|
PR REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 44345
|
| Min. Negotiated Rate |
$674.57 |
| Max. Negotiated Rate |
$187,072.00 |
| Rate for Payer: Aetna Commercial |
$1,358.76
|
| Rate for Payer: Aetna Medicare |
$1,054.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,460.16
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,014.00
|
| Rate for Payer: BCBS Trust/PPO |
$697.88
|
| Rate for Payer: BCN Commercial |
$1,530.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$1,460.16
|
| Rate for Payer: Cofinity Commercial |
$1,358.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.00
|
| Rate for Payer: Healthscope Commercial |
$1,875.90
|
| Rate for Payer: Healthscope Commercial |
$1,622.40
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.70
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187,072.00
|
| Rate for Payer: Nomi Health Commercial |
$1,216.80
|
| Rate for Payer: PACE SWMI |
$1,014.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,381.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,878.08
|
| Rate for Payer: Priority Health Medicare |
$1,014.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,878.08
|
| Rate for Payer: Priority Health SBD |
$1,878.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.00
|
| Rate for Payer: UHC Exchange |
$937.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.00
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 44340
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$111,483.00 |
| Rate for Payer: Aetna Commercial |
$809.04
|
| Rate for Payer: Aetna Medicare |
$627.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.41
|
| Rate for Payer: BCBS Complete |
$425.16
|
| Rate for Payer: BCBS MAPPO |
$603.76
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$918.23
|
| Rate for Payer: BCN Medicare Advantage |
$603.76
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$869.41
|
| Rate for Payer: Cofinity Commercial |
$809.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.76
|
| Rate for Payer: Healthscope Commercial |
$966.02
|
| Rate for Payer: Healthscope Commercial |
$1,116.96
|
| Rate for Payer: Mclaren Medicaid |
$404.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.95
|
| Rate for Payer: Meridian Medicaid |
$425.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,483.00
|
| Rate for Payer: Nomi Health Commercial |
$724.51
|
| Rate for Payer: PACE SWMI |
$603.76
|
| Rate for Payer: PHP Medicare Advantage |
$603.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,133.52
|
| Rate for Payer: Priority Health Medicare |
$603.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,133.52
|
| Rate for Payer: Priority Health SBD |
$1,133.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.76
|
| Rate for Payer: UHC Exchange |
$528.46
|
| Rate for Payer: UHC Medicare Advantage |
$603.76
|
| Rate for Payer: UHCCP Medicaid |
$404.91
|
|
|
PR REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX
|
Professional
|
Both
|
$2,861.00
|
|
|
Service Code
|
HCPCS 44346
|
| Min. Negotiated Rate |
$758.49 |
| Max. Negotiated Rate |
$210,539.00 |
| Rate for Payer: Aetna Commercial |
$1,530.33
|
| Rate for Payer: Aetna Medicare |
$1,187.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.54
|
| Rate for Payer: BCBS Complete |
$796.41
|
| Rate for Payer: BCBS MAPPO |
$1,142.04
|
| Rate for Payer: BCBS Trust/PPO |
$785.58
|
| Rate for Payer: BCN Commercial |
$1,720.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,142.04
|
| Rate for Payer: Cash Price |
$2,288.80
|
| Rate for Payer: Cash Price |
$2,288.80
|
| Rate for Payer: Cofinity Commercial |
$1,644.54
|
| Rate for Payer: Cofinity Commercial |
$1,530.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,142.04
|
| Rate for Payer: Healthscope Commercial |
$2,112.77
|
| Rate for Payer: Healthscope Commercial |
$1,827.26
|
| Rate for Payer: Mclaren Medicaid |
$758.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,199.14
|
| Rate for Payer: Meridian Medicaid |
$796.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210,539.00
|
| Rate for Payer: Nomi Health Commercial |
$1,370.45
|
| Rate for Payer: PACE SWMI |
$1,142.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,142.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$758.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,111.95
|
| Rate for Payer: Priority Health Medicare |
$1,142.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,111.95
|
| Rate for Payer: Priority Health SBD |
$2,111.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,142.04
|
| Rate for Payer: UHC Exchange |
$1,054.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,142.04
|
| Rate for Payer: UHCCP Medicaid |
$758.49
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,619.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$774.47 |
| Max. Negotiated Rate |
$220,169.00 |
| Rate for Payer: Aetna Commercial |
$1,599.64
|
| Rate for Payer: Aetna Medicare |
$1,241.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,599.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.01
|
| Rate for Payer: BCBS Complete |
$813.19
|
| Rate for Payer: BCBS MAPPO |
$1,193.76
|
| Rate for Payer: BCBS Trust/PPO |
$926.64
|
| Rate for Payer: BCN Commercial |
$1,765.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.76
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cofinity Commercial |
$1,719.01
|
| Rate for Payer: Cofinity Commercial |
$1,599.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.76
|
| Rate for Payer: Healthscope Commercial |
$2,208.46
|
| Rate for Payer: Healthscope Commercial |
$1,910.02
|
| Rate for Payer: Mclaren Medicaid |
$774.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,253.45
|
| Rate for Payer: Meridian Medicaid |
$813.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220,169.00
|
| Rate for Payer: Nomi Health Commercial |
$1,432.51
|
| Rate for Payer: PACE SWMI |
$1,193.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,929.99
|
| Rate for Payer: Priority Health Medicare |
$1,193.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,929.99
|
| Rate for Payer: Priority Health SBD |
$1,929.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,890.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,193.76
|
| Rate for Payer: UHC Exchange |
$1,890.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.76
|
| Rate for Payer: UHCCP Medicaid |
$774.47
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,362.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$745.07 |
| Max. Negotiated Rate |
$212,359.00 |
| Rate for Payer: Aetna Commercial |
$1,535.51
|
| Rate for Payer: Aetna Medicare |
$1,191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,535.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,650.10
|
| Rate for Payer: BCBS Complete |
$782.32
|
| Rate for Payer: BCBS MAPPO |
$1,145.90
|
| Rate for Payer: BCBS Trust/PPO |
$876.98
|
| Rate for Payer: BCN Commercial |
$1,707.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.90
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cofinity Commercial |
$1,650.10
|
| Rate for Payer: Cofinity Commercial |
$1,535.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.90
|
| Rate for Payer: Healthscope Commercial |
$2,119.92
|
| Rate for Payer: Healthscope Commercial |
$1,833.44
|
| Rate for Payer: Mclaren Medicaid |
$745.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.20
|
| Rate for Payer: Meridian Medicaid |
$782.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212,359.00
|
| Rate for Payer: Nomi Health Commercial |
$1,375.08
|
| Rate for Payer: PACE SWMI |
$1,145.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,535.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,861.38
|
| Rate for Payer: Priority Health Medicare |
$1,145.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,861.38
|
| Rate for Payer: Priority Health SBD |
$1,861.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,779.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,145.90
|
| Rate for Payer: UHC Exchange |
$1,779.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,145.90
|
| Rate for Payer: UHCCP Medicaid |
$745.07
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,384.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$163.77 |
| Max. Negotiated Rate |
$293,132.00 |
| Rate for Payer: Aetna Commercial |
$2,132.30
|
| Rate for Payer: Aetna Medicare |
$1,654.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,291.43
|
| Rate for Payer: BCBS Complete |
$1,102.59
|
| Rate for Payer: BCBS MAPPO |
$1,591.27
|
| Rate for Payer: BCBS Trust/PPO |
$163.77
|
| Rate for Payer: BCN Commercial |
$2,385.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.27
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cofinity Commercial |
$2,291.43
|
| Rate for Payer: Cofinity Commercial |
$2,132.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.27
|
| Rate for Payer: Healthscope Commercial |
$2,943.85
|
| Rate for Payer: Healthscope Commercial |
$2,546.03
|
| Rate for Payer: Mclaren Medicaid |
$1,050.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,670.83
|
| Rate for Payer: Meridian Medicaid |
$1,102.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293,132.00
|
| Rate for Payer: Nomi Health Commercial |
$1,909.52
|
| Rate for Payer: PACE SWMI |
$1,591.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,499.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,923.91
|
| Rate for Payer: Priority Health Medicare |
$1,591.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,923.91
|
| Rate for Payer: Priority Health SBD |
$2,923.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,591.27
|
| Rate for Payer: UHC Exchange |
$1,559.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,591.27
|
| Rate for Payer: UHCCP Medicaid |
$1,050.09
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$178,639.00 |
| Rate for Payer: Aetna Commercial |
$1,292.68
|
| Rate for Payer: Aetna Medicare |
$1,003.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.15
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$964.69
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$1,462.12
|
| Rate for Payer: BCN Medicare Advantage |
$964.69
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$1,389.15
|
| Rate for Payer: Cofinity Commercial |
$1,292.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.69
|
| Rate for Payer: Healthscope Commercial |
$1,784.68
|
| Rate for Payer: Healthscope Commercial |
$1,543.50
|
| Rate for Payer: Mclaren Medicaid |
$642.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.92
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178,639.00
|
| Rate for Payer: Nomi Health Commercial |
$1,157.63
|
| Rate for Payer: PACE SWMI |
$964.69
|
| Rate for Payer: PHP Medicare Advantage |
$964.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,794.56
|
| Rate for Payer: Priority Health Medicare |
$964.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,794.56
|
| Rate for Payer: Priority Health SBD |
$1,794.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.69
|
| Rate for Payer: UHC Exchange |
$903.16
|
| Rate for Payer: UHC Medicare Advantage |
$964.69
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$106,009.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare |
$598.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.58
|
| Rate for Payer: BCBS Complete |
$403.69
|
| Rate for Payer: BCBS MAPPO |
$575.40
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$575.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$828.58
|
| Rate for Payer: Cofinity Commercial |
$771.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.40
|
| Rate for Payer: Healthscope Commercial |
$920.64
|
| Rate for Payer: Healthscope Commercial |
$1,064.49
|
| Rate for Payer: Mclaren Medicaid |
$384.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.17
|
| Rate for Payer: Meridian Medicaid |
$403.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,009.00
|
| Rate for Payer: Nomi Health Commercial |
$690.48
|
| Rate for Payer: PACE SWMI |
$575.40
|
| Rate for Payer: PHP Medicare Advantage |
$575.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.68
|
| Rate for Payer: Priority Health Medicare |
$575.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.68
|
| Rate for Payer: Priority Health SBD |
$1,072.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.40
|
| Rate for Payer: UHC Exchange |
$502.24
|
| Rate for Payer: UHC Medicare Advantage |
$575.40
|
| Rate for Payer: UHCCP Medicaid |
$384.47
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,128.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$580.21 |
| Max. Negotiated Rate |
$158,798.00 |
| Rate for Payer: Aetna Commercial |
$1,166.62
|
| Rate for Payer: Aetna Medicare |
$905.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,253.68
|
| Rate for Payer: BCBS Complete |
$609.22
|
| Rate for Payer: BCBS MAPPO |
$870.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$1,305.75
|
| Rate for Payer: BCN Medicare Advantage |
$870.61
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,253.68
|
| Rate for Payer: Cofinity Commercial |
$1,166.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.61
|
| Rate for Payer: Healthscope Commercial |
$1,392.98
|
| Rate for Payer: Healthscope Commercial |
$1,610.63
|
| Rate for Payer: Mclaren Medicaid |
$580.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.14
|
| Rate for Payer: Meridian Medicaid |
$609.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158,798.00
|
| Rate for Payer: Nomi Health Commercial |
$1,044.73
|
| Rate for Payer: PACE SWMI |
$870.61
|
| Rate for Payer: PHP Medicare Advantage |
$870.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,683.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,538.38
|
| Rate for Payer: Priority Health Medicare |
$870.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,538.38
|
| Rate for Payer: Priority Health SBD |
$1,538.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.61
|
| Rate for Payer: UHC Medicare Advantage |
$870.61
|
| Rate for Payer: UHCCP Medicaid |
$580.21
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,817.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$79,832.00 |
| Rate for Payer: Aetna Commercial |
$578.84
|
| Rate for Payer: Aetna Medicare |
$449.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.04
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$431.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.26
|
| Rate for Payer: BCN Commercial |
$1,321.38
|
| Rate for Payer: BCN Medicare Advantage |
$431.97
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cofinity Commercial |
$622.04
|
| Rate for Payer: Cofinity Commercial |
$578.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.97
|
| Rate for Payer: Healthscope Commercial |
$691.15
|
| Rate for Payer: Healthscope Commercial |
$799.14
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.57
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,832.00
|
| Rate for Payer: Nomi Health Commercial |
$518.36
|
| Rate for Payer: PACE SWMI |
$431.97
|
| Rate for Payer: PHP Medicare Advantage |
$431.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.18
|
| Rate for Payer: Priority Health Medicare |
$431.97
|
| Rate for Payer: Priority Health Narrow Network |
$771.18
|
| Rate for Payer: Priority Health SBD |
$771.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.97
|
| Rate for Payer: UHC Medicare Advantage |
$431.97
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,825.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$576.80 |
| Max. Negotiated Rate |
$163,345.00 |
| Rate for Payer: Aetna Commercial |
$1,185.40
|
| Rate for Payer: Aetna Medicare |
$920.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.87
|
| Rate for Payer: BCBS Complete |
$605.64
|
| Rate for Payer: BCBS MAPPO |
$884.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.71
|
| Rate for Payer: BCN Commercial |
$1,316.01
|
| Rate for Payer: BCN Medicare Advantage |
$884.63
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cofinity Commercial |
$1,273.87
|
| Rate for Payer: Cofinity Commercial |
$1,185.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.63
|
| Rate for Payer: Healthscope Commercial |
$1,636.57
|
| Rate for Payer: Healthscope Commercial |
$1,415.41
|
| Rate for Payer: Mclaren Medicaid |
$576.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.86
|
| Rate for Payer: Meridian Medicaid |
$605.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163,345.00
|
| Rate for Payer: Nomi Health Commercial |
$1,061.56
|
| Rate for Payer: PACE SWMI |
$884.63
|
| Rate for Payer: PHP Medicare Advantage |
$884.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,435.40
|
| Rate for Payer: Priority Health Medicare |
$884.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,435.40
|
| Rate for Payer: Priority Health SBD |
$1,435.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$884.63
|
| Rate for Payer: UHC Exchange |
$1,106.80
|
| Rate for Payer: UHC Medicare Advantage |
$884.63
|
| Rate for Payer: UHCCP Medicaid |
$576.80
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,119.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$639.85 |
| Max. Negotiated Rate |
$181,298.00 |
| Rate for Payer: Aetna Commercial |
$1,314.77
|
| Rate for Payer: Aetna Medicare |
$1,020.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.88
|
| Rate for Payer: BCBS Complete |
$671.84
|
| Rate for Payer: BCBS MAPPO |
$981.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,460.66
|
| Rate for Payer: BCN Medicare Advantage |
$981.17
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,412.88
|
| Rate for Payer: Cofinity Commercial |
$1,314.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.17
|
| Rate for Payer: Healthscope Commercial |
$1,815.16
|
| Rate for Payer: Healthscope Commercial |
$1,569.87
|
| Rate for Payer: Mclaren Medicaid |
$639.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.23
|
| Rate for Payer: Meridian Medicaid |
$671.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181,298.00
|
| Rate for Payer: Nomi Health Commercial |
$1,177.40
|
| Rate for Payer: PACE SWMI |
$981.17
|
| Rate for Payer: PHP Medicare Advantage |
$981.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,604.51
|
| Rate for Payer: Priority Health Medicare |
$981.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,604.51
|
| Rate for Payer: Priority Health SBD |
$1,604.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,343.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.17
|
| Rate for Payer: UHC Exchange |
$1,343.27
|
| Rate for Payer: UHC Medicare Advantage |
$981.17
|
| Rate for Payer: UHCCP Medicaid |
$639.85
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,087.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$650.08 |
| Max. Negotiated Rate |
$180,173.00 |
| Rate for Payer: Aetna Commercial |
$1,279.16
|
| Rate for Payer: Aetna Medicare |
$992.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.62
|
| Rate for Payer: BCBS Complete |
$682.58
|
| Rate for Payer: BCBS MAPPO |
$954.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.44
|
| Rate for Payer: BCN Commercial |
$1,503.17
|
| Rate for Payer: BCN Medicare Advantage |
$954.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cofinity Commercial |
$1,374.62
|
| Rate for Payer: Cofinity Commercial |
$1,279.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.60
|
| Rate for Payer: Healthscope Commercial |
$1,766.01
|
| Rate for Payer: Healthscope Commercial |
$1,527.36
|
| Rate for Payer: Mclaren Medicaid |
$650.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.33
|
| Rate for Payer: Meridian Medicaid |
$682.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180,173.00
|
| Rate for Payer: Nomi Health Commercial |
$1,145.52
|
| Rate for Payer: PACE SWMI |
$954.60
|
| Rate for Payer: PHP Medicare Advantage |
$954.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,493.17
|
| Rate for Payer: Priority Health Medicare |
$954.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.17
|
| Rate for Payer: Priority Health SBD |
$1,493.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.60
|
| Rate for Payer: UHC Exchange |
$1,200.00
|
| Rate for Payer: UHC Medicare Advantage |
$954.60
|
| Rate for Payer: UHCCP Medicaid |
$650.08
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,239.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$709.50 |
| Max. Negotiated Rate |
$196,506.00 |
| Rate for Payer: Aetna Commercial |
$1,393.48
|
| Rate for Payer: Aetna Medicare |
$1,081.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,497.47
|
| Rate for Payer: BCBS Complete |
$744.98
|
| Rate for Payer: BCBS MAPPO |
$1,039.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.15
|
| Rate for Payer: BCN Commercial |
$1,642.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.91
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,497.47
|
| Rate for Payer: Cofinity Commercial |
$1,393.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.91
|
| Rate for Payer: Healthscope Commercial |
$1,923.83
|
| Rate for Payer: Healthscope Commercial |
$1,663.86
|
| Rate for Payer: Mclaren Medicaid |
$709.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.91
|
| Rate for Payer: Meridian Medicaid |
$744.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196,506.00
|
| Rate for Payer: Nomi Health Commercial |
$1,247.89
|
| Rate for Payer: PACE SWMI |
$1,039.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.79
|
| Rate for Payer: Priority Health Medicare |
$1,039.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,631.79
|
| Rate for Payer: Priority Health SBD |
$1,631.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,208.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,039.91
|
| Rate for Payer: UHC Exchange |
$1,208.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,039.91
|
| Rate for Payer: UHCCP Medicaid |
$709.50
|
|
|
PR REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 36832
|
| Min. Negotiated Rate |
$473.93 |
| Max. Negotiated Rate |
$133,562.00 |
| Rate for Payer: Aetna Commercial |
$968.02
|
| Rate for Payer: Aetna Medicare |
$751.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.02
|
| Rate for Payer: BCBS Complete |
$497.63
|
| Rate for Payer: BCBS MAPPO |
$722.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.65
|
| Rate for Payer: BCN Commercial |
$1,081.45
|
| Rate for Payer: BCN Medicare Advantage |
$722.40
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$968.02
|
| Rate for Payer: Cofinity Commercial |
$1,040.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.40
|
| Rate for Payer: Healthscope Commercial |
$1,336.44
|
| Rate for Payer: Healthscope Commercial |
$1,155.84
|
| Rate for Payer: Mclaren Medicaid |
$473.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.52
|
| Rate for Payer: Meridian Medicaid |
$497.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,562.00
|
| Rate for Payer: Nomi Health Commercial |
$866.88
|
| Rate for Payer: PACE SWMI |
$722.40
|
| Rate for Payer: PHP Medicare Advantage |
$722.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,182.24
|
| Rate for Payer: Priority Health Medicare |
$722.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.24
|
| Rate for Payer: Priority Health SBD |
$1,182.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$830.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.40
|
| Rate for Payer: UHC Exchange |
$830.89
|
| Rate for Payer: UHC Medicare Advantage |
$722.40
|
| Rate for Payer: UHCCP Medicaid |
$473.93
|
|
|
PR REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 36833
|
| Min. Negotiated Rate |
$505.66 |
| Max. Negotiated Rate |
$142,767.00 |
| Rate for Payer: Aetna Commercial |
$1,033.56
|
| Rate for Payer: Aetna Medicare |
$802.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.69
|
| Rate for Payer: BCBS Complete |
$530.94
|
| Rate for Payer: BCBS MAPPO |
$771.31
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$1,155.23
|
| Rate for Payer: BCN Medicare Advantage |
$771.31
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,110.69
|
| Rate for Payer: Cofinity Commercial |
$1,033.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.31
|
| Rate for Payer: Healthscope Commercial |
$1,426.92
|
| Rate for Payer: Healthscope Commercial |
$1,234.10
|
| Rate for Payer: Mclaren Medicaid |
$505.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.88
|
| Rate for Payer: Meridian Medicaid |
$530.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,767.00
|
| Rate for Payer: Nomi Health Commercial |
$925.57
|
| Rate for Payer: PACE SWMI |
$771.31
|
| Rate for Payer: PHP Medicare Advantage |
$771.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.96
|
| Rate for Payer: Priority Health Medicare |
$771.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.96
|
| Rate for Payer: Priority Health SBD |
$1,260.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$863.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.31
|
| Rate for Payer: UHC Exchange |
$863.82
|
| Rate for Payer: UHC Medicare Advantage |
$771.31
|
| Rate for Payer: UHCCP Medicaid |
$505.66
|
|
|
PR REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63688
|
| Min. Negotiated Rate |
$193.83 |
| Max. Negotiated Rate |
$66,366.00 |
| Rate for Payer: Aetna Commercial |
$387.23
|
| Rate for Payer: Aetna Medicare |
$300.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.13
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$288.98
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$547.80
|
| Rate for Payer: BCN Medicare Advantage |
$288.98
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$416.13
|
| Rate for Payer: Cofinity Commercial |
$387.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.98
|
| Rate for Payer: Healthscope Commercial |
$534.61
|
| Rate for Payer: Healthscope Commercial |
$462.37
|
| Rate for Payer: Mclaren Medicaid |
$193.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.43
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,366.00
|
| Rate for Payer: Nomi Health Commercial |
$346.78
|
| Rate for Payer: PACE SWMI |
$288.98
|
| Rate for Payer: PHP Medicare Advantage |
$288.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$516.96
|
| Rate for Payer: Priority Health Medicare |
$288.98
|
| Rate for Payer: Priority Health Narrow Network |
$516.96
|
| Rate for Payer: Priority Health SBD |
$516.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.98
|
| Rate for Payer: UHC Exchange |
$474.64
|
| Rate for Payer: UHC Medicare Advantage |
$288.98
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
|
PR REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS
|
Professional
|
Both
|
$3,184.00
|
|
|
Service Code
|
HCPCS 61880
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$105,680.00 |
| Rate for Payer: Aetna Commercial |
$776.65
|
| Rate for Payer: Aetna Medicare |
$602.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.61
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$579.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.32
|
| Rate for Payer: BCN Commercial |
$871.31
|
| Rate for Payer: BCN Medicare Advantage |
$579.59
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cofinity Commercial |
$834.61
|
| Rate for Payer: Cofinity Commercial |
$776.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.59
|
| Rate for Payer: Healthscope Commercial |
$927.34
|
| Rate for Payer: Healthscope Commercial |
$1,072.24
|
| Rate for Payer: Mclaren Medicaid |
$387.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.57
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105,680.00
|
| Rate for Payer: Nomi Health Commercial |
$695.51
|
| Rate for Payer: PACE SWMI |
$579.59
|
| Rate for Payer: PHP Medicare Advantage |
$579.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.97
|
| Rate for Payer: Priority Health Medicare |
$579.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.97
|
| Rate for Payer: Priority Health SBD |
$1,025.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.59
|
| Rate for Payer: UHC Exchange |
$564.25
|
| Rate for Payer: UHC Medicare Advantage |
$579.59
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
|
|
PR REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR
|
Professional
|
Both
|
$1,048.00
|
|
|
Service Code
|
HCPCS 61888
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$71,964.00 |
| Rate for Payer: Aetna Commercial |
$525.59
|
| Rate for Payer: Aetna Medicare |
$407.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.81
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$392.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
| Rate for Payer: BCN Commercial |
$818.26
|
| Rate for Payer: BCN Medicare Advantage |
$392.23
|
| Rate for Payer: Cash Price |
$838.40
|
| Rate for Payer: Cash Price |
$838.40
|
| Rate for Payer: Cofinity Commercial |
$564.81
|
| Rate for Payer: Cofinity Commercial |
$525.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.23
|
| Rate for Payer: Healthscope Commercial |
$725.63
|
| Rate for Payer: Healthscope Commercial |
$627.57
|
| Rate for Payer: Mclaren Medicaid |
$260.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.84
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,964.00
|
| Rate for Payer: Nomi Health Commercial |
$470.68
|
| Rate for Payer: PACE SWMI |
$392.23
|
| Rate for Payer: PHP Medicare Advantage |
$392.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$681.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.13
|
| Rate for Payer: Priority Health Medicare |
$392.23
|
| Rate for Payer: Priority Health Narrow Network |
$692.13
|
| Rate for Payer: Priority Health SBD |
$692.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.23
|
| Rate for Payer: UHC Exchange |
$437.70
|
| Rate for Payer: UHC Medicare Advantage |
$392.23
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR REVJ/RMVL PERPH NEUROSTIMULATOR ELECTRODE ARRAY
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 64585
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$25,110.00 |
| Rate for Payer: Aetna Commercial |
$183.20
|
| Rate for Payer: Aetna Medicare |
$142.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.88
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$136.72
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$136.72
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cofinity Commercial |
$196.88
|
| Rate for Payer: Cofinity Commercial |
$183.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.72
|
| Rate for Payer: Healthscope Commercial |
$252.93
|
| Rate for Payer: Healthscope Commercial |
$218.75
|
| Rate for Payer: Mclaren Medicaid |
$92.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.56
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,110.00
|
| Rate for Payer: Nomi Health Commercial |
$164.06
|
| Rate for Payer: PACE SWMI |
$136.72
|
| Rate for Payer: PHP Medicare Advantage |
$136.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.25
|
| Rate for Payer: Priority Health Medicare |
$136.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.25
|
| Rate for Payer: Priority Health SBD |
$246.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.72
|
| Rate for Payer: UHC Exchange |
$553.30
|
| Rate for Payer: UHC Medicare Advantage |
$136.72
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
|
|
PR REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 57295
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$89,174.00 |
| Rate for Payer: Aetna Commercial |
$641.74
|
| Rate for Payer: Aetna Medicare |
$498.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.63
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS MAPPO |
$478.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.28
|
| Rate for Payer: BCN Commercial |
$1,021.64
|
| Rate for Payer: BCN Medicare Advantage |
$478.91
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$689.63
|
| Rate for Payer: Cofinity Commercial |
$641.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.91
|
| Rate for Payer: Healthscope Commercial |
$885.98
|
| Rate for Payer: Healthscope Commercial |
$766.26
|
| Rate for Payer: Mclaren Medicaid |
$322.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.86
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,174.00
|
| Rate for Payer: Nomi Health Commercial |
$574.69
|
| Rate for Payer: PACE SWMI |
$478.91
|
| Rate for Payer: PHP Medicare Advantage |
$478.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.01
|
| Rate for Payer: Priority Health Medicare |
$478.91
|
| Rate for Payer: Priority Health Narrow Network |
$752.01
|
| Rate for Payer: Priority Health SBD |
$752.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.91
|
| Rate for Payer: UHC Exchange |
$519.04
|
| Rate for Payer: UHC Medicare Advantage |
$478.91
|
| Rate for Payer: UHCCP Medicaid |
$322.48
|
|
|
PR REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
HCPCS 64583
|
| Min. Negotiated Rate |
$315.92 |
| Max. Negotiated Rate |
$153,488.00 |
| Rate for Payer: Aetna Commercial |
$1,108.53
|
| Rate for Payer: Aetna Medicare |
$860.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.25
|
| Rate for Payer: BCBS Complete |
$582.61
|
| Rate for Payer: BCBS MAPPO |
$827.26
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$1,262.26
|
| Rate for Payer: BCN Medicare Advantage |
$827.26
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Cofinity Commercial |
$1,108.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.26
|
| Rate for Payer: Healthscope Commercial |
$1,323.62
|
| Rate for Payer: Healthscope Commercial |
$1,530.43
|
| Rate for Payer: Mclaren Medicaid |
$554.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.62
|
| Rate for Payer: Meridian Medicaid |
$582.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153,488.00
|
| Rate for Payer: Nomi Health Commercial |
$992.71
|
| Rate for Payer: PACE SWMI |
$827.26
|
| Rate for Payer: PHP Medicare Advantage |
$827.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,475.25
|
| Rate for Payer: Priority Health Medicare |
$827.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,475.25
|
| Rate for Payer: Priority Health SBD |
$1,475.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$827.26
|
| Rate for Payer: UHC Medicare Advantage |
$827.26
|
| Rate for Payer: UHCCP Medicaid |
$554.87
|
|
|
PR REVJ/RPLMNT CH WAL RESPIR ELTRD & CONJ PULSE GEN
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 0467T
|
| Min. Negotiated Rate |
$326.40 |
| Max. Negotiated Rate |
$530.40 |
| Rate for Payer: Aetna Medicare |
$408.00
|
| Rate for Payer: BCBS Complete |
$326.40
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.40
|
|
|
PR REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT
|
Professional
|
Both
|
$4,568.00
|
|
|
Service Code
|
HCPCS 27486
|
| Min. Negotiated Rate |
$907.38 |
| Max. Negotiated Rate |
$248,877.00 |
| Rate for Payer: Aetna Commercial |
$1,812.44
|
| Rate for Payer: Aetna Medicare |
$1,406.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,812.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.70
|
| Rate for Payer: BCBS Complete |
$952.75
|
| Rate for Payer: BCBS MAPPO |
$1,352.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.05
|
| Rate for Payer: BCN Commercial |
$2,050.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.57
|
| Rate for Payer: Cash Price |
$3,654.40
|
| Rate for Payer: Cash Price |
$3,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,947.70
|
| Rate for Payer: Cofinity Commercial |
$1,812.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.57
|
| Rate for Payer: Healthscope Commercial |
$2,502.25
|
| Rate for Payer: Healthscope Commercial |
$2,164.11
|
| Rate for Payer: Mclaren Medicaid |
$907.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.20
|
| Rate for Payer: Meridian Medicaid |
$952.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248,877.00
|
| Rate for Payer: Nomi Health Commercial |
$1,623.08
|
| Rate for Payer: PACE SWMI |
$1,352.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$907.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,969.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,149.42
|
| Rate for Payer: Priority Health Medicare |
$1,352.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,149.42
|
| Rate for Payer: Priority Health SBD |
$2,149.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,534.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.57
|
| Rate for Payer: UHC Exchange |
$1,534.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,352.57
|
| Rate for Payer: UHCCP Medicaid |
$907.38
|
|
|
PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,038.00
|
|
|
Service Code
|
HCPCS 27137
|
| Min. Negotiated Rate |
$944.44 |
| Max. Negotiated Rate |
$259,846.00 |
| Rate for Payer: Aetna Commercial |
$1,890.98
|
| Rate for Payer: Aetna Medicare |
$1,467.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,032.10
|
| Rate for Payer: BCBS Complete |
$991.66
|
| Rate for Payer: BCBS MAPPO |
$1,411.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
| Rate for Payer: BCN Commercial |
$2,136.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,411.18
|
| Rate for Payer: Cash Price |
$2,430.40
|
| Rate for Payer: Cash Price |
$2,430.40
|
| Rate for Payer: Cofinity Commercial |
$2,032.10
|
| Rate for Payer: Cofinity Commercial |
$1,890.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,411.18
|
| Rate for Payer: Healthscope Commercial |
$2,610.68
|
| Rate for Payer: Healthscope Commercial |
$2,257.89
|
| Rate for Payer: Mclaren Medicaid |
$944.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.74
|
| Rate for Payer: Meridian Medicaid |
$991.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259,846.00
|
| Rate for Payer: Nomi Health Commercial |
$1,693.42
|
| Rate for Payer: PACE SWMI |
$1,411.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,411.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,238.48
|
| Rate for Payer: Priority Health Medicare |
$1,411.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,238.48
|
| Rate for Payer: Priority Health SBD |
$2,238.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,871.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,411.18
|
| Rate for Payer: UHC Exchange |
$1,871.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,411.18
|
| Rate for Payer: UHCCP Medicaid |
$944.44
|
|
