|
PR RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 28126
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$43,524.00 |
| Rate for Payer: Aetna Commercial |
$319.75
|
| Rate for Payer: Aetna Medicare |
$248.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.61
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$238.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: BCN Medicare Advantage |
$238.62
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$343.61
|
| Rate for Payer: Cofinity Commercial |
$319.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.62
|
| Rate for Payer: Healthscope Commercial |
$441.45
|
| Rate for Payer: Healthscope Commercial |
$381.79
|
| Rate for Payer: Mclaren Medicaid |
$162.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.55
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,524.00
|
| Rate for Payer: Nomi Health Commercial |
$286.34
|
| Rate for Payer: PACE SWMI |
$238.62
|
| Rate for Payer: PHP Medicare Advantage |
$238.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.25
|
| Rate for Payer: Priority Health Medicare |
$238.62
|
| Rate for Payer: Priority Health Narrow Network |
$387.25
|
| Rate for Payer: Priority Health SBD |
$387.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.62
|
| Rate for Payer: UHC Exchange |
$469.34
|
| Rate for Payer: UHC Medicare Advantage |
$238.62
|
| Rate for Payer: UHCCP Medicaid |
$162.52
|
|
|
PR RESECTION PERICARDIAL CYST/TUMOR
|
Professional
|
Both
|
$2,869.00
|
|
|
Service Code
|
HCPCS 33050
|
| Min. Negotiated Rate |
$639.00 |
| Max. Negotiated Rate |
$178,069.00 |
| Rate for Payer: Aetna Commercial |
$1,297.19
|
| Rate for Payer: Aetna Medicare |
$1,006.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.99
|
| Rate for Payer: BCBS Complete |
$670.95
|
| Rate for Payer: BCBS MAPPO |
$968.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$1,448.93
|
| Rate for Payer: BCN Medicare Advantage |
$968.05
|
| Rate for Payer: Cash Price |
$2,295.20
|
| Rate for Payer: Cash Price |
$2,295.20
|
| Rate for Payer: Cofinity Commercial |
$1,393.99
|
| Rate for Payer: Cofinity Commercial |
$1,297.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.05
|
| Rate for Payer: Healthscope Commercial |
$1,790.89
|
| Rate for Payer: Healthscope Commercial |
$1,548.88
|
| Rate for Payer: Mclaren Medicaid |
$639.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,016.45
|
| Rate for Payer: Meridian Medicaid |
$670.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178,069.00
|
| Rate for Payer: Nomi Health Commercial |
$1,161.66
|
| Rate for Payer: PACE SWMI |
$968.05
|
| Rate for Payer: PHP Medicare Advantage |
$968.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,864.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.56
|
| Rate for Payer: Priority Health Medicare |
$968.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,588.56
|
| Rate for Payer: Priority Health SBD |
$1,588.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,126.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$968.05
|
| Rate for Payer: UHC Exchange |
$1,126.64
|
| Rate for Payer: UHC Medicare Advantage |
$968.05
|
| Rate for Payer: UHCCP Medicaid |
$639.00
|
|
|
PR RESECTION RIBS EXTRAPLEURAL ALL STAGES
|
Professional
|
Both
|
$3,144.00
|
|
|
Service Code
|
HCPCS 32900
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$252,965.00 |
| Rate for Payer: Aetna Commercial |
$1,878.52
|
| Rate for Payer: Aetna Medicare |
$1,457.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,878.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,018.71
|
| Rate for Payer: BCBS Complete |
$976.46
|
| Rate for Payer: BCBS MAPPO |
$1,401.88
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$2,061.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,401.88
|
| Rate for Payer: Cash Price |
$2,515.20
|
| Rate for Payer: Cash Price |
$2,515.20
|
| Rate for Payer: Cofinity Commercial |
$2,018.71
|
| Rate for Payer: Cofinity Commercial |
$1,878.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,401.88
|
| Rate for Payer: Healthscope Commercial |
$2,593.48
|
| Rate for Payer: Healthscope Commercial |
$2,243.01
|
| Rate for Payer: Mclaren Medicaid |
$929.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,471.97
|
| Rate for Payer: Meridian Medicaid |
$976.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252,965.00
|
| Rate for Payer: Nomi Health Commercial |
$1,682.26
|
| Rate for Payer: PACE SWMI |
$1,401.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,401.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$929.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,866.84
|
| Rate for Payer: Priority Health Medicare |
$1,401.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,866.84
|
| Rate for Payer: Priority Health SBD |
$1,866.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,382.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,401.88
|
| Rate for Payer: UHC Exchange |
$1,382.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,401.88
|
| Rate for Payer: UHCCP Medicaid |
$929.96
|
|
|
PR RESECTION SCROTUM
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 55150
|
| Min. Negotiated Rate |
$318.22 |
| Max. Negotiated Rate |
$86,807.00 |
| Rate for Payer: Aetna Commercial |
$633.03
|
| Rate for Payer: Aetna Medicare |
$491.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.27
|
| Rate for Payer: BCBS Complete |
$334.13
|
| Rate for Payer: BCBS MAPPO |
$472.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,291.77
|
| Rate for Payer: BCN Commercial |
$715.42
|
| Rate for Payer: BCN Medicare Advantage |
$472.41
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$680.27
|
| Rate for Payer: Cofinity Commercial |
$633.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.41
|
| Rate for Payer: Healthscope Commercial |
$873.96
|
| Rate for Payer: Healthscope Commercial |
$755.86
|
| Rate for Payer: Mclaren Medicaid |
$318.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.03
|
| Rate for Payer: Meridian Medicaid |
$334.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,807.00
|
| Rate for Payer: Nomi Health Commercial |
$566.89
|
| Rate for Payer: PACE SWMI |
$472.41
|
| Rate for Payer: PHP Medicare Advantage |
$472.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$789.84
|
| Rate for Payer: Priority Health Medicare |
$472.41
|
| Rate for Payer: Priority Health Narrow Network |
$789.84
|
| Rate for Payer: Priority Health SBD |
$789.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.41
|
| Rate for Payer: UHC Exchange |
$568.84
|
| Rate for Payer: UHC Medicare Advantage |
$472.41
|
| Rate for Payer: UHCCP Medicaid |
$318.22
|
|
|
PR RESECTION/TRANSPLANTATION LONG TENDON BICEPS
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 23440
|
| Min. Negotiated Rate |
$134.57 |
| Max. Negotiated Rate |
$134,419.00 |
| Rate for Payer: Aetna Commercial |
$979.46
|
| Rate for Payer: Aetna Medicare |
$760.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.46
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$730.94
|
| Rate for Payer: BCBS Trust/PPO |
$134.57
|
| Rate for Payer: BCN Commercial |
$1,112.72
|
| Rate for Payer: BCN Medicare Advantage |
$730.94
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$979.46
|
| Rate for Payer: Cofinity Commercial |
$1,052.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.94
|
| Rate for Payer: Healthscope Commercial |
$1,352.24
|
| Rate for Payer: Healthscope Commercial |
$1,169.50
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.49
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,419.00
|
| Rate for Payer: Nomi Health Commercial |
$877.13
|
| Rate for Payer: PACE SWMI |
$730.94
|
| Rate for Payer: PHP Medicare Advantage |
$730.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.90
|
| Rate for Payer: Priority Health Medicare |
$730.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,170.90
|
| Rate for Payer: Priority Health SBD |
$1,170.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$730.94
|
| Rate for Payer: UHC Exchange |
$929.79
|
| Rate for Payer: UHC Medicare Advantage |
$730.94
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR RESPIRATORY FLOW VOLUME LOOP
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 94375
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$5,436.00 |
| Rate for Payer: Aetna Commercial |
$47.62
|
| Rate for Payer: Aetna Medicare |
$36.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.18
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$35.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,149.65
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Medicare Advantage |
$35.54
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$51.18
|
| Rate for Payer: Cofinity Commercial |
$47.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.54
|
| Rate for Payer: Healthscope Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$56.86
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.32
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,436.00
|
| Rate for Payer: Nomi Health Commercial |
$42.65
|
| Rate for Payer: PACE SWMI |
$35.54
|
| Rate for Payer: PHP Medicare Advantage |
$35.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.93
|
| Rate for Payer: Priority Health Medicare |
$35.54
|
| Rate for Payer: Priority Health Narrow Network |
$52.93
|
| Rate for Payer: Priority Health SBD |
$19.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.54
|
| Rate for Payer: UHC Exchange |
$54.33
|
| Rate for Payer: UHC Medicare Advantage |
$35.54
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
PR RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E
|
Professional
|
Both
|
$3,690.00
|
|
|
Service Code
|
HCPCS 90378
|
| Min. Negotiated Rate |
$1,476.00 |
| Max. Negotiated Rate |
$185,707.00 |
| Rate for Payer: Aetna Commercial |
$1,857.07
|
| Rate for Payer: Aetna Medicare |
$1,845.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,857.07
|
| Rate for Payer: BCBS Complete |
$1,476.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.79
|
| Rate for Payer: BCN Commercial |
$1,700.79
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185,707.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,398.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,987.80
|
| Rate for Payer: UHC Exchange |
$1,987.80
|
|
|
PR REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 37222
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$32,782.00 |
| Rate for Payer: Aetna Commercial |
$237.72
|
| Rate for Payer: Aetna Medicare |
$184.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.46
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: BCN Commercial |
$903.08
|
| Rate for Payer: BCN Medicare Advantage |
$177.40
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$237.72
|
| Rate for Payer: Cofinity Commercial |
$255.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.40
|
| Rate for Payer: Healthscope Commercial |
$328.19
|
| Rate for Payer: Healthscope Commercial |
$283.84
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.27
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,782.00
|
| Rate for Payer: Nomi Health Commercial |
$212.88
|
| Rate for Payer: PACE SWMI |
$177.40
|
| Rate for Payer: PHP Medicare Advantage |
$177.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.13
|
| Rate for Payer: Priority Health Medicare |
$177.40
|
| Rate for Payer: Priority Health Narrow Network |
$286.13
|
| Rate for Payer: Priority Health SBD |
$286.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.40
|
| Rate for Payer: UHC Medicare Advantage |
$177.40
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 37220
|
| Min. Negotiated Rate |
$248.57 |
| Max. Negotiated Rate |
$70,700.00 |
| Rate for Payer: Aetna Commercial |
$510.93
|
| Rate for Payer: Aetna Medicare |
$396.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.06
|
| Rate for Payer: BCBS Complete |
$261.00
|
| Rate for Payer: BCBS MAPPO |
$381.29
|
| Rate for Payer: BCBS Trust/PPO |
$463.32
|
| Rate for Payer: BCN Commercial |
$3,691.47
|
| Rate for Payer: BCN Medicare Advantage |
$381.29
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$549.06
|
| Rate for Payer: Cofinity Commercial |
$510.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.29
|
| Rate for Payer: Healthscope Commercial |
$610.06
|
| Rate for Payer: Healthscope Commercial |
$705.39
|
| Rate for Payer: Mclaren Medicaid |
$248.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.35
|
| Rate for Payer: Meridian Medicaid |
$261.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70,700.00
|
| Rate for Payer: Nomi Health Commercial |
$457.55
|
| Rate for Payer: PACE SWMI |
$381.29
|
| Rate for Payer: PHP Medicare Advantage |
$381.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.05
|
| Rate for Payer: Priority Health Medicare |
$381.29
|
| Rate for Payer: Priority Health Narrow Network |
$619.05
|
| Rate for Payer: Priority Health SBD |
$619.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.29
|
| Rate for Payer: UHC Medicare Advantage |
$381.29
|
| Rate for Payer: UHCCP Medicaid |
$248.57
|
|
|
PR REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT
|
Professional
|
Both
|
$4,999.00
|
|
|
Service Code
|
HCPCS 24371
|
| Min. Negotiated Rate |
$413.46 |
| Max. Negotiated Rate |
$313,497.00 |
| Rate for Payer: Aetna Commercial |
$2,276.55
|
| Rate for Payer: Aetna Medicare |
$1,766.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,276.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,446.44
|
| Rate for Payer: BCBS Complete |
$1,194.74
|
| Rate for Payer: BCBS MAPPO |
$1,698.92
|
| Rate for Payer: BCBS Trust/PPO |
$413.46
|
| Rate for Payer: BCN Commercial |
$2,578.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,698.92
|
| Rate for Payer: Cash Price |
$3,999.20
|
| Rate for Payer: Cash Price |
$3,999.20
|
| Rate for Payer: Cofinity Commercial |
$2,446.44
|
| Rate for Payer: Cofinity Commercial |
$2,276.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,698.92
|
| Rate for Payer: Healthscope Commercial |
$2,718.27
|
| Rate for Payer: Healthscope Commercial |
$3,143.00
|
| Rate for Payer: Mclaren Medicaid |
$1,137.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,783.87
|
| Rate for Payer: Meridian Medicaid |
$1,194.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313,497.00
|
| Rate for Payer: Nomi Health Commercial |
$2,038.70
|
| Rate for Payer: PACE SWMI |
$1,698.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,698.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,137.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,249.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,700.53
|
| Rate for Payer: Priority Health Medicare |
$1,698.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,700.53
|
| Rate for Payer: Priority Health SBD |
$2,700.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,698.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,698.92
|
| Rate for Payer: UHCCP Medicaid |
$1,137.85
|
|
|
PR REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT
|
Professional
|
Both
|
$3,780.00
|
|
|
Service Code
|
HCPCS 24370
|
| Min. Negotiated Rate |
$355.73 |
| Max. Negotiated Rate |
$272,826.00 |
| Rate for Payer: Aetna Commercial |
$1,982.26
|
| Rate for Payer: Aetna Medicare |
$1,538.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,982.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.19
|
| Rate for Payer: BCBS Complete |
$1,042.21
|
| Rate for Payer: BCBS MAPPO |
$1,479.30
|
| Rate for Payer: BCBS Trust/PPO |
$355.73
|
| Rate for Payer: BCN Commercial |
$2,246.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.30
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Cofinity Commercial |
$2,130.19
|
| Rate for Payer: Cofinity Commercial |
$1,982.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.30
|
| Rate for Payer: Healthscope Commercial |
$2,366.88
|
| Rate for Payer: Healthscope Commercial |
$2,736.70
|
| Rate for Payer: Mclaren Medicaid |
$992.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.26
|
| Rate for Payer: Meridian Medicaid |
$1,042.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272,826.00
|
| Rate for Payer: Nomi Health Commercial |
$1,775.16
|
| Rate for Payer: PACE SWMI |
$1,479.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,457.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,350.43
|
| Rate for Payer: Priority Health Medicare |
$1,479.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,350.43
|
| Rate for Payer: Priority Health SBD |
$2,350.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,479.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.30
|
| Rate for Payer: UHCCP Medicaid |
$992.58
|
|
|
PR REVISION OF LARYNX, UNSPECIFIED
|
Professional
|
Both
|
$2,060.00
|
|
|
Service Code
|
HCPCS 31588
|
| Min. Negotiated Rate |
$824.00 |
| Max. Negotiated Rate |
$1,339.00 |
| Rate for Payer: Aetna Medicare |
$1,030.00
|
| Rate for Payer: BCBS Complete |
$824.00
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,339.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.00
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Facility
|
IP
|
$1,218.00
|
|
|
Service Code
|
CPT 19380
|
| Hospital Charge Code |
19380
|
| Min. Negotiated Rate |
$767.34 |
| Max. Negotiated Rate |
$1,096.20 |
| Rate for Payer: Aetna Commercial |
$1,035.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.70
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$1,047.48
|
| Rate for Payer: Cofinity Commercial |
$852.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$852.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.40
|
| Rate for Payer: Healthscope Commercial |
$1,096.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.30
|
| Rate for Payer: PHP Commercial |
$1,035.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health SBD |
$767.34
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 19380
|
| Min. Negotiated Rate |
$522.92 |
| Max. Negotiated Rate |
$142,526.00 |
| Rate for Payer: Aetna Commercial |
$1,035.99
|
| Rate for Payer: Aetna Medicare |
$804.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.31
|
| Rate for Payer: BCBS Complete |
$549.07
|
| Rate for Payer: BCBS MAPPO |
$773.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,918.45
|
| Rate for Payer: BCN Commercial |
$1,182.11
|
| Rate for Payer: BCN Medicare Advantage |
$773.13
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$1,113.31
|
| Rate for Payer: Cofinity Commercial |
$1,035.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$773.13
|
| Rate for Payer: Healthscope Commercial |
$1,430.29
|
| Rate for Payer: Healthscope Commercial |
$1,237.01
|
| Rate for Payer: Mclaren Medicaid |
$522.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.79
|
| Rate for Payer: Meridian Medicaid |
$549.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,526.00
|
| Rate for Payer: Nomi Health Commercial |
$927.76
|
| Rate for Payer: PACE SWMI |
$773.13
|
| Rate for Payer: PHP Medicare Advantage |
$773.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,097.64
|
| Rate for Payer: Priority Health Medicare |
$773.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.64
|
| Rate for Payer: Priority Health SBD |
$1,097.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$773.13
|
| Rate for Payer: UHC Exchange |
$857.40
|
| Rate for Payer: UHC Medicare Advantage |
$773.13
|
| Rate for Payer: UHCCP Medicaid |
$522.92
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Facility
|
OP
|
$1,218.00
|
|
|
Service Code
|
CPT 19380
|
| Hospital Charge Code |
19380
|
| Min. Negotiated Rate |
$767.34 |
| Max. Negotiated Rate |
$20,082.39 |
| Rate for Payer: Aetna Commercial |
$1,035.30
|
| Rate for Payer: Aetna Medicare |
$6,645.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,987.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,987.00
|
| Rate for Payer: BCBS Complete |
$3,596.07
|
| Rate for Payer: BCBS MAPPO |
$6,389.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,983.93
|
| Rate for Payer: BCN Commercial |
$2,983.93
|
| Rate for Payer: BCN Medicare Advantage |
$6,389.60
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$852.60
|
| Rate for Payer: Cofinity Commercial |
$1,047.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$852.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,389.60
|
| Rate for Payer: Healthscope Commercial |
$1,096.20
|
| Rate for Payer: Mclaren Medicaid |
$3,424.83
|
| Rate for Payer: Mclaren Medicare |
$6,389.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,709.08
|
| Rate for Payer: Meridian Medicaid |
$3,596.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,348.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.30
|
| Rate for Payer: Nomi Health Commercial |
$13,418.16
|
| Rate for Payer: PACE Medicare |
$6,070.12
|
| Rate for Payer: PACE SWMI |
$6,389.60
|
| Rate for Payer: PHP Commercial |
$1,035.30
|
| Rate for Payer: PHP Medicare Advantage |
$6,389.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,424.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,082.39
|
| Rate for Payer: Priority Health Medicare |
$6,389.60
|
| Rate for Payer: Priority Health Narrow Network |
$16,065.91
|
| Rate for Payer: Priority Health SBD |
$767.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6,389.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.12
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,389.60
|
| Rate for Payer: UHC Medicare Advantage |
$6,389.60
|
| Rate for Payer: UHCCP Medicaid |
$3,597.34
|
| Rate for Payer: VA VA |
$6,389.60
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 19380
|
| Hospital Charge Code |
19380
|
| Min. Negotiated Rate |
$522.92 |
| Max. Negotiated Rate |
$142,526.00 |
| Rate for Payer: Aetna Commercial |
$1,035.99
|
| Rate for Payer: Aetna Medicare |
$804.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.31
|
| Rate for Payer: BCBS Complete |
$549.07
|
| Rate for Payer: BCBS MAPPO |
$773.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,918.45
|
| Rate for Payer: BCN Commercial |
$1,182.11
|
| Rate for Payer: BCN Medicare Advantage |
$773.13
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$1,113.31
|
| Rate for Payer: Cofinity Commercial |
$1,035.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$773.13
|
| Rate for Payer: Healthscope Commercial |
$1,430.29
|
| Rate for Payer: Healthscope Commercial |
$1,237.01
|
| Rate for Payer: Mclaren Medicaid |
$522.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.79
|
| Rate for Payer: Meridian Medicaid |
$549.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,526.00
|
| Rate for Payer: Nomi Health Commercial |
$927.76
|
| Rate for Payer: PACE SWMI |
$773.13
|
| Rate for Payer: PHP Medicare Advantage |
$773.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,097.64
|
| Rate for Payer: Priority Health Medicare |
$773.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.64
|
| Rate for Payer: Priority Health SBD |
$1,097.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$773.13
|
| Rate for Payer: UHC Exchange |
$857.40
|
| Rate for Payer: UHC Medicare Advantage |
$773.13
|
| Rate for Payer: UHCCP Medicaid |
$522.92
|
|
|
PR REVISION PERI-IMPLANT CAPSULE BREAST
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 19370
|
| Min. Negotiated Rate |
$435.59 |
| Max. Negotiated Rate |
$118,462.00 |
| Rate for Payer: Aetna Commercial |
$862.18
|
| Rate for Payer: Aetna Medicare |
$669.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$926.52
|
| Rate for Payer: BCBS Complete |
$457.37
|
| Rate for Payer: BCBS MAPPO |
$643.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$983.22
|
| Rate for Payer: BCN Medicare Advantage |
$643.42
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$926.52
|
| Rate for Payer: Cofinity Commercial |
$862.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.42
|
| Rate for Payer: Healthscope Commercial |
$1,190.33
|
| Rate for Payer: Healthscope Commercial |
$1,029.47
|
| Rate for Payer: Mclaren Medicaid |
$435.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.59
|
| Rate for Payer: Meridian Medicaid |
$457.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,462.00
|
| Rate for Payer: Nomi Health Commercial |
$772.10
|
| Rate for Payer: PACE SWMI |
$643.42
|
| Rate for Payer: PHP Medicare Advantage |
$643.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$914.32
|
| Rate for Payer: Priority Health Medicare |
$643.42
|
| Rate for Payer: Priority Health Narrow Network |
$914.32
|
| Rate for Payer: Priority Health SBD |
$914.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.42
|
| Rate for Payer: UHC Exchange |
$700.00
|
| Rate for Payer: UHC Medicare Advantage |
$643.42
|
| Rate for Payer: UHCCP Medicaid |
$435.59
|
|
|
PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 57426
|
| Min. Negotiated Rate |
$559.98 |
| Max. Negotiated Rate |
$154,960.00 |
| Rate for Payer: Aetna Commercial |
$1,118.71
|
| Rate for Payer: Aetna Medicare |
$868.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.20
|
| Rate for Payer: BCBS Complete |
$587.98
|
| Rate for Payer: BCBS MAPPO |
$834.86
|
| Rate for Payer: BCBS Trust/PPO |
$628.68
|
| Rate for Payer: BCN Commercial |
$1,275.45
|
| Rate for Payer: BCN Medicare Advantage |
$834.86
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$1,202.20
|
| Rate for Payer: Cofinity Commercial |
$1,118.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.86
|
| Rate for Payer: Healthscope Commercial |
$1,335.78
|
| Rate for Payer: Healthscope Commercial |
$1,544.49
|
| Rate for Payer: Mclaren Medicaid |
$559.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.60
|
| Rate for Payer: Meridian Medicaid |
$587.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,960.00
|
| Rate for Payer: Nomi Health Commercial |
$1,001.83
|
| Rate for Payer: PACE SWMI |
$834.86
|
| Rate for Payer: PHP Medicare Advantage |
$834.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.09
|
| Rate for Payer: Priority Health Medicare |
$834.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.09
|
| Rate for Payer: Priority Health SBD |
$1,306.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.86
|
| Rate for Payer: UHC Medicare Advantage |
$834.86
|
| Rate for Payer: UHCCP Medicaid |
$559.98
|
|
|
PR REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV
|
Professional
|
Both
|
$2,230.00
|
|
|
Service Code
|
HCPCS 64569
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$138,236.00 |
| Rate for Payer: Aetna Commercial |
$1,019.55
|
| Rate for Payer: Aetna Medicare |
$791.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.64
|
| Rate for Payer: BCBS Complete |
$529.38
|
| Rate for Payer: BCBS MAPPO |
$760.86
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: BCN Commercial |
$1,132.26
|
| Rate for Payer: BCN Medicare Advantage |
$760.86
|
| Rate for Payer: Cash Price |
$1,784.00
|
| Rate for Payer: Cash Price |
$1,784.00
|
| Rate for Payer: Cofinity Commercial |
$1,095.64
|
| Rate for Payer: Cofinity Commercial |
$1,019.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.86
|
| Rate for Payer: Healthscope Commercial |
$1,217.38
|
| Rate for Payer: Healthscope Commercial |
$1,407.59
|
| Rate for Payer: Mclaren Medicaid |
$504.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.90
|
| Rate for Payer: Meridian Medicaid |
$529.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,236.00
|
| Rate for Payer: Nomi Health Commercial |
$913.03
|
| Rate for Payer: PACE SWMI |
$760.86
|
| Rate for Payer: PHP Medicare Advantage |
$760.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.34
|
| Rate for Payer: Priority Health Medicare |
$760.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,335.34
|
| Rate for Payer: Priority Health SBD |
$1,335.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.86
|
| Rate for Payer: UHC Medicare Advantage |
$760.86
|
| Rate for Payer: UHCCP Medicaid |
$504.17
|
|
|
PR REVISION STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$3,917.00
|
|
|
Service Code
|
HCPCS 69662
|
| Min. Negotiated Rate |
$735.06 |
| Max. Negotiated Rate |
$204,606.00 |
| Rate for Payer: Aetna Commercial |
$1,448.30
|
| Rate for Payer: Aetna Medicare |
$1,124.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.38
|
| Rate for Payer: BCBS Complete |
$771.81
|
| Rate for Payer: BCBS MAPPO |
$1,080.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,121.20
|
| Rate for Payer: BCN Commercial |
$1,704.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.82
|
| Rate for Payer: Cash Price |
$3,133.60
|
| Rate for Payer: Cash Price |
$3,133.60
|
| Rate for Payer: Cofinity Commercial |
$1,556.38
|
| Rate for Payer: Cofinity Commercial |
$1,448.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.82
|
| Rate for Payer: Healthscope Commercial |
$1,999.52
|
| Rate for Payer: Healthscope Commercial |
$1,729.31
|
| Rate for Payer: Mclaren Medicaid |
$735.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,134.86
|
| Rate for Payer: Meridian Medicaid |
$771.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204,606.00
|
| Rate for Payer: Nomi Health Commercial |
$1,296.98
|
| Rate for Payer: PACE SWMI |
$1,080.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,546.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,696.48
|
| Rate for Payer: Priority Health Medicare |
$1,080.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,696.48
|
| Rate for Payer: Priority Health SBD |
$1,696.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,580.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,080.82
|
| Rate for Payer: UHC Exchange |
$1,580.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.82
|
| Rate for Payer: UHCCP Medicaid |
$735.06
|
|
|
PR REVISION TRACHEOSTOMY SCAR
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 31830
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$64,798.00 |
| Rate for Payer: Aetna Commercial |
$464.81
|
| Rate for Payer: Aetna Medicare |
$360.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.49
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS MAPPO |
$346.87
|
| Rate for Payer: BCBS Trust/PPO |
$982.11
|
| Rate for Payer: BCN Commercial |
$733.51
|
| Rate for Payer: BCN Medicare Advantage |
$346.87
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$499.49
|
| Rate for Payer: Cofinity Commercial |
$464.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.87
|
| Rate for Payer: Healthscope Commercial |
$641.71
|
| Rate for Payer: Healthscope Commercial |
$554.99
|
| Rate for Payer: Mclaren Medicaid |
$237.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.21
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,798.00
|
| Rate for Payer: Nomi Health Commercial |
$416.24
|
| Rate for Payer: PACE SWMI |
$346.87
|
| Rate for Payer: PHP Medicare Advantage |
$346.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$516.77
|
| Rate for Payer: Priority Health Medicare |
$346.87
|
| Rate for Payer: Priority Health Narrow Network |
$516.77
|
| Rate for Payer: Priority Health SBD |
$516.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.87
|
| Rate for Payer: UHC Exchange |
$529.98
|
| Rate for Payer: UHC Medicare Advantage |
$346.87
|
| Rate for Payer: UHCCP Medicaid |
$237.07
|
|
|
PR REVIS PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$2,060.00
|
|
|
Service Code
|
HCPCS 49426
|
| Min. Negotiated Rate |
$433.46 |
| Max. Negotiated Rate |
$120,037.00 |
| Rate for Payer: Aetna Commercial |
$873.80
|
| Rate for Payer: Aetna Medicare |
$678.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.01
|
| Rate for Payer: BCBS Complete |
$455.13
|
| Rate for Payer: BCBS MAPPO |
$652.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.94
|
| Rate for Payer: BCN Commercial |
$982.73
|
| Rate for Payer: BCN Medicare Advantage |
$652.09
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cofinity Commercial |
$939.01
|
| Rate for Payer: Cofinity Commercial |
$873.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.09
|
| Rate for Payer: Healthscope Commercial |
$1,206.37
|
| Rate for Payer: Healthscope Commercial |
$1,043.34
|
| Rate for Payer: Mclaren Medicaid |
$433.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.69
|
| Rate for Payer: Meridian Medicaid |
$455.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,037.00
|
| Rate for Payer: Nomi Health Commercial |
$782.51
|
| Rate for Payer: PACE SWMI |
$652.09
|
| Rate for Payer: PHP Medicare Advantage |
$652.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.92
|
| Rate for Payer: Priority Health Medicare |
$652.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.92
|
| Rate for Payer: Priority Health SBD |
$1,206.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.09
|
| Rate for Payer: UHC Exchange |
$727.43
|
| Rate for Payer: UHC Medicare Advantage |
$652.09
|
| Rate for Payer: UHCCP Medicaid |
$433.46
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT
|
Professional
|
Both
|
$4,192.00
|
|
|
Service Code
|
HCPCS 23474
|
| Min. Negotiated Rate |
$341.30 |
| Max. Negotiated Rate |
$308,419.00 |
| Rate for Payer: Aetna Commercial |
$2,237.25
|
| Rate for Payer: Aetna Medicare |
$1,736.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,237.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,404.21
|
| Rate for Payer: BCBS Complete |
$1,173.49
|
| Rate for Payer: BCBS MAPPO |
$1,669.59
|
| Rate for Payer: BCBS Trust/PPO |
$341.30
|
| Rate for Payer: BCN Commercial |
$2,535.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,669.59
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cofinity Commercial |
$2,404.21
|
| Rate for Payer: Cofinity Commercial |
$2,237.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,669.59
|
| Rate for Payer: Healthscope Commercial |
$2,671.34
|
| Rate for Payer: Healthscope Commercial |
$3,088.74
|
| Rate for Payer: Mclaren Medicaid |
$1,117.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,753.07
|
| Rate for Payer: Meridian Medicaid |
$1,173.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308,419.00
|
| Rate for Payer: Nomi Health Commercial |
$2,003.51
|
| Rate for Payer: PACE SWMI |
$1,669.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,669.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,724.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,652.18
|
| Rate for Payer: Priority Health Medicare |
$1,669.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,652.18
|
| Rate for Payer: Priority Health SBD |
$2,652.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,669.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.59
|
| Rate for Payer: UHCCP Medicaid |
$1,117.61
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT
|
Professional
|
Both
|
$3,586.00
|
|
|
Service Code
|
HCPCS 23473
|
| Min. Negotiated Rate |
$225.83 |
| Max. Negotiated Rate |
$285,539.00 |
| Rate for Payer: Aetna Commercial |
$2,071.59
|
| Rate for Payer: Aetna Medicare |
$1,607.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,071.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,226.18
|
| Rate for Payer: BCBS Complete |
$1,087.39
|
| Rate for Payer: BCBS MAPPO |
$1,545.96
|
| Rate for Payer: BCBS Trust/PPO |
$225.83
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,545.96
|
| Rate for Payer: Cash Price |
$2,868.80
|
| Rate for Payer: Cash Price |
$2,868.80
|
| Rate for Payer: Cofinity Commercial |
$2,226.18
|
| Rate for Payer: Cofinity Commercial |
$2,071.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,545.96
|
| Rate for Payer: Healthscope Commercial |
$2,473.54
|
| Rate for Payer: Healthscope Commercial |
$2,860.03
|
| Rate for Payer: Mclaren Medicaid |
$1,035.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.26
|
| Rate for Payer: Meridian Medicaid |
$1,087.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285,539.00
|
| Rate for Payer: Nomi Health Commercial |
$1,855.15
|
| Rate for Payer: PACE SWMI |
$1,545.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,545.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,035.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,330.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,457.28
|
| Rate for Payer: Priority Health Medicare |
$1,545.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,457.28
|
| Rate for Payer: Priority Health SBD |
$2,457.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,545.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,545.96
|
| Rate for Payer: UHCCP Medicaid |
$1,035.61
|
|
|
PR REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT
|
Professional
|
Both
|
$2,083.00
|
|
|
Service Code
|
HCPCS 25449
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$183,357.00 |
| Rate for Payer: Aetna Commercial |
$1,334.28
|
| Rate for Payer: Aetna Medicare |
$1,035.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,334.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.85
|
| Rate for Payer: BCBS Complete |
$704.95
|
| Rate for Payer: BCBS MAPPO |
$995.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$1,516.36
|
| Rate for Payer: BCN Medicare Advantage |
$995.73
|
| Rate for Payer: Cash Price |
$1,666.40
|
| Rate for Payer: Cash Price |
$1,666.40
|
| Rate for Payer: Cofinity Commercial |
$1,433.85
|
| Rate for Payer: Cofinity Commercial |
$1,334.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.73
|
| Rate for Payer: Healthscope Commercial |
$1,842.10
|
| Rate for Payer: Healthscope Commercial |
$1,593.17
|
| Rate for Payer: Mclaren Medicaid |
$671.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.52
|
| Rate for Payer: Meridian Medicaid |
$704.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,357.00
|
| Rate for Payer: Nomi Health Commercial |
$1,194.88
|
| Rate for Payer: PACE SWMI |
$995.73
|
| Rate for Payer: PHP Medicare Advantage |
$995.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,589.17
|
| Rate for Payer: Priority Health Medicare |
$995.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,589.17
|
| Rate for Payer: Priority Health SBD |
$1,589.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,160.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.73
|
| Rate for Payer: UHC Exchange |
$1,160.89
|
| Rate for Payer: UHC Medicare Advantage |
$995.73
|
| Rate for Payer: UHCCP Medicaid |
$671.38
|
|
