|
PR RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA
|
Professional
|
Both
|
$3,292.00
|
|
|
Service Code
|
HCPCS 27091
|
| Min. Negotiated Rate |
$1,316.80 |
| Max. Negotiated Rate |
$2,836.86 |
| Rate for Payer: Aetna Commercial |
$2,054.81
|
| Rate for Payer: Aetna Medicare |
$1,594.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,208.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,054.81
|
| Rate for Payer: BCBS Complete |
$1,316.80
|
| Rate for Payer: BCBS MAPPO |
$1,533.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,533.44
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cofinity Commercial |
$2,208.15
|
| Rate for Payer: Cofinity Commercial |
$2,054.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,533.44
|
| Rate for Payer: Healthscope Commercial |
$2,453.50
|
| Rate for Payer: Healthscope Commercial |
$2,836.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,610.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,139.80
|
| Rate for Payer: Nomi Health Commercial |
$1,840.13
|
| Rate for Payer: PACE SWMI |
$1,533.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,533.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,139.80
|
| Rate for Payer: Priority Health Medicare |
$1,533.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,533.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,533.44
|
|
|
PR RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF
|
Professional
|
Both
|
$2,625.00
|
|
|
Service Code
|
HCPCS 33971
|
| Min. Negotiated Rate |
$676.18 |
| Max. Negotiated Rate |
$1,706.25 |
| Rate for Payer: Aetna Commercial |
$906.08
|
| Rate for Payer: Aetna Medicare |
$703.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$973.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.08
|
| Rate for Payer: BCBS Complete |
$1,050.00
|
| Rate for Payer: BCBS MAPPO |
$676.18
|
| Rate for Payer: BCN Medicare Advantage |
$676.18
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cofinity Commercial |
$973.70
|
| Rate for Payer: Cofinity Commercial |
$906.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.18
|
| Rate for Payer: Healthscope Commercial |
$1,081.89
|
| Rate for Payer: Healthscope Commercial |
$1,250.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,706.25
|
| Rate for Payer: Nomi Health Commercial |
$811.42
|
| Rate for Payer: PACE SWMI |
$676.18
|
| Rate for Payer: PHP Medicare Advantage |
$676.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,706.25
|
| Rate for Payer: Priority Health Medicare |
$676.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.18
|
| Rate for Payer: UHC Medicare Advantage |
$676.18
|
|
|
PR RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 33284
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$318.50 |
| Rate for Payer: Aetna Medicare |
$245.00
|
| Rate for Payer: BCBS Complete |
$196.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
HCPCS 33262
|
| Min. Negotiated Rate |
$268.40 |
| Max. Negotiated Rate |
$652.09 |
| Rate for Payer: Aetna Commercial |
$472.32
|
| Rate for Payer: Aetna Medicare |
$366.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.57
|
| Rate for Payer: BCBS Complete |
$268.40
|
| Rate for Payer: BCBS MAPPO |
$352.48
|
| Rate for Payer: BCN Medicare Advantage |
$352.48
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$472.32
|
| Rate for Payer: Cofinity Commercial |
$507.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.48
|
| Rate for Payer: Healthscope Commercial |
$563.97
|
| Rate for Payer: Healthscope Commercial |
$652.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.15
|
| Rate for Payer: Nomi Health Commercial |
$422.98
|
| Rate for Payer: PACE SWMI |
$352.48
|
| Rate for Payer: PHP Medicare Advantage |
$352.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.15
|
| Rate for Payer: Priority Health Medicare |
$352.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.48
|
| Rate for Payer: UHC Medicare Advantage |
$352.48
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 33263
|
| Min. Negotiated Rate |
$314.80 |
| Max. Negotiated Rate |
$678.76 |
| Rate for Payer: Aetna Commercial |
$491.65
|
| Rate for Payer: Aetna Medicare |
$381.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.65
|
| Rate for Payer: BCBS Complete |
$314.80
|
| Rate for Payer: BCBS MAPPO |
$366.90
|
| Rate for Payer: BCN Medicare Advantage |
$366.90
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$528.34
|
| Rate for Payer: Cofinity Commercial |
$491.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.90
|
| Rate for Payer: Healthscope Commercial |
$678.76
|
| Rate for Payer: Healthscope Commercial |
$587.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$385.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.55
|
| Rate for Payer: Nomi Health Commercial |
$440.28
|
| Rate for Payer: PACE SWMI |
$366.90
|
| Rate for Payer: PHP Medicare Advantage |
$366.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.55
|
| Rate for Payer: Priority Health Medicare |
$366.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.90
|
| Rate for Payer: UHC Medicare Advantage |
$366.90
|
|
|
PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 33264
|
| Min. Negotiated Rate |
$328.80 |
| Max. Negotiated Rate |
$707.46 |
| Rate for Payer: Aetna Commercial |
$512.43
|
| Rate for Payer: Aetna Medicare |
$397.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.43
|
| Rate for Payer: BCBS Complete |
$328.80
|
| Rate for Payer: BCBS MAPPO |
$382.41
|
| Rate for Payer: BCN Medicare Advantage |
$382.41
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$550.67
|
| Rate for Payer: Cofinity Commercial |
$512.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.41
|
| Rate for Payer: Healthscope Commercial |
$611.86
|
| Rate for Payer: Healthscope Commercial |
$707.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.30
|
| Rate for Payer: Nomi Health Commercial |
$458.89
|
| Rate for Payer: PACE SWMI |
$382.41
|
| Rate for Payer: PHP Medicare Advantage |
$382.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.30
|
| Rate for Payer: Priority Health Medicare |
$382.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.41
|
| Rate for Payer: UHC Medicare Advantage |
$382.41
|
|
|
PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH
|
Professional
|
Both
|
$1,392.00
|
|
|
Service Code
|
HCPCS 54406
|
| Min. Negotiated Rate |
$556.80 |
| Max. Negotiated Rate |
$1,294.08 |
| Rate for Payer: Aetna Commercial |
$937.33
|
| Rate for Payer: Aetna Medicare |
$727.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.28
|
| Rate for Payer: BCBS Complete |
$556.80
|
| Rate for Payer: BCBS MAPPO |
$699.50
|
| Rate for Payer: BCN Medicare Advantage |
$699.50
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cofinity Commercial |
$937.33
|
| Rate for Payer: Cofinity Commercial |
$1,007.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.50
|
| Rate for Payer: Healthscope Commercial |
$1,294.08
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.80
|
| Rate for Payer: Nomi Health Commercial |
$839.40
|
| Rate for Payer: PACE SWMI |
$699.50
|
| Rate for Payer: PHP Medicare Advantage |
$699.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.80
|
| Rate for Payer: Priority Health Medicare |
$699.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.50
|
| Rate for Payer: UHC Medicare Advantage |
$699.50
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY
|
Professional
|
Both
|
$3,691.00
|
|
|
Service Code
|
HCPCS 32484
|
| Min. Negotiated Rate |
$1,378.86 |
| Max. Negotiated Rate |
$2,550.89 |
| Rate for Payer: Aetna Commercial |
$1,847.67
|
| Rate for Payer: Aetna Medicare |
$1,434.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,985.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.67
|
| Rate for Payer: BCBS Complete |
$1,476.40
|
| Rate for Payer: BCBS MAPPO |
$1,378.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.86
|
| Rate for Payer: Cash Price |
$2,952.80
|
| Rate for Payer: Cash Price |
$2,952.80
|
| Rate for Payer: Cofinity Commercial |
$1,985.56
|
| Rate for Payer: Cofinity Commercial |
$1,847.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.86
|
| Rate for Payer: Healthscope Commercial |
$2,206.18
|
| Rate for Payer: Healthscope Commercial |
$2,550.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,399.15
|
| Rate for Payer: Nomi Health Commercial |
$1,654.63
|
| Rate for Payer: PACE SWMI |
$1,378.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,399.15
|
| Rate for Payer: Priority Health Medicare |
$1,378.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,378.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,378.86
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC
|
Professional
|
Both
|
$5,362.00
|
|
|
Service Code
|
HCPCS 32482
|
| Min. Negotiated Rate |
$1,520.63 |
| Max. Negotiated Rate |
$3,485.30 |
| Rate for Payer: Aetna Commercial |
$2,037.64
|
| Rate for Payer: Aetna Medicare |
$1,581.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,189.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,037.64
|
| Rate for Payer: BCBS Complete |
$2,144.80
|
| Rate for Payer: BCBS MAPPO |
$1,520.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,520.63
|
| Rate for Payer: Cash Price |
$4,289.60
|
| Rate for Payer: Cash Price |
$4,289.60
|
| Rate for Payer: Cofinity Commercial |
$2,189.71
|
| Rate for Payer: Cofinity Commercial |
$2,037.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,520.63
|
| Rate for Payer: Healthscope Commercial |
$2,813.17
|
| Rate for Payer: Healthscope Commercial |
$2,433.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,596.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,485.30
|
| Rate for Payer: Nomi Health Commercial |
$1,824.76
|
| Rate for Payer: PACE SWMI |
$1,520.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,520.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,485.30
|
| Rate for Payer: Priority Health Medicare |
$1,520.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,520.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,520.63
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT
|
Professional
|
Both
|
$4,766.00
|
|
|
Service Code
|
HCPCS 32480
|
| Min. Negotiated Rate |
$1,421.35 |
| Max. Negotiated Rate |
$3,097.90 |
| Rate for Payer: Aetna Commercial |
$1,904.61
|
| Rate for Payer: Aetna Medicare |
$1,478.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,046.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.61
|
| Rate for Payer: BCBS Complete |
$1,906.40
|
| Rate for Payer: BCBS MAPPO |
$1,421.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,421.35
|
| Rate for Payer: Cash Price |
$3,812.80
|
| Rate for Payer: Cash Price |
$3,812.80
|
| Rate for Payer: Cofinity Commercial |
$2,046.74
|
| Rate for Payer: Cofinity Commercial |
$1,904.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,421.35
|
| Rate for Payer: Healthscope Commercial |
$2,274.16
|
| Rate for Payer: Healthscope Commercial |
$2,629.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,492.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,097.90
|
| Rate for Payer: Nomi Health Commercial |
$1,705.62
|
| Rate for Payer: PACE SWMI |
$1,421.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,421.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,097.90
|
| Rate for Payer: Priority Health Medicare |
$1,421.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,421.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,421.35
|
|
|
PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC
|
Professional
|
Both
|
$4,483.00
|
|
|
Service Code
|
HCPCS 32488
|
| Min. Negotiated Rate |
$1,793.20 |
| Max. Negotiated Rate |
$4,248.65 |
| Rate for Payer: Aetna Commercial |
$3,077.40
|
| Rate for Payer: Aetna Medicare |
$2,388.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,307.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,077.40
|
| Rate for Payer: BCBS Complete |
$1,793.20
|
| Rate for Payer: BCBS MAPPO |
$2,296.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,296.57
|
| Rate for Payer: Cash Price |
$3,586.40
|
| Rate for Payer: Cash Price |
$3,586.40
|
| Rate for Payer: Cofinity Commercial |
$3,307.06
|
| Rate for Payer: Cofinity Commercial |
$3,077.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,296.57
|
| Rate for Payer: Healthscope Commercial |
$4,248.65
|
| Rate for Payer: Healthscope Commercial |
$3,674.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,411.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,913.95
|
| Rate for Payer: Nomi Health Commercial |
$2,755.88
|
| Rate for Payer: PACE SWMI |
$2,296.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,296.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.95
|
| Rate for Payer: Priority Health Medicare |
$2,296.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,296.57
|
| Rate for Payer: UHC Medicare Advantage |
$2,296.57
|
|
|
PR RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY
|
Professional
|
Both
|
$4,436.00
|
|
|
Service Code
|
HCPCS 32486
|
| Min. Negotiated Rate |
$1,774.40 |
| Max. Negotiated Rate |
$4,159.45 |
| Rate for Payer: Aetna Commercial |
$3,012.79
|
| Rate for Payer: Aetna Medicare |
$2,338.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,237.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,012.79
|
| Rate for Payer: BCBS Complete |
$1,774.40
|
| Rate for Payer: BCBS MAPPO |
$2,248.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,248.35
|
| Rate for Payer: Cash Price |
$3,548.80
|
| Rate for Payer: Cash Price |
$3,548.80
|
| Rate for Payer: Cofinity Commercial |
$3,237.62
|
| Rate for Payer: Cofinity Commercial |
$3,012.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,248.35
|
| Rate for Payer: Healthscope Commercial |
$3,597.36
|
| Rate for Payer: Healthscope Commercial |
$4,159.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,883.40
|
| Rate for Payer: Nomi Health Commercial |
$2,698.02
|
| Rate for Payer: PACE SWMI |
$2,248.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,248.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,883.40
|
| Rate for Payer: Priority Health Medicare |
$2,248.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,248.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,248.35
|
|
|
PR RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 32552
|
| Min. Negotiated Rate |
$138.40 |
| Max. Negotiated Rate |
$273.71 |
| Rate for Payer: Aetna Commercial |
$198.25
|
| Rate for Payer: Aetna Medicare |
$153.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.25
|
| Rate for Payer: BCBS Complete |
$138.40
|
| Rate for Payer: BCBS MAPPO |
$147.95
|
| Rate for Payer: BCN Medicare Advantage |
$147.95
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cofinity Commercial |
$213.05
|
| Rate for Payer: Cofinity Commercial |
$198.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.95
|
| Rate for Payer: Healthscope Commercial |
$273.71
|
| Rate for Payer: Healthscope Commercial |
$236.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.90
|
| Rate for Payer: Nomi Health Commercial |
$177.54
|
| Rate for Payer: PACE SWMI |
$147.95
|
| Rate for Payer: PHP Medicare Advantage |
$147.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.90
|
| Rate for Payer: Priority Health Medicare |
$147.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.95
|
| Rate for Payer: UHC Medicare Advantage |
$147.95
|
|
|
PR RMVL NFROS TUBE REQ FLUORO GUIDANCE
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 50389
|
| Min. Negotiated Rate |
$50.83 |
| Max. Negotiated Rate |
$196.30 |
| Rate for Payer: Aetna Commercial |
$68.11
|
| Rate for Payer: Aetna Medicare |
$52.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.11
|
| Rate for Payer: BCBS Complete |
$120.80
|
| Rate for Payer: BCBS MAPPO |
$50.83
|
| Rate for Payer: BCN Medicare Advantage |
$50.83
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$73.20
|
| Rate for Payer: Cofinity Commercial |
$68.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.83
|
| Rate for Payer: Healthscope Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.30
|
| Rate for Payer: Nomi Health Commercial |
$61.00
|
| Rate for Payer: PACE SWMI |
$50.83
|
| Rate for Payer: PHP Medicare Advantage |
$50.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health Medicare |
$50.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.83
|
| Rate for Payer: UHC Medicare Advantage |
$50.83
|
|
|
PR RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 49623
|
| Min. Negotiated Rate |
$160.80 |
| Max. Negotiated Rate |
$365.69 |
| Rate for Payer: Aetna Commercial |
$264.88
|
| Rate for Payer: Aetna Medicare |
$205.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.88
|
| Rate for Payer: BCBS Complete |
$160.80
|
| Rate for Payer: BCBS MAPPO |
$197.67
|
| Rate for Payer: BCN Medicare Advantage |
$197.67
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$284.64
|
| Rate for Payer: Cofinity Commercial |
$264.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.67
|
| Rate for Payer: Healthscope Commercial |
$365.69
|
| Rate for Payer: Healthscope Commercial |
$316.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.30
|
| Rate for Payer: Nomi Health Commercial |
$237.20
|
| Rate for Payer: PACE SWMI |
$197.67
|
| Rate for Payer: PHP Medicare Advantage |
$197.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health Medicare |
$197.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.67
|
| Rate for Payer: UHC Medicare Advantage |
$197.67
|
|
|
PR RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 54415
|
| Min. Negotiated Rate |
$433.60 |
| Max. Negotiated Rate |
$940.67 |
| Rate for Payer: Aetna Commercial |
$681.35
|
| Rate for Payer: Aetna Medicare |
$528.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.35
|
| Rate for Payer: BCBS Complete |
$433.60
|
| Rate for Payer: BCBS MAPPO |
$508.47
|
| Rate for Payer: BCN Medicare Advantage |
$508.47
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$732.20
|
| Rate for Payer: Cofinity Commercial |
$681.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.47
|
| Rate for Payer: Healthscope Commercial |
$813.55
|
| Rate for Payer: Healthscope Commercial |
$940.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$704.60
|
| Rate for Payer: Nomi Health Commercial |
$610.16
|
| Rate for Payer: PACE SWMI |
$508.47
|
| Rate for Payer: PHP Medicare Advantage |
$508.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health Medicare |
$508.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.47
|
| Rate for Payer: UHC Medicare Advantage |
$508.47
|
|
|
PR RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE
|
Professional
|
Both
|
$720.00
|
|
|
Service Code
|
HCPCS 33272
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$612.00 |
| Rate for Payer: Aetna Commercial |
$443.29
|
| Rate for Payer: Aetna Medicare |
$344.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.29
|
| Rate for Payer: BCBS Complete |
$288.00
|
| Rate for Payer: BCBS MAPPO |
$330.81
|
| Rate for Payer: BCN Medicare Advantage |
$330.81
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$476.37
|
| Rate for Payer: Cofinity Commercial |
$443.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.81
|
| Rate for Payer: Healthscope Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$529.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.00
|
| Rate for Payer: Nomi Health Commercial |
$396.97
|
| Rate for Payer: PACE SWMI |
$330.81
|
| Rate for Payer: PHP Medicare Advantage |
$330.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.00
|
| Rate for Payer: Priority Health Medicare |
$330.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.81
|
| Rate for Payer: UHC Medicare Advantage |
$330.81
|
|
|
PR RMVL PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$1,599.00
|
|
|
Service Code
|
HCPCS 49429
|
| Min. Negotiated Rate |
$445.65 |
| Max. Negotiated Rate |
$1,039.35 |
| Rate for Payer: Aetna Commercial |
$597.17
|
| Rate for Payer: Aetna Medicare |
$463.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.17
|
| Rate for Payer: BCBS Complete |
$639.60
|
| Rate for Payer: BCBS MAPPO |
$445.65
|
| Rate for Payer: BCN Medicare Advantage |
$445.65
|
| Rate for Payer: Cash Price |
$1,279.20
|
| Rate for Payer: Cash Price |
$1,279.20
|
| Rate for Payer: Cofinity Commercial |
$641.74
|
| Rate for Payer: Cofinity Commercial |
$597.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.65
|
| Rate for Payer: Healthscope Commercial |
$713.04
|
| Rate for Payer: Healthscope Commercial |
$824.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.35
|
| Rate for Payer: Nomi Health Commercial |
$534.78
|
| Rate for Payer: PACE SWMI |
$445.65
|
| Rate for Payer: PHP Medicare Advantage |
$445.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.35
|
| Rate for Payer: Priority Health Medicare |
$445.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.65
|
| Rate for Payer: UHC Medicare Advantage |
$445.65
|
|
|
PR RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH
|
Professional
|
Both
|
$2,296.00
|
|
|
Service Code
|
HCPCS 62355
|
| Min. Negotiated Rate |
$269.92 |
| Max. Negotiated Rate |
$1,492.40 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna Medicare |
$280.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.69
|
| Rate for Payer: BCBS Complete |
$918.40
|
| Rate for Payer: BCBS MAPPO |
$269.92
|
| Rate for Payer: BCN Medicare Advantage |
$269.92
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cofinity Commercial |
$388.68
|
| Rate for Payer: Cofinity Commercial |
$361.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.92
|
| Rate for Payer: Healthscope Commercial |
$499.35
|
| Rate for Payer: Healthscope Commercial |
$431.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$283.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,492.40
|
| Rate for Payer: Nomi Health Commercial |
$323.90
|
| Rate for Payer: PACE SWMI |
$269.92
|
| Rate for Payer: PHP Medicare Advantage |
$269.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,492.40
|
| Rate for Payer: Priority Health Medicare |
$269.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.92
|
| Rate for Payer: UHC Medicare Advantage |
$269.92
|
|
|
PR RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY
|
Professional
|
Both
|
$2,640.00
|
|
|
Service Code
|
HCPCS 33237
|
| Min. Negotiated Rate |
$804.41 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Aetna Commercial |
$1,077.91
|
| Rate for Payer: Aetna Medicare |
$836.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.91
|
| Rate for Payer: BCBS Complete |
$1,056.00
|
| Rate for Payer: BCBS MAPPO |
$804.41
|
| Rate for Payer: BCN Medicare Advantage |
$804.41
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,158.35
|
| Rate for Payer: Cofinity Commercial |
$1,077.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.41
|
| Rate for Payer: Healthscope Commercial |
$1,287.06
|
| Rate for Payer: Healthscope Commercial |
$1,488.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$844.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,716.00
|
| Rate for Payer: Nomi Health Commercial |
$965.29
|
| Rate for Payer: PACE SWMI |
$804.41
|
| Rate for Payer: PHP Medicare Advantage |
$804.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,716.00
|
| Rate for Payer: Priority Health Medicare |
$804.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.41
|
| Rate for Payer: UHC Medicare Advantage |
$804.41
|
|
|
PR RMVL PROSTC MATRL/MESH ABDL WALL FOR INFECTION
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 11008
|
| Min. Negotiated Rate |
$263.80 |
| Max. Negotiated Rate |
$536.25 |
| Rate for Payer: Aetna Commercial |
$353.49
|
| Rate for Payer: Aetna Medicare |
$274.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.49
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS MAPPO |
$263.80
|
| Rate for Payer: BCN Medicare Advantage |
$263.80
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$379.87
|
| Rate for Payer: Cofinity Commercial |
$353.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.80
|
| Rate for Payer: Healthscope Commercial |
$488.03
|
| Rate for Payer: Healthscope Commercial |
$422.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$536.25
|
| Rate for Payer: Nomi Health Commercial |
$316.56
|
| Rate for Payer: PACE SWMI |
$263.80
|
| Rate for Payer: PHP Medicare Advantage |
$263.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health Medicare |
$263.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.80
|
| Rate for Payer: UHC Medicare Advantage |
$263.80
|
|
|
PR RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER
|
Professional
|
Both
|
$3,367.00
|
|
|
Service Code
|
HCPCS 27488
|
| Min. Negotiated Rate |
$1,156.49 |
| Max. Negotiated Rate |
$2,188.55 |
| Rate for Payer: Aetna Commercial |
$1,549.70
|
| Rate for Payer: Aetna Medicare |
$1,202.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,665.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,549.70
|
| Rate for Payer: BCBS Complete |
$1,346.80
|
| Rate for Payer: BCBS MAPPO |
$1,156.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,156.49
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,665.35
|
| Rate for Payer: Cofinity Commercial |
$1,549.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,156.49
|
| Rate for Payer: Healthscope Commercial |
$1,850.38
|
| Rate for Payer: Healthscope Commercial |
$2,139.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,214.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,188.55
|
| Rate for Payer: Nomi Health Commercial |
$1,387.79
|
| Rate for Payer: PACE SWMI |
$1,156.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,156.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,188.55
|
| Rate for Payer: Priority Health Medicare |
$1,156.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,156.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.49
|
|
|
PR RMVL/REVJ SLING MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 53442
|
| Min. Negotiated Rate |
$634.80 |
| Max. Negotiated Rate |
$1,390.11 |
| Rate for Payer: Aetna Commercial |
$1,006.89
|
| Rate for Payer: Aetna Medicare |
$781.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.89
|
| Rate for Payer: BCBS Complete |
$634.80
|
| Rate for Payer: BCBS MAPPO |
$751.41
|
| Rate for Payer: BCN Medicare Advantage |
$751.41
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,082.03
|
| Rate for Payer: Cofinity Commercial |
$1,006.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.41
|
| Rate for Payer: Healthscope Commercial |
$1,390.11
|
| Rate for Payer: Healthscope Commercial |
$1,202.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,031.55
|
| Rate for Payer: Nomi Health Commercial |
$901.69
|
| Rate for Payer: PACE SWMI |
$751.41
|
| Rate for Payer: PHP Medicare Advantage |
$751.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health Medicare |
$751.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.41
|
| Rate for Payer: UHC Medicare Advantage |
$751.41
|
|
|
PR RMVL/REVJ SLING STRESS INCONTINENCE
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 57287
|
| Min. Negotiated Rate |
$493.60 |
| Max. Negotiated Rate |
$1,303.44 |
| Rate for Payer: Aetna Commercial |
$944.11
|
| Rate for Payer: Aetna Medicare |
$732.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.57
|
| Rate for Payer: BCBS Complete |
$493.60
|
| Rate for Payer: BCBS MAPPO |
$704.56
|
| Rate for Payer: BCN Medicare Advantage |
$704.56
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$944.11
|
| Rate for Payer: Cofinity Commercial |
$1,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.56
|
| Rate for Payer: Healthscope Commercial |
$1,127.30
|
| Rate for Payer: Healthscope Commercial |
$1,303.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.10
|
| Rate for Payer: Nomi Health Commercial |
$845.47
|
| Rate for Payer: PACE SWMI |
$704.56
|
| Rate for Payer: PHP Medicare Advantage |
$704.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.10
|
| Rate for Payer: Priority Health Medicare |
$704.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.56
|
| Rate for Payer: UHC Medicare Advantage |
$704.56
|
|
|
PR RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 54410
|
| Min. Negotiated Rate |
$669.20 |
| Max. Negotiated Rate |
$1,525.99 |
| Rate for Payer: Aetna Commercial |
$1,105.31
|
| Rate for Payer: Aetna Medicare |
$857.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,187.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.31
|
| Rate for Payer: BCBS Complete |
$669.20
|
| Rate for Payer: BCBS MAPPO |
$824.86
|
| Rate for Payer: BCN Medicare Advantage |
$824.86
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,187.80
|
| Rate for Payer: Cofinity Commercial |
$1,105.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.86
|
| Rate for Payer: Healthscope Commercial |
$1,525.99
|
| Rate for Payer: Healthscope Commercial |
$1,319.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,087.45
|
| Rate for Payer: Nomi Health Commercial |
$989.83
|
| Rate for Payer: PACE SWMI |
$824.86
|
| Rate for Payer: PHP Medicare Advantage |
$824.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health Medicare |
$824.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$824.86
|
| Rate for Payer: UHC Medicare Advantage |
$824.86
|
|
