|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$8,810.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$2,636.94 |
| Max. Negotiated Rate |
$5,726.50 |
| Rate for Payer: Aetna Commercial |
$3,533.50
|
| Rate for Payer: Aetna Medicare |
$2,742.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,797.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,533.50
|
| Rate for Payer: BCBS Complete |
$3,524.00
|
| Rate for Payer: BCBS MAPPO |
$2,636.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,636.94
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cofinity Commercial |
$3,797.19
|
| Rate for Payer: Cofinity Commercial |
$3,533.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,636.94
|
| Rate for Payer: Healthscope Commercial |
$4,878.34
|
| Rate for Payer: Healthscope Commercial |
$4,219.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,768.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,726.50
|
| Rate for Payer: Nomi Health Commercial |
$3,164.33
|
| Rate for Payer: PACE SWMI |
$2,636.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,636.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: Priority Health Medicare |
$2,636.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,636.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,636.94
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$157.48 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Aetna Commercial |
$211.02
|
| Rate for Payer: Aetna Medicare |
$163.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.02
|
| Rate for Payer: BCBS Complete |
$197.60
|
| Rate for Payer: BCBS MAPPO |
$157.48
|
| Rate for Payer: BCN Medicare Advantage |
$157.48
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cofinity Commercial |
$226.77
|
| Rate for Payer: Cofinity Commercial |
$211.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.48
|
| Rate for Payer: Healthscope Commercial |
$251.97
|
| Rate for Payer: Healthscope Commercial |
$291.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.10
|
| Rate for Payer: Nomi Health Commercial |
$188.98
|
| Rate for Payer: PACE SWMI |
$157.48
|
| Rate for Payer: PHP Medicare Advantage |
$157.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.10
|
| Rate for Payer: Priority Health Medicare |
$157.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.48
|
| Rate for Payer: UHC Medicare Advantage |
$157.48
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$99.43 |
| Max. Negotiated Rate |
$244.40 |
| Rate for Payer: Aetna Commercial |
$133.24
|
| Rate for Payer: Aetna Medicare |
$103.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.24
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: BCBS MAPPO |
$99.43
|
| Rate for Payer: BCN Medicare Advantage |
$99.43
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$143.18
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.43
|
| Rate for Payer: Healthscope Commercial |
$183.95
|
| Rate for Payer: Healthscope Commercial |
$159.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.40
|
| Rate for Payer: Nomi Health Commercial |
$119.32
|
| Rate for Payer: PACE SWMI |
$99.43
|
| Rate for Payer: PHP Medicare Advantage |
$99.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.40
|
| Rate for Payer: Priority Health Medicare |
$99.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.43
|
| Rate for Payer: UHC Medicare Advantage |
$99.43
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$336.80 |
| Max. Negotiated Rate |
$706.40 |
| Rate for Payer: Aetna Commercial |
$511.67
|
| Rate for Payer: Aetna Medicare |
$397.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.67
|
| Rate for Payer: BCBS Complete |
$336.80
|
| Rate for Payer: BCBS MAPPO |
$381.84
|
| Rate for Payer: BCN Medicare Advantage |
$381.84
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$549.85
|
| Rate for Payer: Cofinity Commercial |
$511.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.84
|
| Rate for Payer: Healthscope Commercial |
$610.94
|
| Rate for Payer: Healthscope Commercial |
$706.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.30
|
| Rate for Payer: Nomi Health Commercial |
$458.21
|
| Rate for Payer: PACE SWMI |
$381.84
|
| Rate for Payer: PHP Medicare Advantage |
$381.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health Medicare |
$381.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.84
|
| Rate for Payer: UHC Medicare Advantage |
$381.84
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$82.68 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$110.79
|
| Rate for Payer: Aetna Medicare |
$85.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.79
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$82.68
|
| Rate for Payer: BCN Medicare Advantage |
$82.68
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$119.06
|
| Rate for Payer: Cofinity Commercial |
$110.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.68
|
| Rate for Payer: Healthscope Commercial |
$152.96
|
| Rate for Payer: Healthscope Commercial |
$132.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.90
|
| Rate for Payer: Nomi Health Commercial |
$99.22
|
| Rate for Payer: PACE SWMI |
$82.68
|
| Rate for Payer: PHP Medicare Advantage |
$82.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Medicare |
$82.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.68
|
| Rate for Payer: UHC Medicare Advantage |
$82.68
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$4,931.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$1,963.37 |
| Max. Negotiated Rate |
$3,632.23 |
| Rate for Payer: Aetna Commercial |
$2,630.92
|
| Rate for Payer: Aetna Medicare |
$2,041.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,827.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,630.92
|
| Rate for Payer: BCBS Complete |
$1,972.40
|
| Rate for Payer: BCBS MAPPO |
$1,963.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,963.37
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Cofinity Commercial |
$2,827.25
|
| Rate for Payer: Cofinity Commercial |
$2,630.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,963.37
|
| Rate for Payer: Healthscope Commercial |
$3,141.39
|
| Rate for Payer: Healthscope Commercial |
$3,632.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,061.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,205.15
|
| Rate for Payer: Nomi Health Commercial |
$2,356.04
|
| Rate for Payer: PACE SWMI |
$1,963.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,963.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,205.15
|
| Rate for Payer: Priority Health Medicare |
$1,963.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,963.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,963.37
|
|
|
PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ
|
Professional
|
Both
|
$3,670.00
|
|
|
Service Code
|
HCPCS 32503
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$3,189.27 |
| Rate for Payer: Aetna Commercial |
$2,310.07
|
| Rate for Payer: Aetna Medicare |
$1,792.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,482.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,310.07
|
| Rate for Payer: BCBS Complete |
$1,468.00
|
| Rate for Payer: BCBS MAPPO |
$1,723.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.93
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Cofinity Commercial |
$2,482.46
|
| Rate for Payer: Cofinity Commercial |
$2,310.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.93
|
| Rate for Payer: Healthscope Commercial |
$3,189.27
|
| Rate for Payer: Healthscope Commercial |
$2,758.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,810.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,385.50
|
| Rate for Payer: Nomi Health Commercial |
$2,068.72
|
| Rate for Payer: PACE SWMI |
$1,723.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,385.50
|
| Rate for Payer: Priority Health Medicare |
$1,723.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,723.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,723.93
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$904.40 |
| Max. Negotiated Rate |
$2,244.03 |
| Rate for Payer: Aetna Commercial |
$1,625.41
|
| Rate for Payer: Aetna Medicare |
$1,261.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,746.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.41
|
| Rate for Payer: BCBS Complete |
$904.40
|
| Rate for Payer: BCBS MAPPO |
$1,212.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.99
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,746.71
|
| Rate for Payer: Cofinity Commercial |
$1,625.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.99
|
| Rate for Payer: Healthscope Commercial |
$1,940.78
|
| Rate for Payer: Healthscope Commercial |
$2,244.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,469.65
|
| Rate for Payer: Nomi Health Commercial |
$1,455.59
|
| Rate for Payer: PACE SWMI |
$1,212.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health Medicare |
$1,212.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,212.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,212.99
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,676.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$775.59 |
| Max. Negotiated Rate |
$2,389.40 |
| Rate for Payer: Aetna Commercial |
$1,039.29
|
| Rate for Payer: Aetna Medicare |
$806.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.29
|
| Rate for Payer: BCBS Complete |
$1,470.40
|
| Rate for Payer: BCBS MAPPO |
$775.59
|
| Rate for Payer: BCN Medicare Advantage |
$775.59
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cofinity Commercial |
$1,116.85
|
| Rate for Payer: Cofinity Commercial |
$1,039.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.59
|
| Rate for Payer: Healthscope Commercial |
$1,434.84
|
| Rate for Payer: Healthscope Commercial |
$1,240.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,389.40
|
| Rate for Payer: Nomi Health Commercial |
$930.71
|
| Rate for Payer: PACE SWMI |
$775.59
|
| Rate for Payer: PHP Medicare Advantage |
$775.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,389.40
|
| Rate for Payer: Priority Health Medicare |
$775.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.59
|
| Rate for Payer: UHC Medicare Advantage |
$775.59
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,417.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$2,014.99 |
| Max. Negotiated Rate |
$3,727.73 |
| Rate for Payer: Aetna Commercial |
$2,700.09
|
| Rate for Payer: Aetna Medicare |
$2,095.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,901.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,700.09
|
| Rate for Payer: BCBS Complete |
$2,166.80
|
| Rate for Payer: BCBS MAPPO |
$2,014.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.99
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cofinity Commercial |
$2,901.59
|
| Rate for Payer: Cofinity Commercial |
$2,700.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.99
|
| Rate for Payer: Healthscope Commercial |
$3,223.98
|
| Rate for Payer: Healthscope Commercial |
$3,727.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,521.05
|
| Rate for Payer: Nomi Health Commercial |
$2,417.99
|
| Rate for Payer: PACE SWMI |
$2,014.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.05
|
| Rate for Payer: Priority Health Medicare |
$2,014.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.99
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,464.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$2,348.54 |
| Max. Negotiated Rate |
$4,851.60 |
| Rate for Payer: Aetna Commercial |
$3,147.04
|
| Rate for Payer: Aetna Medicare |
$2,442.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,147.04
|
| Rate for Payer: BCBS Complete |
$2,985.60
|
| Rate for Payer: BCBS MAPPO |
$2,348.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,348.54
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cofinity Commercial |
$3,381.90
|
| Rate for Payer: Cofinity Commercial |
$3,147.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,348.54
|
| Rate for Payer: Healthscope Commercial |
$4,344.80
|
| Rate for Payer: Healthscope Commercial |
$3,757.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,465.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,851.60
|
| Rate for Payer: Nomi Health Commercial |
$2,818.25
|
| Rate for Payer: PACE SWMI |
$2,348.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,348.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,851.60
|
| Rate for Payer: Priority Health Medicare |
$2,348.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,348.54
|
| Rate for Payer: UHC Medicare Advantage |
$2,348.54
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$6,974.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$2,789.60 |
| Max. Negotiated Rate |
$5,994.83 |
| Rate for Payer: Aetna Commercial |
$4,342.20
|
| Rate for Payer: Aetna Medicare |
$3,370.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,666.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,342.20
|
| Rate for Payer: BCBS Complete |
$2,789.60
|
| Rate for Payer: BCBS MAPPO |
$3,240.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,240.45
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cofinity Commercial |
$4,666.25
|
| Rate for Payer: Cofinity Commercial |
$4,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,240.45
|
| Rate for Payer: Healthscope Commercial |
$5,184.72
|
| Rate for Payer: Healthscope Commercial |
$5,994.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,402.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,533.10
|
| Rate for Payer: Nomi Health Commercial |
$3,888.54
|
| Rate for Payer: PACE SWMI |
$3,240.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,240.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,533.10
|
| Rate for Payer: Priority Health Medicare |
$3,240.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,240.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,240.45
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,225.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$2,741.82 |
| Max. Negotiated Rate |
$5,072.37 |
| Rate for Payer: Aetna Commercial |
$3,674.04
|
| Rate for Payer: Aetna Medicare |
$2,851.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,948.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,674.04
|
| Rate for Payer: BCBS Complete |
$2,890.00
|
| Rate for Payer: BCBS MAPPO |
$2,741.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,741.82
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cofinity Commercial |
$3,948.22
|
| Rate for Payer: Cofinity Commercial |
$3,674.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,741.82
|
| Rate for Payer: Healthscope Commercial |
$5,072.37
|
| Rate for Payer: Healthscope Commercial |
$4,386.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,878.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,696.25
|
| Rate for Payer: Nomi Health Commercial |
$3,290.18
|
| Rate for Payer: PACE SWMI |
$2,741.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,741.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,696.25
|
| Rate for Payer: Priority Health Medicare |
$2,741.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,741.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,741.82
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,724.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,889.60 |
| Max. Negotiated Rate |
$3,814.87 |
| Rate for Payer: Aetna Commercial |
$2,763.20
|
| Rate for Payer: Aetna Medicare |
$2,144.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,969.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,763.20
|
| Rate for Payer: BCBS Complete |
$1,889.60
|
| Rate for Payer: BCBS MAPPO |
$2,062.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,062.09
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Cofinity Commercial |
$2,969.41
|
| Rate for Payer: Cofinity Commercial |
$2,763.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,062.09
|
| Rate for Payer: Healthscope Commercial |
$3,299.34
|
| Rate for Payer: Healthscope Commercial |
$3,814.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,165.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,070.60
|
| Rate for Payer: Nomi Health Commercial |
$2,474.51
|
| Rate for Payer: PACE SWMI |
$2,062.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,062.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,070.60
|
| Rate for Payer: Priority Health Medicare |
$2,062.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,062.09
|
| Rate for Payer: UHC Medicare Advantage |
$2,062.09
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,219.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$2,832.82 |
| Max. Negotiated Rate |
$6,642.35 |
| Rate for Payer: Aetna Commercial |
$3,795.98
|
| Rate for Payer: Aetna Medicare |
$2,946.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,079.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,795.98
|
| Rate for Payer: BCBS Complete |
$4,087.60
|
| Rate for Payer: BCBS MAPPO |
$2,832.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,832.82
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Cofinity Commercial |
$4,079.26
|
| Rate for Payer: Cofinity Commercial |
$3,795.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,832.82
|
| Rate for Payer: Healthscope Commercial |
$5,240.72
|
| Rate for Payer: Healthscope Commercial |
$4,532.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,974.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,642.35
|
| Rate for Payer: Nomi Health Commercial |
$3,399.38
|
| Rate for Payer: PACE SWMI |
$2,832.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,832.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,642.35
|
| Rate for Payer: Priority Health Medicare |
$2,832.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,832.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,832.82
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL
|
Professional
|
Both
|
$10,653.00
|
|
|
Service Code
|
HCPCS 61608
|
| Min. Negotiated Rate |
$3,210.47 |
| Max. Negotiated Rate |
$6,924.45 |
| Rate for Payer: Aetna Commercial |
$4,302.03
|
| Rate for Payer: Aetna Medicare |
$3,338.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,623.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,302.03
|
| Rate for Payer: BCBS Complete |
$4,261.20
|
| Rate for Payer: BCBS MAPPO |
$3,210.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,210.47
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Cofinity Commercial |
$4,623.08
|
| Rate for Payer: Cofinity Commercial |
$4,302.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,210.47
|
| Rate for Payer: Healthscope Commercial |
$5,136.75
|
| Rate for Payer: Healthscope Commercial |
$5,939.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,370.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,924.45
|
| Rate for Payer: Nomi Health Commercial |
$3,852.56
|
| Rate for Payer: PACE SWMI |
$3,210.47
|
| Rate for Payer: PHP Medicare Advantage |
$3,210.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,924.45
|
| Rate for Payer: Priority Health Medicare |
$3,210.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,210.47
|
| Rate for Payer: UHC Medicare Advantage |
$3,210.47
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL
|
Professional
|
Both
|
$6,021.00
|
|
|
Service Code
|
HCPCS 61607
|
| Min. Negotiated Rate |
$2,408.40 |
| Max. Negotiated Rate |
$5,505.05 |
| Rate for Payer: Aetna Commercial |
$3,987.44
|
| Rate for Payer: Aetna Medicare |
$3,094.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,285.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,987.44
|
| Rate for Payer: BCBS Complete |
$2,408.40
|
| Rate for Payer: BCBS MAPPO |
$2,975.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,975.70
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cofinity Commercial |
$4,285.01
|
| Rate for Payer: Cofinity Commercial |
$3,987.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,975.70
|
| Rate for Payer: Healthscope Commercial |
$5,505.05
|
| Rate for Payer: Healthscope Commercial |
$4,761.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,124.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,913.65
|
| Rate for Payer: Nomi Health Commercial |
$3,570.84
|
| Rate for Payer: PACE SWMI |
$2,975.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,975.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,913.65
|
| Rate for Payer: Priority Health Medicare |
$2,975.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,975.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,975.70
|
|
|
PR RESCJ PALATE/EXTENSIVE RESCJ LESION
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 42120
|
| Min. Negotiated Rate |
$820.80 |
| Max. Negotiated Rate |
$1,734.23 |
| Rate for Payer: Aetna Commercial |
$1,256.14
|
| Rate for Payer: Aetna Medicare |
$974.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.14
|
| Rate for Payer: BCBS Complete |
$820.80
|
| Rate for Payer: BCBS MAPPO |
$937.42
|
| Rate for Payer: BCN Medicare Advantage |
$937.42
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$1,349.88
|
| Rate for Payer: Cofinity Commercial |
$1,256.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.42
|
| Rate for Payer: Healthscope Commercial |
$1,499.87
|
| Rate for Payer: Healthscope Commercial |
$1,734.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.80
|
| Rate for Payer: Nomi Health Commercial |
$1,124.90
|
| Rate for Payer: PACE SWMI |
$937.42
|
| Rate for Payer: PHP Medicare Advantage |
$937.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.80
|
| Rate for Payer: Priority Health Medicare |
$937.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.42
|
| Rate for Payer: UHC Medicare Advantage |
$937.42
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 58952
|
| Min. Negotiated Rate |
$1,387.20 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna Commercial |
$2,116.78
|
| Rate for Payer: Aetna Medicare |
$1,642.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,116.78
|
| Rate for Payer: BCBS Complete |
$1,387.20
|
| Rate for Payer: BCBS MAPPO |
$1,579.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,579.69
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cofinity Commercial |
$2,274.75
|
| Rate for Payer: Cofinity Commercial |
$2,116.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,579.69
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Healthscope Commercial |
$2,527.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,658.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,254.20
|
| Rate for Payer: Nomi Health Commercial |
$1,895.63
|
| Rate for Payer: PACE SWMI |
$1,579.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,579.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.20
|
| Rate for Payer: Priority Health Medicare |
$1,579.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,579.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,579.69
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD
|
Professional
|
Both
|
$4,936.00
|
|
|
Service Code
|
HCPCS 58951
|
| Min. Negotiated Rate |
$1,386.64 |
| Max. Negotiated Rate |
$3,208.40 |
| Rate for Payer: Aetna Commercial |
$1,858.10
|
| Rate for Payer: Aetna Medicare |
$1,442.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,996.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.10
|
| Rate for Payer: BCBS Complete |
$1,974.40
|
| Rate for Payer: BCBS MAPPO |
$1,386.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,386.64
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Cofinity Commercial |
$1,996.76
|
| Rate for Payer: Cofinity Commercial |
$1,858.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,386.64
|
| Rate for Payer: Healthscope Commercial |
$2,218.62
|
| Rate for Payer: Healthscope Commercial |
$2,565.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,455.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,208.40
|
| Rate for Payer: Nomi Health Commercial |
$1,663.97
|
| Rate for Payer: PACE SWMI |
$1,386.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,386.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,208.40
|
| Rate for Payer: Priority Health Medicare |
$1,386.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,386.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,386.64
|
|
|
PR RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS
|
Professional
|
Both
|
$6,636.00
|
|
|
Service Code
|
HCPCS 48105
|
| Min. Negotiated Rate |
$2,654.40 |
| Max. Negotiated Rate |
$5,053.65 |
| Rate for Payer: Aetna Commercial |
$3,660.48
|
| Rate for Payer: Aetna Medicare |
$2,840.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,933.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,660.48
|
| Rate for Payer: BCBS Complete |
$2,654.40
|
| Rate for Payer: BCBS MAPPO |
$2,731.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,731.70
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Cofinity Commercial |
$3,933.65
|
| Rate for Payer: Cofinity Commercial |
$3,660.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,731.70
|
| Rate for Payer: Healthscope Commercial |
$4,370.72
|
| Rate for Payer: Healthscope Commercial |
$5,053.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,868.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,313.40
|
| Rate for Payer: Nomi Health Commercial |
$3,278.04
|
| Rate for Payer: PACE SWMI |
$2,731.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,731.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,313.40
|
| Rate for Payer: Priority Health Medicare |
$2,731.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,731.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,731.70
|
|
|
PR RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY
|
Professional
|
Both
|
$3,325.00
|
|
|
Service Code
|
HCPCS 58957
|
| Min. Negotiated Rate |
$1,330.00 |
| Max. Negotiated Rate |
$2,161.25 |
| Rate for Payer: Aetna Medicare |
$1,662.50
|
| Rate for Payer: BCBS Complete |
$1,330.00
|
| Rate for Payer: Cash Price |
$2,660.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,161.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,161.25
|
|
|
PR RESEC RECURRENT LARYNX NERVE
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 31595
|
| Min. Negotiated Rate |
$550.80 |
| Max. Negotiated Rate |
$895.05 |
| Rate for Payer: Aetna Medicare |
$688.50
|
| Rate for Payer: BCBS Complete |
$550.80
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
|
|
PR RESECTION CONDYLE DISTAL END PHALANX EACH TOE
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 28153
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$464.42 |
| Rate for Payer: Aetna Commercial |
$336.39
|
| Rate for Payer: Aetna Medicare |
$261.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.39
|
| Rate for Payer: BCBS Complete |
$261.60
|
| Rate for Payer: BCBS MAPPO |
$251.04
|
| Rate for Payer: BCN Medicare Advantage |
$251.04
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Cofinity Commercial |
$336.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.04
|
| Rate for Payer: Healthscope Commercial |
$464.42
|
| Rate for Payer: Healthscope Commercial |
$401.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.10
|
| Rate for Payer: Nomi Health Commercial |
$301.25
|
| Rate for Payer: PACE SWMI |
$251.04
|
| Rate for Payer: PHP Medicare Advantage |
$251.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.10
|
| Rate for Payer: Priority Health Medicare |
$251.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.04
|
| Rate for Payer: UHC Medicare Advantage |
$251.04
|
|
|
PR RESECTION EXTERNAL CARDIAC TUMOR
|
Professional
|
Both
|
$4,644.00
|
|
|
Service Code
|
HCPCS 33130
|
| Min. Negotiated Rate |
$1,306.94 |
| Max. Negotiated Rate |
$3,018.60 |
| Rate for Payer: Aetna Commercial |
$1,751.30
|
| Rate for Payer: Aetna Medicare |
$1,359.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,751.30
|
| Rate for Payer: BCBS Complete |
$1,857.60
|
| Rate for Payer: BCBS MAPPO |
$1,306.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.94
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,881.99
|
| Rate for Payer: Cofinity Commercial |
$1,751.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.94
|
| Rate for Payer: Healthscope Commercial |
$2,091.10
|
| Rate for Payer: Healthscope Commercial |
$2,417.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,372.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,018.60
|
| Rate for Payer: Nomi Health Commercial |
$1,568.33
|
| Rate for Payer: PACE SWMI |
$1,306.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.60
|
| Rate for Payer: Priority Health Medicare |
$1,306.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.94
|
|
