|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Facility
|
IP
|
$2,602.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
27650
|
| Min. Negotiated Rate |
$1,639.26 |
| Max. Negotiated Rate |
$2,341.80 |
| Rate for Payer: Aetna Commercial |
$2,211.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,691.30
|
| Rate for Payer: Cash Price |
$2,081.60
|
| Rate for Payer: Cofinity Commercial |
$1,821.40
|
| Rate for Payer: Cofinity Commercial |
$2,237.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,821.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.60
|
| Rate for Payer: Healthscope Commercial |
$2,341.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,211.70
|
| Rate for Payer: PHP Commercial |
$2,211.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,691.30
|
| Rate for Payer: Priority Health SBD |
$1,639.26
|
|
|
PR REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT
|
Professional
|
Both
|
$1,814.00
|
|
|
Service Code
|
HCPCS 27407
|
| Min. Negotiated Rate |
$95.09 |
| Max. Negotiated Rate |
$141,484.00 |
| Rate for Payer: Aetna Commercial |
$1,033.02
|
| Rate for Payer: Aetna Medicare |
$801.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.11
|
| Rate for Payer: BCBS Complete |
$547.05
|
| Rate for Payer: BCBS MAPPO |
$770.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.09
|
| Rate for Payer: BCN Commercial |
$1,173.32
|
| Rate for Payer: BCN Medicare Advantage |
$770.91
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,110.11
|
| Rate for Payer: Cofinity Commercial |
$1,033.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.91
|
| Rate for Payer: Healthscope Commercial |
$1,426.18
|
| Rate for Payer: Healthscope Commercial |
$1,233.46
|
| Rate for Payer: Mclaren Medicaid |
$521.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.46
|
| Rate for Payer: Meridian Medicaid |
$547.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,484.00
|
| Rate for Payer: Nomi Health Commercial |
$925.09
|
| Rate for Payer: PACE SWMI |
$770.91
|
| Rate for Payer: PHP Medicare Advantage |
$770.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,232.98
|
| Rate for Payer: Priority Health Medicare |
$770.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,232.98
|
| Rate for Payer: Priority Health SBD |
$1,232.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.91
|
| Rate for Payer: UHC Exchange |
$1,067.28
|
| Rate for Payer: UHC Medicare Advantage |
$770.91
|
| Rate for Payer: UHCCP Medicaid |
$521.00
|
|
|
PR REPAIR RECTOCELE SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,288.00
|
|
|
Service Code
|
HCPCS 45560
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$122,814.00 |
| Rate for Payer: Aetna Commercial |
$888.55
|
| Rate for Payer: Aetna Medicare |
$689.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.86
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$663.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,240.52
|
| Rate for Payer: BCN Commercial |
$1,009.12
|
| Rate for Payer: BCN Medicare Advantage |
$663.10
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cash Price |
$1,030.40
|
| Rate for Payer: Cofinity Commercial |
$954.86
|
| Rate for Payer: Cofinity Commercial |
$888.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.10
|
| Rate for Payer: Healthscope Commercial |
$1,226.74
|
| Rate for Payer: Healthscope Commercial |
$1,060.96
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.26
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122,814.00
|
| Rate for Payer: Nomi Health Commercial |
$795.72
|
| Rate for Payer: PACE SWMI |
$663.10
|
| Rate for Payer: PHP Medicare Advantage |
$663.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$837.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.12
|
| Rate for Payer: Priority Health Medicare |
$663.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.12
|
| Rate for Payer: Priority Health SBD |
$1,239.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.10
|
| Rate for Payer: UHC Exchange |
$728.46
|
| Rate for Payer: UHC Medicare Advantage |
$663.10
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 27654
|
| Min. Negotiated Rate |
$467.11 |
| Max. Negotiated Rate |
$126,405.00 |
| Rate for Payer: Aetna Commercial |
$924.28
|
| Rate for Payer: Aetna Medicare |
$717.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.25
|
| Rate for Payer: BCBS Complete |
$490.47
|
| Rate for Payer: BCBS MAPPO |
$689.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.09
|
| Rate for Payer: BCN Commercial |
$1,047.73
|
| Rate for Payer: BCN Medicare Advantage |
$689.76
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$993.25
|
| Rate for Payer: Cofinity Commercial |
$924.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.76
|
| Rate for Payer: Healthscope Commercial |
$1,276.06
|
| Rate for Payer: Healthscope Commercial |
$1,103.62
|
| Rate for Payer: Mclaren Medicaid |
$467.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$724.25
|
| Rate for Payer: Meridian Medicaid |
$490.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126,405.00
|
| Rate for Payer: Nomi Health Commercial |
$827.71
|
| Rate for Payer: PACE SWMI |
$689.76
|
| Rate for Payer: PHP Medicare Advantage |
$689.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.73
|
| Rate for Payer: Priority Health Medicare |
$689.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,103.73
|
| Rate for Payer: Priority Health SBD |
$1,103.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.76
|
| Rate for Payer: UHC Exchange |
$1,055.68
|
| Rate for Payer: UHC Medicare Advantage |
$689.76
|
| Rate for Payer: UHCCP Medicaid |
$467.11
|
|
|
PR REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL
|
Professional
|
Both
|
$2,993.00
|
|
|
Service Code
|
HCPCS 27698
|
| Min. Negotiated Rate |
$414.92 |
| Max. Negotiated Rate |
$113,463.00 |
| Rate for Payer: Aetna Commercial |
$822.96
|
| Rate for Payer: Aetna Medicare |
$638.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.38
|
| Rate for Payer: BCBS Complete |
$435.67
|
| Rate for Payer: BCBS MAPPO |
$614.15
|
| Rate for Payer: BCBS Trust/PPO |
$474.94
|
| Rate for Payer: BCN Commercial |
$938.75
|
| Rate for Payer: BCN Medicare Advantage |
$614.15
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Cash Price |
$2,394.40
|
| Rate for Payer: Cofinity Commercial |
$884.38
|
| Rate for Payer: Cofinity Commercial |
$822.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.15
|
| Rate for Payer: Healthscope Commercial |
$982.64
|
| Rate for Payer: Healthscope Commercial |
$1,136.18
|
| Rate for Payer: Mclaren Medicaid |
$414.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.86
|
| Rate for Payer: Meridian Medicaid |
$435.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,463.00
|
| Rate for Payer: Nomi Health Commercial |
$736.98
|
| Rate for Payer: PACE SWMI |
$614.15
|
| Rate for Payer: PHP Medicare Advantage |
$614.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$982.61
|
| Rate for Payer: Priority Health Medicare |
$614.15
|
| Rate for Payer: Priority Health Narrow Network |
$982.61
|
| Rate for Payer: Priority Health SBD |
$982.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.15
|
| Rate for Payer: UHC Exchange |
$867.53
|
| Rate for Payer: UHC Medicare Advantage |
$614.15
|
| Rate for Payer: UHCCP Medicaid |
$414.92
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE COMPLEX
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 26562
|
| Min. Negotiated Rate |
$616.00 |
| Max. Negotiated Rate |
$243,434.00 |
| Rate for Payer: Aetna Commercial |
$1,752.14
|
| Rate for Payer: Aetna Medicare |
$1,359.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,752.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,882.90
|
| Rate for Payer: BCBS Complete |
$933.96
|
| Rate for Payer: BCBS MAPPO |
$1,307.57
|
| Rate for Payer: BCBS Trust/PPO |
$616.00
|
| Rate for Payer: BCN Commercial |
$2,031.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,307.57
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,882.90
|
| Rate for Payer: Cofinity Commercial |
$1,752.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,307.57
|
| Rate for Payer: Healthscope Commercial |
$2,419.00
|
| Rate for Payer: Healthscope Commercial |
$2,092.11
|
| Rate for Payer: Mclaren Medicaid |
$889.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,372.95
|
| Rate for Payer: Meridian Medicaid |
$933.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243,434.00
|
| Rate for Payer: Nomi Health Commercial |
$1,569.08
|
| Rate for Payer: PACE SWMI |
$1,307.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,307.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$889.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.45
|
| Rate for Payer: Priority Health Medicare |
$1,307.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,121.45
|
| Rate for Payer: Priority Health SBD |
$2,121.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,351.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,307.57
|
| Rate for Payer: UHC Exchange |
$1,351.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,307.57
|
| Rate for Payer: UHCCP Medicaid |
$889.49
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26560
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$111,982.00 |
| Rate for Payer: Aetna Commercial |
$795.26
|
| Rate for Payer: Aetna Medicare |
$617.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$854.61
|
| Rate for Payer: BCBS Complete |
$430.97
|
| Rate for Payer: BCBS MAPPO |
$593.48
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$948.52
|
| Rate for Payer: BCN Medicare Advantage |
$593.48
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$854.61
|
| Rate for Payer: Cofinity Commercial |
$795.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$593.48
|
| Rate for Payer: Healthscope Commercial |
$949.57
|
| Rate for Payer: Healthscope Commercial |
$1,097.94
|
| Rate for Payer: Mclaren Medicaid |
$410.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$623.15
|
| Rate for Payer: Meridian Medicaid |
$430.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,982.00
|
| Rate for Payer: Nomi Health Commercial |
$712.18
|
| Rate for Payer: PACE SWMI |
$593.48
|
| Rate for Payer: PHP Medicare Advantage |
$593.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.17
|
| Rate for Payer: Priority Health Medicare |
$593.48
|
| Rate for Payer: Priority Health Narrow Network |
$986.17
|
| Rate for Payer: Priority Health SBD |
$986.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$593.48
|
| Rate for Payer: UHC Exchange |
$721.02
|
| Rate for Payer: UHC Medicare Advantage |
$593.48
|
| Rate for Payer: UHCCP Medicaid |
$410.45
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT
|
Professional
|
Both
|
$2,404.00
|
|
|
Service Code
|
HCPCS 26561
|
| Min. Negotiated Rate |
$540.45 |
| Max. Negotiated Rate |
$173,995.00 |
| Rate for Payer: Aetna Commercial |
$1,243.72
|
| Rate for Payer: Aetna Medicare |
$965.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.54
|
| Rate for Payer: BCBS Complete |
$665.58
|
| Rate for Payer: BCBS MAPPO |
$928.15
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$1,457.24
|
| Rate for Payer: BCN Medicare Advantage |
$928.15
|
| Rate for Payer: Cash Price |
$1,923.20
|
| Rate for Payer: Cash Price |
$1,923.20
|
| Rate for Payer: Cofinity Commercial |
$1,336.54
|
| Rate for Payer: Cofinity Commercial |
$1,243.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.15
|
| Rate for Payer: Healthscope Commercial |
$1,717.08
|
| Rate for Payer: Healthscope Commercial |
$1,485.04
|
| Rate for Payer: Mclaren Medicaid |
$633.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.56
|
| Rate for Payer: Meridian Medicaid |
$665.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173,995.00
|
| Rate for Payer: Nomi Health Commercial |
$1,113.78
|
| Rate for Payer: PACE SWMI |
$928.15
|
| Rate for Payer: PHP Medicare Advantage |
$928.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.91
|
| Rate for Payer: Priority Health Medicare |
$928.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.91
|
| Rate for Payer: Priority Health SBD |
$1,516.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.15
|
| Rate for Payer: UHC Exchange |
$1,056.39
|
| Rate for Payer: UHC Medicare Advantage |
$928.15
|
| Rate for Payer: UHCCP Medicaid |
$633.89
|
|
|
PR REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 28208
|
| Min. Negotiated Rate |
$208.74 |
| Max. Negotiated Rate |
$56,570.00 |
| Rate for Payer: Aetna Commercial |
$410.50
|
| Rate for Payer: Aetna Medicare |
$318.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.13
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS MAPPO |
$306.34
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$709.56
|
| Rate for Payer: BCN Medicare Advantage |
$306.34
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cofinity Commercial |
$441.13
|
| Rate for Payer: Cofinity Commercial |
$410.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.34
|
| Rate for Payer: Healthscope Commercial |
$566.73
|
| Rate for Payer: Healthscope Commercial |
$490.14
|
| Rate for Payer: Mclaren Medicaid |
$208.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.66
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,570.00
|
| Rate for Payer: Nomi Health Commercial |
$367.61
|
| Rate for Payer: PACE SWMI |
$306.34
|
| Rate for Payer: PHP Medicare Advantage |
$306.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.13
|
| Rate for Payer: Priority Health Medicare |
$306.34
|
| Rate for Payer: Priority Health Narrow Network |
$496.13
|
| Rate for Payer: Priority Health SBD |
$496.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.34
|
| Rate for Payer: UHC Exchange |
$504.11
|
| Rate for Payer: UHC Medicare Advantage |
$306.34
|
| Rate for Payer: UHCCP Medicaid |
$208.74
|
|
|
PR REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA TDN/MUSC
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 24341
|
| Min. Negotiated Rate |
$91.92 |
| Max. Negotiated Rate |
$132,392.00 |
| Rate for Payer: Aetna Commercial |
$968.40
|
| Rate for Payer: Aetna Medicare |
$751.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.40
|
| Rate for Payer: BCBS Complete |
$515.74
|
| Rate for Payer: BCBS MAPPO |
$722.69
|
| Rate for Payer: BCBS Trust/PPO |
$91.92
|
| Rate for Payer: BCN Commercial |
$1,102.94
|
| Rate for Payer: BCN Medicare Advantage |
$722.69
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$968.40
|
| Rate for Payer: Cofinity Commercial |
$1,040.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.69
|
| Rate for Payer: Healthscope Commercial |
$1,336.98
|
| Rate for Payer: Healthscope Commercial |
$1,156.30
|
| Rate for Payer: Mclaren Medicaid |
$491.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.82
|
| Rate for Payer: Meridian Medicaid |
$515.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,392.00
|
| Rate for Payer: Nomi Health Commercial |
$867.23
|
| Rate for Payer: PACE SWMI |
$722.69
|
| Rate for Payer: PHP Medicare Advantage |
$722.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,164.28
|
| Rate for Payer: Priority Health Medicare |
$722.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,164.28
|
| Rate for Payer: Priority Health SBD |
$1,164.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.69
|
| Rate for Payer: UHC Exchange |
$670.45
|
| Rate for Payer: UHC Medicare Advantage |
$722.69
|
| Rate for Payer: UHCCP Medicaid |
$491.18
|
|
|
PR REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 33363
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$241,270.00 |
| Rate for Payer: Aetna Commercial |
$1,750.08
|
| Rate for Payer: Aetna Medicare |
$1,358.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,750.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,880.68
|
| Rate for Payer: BCBS Complete |
$897.51
|
| Rate for Payer: BCBS MAPPO |
$1,306.03
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,948.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.03
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,880.68
|
| Rate for Payer: Cofinity Commercial |
$1,750.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.03
|
| Rate for Payer: Healthscope Commercial |
$2,089.65
|
| Rate for Payer: Healthscope Commercial |
$2,416.16
|
| Rate for Payer: Mclaren Medicaid |
$854.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,371.33
|
| Rate for Payer: Meridian Medicaid |
$897.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241,270.00
|
| Rate for Payer: Nomi Health Commercial |
$1,567.24
|
| Rate for Payer: PACE SWMI |
$1,306.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,130.49
|
| Rate for Payer: Priority Health Medicare |
$1,306.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,130.49
|
| Rate for Payer: Priority Health SBD |
$2,130.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.03
|
| Rate for Payer: UHCCP Medicaid |
$854.77
|
|
|
PR REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH
|
Professional
|
Both
|
$4,316.00
|
|
|
Service Code
|
HCPCS 33362
|
| Min. Negotiated Rate |
$618.64 |
| Max. Negotiated Rate |
$233,006.00 |
| Rate for Payer: Aetna Commercial |
$1,689.73
|
| Rate for Payer: Aetna Medicare |
$1,311.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,689.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,815.83
|
| Rate for Payer: BCBS Complete |
$866.65
|
| Rate for Payer: BCBS MAPPO |
$1,260.99
|
| Rate for Payer: BCBS Trust/PPO |
$618.64
|
| Rate for Payer: BCN Commercial |
$1,882.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,260.99
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cofinity Commercial |
$1,815.83
|
| Rate for Payer: Cofinity Commercial |
$1,689.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,260.99
|
| Rate for Payer: Healthscope Commercial |
$2,017.58
|
| Rate for Payer: Healthscope Commercial |
$2,332.83
|
| Rate for Payer: Mclaren Medicaid |
$825.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,324.04
|
| Rate for Payer: Meridian Medicaid |
$866.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233,006.00
|
| Rate for Payer: Nomi Health Commercial |
$1,513.19
|
| Rate for Payer: PACE SWMI |
$1,260.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,260.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,805.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.85
|
| Rate for Payer: Priority Health Medicare |
$1,260.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.85
|
| Rate for Payer: Priority Health SBD |
$2,052.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,260.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,260.99
|
| Rate for Payer: UHCCP Medicaid |
$825.38
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH
|
Professional
|
Both
|
$5,215.00
|
|
|
Service Code
|
HCPCS 33365
|
| Min. Negotiated Rate |
$775.54 |
| Max. Negotiated Rate |
$251,870.00 |
| Rate for Payer: Aetna Commercial |
$1,822.96
|
| Rate for Payer: Aetna Medicare |
$1,414.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,822.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.00
|
| Rate for Payer: BCBS Complete |
$934.86
|
| Rate for Payer: BCBS MAPPO |
$1,360.42
|
| Rate for Payer: BCBS Trust/PPO |
$775.54
|
| Rate for Payer: BCN Commercial |
$2,034.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,360.42
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,959.00
|
| Rate for Payer: Cofinity Commercial |
$1,822.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,360.42
|
| Rate for Payer: Healthscope Commercial |
$2,176.67
|
| Rate for Payer: Healthscope Commercial |
$2,516.78
|
| Rate for Payer: Mclaren Medicaid |
$890.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,428.44
|
| Rate for Payer: Meridian Medicaid |
$934.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251,870.00
|
| Rate for Payer: Nomi Health Commercial |
$1,632.50
|
| Rate for Payer: PACE SWMI |
$1,360.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,360.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,389.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,219.31
|
| Rate for Payer: Priority Health Medicare |
$1,360.42
|
| Rate for Payer: Priority Health Narrow Network |
$2,219.31
|
| Rate for Payer: Priority Health SBD |
$2,219.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,360.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,360.42
|
| Rate for Payer: UHCCP Medicaid |
$890.34
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSTHORACIC APPROACH
|
Professional
|
Both
|
$3,171.00
|
|
|
Service Code
|
HCPCS 0318T
|
| Min. Negotiated Rate |
$1,268.40 |
| Max. Negotiated Rate |
$2,061.15 |
| Rate for Payer: Aetna Medicare |
$1,585.50
|
| Rate for Payer: BCBS Complete |
$1,268.40
|
| Rate for Payer: Cash Price |
$2,536.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.15
|
|
|
PR REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH
|
Professional
|
Both
|
$3,945.00
|
|
|
Service Code
|
HCPCS 33361
|
| Min. Negotiated Rate |
$756.36 |
| Max. Negotiated Rate |
$213,543.00 |
| Rate for Payer: Aetna Commercial |
$1,547.79
|
| Rate for Payer: Aetna Medicare |
$1,201.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,663.30
|
| Rate for Payer: BCBS Complete |
$794.18
|
| Rate for Payer: BCBS MAPPO |
$1,155.07
|
| Rate for Payer: BCBS Trust/PPO |
$920.83
|
| Rate for Payer: BCN Commercial |
$1,725.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.07
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,663.30
|
| Rate for Payer: Cofinity Commercial |
$1,547.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.07
|
| Rate for Payer: Healthscope Commercial |
$1,848.11
|
| Rate for Payer: Healthscope Commercial |
$2,136.88
|
| Rate for Payer: Mclaren Medicaid |
$756.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,212.82
|
| Rate for Payer: Meridian Medicaid |
$794.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213,543.00
|
| Rate for Payer: Nomi Health Commercial |
$1,386.08
|
| Rate for Payer: PACE SWMI |
$1,155.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$756.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,883.72
|
| Rate for Payer: Priority Health Medicare |
$1,155.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,883.72
|
| Rate for Payer: Priority Health SBD |
$1,883.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.07
|
| Rate for Payer: UHCCP Medicaid |
$756.36
|
|
|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$130,990.00 |
| Rate for Payer: Aetna Commercial |
$946.96
|
| Rate for Payer: Aetna Medicare |
$734.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.96
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$706.69
|
| Rate for Payer: BCBS Trust/PPO |
$506.11
|
| Rate for Payer: BCN Commercial |
$1,054.56
|
| Rate for Payer: BCN Medicare Advantage |
$706.69
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$946.96
|
| Rate for Payer: Cofinity Commercial |
$1,017.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.69
|
| Rate for Payer: Healthscope Commercial |
$1,130.70
|
| Rate for Payer: Healthscope Commercial |
$1,307.38
|
| Rate for Payer: Mclaren Medicaid |
$460.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.02
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130,990.00
|
| Rate for Payer: Nomi Health Commercial |
$848.03
|
| Rate for Payer: PACE SWMI |
$706.69
|
| Rate for Payer: PHP Medicare Advantage |
$706.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.62
|
| Rate for Payer: Priority Health Medicare |
$706.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.62
|
| Rate for Payer: Priority Health SBD |
$1,146.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$706.69
|
| Rate for Payer: UHC Medicare Advantage |
$706.69
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$15,583.00 |
| Rate for Payer: Aetna Commercial |
$112.04
|
| Rate for Payer: Aetna Medicare |
$86.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.40
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$83.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.73
|
| Rate for Payer: BCN Commercial |
$946.08
|
| Rate for Payer: BCN Medicare Advantage |
$83.61
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Cofinity Commercial |
$112.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.61
|
| Rate for Payer: Healthscope Commercial |
$133.78
|
| Rate for Payer: Healthscope Commercial |
$154.68
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.79
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,583.00
|
| Rate for Payer: Nomi Health Commercial |
$100.33
|
| Rate for Payer: PACE SWMI |
$83.61
|
| Rate for Payer: PHP Medicare Advantage |
$83.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$887.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.92
|
| Rate for Payer: Priority Health Medicare |
$83.61
|
| Rate for Payer: Priority Health Narrow Network |
$153.92
|
| Rate for Payer: Priority Health SBD |
$153.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.61
|
| Rate for Payer: UHC Medicare Advantage |
$83.61
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$11,745.00 |
| Rate for Payer: Aetna Commercial |
$83.67
|
| Rate for Payer: Aetna Medicare |
$64.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.91
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$62.44
|
| Rate for Payer: BCBS Trust/PPO |
$631.32
|
| Rate for Payer: BCN Commercial |
$885.97
|
| Rate for Payer: BCN Medicare Advantage |
$62.44
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$89.91
|
| Rate for Payer: Cofinity Commercial |
$83.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.44
|
| Rate for Payer: Healthscope Commercial |
$115.51
|
| Rate for Payer: Healthscope Commercial |
$99.90
|
| Rate for Payer: Mclaren Medicaid |
$41.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.56
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,745.00
|
| Rate for Payer: Nomi Health Commercial |
$74.93
|
| Rate for Payer: PACE SWMI |
$62.44
|
| Rate for Payer: PHP Medicare Advantage |
$62.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.95
|
| Rate for Payer: Priority Health Medicare |
$62.44
|
| Rate for Payer: Priority Health Narrow Network |
$113.95
|
| Rate for Payer: Priority Health SBD |
$113.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.44
|
| Rate for Payer: UHC Medicare Advantage |
$62.44
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,493.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$24,071.00 |
| Rate for Payer: Aetna Commercial |
$172.27
|
| Rate for Payer: Aetna Medicare |
$133.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.13
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$128.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,855.46
|
| Rate for Payer: BCN Commercial |
$1,148.88
|
| Rate for Payer: BCN Medicare Advantage |
$128.56
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Cofinity Commercial |
$185.13
|
| Rate for Payer: Cofinity Commercial |
$172.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.56
|
| Rate for Payer: Healthscope Commercial |
$205.70
|
| Rate for Payer: Healthscope Commercial |
$237.84
|
| Rate for Payer: Mclaren Medicaid |
$85.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.99
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,071.00
|
| Rate for Payer: Nomi Health Commercial |
$154.27
|
| Rate for Payer: PACE SWMI |
$128.56
|
| Rate for Payer: PHP Medicare Advantage |
$128.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.85
|
| Rate for Payer: Priority Health Medicare |
$128.56
|
| Rate for Payer: Priority Health Narrow Network |
$236.85
|
| Rate for Payer: Priority Health SBD |
$236.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.56
|
| Rate for Payer: UHC Medicare Advantage |
$128.56
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$5,864.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$545.73 |
| Max. Negotiated Rate |
$495,659.00 |
| Rate for Payer: Aetna Commercial |
$3,597.16
|
| Rate for Payer: Aetna Medicare |
$2,791.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,597.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,865.61
|
| Rate for Payer: BCBS Complete |
$1,848.69
|
| Rate for Payer: BCBS MAPPO |
$2,684.45
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCN Commercial |
$4,011.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,684.45
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Cofinity Commercial |
$3,865.61
|
| Rate for Payer: Cofinity Commercial |
$3,597.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,684.45
|
| Rate for Payer: Healthscope Commercial |
$4,966.23
|
| Rate for Payer: Healthscope Commercial |
$4,295.12
|
| Rate for Payer: Mclaren Medicaid |
$1,760.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,818.67
|
| Rate for Payer: Meridian Medicaid |
$1,848.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495,659.00
|
| Rate for Payer: Nomi Health Commercial |
$3,221.34
|
| Rate for Payer: PACE SWMI |
$2,684.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,684.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,760.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,811.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,380.64
|
| Rate for Payer: Priority Health Medicare |
$2,684.45
|
| Rate for Payer: Priority Health Narrow Network |
$4,380.64
|
| Rate for Payer: Priority Health SBD |
$4,380.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,041.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,684.45
|
| Rate for Payer: UHC Exchange |
$3,041.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,684.45
|
| Rate for Payer: UHCCP Medicaid |
$1,760.66
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$98,935.00 |
| Rate for Payer: Aetna Commercial |
$720.57
|
| Rate for Payer: Aetna Medicare |
$559.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.35
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS MAPPO |
$537.74
|
| Rate for Payer: BCBS Trust/PPO |
$381.90
|
| Rate for Payer: BCN Commercial |
$822.45
|
| Rate for Payer: BCN Medicare Advantage |
$537.74
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$774.35
|
| Rate for Payer: Cofinity Commercial |
$720.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.74
|
| Rate for Payer: Healthscope Commercial |
$994.82
|
| Rate for Payer: Healthscope Commercial |
$860.38
|
| Rate for Payer: Mclaren Medicaid |
$364.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.63
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,935.00
|
| Rate for Payer: Nomi Health Commercial |
$645.29
|
| Rate for Payer: PACE SWMI |
$537.74
|
| Rate for Payer: PHP Medicare Advantage |
$537.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.32
|
| Rate for Payer: Priority Health Medicare |
$537.74
|
| Rate for Payer: Priority Health Narrow Network |
$765.32
|
| Rate for Payer: Priority Health SBD |
$765.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.74
|
| Rate for Payer: UHC Exchange |
$617.84
|
| Rate for Payer: UHC Medicare Advantage |
$537.74
|
| Rate for Payer: UHCCP Medicaid |
$364.66
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$8,810.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$487,321.00 |
| Rate for Payer: Aetna Commercial |
$3,533.50
|
| Rate for Payer: Aetna Medicare |
$2,742.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,533.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,797.19
|
| Rate for Payer: BCBS Complete |
$1,814.25
|
| Rate for Payer: BCBS MAPPO |
$2,636.94
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$3,939.71
|
| 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: Mclaren Medicaid |
$1,727.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,768.79
|
| Rate for Payer: Meridian Medicaid |
$1,814.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487,321.00
|
| 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 Choice Medicaid |
$1,727.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,301.94
|
| Rate for Payer: Priority Health Medicare |
$2,636.94
|
| Rate for Payer: Priority Health Narrow Network |
$4,301.94
|
| Rate for Payer: Priority Health SBD |
$4,301.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,164.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,636.94
|
| Rate for Payer: UHC Exchange |
$3,164.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,636.94
|
| Rate for Payer: UHCCP Medicaid |
$1,727.86
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$103.52 |
| Max. Negotiated Rate |
$29,288.00 |
| Rate for Payer: Aetna Commercial |
$211.02
|
| Rate for Payer: Aetna Medicare |
$163.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.77
|
| Rate for Payer: BCBS Complete |
$108.70
|
| Rate for Payer: BCBS MAPPO |
$157.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.15
|
| Rate for Payer: BCN Commercial |
$237.01
|
| 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: Mclaren Medicaid |
$103.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.35
|
| Rate for Payer: Meridian Medicaid |
$108.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,288.00
|
| 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 Choice Medicaid |
$103.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.47
|
| Rate for Payer: Priority Health Medicare |
$157.48
|
| Rate for Payer: Priority Health Narrow Network |
$258.47
|
| Rate for Payer: Priority Health SBD |
$258.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.48
|
| Rate for Payer: UHC Medicare Advantage |
$157.48
|
| Rate for Payer: UHCCP Medicaid |
$103.52
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$18,614.00 |
| Rate for Payer: Aetna Commercial |
$133.24
|
| Rate for Payer: Aetna Medicare |
$103.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.18
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS MAPPO |
$99.43
|
| Rate for Payer: BCBS Trust/PPO |
$106.72
|
| Rate for Payer: BCN Commercial |
$181.30
|
| 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: Mclaren Medicaid |
$65.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.40
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,614.00
|
| 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 Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.35
|
| Rate for Payer: Priority Health Medicare |
$99.43
|
| Rate for Payer: Priority Health Narrow Network |
$184.35
|
| Rate for Payer: Priority Health SBD |
$184.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.43
|
| Rate for Payer: UHC Exchange |
$141.57
|
| Rate for Payer: UHC Medicare Advantage |
$99.43
|
| Rate for Payer: UHCCP Medicaid |
$65.60
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$253.47 |
| Max. Negotiated Rate |
$70,533.00 |
| Rate for Payer: Aetna Commercial |
$511.67
|
| Rate for Payer: Aetna Medicare |
$397.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.85
|
| Rate for Payer: BCBS Complete |
$266.14
|
| Rate for Payer: BCBS MAPPO |
$381.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.52
|
| Rate for Payer: BCN Commercial |
$576.15
|
| 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: Mclaren Medicaid |
$253.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.93
|
| Rate for Payer: Meridian Medicaid |
$266.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70,533.00
|
| 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 Choice Medicaid |
$253.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.34
|
| Rate for Payer: Priority Health Medicare |
$381.84
|
| Rate for Payer: Priority Health Narrow Network |
$632.34
|
| Rate for Payer: Priority Health SBD |
$632.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.84
|
| Rate for Payer: UHC Medicare Advantage |
$381.84
|
| Rate for Payer: UHCCP Medicaid |
$253.47
|
|
