MAPPO |
$175.02
|
| Rate for Payer: BCBS Trust/PPO |
$169.58
|
| Rate for Payer: BCN Commercial |
$262.91
|
| Rate for Payer: BCN Medicare Advantage |
$175.02
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$252.03
|
| Rate for Payer: Cofinity Commercial |
$234.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.02
|
| Rate for Payer: Healthscope Commercial |
$323.79
|
| Rate for Payer: Healthscope Commercial |
$280.03
|
| Rate for Payer: Mclaren Medicaid |
$117.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.77
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,824.00
|
| Rate for Payer: Nomi Health Commercial |
$210.02
|
| Rate for Payer: PACE SWMI |
$175.02
|
| Rate for Payer: PHP Medicare Advantage |
$175.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Medicare |
$175.02
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: Priority Health SBD |
$325.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.02
|
| Rate for Payer: UHC Exchange |
$161.30
|
| Rate for Payer: UHC Medicare Advantage |
$175.02
|
| Rate for Payer: UHCCP Medicaid |
$117.58
|
|
|
PR REPAIR ANORECTAL FISTULA PLUG
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 46707
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$89,375.00 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$506.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.68
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Healthscope Commercial |
$779.65
|
| Rate for Payer: Healthscope Commercial |
$901.47
|
| Rate for Payer: Mclaren Medicaid |
$328.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,375.00
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.41
|
| Rate for Payer: Priority Health Medicare |
$487.28
|
| Rate for Payer: Priority Health Narrow Network |
$910.41
|
| Rate for Payer: Priority Health SBD |
$910.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
| Rate for Payer: UHCCP Medicaid |
$328.87
|
|
|
PR REPAIR BIFID EARLOBES - BILATERAL
|
Professional
|
Both
|
$1,020.00
|
|
|
Service Code
|
HCPCS 00535
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$408.00 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Medicare |
$510.00
|
| Rate for Payer: BCBS Complete |
$408.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
|
|
PR REPAIR BIFID EARLOBES - UNILATERAL
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 00534
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$244.80 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
|
|
PR REPAIR BLOOD VESSEL DIRECT HAND FINGER
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 35207
|
| Min. Negotiated Rate |
$292.68 |
| Max. Negotiated Rate |
$134,168.00 |
| Rate for Payer: Aetna Commercial |
$972.95
|
| Rate for Payer: Aetna Medicare |
$755.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.95
|
| Rate for Payer: BCBS Complete |
$514.17
|
| Rate for Payer: BCBS MAPPO |
$726.08
|
| Rate for Payer: BCBS Trust/PPO |
$292.68
|
| Rate for Payer: BCN Commercial |
$1,109.79
|
| Rate for Payer: BCN Medicare Advantage |
$726.08
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$972.95
|
| Rate for Payer: Cofinity Commercial |
$1,045.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.08
|
| Rate for Payer: Healthscope Commercial |
$1,343.25
|
| Rate for Payer: Healthscope Commercial |
$1,161.73
|
| Rate for Payer: Mclaren Medicaid |
$489.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.38
|
| Rate for Payer: Meridian Medicaid |
$514.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,168.00
|
| Rate for Payer: Nomi Health Commercial |
$871.30
|
| Rate for Payer: PACE SWMI |
$726.08
|
| Rate for Payer: PHP Medicare Advantage |
$726.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.90
|
| Rate for Payer: Priority Health Medicare |
$726.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.90
|
| Rate for Payer: Priority Health SBD |
$1,209.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,008.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$726.08
|
| Rate for Payer: UHC Exchange |
$1,008.12
|
| Rate for Payer: UHC Medicare Advantage |
$726.08
|
| Rate for Payer: UHCCP Medicaid |
$489.69
|
|
|
PR REPAIR BLOOD VESSEL DIRECT INTRA-ABDOMINAL
|
Professional
|
Both
|
$5,052.00
|
|
|
Service Code
|
HCPCS 35221
|
| Min. Negotiated Rate |
$926.34 |
| Max. Negotiated Rate |
$261,947.00 |
| Rate for Payer: Aetna Commercial |
$1,893.10
|
| Rate for Payer: Aetna Medicare |
$1,469.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,893.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,034.37
|
| Rate for Payer: BCBS Complete |
$972.66
|
| Rate for Payer: BCBS MAPPO |
$1,412.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.77
|
| Rate for Payer: BCN Commercial |
$2,119.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,412.76
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cofinity Commercial |
$2,034.37
|
| Rate for Payer: Cofinity Commercial |
$1,893.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,412.76
|
| Rate for Payer: Healthscope Commercial |
$2,613.61
|
| Rate for Payer: Healthscope Commercial |
$2,260.42
|
| Rate for Payer: Mclaren Medicaid |
$926.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,483.40
|
| Rate for Payer: Meridian Medicaid |
$972.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261,947.00
|
| Rate for Payer: Nomi Health Commercial |
$1,695.31
|
| Rate for Payer: PACE SWMI |
$1,412.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,412.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,283.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,313.97
|
| Rate for Payer: Priority Health Medicare |
$1,412.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,313.97
|
| Rate for Payer: Priority Health SBD |
$2,313.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,507.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,412.76
|
| Rate for Payer: UHC Exchange |
$1,507.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,412.76
|
| Rate for Payer: UHCCP Medicaid |
$926.34
|
|
|
PR REPAIR BLOOD VESSEL DIRECT LOWER EXTREMITY
|
Professional
|
Both
|
$2,660.00
|
|
|
Service Code
|
HCPCS 35226
|
| Min. Negotiated Rate |
$519.51 |
| Max. Negotiated Rate |
$147,398.00 |
| Rate for Payer: Aetna Commercial |
$1,063.89
|
| Rate for Payer: Aetna Medicare |
$825.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.29
|
| Rate for Payer: BCBS Complete |
$545.49
|
| Rate for Payer: BCBS MAPPO |
$793.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,526.86
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| Rate for Payer: BCN Medicare Advantage |
$793.95
|
| Rate for Payer: Cash Price |
$2,128.00
|
| Rate for Payer: Cash Price |
$2,128.00
|
| Rate for Payer: Cofinity Commercial |
$1,143.29
|
| Rate for Payer: Cofinity Commercial |
$1,063.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.95
|
| Rate for Payer: Healthscope Commercial |
$1,468.81
|
| Rate for Payer: Healthscope Commercial |
$1,270.32
|
| Rate for Payer: Mclaren Medicaid |
$519.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$833.65
|
| Rate for Payer: Meridian Medicaid |
$545.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,398.00
|
| Rate for Payer: Nomi Health Commercial |
$952.74
|
| Rate for Payer: PACE SWMI |
$793.95
|
| Rate for Payer: PHP Medicare Advantage |
$793.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,294.99
|
| Rate for Payer: Priority Health Medicare |
$793.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,294.99
|
| Rate for Payer: Priority Health SBD |
$1,294.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.95
|
| Rate for Payer: UHC Exchange |
$992.35
|
| Rate for Payer: UHC Medicare Advantage |
$793.95
|
| Rate for Payer: UHCCP Medicaid |
$519.51
|
|
|
PR REPAIR BLOOD VESSEL DIRECT NECK
|
Professional
|
Both
|
$4,240.00
|
|
|
Service Code
|
HCPCS 35201
|
| Min. Negotiated Rate |
$584.05 |
| Max. Negotiated Rate |
$165,676.00 |
| Rate for Payer: Aetna Commercial |
$1,192.77
|
| Rate for Payer: Aetna Medicare |
$925.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.79
|
| Rate for Payer: BCBS Complete |
$613.25
|
| Rate for Payer: BCBS MAPPO |
$890.13
|
| Rate for Payer: BCBS Trust/PPO |
$871.17
|
| Rate for Payer: BCN Commercial |
$1,340.94
|
| Rate for Payer: BCN Medicare Advantage |
$890.13
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cofinity Commercial |
$1,281.79
|
| Rate for Payer: Cofinity Commercial |
$1,192.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.13
|
| Rate for Payer: Healthscope Commercial |
$1,646.74
|
| Rate for Payer: Healthscope Commercial |
$1,424.21
|
| Rate for Payer: Mclaren Medicaid |
$584.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.64
|
| Rate for Payer: Meridian Medicaid |
$613.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165,676.00
|
| Rate for Payer: Nomi Health Commercial |
$1,068.16
|
| Rate for Payer: PACE SWMI |
$890.13
|
| Rate for Payer: PHP Medicare Advantage |
$890.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,463.58
|
| Rate for Payer: Priority Health Medicare |
$890.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,463.58
|
| Rate for Payer: Priority Health SBD |
$1,463.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.13
|
| Rate for Payer: UHC Exchange |
$1,172.31
|
| Rate for Payer: UHC Medicare Advantage |
$890.13
|
| Rate for Payer: UHCCP Medicaid |
$584.05
|
|
|
PR REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 35206
|
| Min. Negotiated Rate |
$503.53 |
| Max. Negotiated Rate |
$139,133.00 |
| Rate for Payer: Aetna Commercial |
$1,022.62
|
| Rate for Payer: Aetna Medicare |
$793.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,022.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.94
|
| Rate for Payer: BCBS Complete |
$528.71
|
| Rate for Payer: BCBS MAPPO |
$763.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.46
|
| Rate for Payer: BCN Commercial |
$1,129.33
|
| Rate for Payer: BCN Medicare Advantage |
$763.15
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,098.94
|
| Rate for Payer: Cofinity Commercial |
$1,022.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.15
|
| Rate for Payer: Healthscope Commercial |
$1,411.83
|
| Rate for Payer: Healthscope Commercial |
$1,221.04
|
| Rate for Payer: Mclaren Medicaid |
$503.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.31
|
| Rate for Payer: Meridian Medicaid |
$528.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139,133.00
|
| Rate for Payer: Nomi Health Commercial |
$915.78
|
| Rate for Payer: PACE SWMI |
$763.15
|
| Rate for Payer: PHP Medicare Advantage |
$763.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,813.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,243.40
|
| Rate for Payer: Priority Health Medicare |
$763.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,243.40
|
| Rate for Payer: Priority Health SBD |
$1,243.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,046.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.15
|
| Rate for Payer: UHC Exchange |
$1,046.73
|
| Rate for Payer: UHC Medicare Advantage |
$763.15
|
| Rate for Payer: UHCCP Medicaid |
$503.53
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL
|
Professional
|
Both
|
$3,839.00
|
|
|
Service Code
|
HCPCS 35251
|
| Min. Negotiated Rate |
$808.30 |
| Max. Negotiated Rate |
$310,972.00 |
| Rate for Payer: Aetna Commercial |
$2,226.45
|
| Rate for Payer: Aetna Medicare |
$1,727.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,226.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,392.60
|
| Rate for Payer: BCBS Complete |
$1,141.74
|
| Rate for Payer: BCBS MAPPO |
$1,661.53
|
| Rate for Payer: BCBS Trust/PPO |
$808.30
|
| Rate for Payer: BCN Commercial |
$2,514.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.53
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,392.60
|
| Rate for Payer: Cofinity Commercial |
$2,226.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.53
|
| Rate for Payer: Healthscope Commercial |
$3,073.83
|
| Rate for Payer: Healthscope Commercial |
$2,658.45
|
| Rate for Payer: Mclaren Medicaid |
$1,087.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,744.61
|
| Rate for Payer: Meridian Medicaid |
$1,141.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310,972.00
|
| Rate for Payer: Nomi Health Commercial |
$1,993.84
|
| Rate for Payer: PACE SWMI |
$1,661.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,087.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,495.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,725.59
|
| Rate for Payer: Priority Health Medicare |
$1,661.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,725.59
|
| Rate for Payer: Priority Health SBD |
$2,725.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,875.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,661.53
|
| Rate for Payer: UHC Exchange |
$1,875.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,661.53
|
| Rate for Payer: UHCCP Medicaid |
$1,087.37
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 35256
|
| Min. Negotiated Rate |
$639.43 |
| Max. Negotiated Rate |
$180,833.00 |
| Rate for Payer: Aetna Commercial |
$1,310.69
|
| Rate for Payer: Aetna Medicare |
$1,017.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.51
|
| Rate for Payer: BCBS Complete |
$671.40
|
| Rate for Payer: BCBS MAPPO |
$978.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,459.19
|
| Rate for Payer: BCN Medicare Advantage |
$978.13
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,408.51
|
| Rate for Payer: Cofinity Commercial |
$1,310.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.13
|
| Rate for Payer: Healthscope Commercial |
$1,809.54
|
| Rate for Payer: Healthscope Commercial |
$1,565.01
|
| Rate for Payer: Mclaren Medicaid |
$639.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.04
|
| Rate for Payer: Meridian Medicaid |
$671.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180,833.00
|
| Rate for Payer: Nomi Health Commercial |
$1,173.76
|
| Rate for Payer: PACE SWMI |
$978.13
|
| Rate for Payer: PHP Medicare Advantage |
$978.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,578.99
|
| Rate for Payer: Priority Health Medicare |
$978.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,578.99
|
| Rate for Payer: Priority Health SBD |
$1,578.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.13
|
| Rate for Payer: UHC Exchange |
$1,236.27
|
| Rate for Payer: UHC Medicare Advantage |
$978.13
|
| Rate for Payer: UHCCP Medicaid |
$639.43
|
|
|
PR REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK
|
Professional
|
Both
|
$4,692.00
|
|
|
Service Code
|
HCPCS 35261
|
| Min. Negotiated Rate |
$615.36 |
| Max. Negotiated Rate |
$173,948.00 |
| Rate for Payer: Aetna Commercial |
$1,266.84
|
| Rate for Payer: Aetna Medicare |
$983.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.38
|
| Rate for Payer: BCBS Complete |
$646.13
|
| Rate for Payer: BCBS MAPPO |
$945.40
|
| Rate for Payer: BCBS Trust/PPO |
$773.96
|
| Rate for Payer: BCN Commercial |
$1,398.59
|
| Rate for Payer: BCN Medicare Advantage |
$945.40
|
| Rate for Payer: Cash Price |
$3,753.60
|
| Rate for Payer: Cash Price |
$3,753.60
|
| Rate for Payer: Cofinity Commercial |
$1,361.38
|
| Rate for Payer: Cofinity Commercial |
$1,266.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.40
|
| Rate for Payer: Healthscope Commercial |
$1,748.99
|
| Rate for Payer: Healthscope Commercial |
$1,512.64
|
| Rate for Payer: Mclaren Medicaid |
$615.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.67
|
| Rate for Payer: Meridian Medicaid |
$646.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173,948.00
|
| Rate for Payer: Nomi Health Commercial |
$1,134.48
|
| Rate for Payer: PACE SWMI |
$945.40
|
| Rate for Payer: PHP Medicare Advantage |
$945.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,049.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,531.13
|
| Rate for Payer: Priority Health Medicare |
$945.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,531.13
|
| Rate for Payer: Priority Health SBD |
$1,531.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,183.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.40
|
| Rate for Payer: UHC Exchange |
$1,183.96
|
| Rate for Payer: UHC Medicare Advantage |
$945.40
|
| Rate for Payer: UHCCP Medicaid |
$615.36
|
|
|
PR REPAIR BLOOD VESSEL W/VEIN GRAFT NECK
|
Professional
|
Both
|
$1,896.00
|
|
|
Service Code
|
HCPCS 35231
|
| Min. Negotiated Rate |
$794.92 |
| Max. Negotiated Rate |
$221,216.00 |
| Rate for Payer: Aetna Commercial |
$1,599.79
|
| Rate for Payer: Aetna Medicare |
$1,241.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,599.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.17
|
| Rate for Payer: BCBS Complete |
$834.67
|
| Rate for Payer: BCBS MAPPO |
$1,193.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.31
|
| Rate for Payer: BCN Commercial |
$1,810.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.87
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cofinity Commercial |
$1,719.17
|
| Rate for Payer: Cofinity Commercial |
$1,599.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.87
|
| Rate for Payer: Healthscope Commercial |
$2,208.66
|
| Rate for Payer: Healthscope Commercial |
$1,910.19
|
| Rate for Payer: Mclaren Medicaid |
$794.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,253.56
|
| Rate for Payer: Meridian Medicaid |
$834.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221,216.00
|
| Rate for Payer: Nomi Health Commercial |
$1,432.64
|
| Rate for Payer: PACE SWMI |
$1,193.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,969.88
|
| Rate for Payer: Priority Health Medicare |
$1,193.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,969.88
|
| Rate for Payer: Priority Health SBD |
$1,969.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,193.87
|
| Rate for Payer: UHC Exchange |
$1,342.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.87
|
| Rate for Payer: UHCCP Medicaid |
$794.92
|
|
