|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.07
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Healthscope Commercial |
$332.83
|
| Rate for Payer: Healthscope Commercial |
$287.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.40
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$179.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$451.08 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Cofinity Commercial |
$501.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$451.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$852.97
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$270.27 |
| Max. Negotiated Rate |
$386.10 |
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.85
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health SBD |
$270.27
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$270.27 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$270.27
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$339.48
|
| Rate for Payer: VA VA |
$602.98
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$278.85 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: BCBS Complete |
$171.60
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Healthscope Commercial |
$206.53
|
| Rate for Payer: Healthscope Commercial |
$238.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.85
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$129.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$278.85 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.97
|
| Rate for Payer: BCBS Complete |
$171.60
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Healthscope Commercial |
$206.53
|
| Rate for Payer: Healthscope Commercial |
$238.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.85
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$129.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
|
|
PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 11983
|
| Min. Negotiated Rate |
$99.73 |
| Max. Negotiated Rate |
$261.30 |
| Rate for Payer: Aetna Commercial |
$133.64
|
| Rate for Payer: Aetna Medicare |
$103.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.64
|
| Rate for Payer: BCBS Complete |
$160.80
|
| Rate for Payer: BCBS MAPPO |
$99.73
|
| Rate for Payer: BCN Medicare Advantage |
$99.73
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$143.61
|
| Rate for Payer: Cofinity Commercial |
$133.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.73
|
| Rate for Payer: Healthscope Commercial |
$184.50
|
| Rate for Payer: Healthscope Commercial |
$159.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.30
|
| Rate for Payer: Nomi Health Commercial |
$119.68
|
| Rate for Payer: PACE SWMI |
$99.73
|
| Rate for Payer: PHP Medicare Advantage |
$99.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health Medicare |
$99.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.73
|
| Rate for Payer: UHC Medicare Advantage |
$99.73
|
|
|
PR RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 50575
|
| Min. Negotiated Rate |
$554.40 |
| Max. Negotiated Rate |
$1,251.82 |
| Rate for Payer: Aetna Commercial |
$906.72
|
| Rate for Payer: Aetna Medicare |
$703.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.72
|
| Rate for Payer: BCBS Complete |
$554.40
|
| Rate for Payer: BCBS MAPPO |
$676.66
|
| Rate for Payer: BCN Medicare Advantage |
$676.66
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$974.39
|
| Rate for Payer: Cofinity Commercial |
$906.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.66
|
| Rate for Payer: Healthscope Commercial |
$1,082.66
|
| Rate for Payer: Healthscope Commercial |
$1,251.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$900.90
|
| Rate for Payer: Nomi Health Commercial |
$811.99
|
| Rate for Payer: PACE SWMI |
$676.66
|
| Rate for Payer: PHP Medicare Advantage |
$676.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health Medicare |
$676.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.66
|
| Rate for Payer: UHC Medicare Advantage |
$676.66
|
|
|
PR ROBOTIC SURGICAL SYSTEM
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS S2900
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 95852
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$7.25
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.79
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS MAPPO |
$5.41
|
| Rate for Payer: BCN Medicare Advantage |
$5.41
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Cofinity Commercial |
$7.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.41
|
| Rate for Payer: Healthscope Commercial |
$8.66
|
| Rate for Payer: Healthscope Commercial |
$10.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.00
|
| Rate for Payer: Nomi Health Commercial |
$6.49
|
| Rate for Payer: PACE SWMI |
$5.41
|
| Rate for Payer: PHP Medicare Advantage |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.41
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
|
|
PR ROPRTJ > 1 MO AFTER ORIGINAL OPRATION
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
HCPCS 35700
|
| Min. Negotiated Rate |
$145.85 |
| Max. Negotiated Rate |
$375.70 |
| Rate for Payer: Aetna Commercial |
$195.44
|
| Rate for Payer: Aetna Medicare |
$151.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.02
|
| Rate for Payer: BCBS Complete |
$231.20
|
| Rate for Payer: BCBS MAPPO |
$145.85
|
| Rate for Payer: BCN Medicare Advantage |
$145.85
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Cofinity Commercial |
$210.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.85
|
| Rate for Payer: Healthscope Commercial |
$233.36
|
| Rate for Payer: Healthscope Commercial |
$269.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.70
|
| Rate for Payer: Nomi Health Commercial |
$175.02
|
| Rate for Payer: PACE SWMI |
$145.85
|
| Rate for Payer: PHP Medicare Advantage |
$145.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.70
|
| Rate for Payer: Priority Health Medicare |
$145.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.85
|
| Rate for Payer: UHC Medicare Advantage |
$145.85
|
|
|
PR ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ
|
Professional
|
Both
|
$1,703.00
|
|
|
Service Code
|
HCPCS 33530
|
| Min. Negotiated Rate |
$502.04 |
| Max. Negotiated Rate |
$1,106.95 |
| Rate for Payer: Aetna Commercial |
$672.73
|
| Rate for Payer: Aetna Medicare |
$522.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.73
|
| Rate for Payer: BCBS Complete |
$681.20
|
| Rate for Payer: BCBS MAPPO |
$502.04
|
| Rate for Payer: BCN Medicare Advantage |
$502.04
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cofinity Commercial |
$722.94
|
| Rate for Payer: Cofinity Commercial |
$672.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.04
|
| Rate for Payer: Healthscope Commercial |
$928.77
|
| Rate for Payer: Healthscope Commercial |
$803.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.95
|
| Rate for Payer: Nomi Health Commercial |
$602.45
|
| Rate for Payer: PACE SWMI |
$502.04
|
| Rate for Payer: PHP Medicare Advantage |
$502.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,106.95
|
| Rate for Payer: Priority Health Medicare |
$502.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.04
|
| Rate for Payer: UHC Medicare Advantage |
$502.04
|
|
|
PR ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 35390
|
| Min. Negotiated Rate |
$126.40 |
| Max. Negotiated Rate |
$283.42 |
| Rate for Payer: Aetna Commercial |
$205.29
|
| Rate for Payer: Aetna Medicare |
$159.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.29
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$153.20
|
| Rate for Payer: BCN Medicare Advantage |
$153.20
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$220.61
|
| Rate for Payer: Cofinity Commercial |
$205.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.20
|
| Rate for Payer: Healthscope Commercial |
$245.12
|
| Rate for Payer: Healthscope Commercial |
$283.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.40
|
| Rate for Payer: Nomi Health Commercial |
$183.84
|
| Rate for Payer: PACE SWMI |
$153.20
|
| Rate for Payer: PHP Medicare Advantage |
$153.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$153.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.20
|
| Rate for Payer: UHC Medicare Advantage |
$153.20
|
|
|
PR ROUT FOOT CARE PER VISIT
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS S0390
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
|
|
PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB
|
Professional
|
Both
|
$4,028.00
|
|
|
Service Code
|
HCPCS 59610
|
| Min. Negotiated Rate |
$1,611.20 |
| Max. Negotiated Rate |
$4,548.65 |
| Rate for Payer: Aetna Commercial |
$3,294.70
|
| Rate for Payer: Aetna Medicare |
$2,557.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,294.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,540.57
|
| Rate for Payer: BCBS Complete |
$1,611.20
|
| Rate for Payer: BCBS MAPPO |
$2,458.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,458.73
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cofinity Commercial |
$3,540.57
|
| Rate for Payer: Cofinity Commercial |
$3,294.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,458.73
|
| Rate for Payer: Healthscope Commercial |
$4,548.65
|
| Rate for Payer: Healthscope Commercial |
$3,933.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,581.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,618.20
|
| Rate for Payer: Nomi Health Commercial |
$2,950.48
|
| Rate for Payer: PACE SWMI |
$2,458.73
|
| Rate for Payer: PHP Medicare Advantage |
$2,458.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.20
|
| Rate for Payer: Priority Health Medicare |
$2,458.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,458.73
|
| Rate for Payer: UHC Medicare Advantage |
$2,458.73
|
|
|
PR ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC
|
Professional
|
Both
|
$4,323.00
|
|
|
Service Code
|
HCPCS 59618
|
| Min. Negotiated Rate |
$1,729.20 |
| Max. Negotiated Rate |
$4,875.40 |
| Rate for Payer: Aetna Commercial |
$3,531.37
|
| Rate for Payer: Aetna Medicare |
$2,740.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,531.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,794.90
|
| Rate for Payer: BCBS Complete |
$1,729.20
|
| Rate for Payer: BCBS MAPPO |
$2,635.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,635.35
|
| Rate for Payer: Cash Price |
$3,458.40
|
| Rate for Payer: Cash Price |
$3,458.40
|
| Rate for Payer: Cofinity Commercial |
$3,531.37
|
| Rate for Payer: Cofinity Commercial |
$3,794.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,635.35
|
| Rate for Payer: Healthscope Commercial |
$4,216.56
|
| Rate for Payer: Healthscope Commercial |
$4,875.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,767.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,809.95
|
| Rate for Payer: Nomi Health Commercial |
$3,162.42
|
| Rate for Payer: PACE SWMI |
$2,635.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,635.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.95
|
| Rate for Payer: Priority Health Medicare |
$2,635.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,635.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,635.35
|
|
|
PR RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST
|
Professional
|
Both
|
$2,539.00
|
|
|
Service Code
|
HCPCS 50840
|
| Min. Negotiated Rate |
$1,015.60 |
| Max. Negotiated Rate |
$2,172.95 |
| Rate for Payer: Aetna Commercial |
$1,573.92
|
| Rate for Payer: Aetna Medicare |
$1,221.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,691.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,573.92
|
| Rate for Payer: BCBS Complete |
$1,015.60
|
| Rate for Payer: BCBS MAPPO |
$1,174.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,174.57
|
| Rate for Payer: Cash Price |
$2,031.20
|
| Rate for Payer: Cash Price |
$2,031.20
|
| Rate for Payer: Cofinity Commercial |
$1,691.38
|
| Rate for Payer: Cofinity Commercial |
$1,573.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,174.57
|
| Rate for Payer: Healthscope Commercial |
$2,172.95
|
| Rate for Payer: Healthscope Commercial |
$1,879.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,233.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.35
|
| Rate for Payer: Nomi Health Commercial |
$1,409.48
|
| Rate for Payer: PACE SWMI |
$1,174.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,174.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.35
|
| Rate for Payer: Priority Health Medicare |
$1,174.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,174.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,174.57
|
|
|
PR RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS
|
Professional
|
Both
|
$9,690.00
|
|
|
Service Code
|
HCPCS 33411
|
| Min. Negotiated Rate |
$3,212.15 |
| Max. Negotiated Rate |
$6,298.50 |
| Rate for Payer: Aetna Commercial |
$4,304.28
|
| Rate for Payer: Aetna Medicare |
$3,340.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,625.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,304.28
|
| Rate for Payer: BCBS Complete |
$3,876.00
|
| Rate for Payer: BCBS MAPPO |
$3,212.15
|
| Rate for Payer: BCN Medicare Advantage |
$3,212.15
|
| Rate for Payer: Cash Price |
$7,752.00
|
| Rate for Payer: Cash Price |
$7,752.00
|
| Rate for Payer: Cofinity Commercial |
$4,625.50
|
| Rate for Payer: Cofinity Commercial |
$4,304.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,212.15
|
| Rate for Payer: Healthscope Commercial |
$5,139.44
|
| Rate for Payer: Healthscope Commercial |
$5,942.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,372.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,298.50
|
| Rate for Payer: Nomi Health Commercial |
$3,854.58
|
| Rate for Payer: PACE SWMI |
$3,212.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,212.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,298.50
|
| Rate for Payer: Priority Health Medicare |
$3,212.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,212.15
|
| Rate for Payer: UHC Medicare Advantage |
$3,212.15
|
|
|
PR RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND
|
Professional
|
Both
|
$6,847.00
|
|
|
Service Code
|
HCPCS 33406
|
| Min. Negotiated Rate |
$2,738.80 |
| Max. Negotiated Rate |
$5,118.25 |
| Rate for Payer: Aetna Commercial |
$3,707.27
|
| Rate for Payer: Aetna Medicare |
$2,877.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,983.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,707.27
|
| Rate for Payer: BCBS Complete |
$2,738.80
|
| Rate for Payer: BCBS MAPPO |
$2,766.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,766.62
|
| Rate for Payer: Cash Price |
$5,477.60
|
| Rate for Payer: Cash Price |
$5,477.60
|
| Rate for Payer: Cofinity Commercial |
$3,983.93
|
| Rate for Payer: Cofinity Commercial |
$3,707.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,766.62
|
| Rate for Payer: Healthscope Commercial |
$5,118.25
|
| Rate for Payer: Healthscope Commercial |
$4,426.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,904.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,450.55
|
| Rate for Payer: Nomi Health Commercial |
$3,319.94
|
| Rate for Payer: PACE SWMI |
$2,766.62
|
| Rate for Payer: PHP Medicare Advantage |
$2,766.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,450.55
|
| Rate for Payer: Priority Health Medicare |
$2,766.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,766.62
|
| Rate for Payer: UHC Medicare Advantage |
$2,766.62
|
|
|
PR RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE
|
Professional
|
Both
|
$8,127.00
|
|
|
Service Code
|
HCPCS 33410
|
| Min. Negotiated Rate |
$2,440.87 |
| Max. Negotiated Rate |
$5,282.55 |
| Rate for Payer: Aetna Commercial |
$3,270.77
|
| Rate for Payer: Aetna Medicare |
$2,538.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,514.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,270.77
|
| Rate for Payer: BCBS Complete |
$3,250.80
|
| Rate for Payer: BCBS MAPPO |
$2,440.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,440.87
|
| Rate for Payer: Cash Price |
$6,501.60
|
| Rate for Payer: Cash Price |
$6,501.60
|
| Rate for Payer: Cofinity Commercial |
$3,514.85
|
| Rate for Payer: Cofinity Commercial |
$3,270.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,440.87
|
| Rate for Payer: Healthscope Commercial |
$3,905.39
|
| Rate for Payer: Healthscope Commercial |
$4,515.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,562.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,282.55
|
| Rate for Payer: Nomi Health Commercial |
$2,929.04
|
| Rate for Payer: PACE SWMI |
$2,440.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,440.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,282.55
|
| Rate for Payer: Priority Health Medicare |
$2,440.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,440.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,440.87
|
|
|
PR RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL
|
Professional
|
Both
|
$5,033.00
|
|
|
Service Code
|
HCPCS 62143
|
| Min. Negotiated Rate |
$1,036.68 |
| Max. Negotiated Rate |
$3,271.45 |
| Rate for Payer: Aetna Commercial |
$1,389.15
|
| Rate for Payer: Aetna Medicare |
$1,078.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,492.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.15
|
| Rate for Payer: BCBS Complete |
$2,013.20
|
| Rate for Payer: BCBS MAPPO |
$1,036.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.68
|
| Rate for Payer: Cash Price |
$4,026.40
|
| Rate for Payer: Cash Price |
$4,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,492.82
|
| Rate for Payer: Cofinity Commercial |
$1,389.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.68
|
| Rate for Payer: Healthscope Commercial |
$1,917.86
|
| Rate for Payer: Healthscope Commercial |
$1,658.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,088.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,271.45
|
| Rate for Payer: Nomi Health Commercial |
$1,244.02
|
| Rate for Payer: PACE SWMI |
$1,036.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,271.45
|
| Rate for Payer: Priority Health Medicare |
$1,036.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.68
|
|
|
PR RPLCMT CATH CTR VAD SUBQ PORT/PMP
|
Professional
|
Both
|
$1,024.00
|
|
|
Service Code
|
HCPCS 36578
|
| Min. Negotiated Rate |
$191.32 |
| Max. Negotiated Rate |
$665.60 |
| Rate for Payer: Aetna Commercial |
$256.37
|
| Rate for Payer: Aetna Medicare |
$198.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.37
|
| Rate for Payer: BCBS Complete |
$409.60
|
| Rate for Payer: BCBS MAPPO |
$191.32
|
| Rate for Payer: BCN Medicare Advantage |
$191.32
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cofinity Commercial |
$275.50
|
| Rate for Payer: Cofinity Commercial |
$256.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.32
|
| Rate for Payer: Healthscope Commercial |
$306.11
|
| Rate for Payer: Healthscope Commercial |
$353.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.60
|
| Rate for Payer: Nomi Health Commercial |
$229.58
|
| Rate for Payer: PACE SWMI |
$191.32
|
| Rate for Payer: PHP Medicare Advantage |
$191.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.60
|
| Rate for Payer: Priority Health Medicare |
$191.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.32
|
| Rate for Payer: UHC Medicare Advantage |
$191.32
|
|
|
PR RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 36580
|
| Min. Negotiated Rate |
$61.41 |
| Max. Negotiated Rate |
$501.15 |
| Rate for Payer: Aetna Commercial |
$82.29
|
| Rate for Payer: Aetna Medicare |
$63.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.29
|
| Rate for Payer: BCBS Complete |
$308.40
|
| Rate for Payer: BCBS MAPPO |
$61.41
|
| Rate for Payer: BCN Medicare Advantage |
$61.41
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$82.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.41
|
| Rate for Payer: Healthscope Commercial |
$98.26
|
| Rate for Payer: Healthscope Commercial |
$113.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$501.15
|
| Rate for Payer: Nomi Health Commercial |
$73.69
|
| Rate for Payer: PACE SWMI |
$61.41
|
| Rate for Payer: PHP Medicare Advantage |
$61.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.15
|
| Rate for Payer: Priority Health Medicare |
$61.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.41
|
| Rate for Payer: UHC Medicare Advantage |
$61.41
|
|
|
PR RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 36585
|
| Min. Negotiated Rate |
$293.26 |
| Max. Negotiated Rate |
$1,392.30 |
| Rate for Payer: Aetna Commercial |
$392.97
|
| Rate for Payer: Aetna Medicare |
$304.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.97
|
| Rate for Payer: BCBS Complete |
$856.80
|
| Rate for Payer: BCBS MAPPO |
$293.26
|
| Rate for Payer: BCN Medicare Advantage |
$293.26
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$422.29
|
| Rate for Payer: Cofinity Commercial |
$392.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.26
|
| Rate for Payer: Healthscope Commercial |
$469.22
|
| Rate for Payer: Healthscope Commercial |
$542.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,392.30
|
| Rate for Payer: Nomi Health Commercial |
$351.91
|
| Rate for Payer: PACE SWMI |
$293.26
|
| Rate for Payer: PHP Medicare Advantage |
$293.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health Medicare |
$293.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.26
|
| Rate for Payer: UHC Medicare Advantage |
$293.26
|
|
|
PR RPLCMT COMPL TUN CTR VAD W/SUBQ PMP
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 36583
|
| Min. Negotiated Rate |
$317.76 |
| Max. Negotiated Rate |
$1,264.25 |
| Rate for Payer: Aetna Commercial |
$425.80
|
| Rate for Payer: Aetna Medicare |
$330.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.80
|
| Rate for Payer: BCBS Complete |
$778.00
|
| Rate for Payer: BCBS MAPPO |
$317.76
|
| Rate for Payer: BCN Medicare Advantage |
$317.76
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$457.57
|
| Rate for Payer: Cofinity Commercial |
$425.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.76
|
| Rate for Payer: Healthscope Commercial |
$587.86
|
| Rate for Payer: Healthscope Commercial |
$508.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.25
|
| Rate for Payer: Nomi Health Commercial |
$381.31
|
| Rate for Payer: PACE SWMI |
$317.76
|
| Rate for Payer: PHP Medicare Advantage |
$317.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.25
|
| Rate for Payer: Priority Health Medicare |
$317.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.76
|
| Rate for Payer: UHC Medicare Advantage |
$317.76
|
|
