|
PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 33263
|
| Min. Negotiated Rate |
$244.10 |
| Max. Negotiated Rate |
$68,330.00 |
| Rate for Payer: Aetna Commercial |
$491.65
|
| Rate for Payer: Aetna Medicare |
$381.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.34
|
| Rate for Payer: BCBS Complete |
$256.30
|
| Rate for Payer: BCBS MAPPO |
$366.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,021.04
|
| Rate for Payer: BCN Commercial |
$560.02
|
| 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 |
$587.04
|
| Rate for Payer: Healthscope Commercial |
$678.76
|
| Rate for Payer: Mclaren Medicaid |
$244.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$385.24
|
| Rate for Payer: Meridian Medicaid |
$256.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,330.00
|
| 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 Choice Medicaid |
$244.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$607.34
|
| Rate for Payer: Priority Health Medicare |
$366.90
|
| Rate for Payer: Priority Health Narrow Network |
$607.34
|
| Rate for Payer: Priority Health SBD |
$607.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.90
|
| Rate for Payer: UHC Medicare Advantage |
$366.90
|
| Rate for Payer: UHCCP Medicaid |
$244.10
|
|
|
PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 33264
|
| Min. Negotiated Rate |
$254.32 |
| Max. Negotiated Rate |
$71,249.00 |
| Rate for Payer: Aetna Commercial |
$512.43
|
| Rate for Payer: Aetna Medicare |
$397.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.67
|
| Rate for Payer: BCBS Complete |
$267.04
|
| Rate for Payer: BCBS MAPPO |
$382.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.63
|
| Rate for Payer: BCN Commercial |
$583.97
|
| 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: Mclaren Medicaid |
$254.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.53
|
| Rate for Payer: Meridian Medicaid |
$267.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,249.00
|
| 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 Choice Medicaid |
$254.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.40
|
| Rate for Payer: Priority Health Medicare |
$382.41
|
| Rate for Payer: Priority Health Narrow Network |
$633.40
|
| Rate for Payer: Priority Health SBD |
$633.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.41
|
| Rate for Payer: UHC Medicare Advantage |
$382.41
|
| Rate for Payer: UHCCP Medicaid |
$254.32
|
|
|
PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH
|
Professional
|
Both
|
$1,392.00
|
|
|
Service Code
|
HCPCS 54406
|
| Min. Negotiated Rate |
$469.24 |
| Max. Negotiated Rate |
$128,576.00 |
| Rate for Payer: Aetna Commercial |
$937.33
|
| Rate for Payer: Aetna Medicare |
$727.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.33
|
| Rate for Payer: BCBS Complete |
$492.70
|
| Rate for Payer: BCBS MAPPO |
$699.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.10
|
| Rate for Payer: BCN Commercial |
$1,055.55
|
| 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: Mclaren Medicaid |
$469.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.48
|
| Rate for Payer: Meridian Medicaid |
$492.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,576.00
|
| 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 Choice Medicaid |
$469.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.33
|
| Rate for Payer: Priority Health Medicare |
$699.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,165.33
|
| Rate for Payer: Priority Health SBD |
$1,165.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.50
|
| Rate for Payer: UHC Exchange |
$792.33
|
| Rate for Payer: UHC Medicare Advantage |
$699.50
|
| Rate for Payer: UHCCP Medicaid |
$469.24
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY
|
Professional
|
Both
|
$3,691.00
|
|
|
Service Code
|
HCPCS 32484
|
| Min. Negotiated Rate |
$524.07 |
| Max. Negotiated Rate |
$254,077.00 |
| Rate for Payer: Aetna Commercial |
$1,847.67
|
| Rate for Payer: Aetna Medicare |
$1,434.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,985.56
|
| Rate for Payer: BCBS Complete |
$951.64
|
| Rate for Payer: BCBS MAPPO |
$1,378.86
|
| Rate for Payer: BCBS Trust/PPO |
$524.07
|
| Rate for Payer: BCN Commercial |
$2,059.77
|
| 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 |
$2,550.89
|
| Rate for Payer: Healthscope Commercial |
$2,206.18
|
| Rate for Payer: Mclaren Medicaid |
$906.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.80
|
| Rate for Payer: Meridian Medicaid |
$951.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254,077.00
|
| 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 Choice Medicaid |
$906.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,399.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,962.31
|
| Rate for Payer: Priority Health Medicare |
$1,378.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.31
|
| Rate for Payer: Priority Health SBD |
$1,962.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,667.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,378.86
|
| Rate for Payer: UHC Exchange |
$1,667.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,378.86
|
| Rate for Payer: UHCCP Medicaid |
$906.32
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC
|
Professional
|
Both
|
$5,362.00
|
|
|
Service Code
|
HCPCS 32482
|
| Min. Negotiated Rate |
$550.49 |
| Max. Negotiated Rate |
$279,997.00 |
| Rate for Payer: Aetna Commercial |
$2,037.64
|
| Rate for Payer: Aetna Medicare |
$1,581.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,037.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,189.71
|
| Rate for Payer: BCBS Complete |
$1,051.38
|
| Rate for Payer: BCBS MAPPO |
$1,520.63
|
| Rate for Payer: BCBS Trust/PPO |
$550.49
|
| Rate for Payer: BCN Commercial |
$2,273.82
|
| 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: Mclaren Medicaid |
$1,001.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,596.66
|
| Rate for Payer: Meridian Medicaid |
$1,051.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279,997.00
|
| 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 Choice Medicaid |
$1,001.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,485.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.70
|
| Rate for Payer: Priority Health Medicare |
$1,520.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,166.70
|
| Rate for Payer: Priority Health SBD |
$2,166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,887.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,520.63
|
| Rate for Payer: UHC Exchange |
$1,887.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,520.63
|
| Rate for Payer: UHCCP Medicaid |
$1,001.31
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT
|
Professional
|
Both
|
$4,766.00
|
|
|
Service Code
|
HCPCS 32480
|
| Min. Negotiated Rate |
$546.26 |
| Max. Negotiated Rate |
$262,100.00 |
| Rate for Payer: Aetna Commercial |
$1,904.61
|
| Rate for Payer: Aetna Medicare |
$1,478.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,046.74
|
| Rate for Payer: BCBS Complete |
$982.28
|
| Rate for Payer: BCBS MAPPO |
$1,421.35
|
| Rate for Payer: BCBS Trust/PPO |
$546.26
|
| Rate for Payer: BCN Commercial |
$2,127.70
|
| 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 |
$2,629.50
|
| Rate for Payer: Healthscope Commercial |
$2,274.16
|
| Rate for Payer: Mclaren Medicaid |
$935.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,492.42
|
| Rate for Payer: Meridian Medicaid |
$982.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262,100.00
|
| 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 Choice Medicaid |
$935.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,097.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,027.21
|
| Rate for Payer: Priority Health Medicare |
$1,421.35
|
| Rate for Payer: Priority Health Narrow Network |
$2,027.21
|
| Rate for Payer: Priority Health SBD |
$2,027.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,806.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,421.35
|
| Rate for Payer: UHC Exchange |
$1,806.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,421.35
|
| Rate for Payer: UHCCP Medicaid |
$935.50
|
|
|
PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC
|
Professional
|
Both
|
$4,483.00
|
|
|
Service Code
|
HCPCS 32488
|
| Min. Negotiated Rate |
$873.28 |
| Max. Negotiated Rate |
$423,900.00 |
| Rate for Payer: Aetna Commercial |
$3,077.40
|
| Rate for Payer: Aetna Medicare |
$2,388.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,077.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,307.06
|
| Rate for Payer: BCBS Complete |
$1,581.43
|
| Rate for Payer: BCBS MAPPO |
$2,296.57
|
| Rate for Payer: BCBS Trust/PPO |
$873.28
|
| Rate for Payer: BCN Commercial |
$3,431.00
|
| 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: Mclaren Medicaid |
$1,506.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,411.40
|
| Rate for Payer: Meridian Medicaid |
$1,581.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423,900.00
|
| 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 Choice Medicaid |
$1,506.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,268.36
|
| Rate for Payer: Priority Health Medicare |
$2,296.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,268.36
|
| Rate for Payer: Priority Health SBD |
$3,268.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,056.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,296.57
|
| Rate for Payer: UHC Exchange |
$2,056.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,296.57
|
| Rate for Payer: UHCCP Medicaid |
$1,506.12
|
|
|
PR RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY
|
Professional
|
Both
|
$4,436.00
|
|
|
Service Code
|
HCPCS 32486
|
| Min. Negotiated Rate |
$663.54 |
| Max. Negotiated Rate |
$415,373.00 |
| Rate for Payer: Aetna Commercial |
$3,012.79
|
| Rate for Payer: Aetna Medicare |
$2,338.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,012.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,237.62
|
| Rate for Payer: BCBS Complete |
$1,545.20
|
| Rate for Payer: BCBS MAPPO |
$2,248.35
|
| Rate for Payer: BCBS Trust/PPO |
$663.54
|
| Rate for Payer: BCN Commercial |
$3,356.72
|
| 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 |
$4,159.45
|
| Rate for Payer: Healthscope Commercial |
$3,597.36
|
| Rate for Payer: Mclaren Medicaid |
$1,471.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,360.77
|
| Rate for Payer: Meridian Medicaid |
$1,545.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$415,373.00
|
| 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 Choice Medicaid |
$1,471.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,883.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,195.13
|
| Rate for Payer: Priority Health Medicare |
$2,248.35
|
| Rate for Payer: Priority Health Narrow Network |
$3,195.13
|
| Rate for Payer: Priority Health SBD |
$3,195.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,932.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,248.35
|
| Rate for Payer: UHC Exchange |
$1,932.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,248.35
|
| Rate for Payer: UHCCP Medicaid |
$1,471.62
|
|
|
PR RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 32552
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$27,520.00 |
| Rate for Payer: Aetna Commercial |
$198.25
|
| Rate for Payer: Aetna Medicare |
$153.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.05
|
| Rate for Payer: BCBS Complete |
$104.44
|
| Rate for Payer: BCBS MAPPO |
$147.95
|
| Rate for Payer: BCBS Trust/PPO |
$887.54
|
| Rate for Payer: BCN Commercial |
$265.85
|
| 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 |
$236.72
|
| Rate for Payer: Healthscope Commercial |
$273.71
|
| Rate for Payer: Mclaren Medicaid |
$99.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.35
|
| Rate for Payer: Meridian Medicaid |
$104.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,520.00
|
| 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 Choice Medicaid |
$99.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.98
|
| Rate for Payer: Priority Health Medicare |
$147.95
|
| Rate for Payer: Priority Health Narrow Network |
$215.98
|
| Rate for Payer: Priority Health SBD |
$215.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.95
|
| Rate for Payer: UHC Medicare Advantage |
$147.95
|
| Rate for Payer: UHCCP Medicaid |
$99.47
|
|
|
PR RMVL NFROS TUBE REQ FLUORO GUIDANCE
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 50389
|
| Min. Negotiated Rate |
$33.65 |
| Max. Negotiated Rate |
$9,376.00 |
| Rate for Payer: Aetna Commercial |
$68.11
|
| Rate for Payer: Aetna Medicare |
$52.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.20
|
| Rate for Payer: BCBS Complete |
$35.33
|
| Rate for Payer: BCBS MAPPO |
$50.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,593.50
|
| Rate for Payer: BCN Commercial |
$615.25
|
| 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 |
$94.04
|
| Rate for Payer: Healthscope Commercial |
$81.33
|
| Rate for Payer: Mclaren Medicaid |
$33.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.37
|
| Rate for Payer: Meridian Medicaid |
$35.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,376.00
|
| 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 Choice Medicaid |
$33.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health Medicare |
$50.83
|
| Rate for Payer: Priority Health Narrow Network |
$83.09
|
| Rate for Payer: Priority Health SBD |
$83.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.83
|
| Rate for Payer: UHC Exchange |
$62.15
|
| Rate for Payer: UHC Medicare Advantage |
$50.83
|
| Rate for Payer: UHCCP Medicaid |
$33.65
|
|
|
PR RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 49623
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$35,505.00 |
| Rate for Payer: Aetna Commercial |
$264.88
|
| Rate for Payer: Aetna Medicare |
$205.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.64
|
| Rate for Payer: BCBS Complete |
$135.98
|
| Rate for Payer: BCBS MAPPO |
$197.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,514.78
|
| Rate for Payer: BCN Commercial |
$287.34
|
| 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 |
$316.27
|
| Rate for Payer: Healthscope Commercial |
$365.69
|
| Rate for Payer: Mclaren Medicaid |
$129.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.55
|
| Rate for Payer: Meridian Medicaid |
$135.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,505.00
|
| 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 Choice Medicaid |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.80
|
| Rate for Payer: Priority Health Medicare |
$197.67
|
| Rate for Payer: Priority Health Narrow Network |
$350.80
|
| Rate for Payer: Priority Health SBD |
$350.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.67
|
| Rate for Payer: UHC Medicare Advantage |
$197.67
|
| Rate for Payer: UHCCP Medicaid |
$129.50
|
|
|
PR RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 54415
|
| Min. Negotiated Rate |
$342.50 |
| Max. Negotiated Rate |
$93,296.00 |
| Rate for Payer: Aetna Commercial |
$681.35
|
| Rate for Payer: Aetna Medicare |
$528.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.20
|
| Rate for Payer: BCBS Complete |
$359.62
|
| Rate for Payer: BCBS MAPPO |
$508.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.10
|
| Rate for Payer: BCN Commercial |
$768.69
|
| 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 |
$940.67
|
| Rate for Payer: Healthscope Commercial |
$813.55
|
| Rate for Payer: Mclaren Medicaid |
$342.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.89
|
| Rate for Payer: Meridian Medicaid |
$359.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,296.00
|
| 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 Choice Medicaid |
$342.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$852.16
|
| Rate for Payer: Priority Health Medicare |
$508.47
|
| Rate for Payer: Priority Health Narrow Network |
$852.16
|
| Rate for Payer: Priority Health SBD |
$852.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.47
|
| Rate for Payer: UHC Exchange |
$585.21
|
| Rate for Payer: UHC Medicare Advantage |
$508.47
|
| Rate for Payer: UHCCP Medicaid |
$342.50
|
|
|
PR RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE
|
Professional
|
Both
|
$720.00
|
|
|
Service Code
|
HCPCS 33272
|
| Min. Negotiated Rate |
$220.24 |
| Max. Negotiated Rate |
$61,173.00 |
| Rate for Payer: Aetna Commercial |
$443.29
|
| Rate for Payer: Aetna Medicare |
$344.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.37
|
| Rate for Payer: BCBS Complete |
$231.25
|
| Rate for Payer: BCBS MAPPO |
$330.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,196.14
|
| Rate for Payer: BCN Commercial |
$501.39
|
| 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 |
$529.30
|
| Rate for Payer: Healthscope Commercial |
$612.00
|
| Rate for Payer: Mclaren Medicaid |
$220.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.35
|
| Rate for Payer: Meridian Medicaid |
$231.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,173.00
|
| 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 Choice Medicaid |
$220.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$545.65
|
| Rate for Payer: Priority Health Medicare |
$330.81
|
| Rate for Payer: Priority Health Narrow Network |
$545.65
|
| Rate for Payer: Priority Health SBD |
$545.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.81
|
| Rate for Payer: UHC Medicare Advantage |
$330.81
|
| Rate for Payer: UHCCP Medicaid |
$220.24
|
|
|
PR RMVL PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$1,599.00
|
|
|
Service Code
|
HCPCS 49429
|
| Min. Negotiated Rate |
$295.01 |
| Max. Negotiated Rate |
$82,170.00 |
| Rate for Payer: Aetna Commercial |
$597.17
|
| Rate for Payer: Aetna Medicare |
$463.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.74
|
| Rate for Payer: BCBS Complete |
$309.76
|
| Rate for Payer: BCBS MAPPO |
$445.65
|
| Rate for Payer: BCN Commercial |
$670.47
|
| 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 |
$824.45
|
| Rate for Payer: Healthscope Commercial |
$713.04
|
| Rate for Payer: Mclaren Medicaid |
$295.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.93
|
| Rate for Payer: Meridian Medicaid |
$309.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,170.00
|
| 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 Choice Medicaid |
$295.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$820.31
|
| Rate for Payer: Priority Health Medicare |
$445.65
|
| Rate for Payer: Priority Health Narrow Network |
$820.31
|
| Rate for Payer: Priority Health SBD |
$820.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$506.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.65
|
| Rate for Payer: UHC Exchange |
$506.96
|
| Rate for Payer: UHC Medicare Advantage |
$445.65
|
| Rate for Payer: UHCCP Medicaid |
$295.01
|
|
|
PR RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH
|
Professional
|
Both
|
$2,296.00
|
|
|
Service Code
|
HCPCS 62355
|
| Min. Negotiated Rate |
$182.33 |
| Max. Negotiated Rate |
$48,652.00 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna Medicare |
$280.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.68
|
| Rate for Payer: BCBS Complete |
$191.45
|
| Rate for Payer: BCBS MAPPO |
$269.92
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$403.65
|
| 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: Mclaren Medicaid |
$182.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$283.42
|
| Rate for Payer: Meridian Medicaid |
$191.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,652.00
|
| 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 Choice Medicaid |
$182.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,492.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.58
|
| Rate for Payer: Priority Health Medicare |
$269.92
|
| Rate for Payer: Priority Health Narrow Network |
$476.58
|
| Rate for Payer: Priority Health SBD |
$476.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.92
|
| Rate for Payer: UHC Exchange |
$440.58
|
| Rate for Payer: UHC Medicare Advantage |
$269.92
|
| Rate for Payer: UHCCP Medicaid |
$182.33
|
|
|
PR RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY
|
Professional
|
Both
|
$2,640.00
|
|
|
Service Code
|
HCPCS 33237
|
| Min. Negotiated Rate |
$533.35 |
| Max. Negotiated Rate |
$148,397.00 |
| Rate for Payer: Aetna Commercial |
$1,077.91
|
| Rate for Payer: Aetna Medicare |
$836.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.35
|
| Rate for Payer: BCBS Complete |
$560.02
|
| Rate for Payer: BCBS MAPPO |
$804.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.34
|
| Rate for Payer: BCN Commercial |
$1,211.44
|
| 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 |
$1,488.16
|
| Rate for Payer: Healthscope Commercial |
$1,287.06
|
| Rate for Payer: Mclaren Medicaid |
$533.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$844.63
|
| Rate for Payer: Meridian Medicaid |
$560.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148,397.00
|
| 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 Choice Medicaid |
$533.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,716.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.72
|
| Rate for Payer: Priority Health Medicare |
$804.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.72
|
| Rate for Payer: Priority Health SBD |
$1,323.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,117.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.41
|
| Rate for Payer: UHC Exchange |
$1,117.48
|
| Rate for Payer: UHC Medicare Advantage |
$804.41
|
| Rate for Payer: UHCCP Medicaid |
$533.35
|
|
|
PR RMVL PROSTC MATRL/MESH ABDL WALL FOR INFECTION
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 11008
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$48,821.00 |
| Rate for Payer: Aetna Commercial |
$353.49
|
| Rate for Payer: Aetna Medicare |
$274.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.87
|
| Rate for Payer: BCBS Complete |
$181.38
|
| Rate for Payer: BCBS MAPPO |
$263.80
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$394.85
|
| 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: Mclaren Medicaid |
$172.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.99
|
| Rate for Payer: Meridian Medicaid |
$181.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,821.00
|
| 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 Choice Medicaid |
$172.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.82
|
| Rate for Payer: Priority Health Medicare |
$263.80
|
| Rate for Payer: Priority Health Narrow Network |
$364.82
|
| Rate for Payer: Priority Health SBD |
$364.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.80
|
| Rate for Payer: UHC Exchange |
$331.18
|
| Rate for Payer: UHC Medicare Advantage |
$263.80
|
| Rate for Payer: UHCCP Medicaid |
$172.74
|
|
|
PR RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER
|
Professional
|
Both
|
$3,367.00
|
|
|
Service Code
|
HCPCS 27488
|
| Min. Negotiated Rate |
$777.45 |
| Max. Negotiated Rate |
$212,809.00 |
| Rate for Payer: Aetna Commercial |
$1,549.70
|
| Rate for Payer: Aetna Medicare |
$1,202.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,549.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,665.35
|
| Rate for Payer: BCBS Complete |
$816.32
|
| Rate for Payer: BCBS MAPPO |
$1,156.49
|
| Rate for Payer: BCBS Trust/PPO |
$995.85
|
| Rate for Payer: BCN Commercial |
$1,756.31
|
| 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 |
$2,139.51
|
| Rate for Payer: Healthscope Commercial |
$1,850.38
|
| Rate for Payer: Mclaren Medicaid |
$777.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,214.31
|
| Rate for Payer: Meridian Medicaid |
$816.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212,809.00
|
| 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 Choice Medicaid |
$777.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,188.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,842.58
|
| Rate for Payer: Priority Health Medicare |
$1,156.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,842.58
|
| Rate for Payer: Priority Health SBD |
$1,842.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,156.49
|
| Rate for Payer: UHC Exchange |
$1,357.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.49
|
| Rate for Payer: UHCCP Medicaid |
$777.45
|
|
|
PR RMVL/REVJ SLING MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 53442
|
| Min. Negotiated Rate |
$505.02 |
| Max. Negotiated Rate |
$137,907.00 |
| Rate for Payer: Aetna Commercial |
$1,006.89
|
| Rate for Payer: Aetna Medicare |
$781.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.03
|
| Rate for Payer: BCBS Complete |
$530.27
|
| Rate for Payer: BCBS MAPPO |
$751.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,276.37
|
| Rate for Payer: BCN Commercial |
$1,134.22
|
| 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: Mclaren Medicaid |
$505.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.98
|
| Rate for Payer: Meridian Medicaid |
$530.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137,907.00
|
| 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 Choice Medicaid |
$505.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,253.20
|
| Rate for Payer: Priority Health Medicare |
$751.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,253.20
|
| Rate for Payer: Priority Health SBD |
$1,253.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.41
|
| Rate for Payer: UHC Exchange |
$759.84
|
| Rate for Payer: UHC Medicare Advantage |
$751.41
|
| Rate for Payer: UHCCP Medicaid |
$505.02
|
|
|
PR RMVL/REVJ SLING STRESS INCONTINENCE
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 57287
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$131,389.00 |
| Rate for Payer: Aetna Commercial |
$944.11
|
| Rate for Payer: Aetna Medicare |
$732.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$944.11
|
| Rate for Payer: BCBS Complete |
$499.63
|
| Rate for Payer: BCBS MAPPO |
$704.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,457.12
|
| Rate for Payer: BCN Commercial |
$1,509.08
|
| 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 |
$1,303.44
|
| Rate for Payer: Healthscope Commercial |
$1,127.30
|
| Rate for Payer: Mclaren Medicaid |
$475.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.79
|
| Rate for Payer: Meridian Medicaid |
$499.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,389.00
|
| 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 Choice Medicaid |
$475.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.64
|
| Rate for Payer: Priority Health Medicare |
$704.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.64
|
| Rate for Payer: Priority Health SBD |
$1,111.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.56
|
| Rate for Payer: UHC Exchange |
$841.98
|
| Rate for Payer: UHC Medicare Advantage |
$704.56
|
| Rate for Payer: UHCCP Medicaid |
$475.84
|
|
|
PR RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 54410
|
| Min. Negotiated Rate |
$553.37 |
| Max. Negotiated Rate |
$151,585.00 |
| Rate for Payer: Aetna Commercial |
$1,105.31
|
| Rate for Payer: Aetna Medicare |
$857.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,187.80
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$824.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,612.13
|
| Rate for Payer: BCN Commercial |
$1,244.66
|
| 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: Mclaren Medicaid |
$553.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.10
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,585.00
|
| 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 Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,374.64
|
| Rate for Payer: Priority Health Medicare |
$824.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,374.64
|
| Rate for Payer: Priority Health SBD |
$1,374.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$983.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$824.86
|
| Rate for Payer: UHC Exchange |
$983.03
|
| Rate for Payer: UHC Medicare Advantage |
$824.86
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
|
|
PR RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 50382
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$44,302.00 |
| Rate for Payer: Aetna Commercial |
$318.02
|
| Rate for Payer: Aetna Medicare |
$246.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.76
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$237.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,259.15
|
| Rate for Payer: BCN Commercial |
$1,487.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.33
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$341.76
|
| Rate for Payer: Cofinity Commercial |
$318.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.33
|
| Rate for Payer: Healthscope Commercial |
$439.06
|
| Rate for Payer: Healthscope Commercial |
$379.73
|
| Rate for Payer: Mclaren Medicaid |
$157.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.20
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,302.00
|
| Rate for Payer: Nomi Health Commercial |
$284.80
|
| Rate for Payer: PACE SWMI |
$237.33
|
| Rate for Payer: PHP Medicare Advantage |
$237.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$237.33
|
| Rate for Payer: Priority Health Narrow Network |
$389.86
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.33
|
| Rate for Payer: UHC Exchange |
$310.87
|
| Rate for Payer: UHC Medicare Advantage |
$237.33
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
|
PR RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 53448
|
| Min. Negotiated Rate |
$807.77 |
| Max. Negotiated Rate |
$224,080.00 |
| Rate for Payer: Aetna Commercial |
$1,629.65
|
| Rate for Payer: Aetna Medicare |
$1,264.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,751.27
|
| Rate for Payer: BCBS Complete |
$853.67
|
| Rate for Payer: BCBS MAPPO |
$1,216.16
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,834.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,216.16
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,751.27
|
| Rate for Payer: Cofinity Commercial |
$1,629.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,216.16
|
| Rate for Payer: Healthscope Commercial |
$2,249.90
|
| Rate for Payer: Healthscope Commercial |
$1,945.86
|
| Rate for Payer: Mclaren Medicaid |
$813.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.97
|
| Rate for Payer: Meridian Medicaid |
$853.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224,080.00
|
| Rate for Payer: Nomi Health Commercial |
$1,459.39
|
| Rate for Payer: PACE SWMI |
$1,216.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,216.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,020.14
|
| Rate for Payer: Priority Health Medicare |
$1,216.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,020.14
|
| Rate for Payer: Priority Health SBD |
$2,020.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,443.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,216.16
|
| Rate for Payer: UHC Exchange |
$1,443.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,216.16
|
| Rate for Payer: UHCCP Medicaid |
$813.02
|
|
|
PR RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL
|
Professional
|
Both
|
$2,131.00
|
|
|
Service Code
|
HCPCS 54411
|
| Min. Negotiated Rate |
$658.38 |
| Max. Negotiated Rate |
$181,022.00 |
| Rate for Payer: Aetna Commercial |
$1,316.54
|
| Rate for Payer: Aetna Medicare |
$1,021.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,316.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.79
|
| Rate for Payer: BCBS Complete |
$691.30
|
| Rate for Payer: BCBS MAPPO |
$982.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.16
|
| Rate for Payer: BCN Commercial |
$1,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$982.49
|
| Rate for Payer: Cash Price |
$1,704.80
|
| Rate for Payer: Cash Price |
$1,704.80
|
| Rate for Payer: Cofinity Commercial |
$1,414.79
|
| Rate for Payer: Cofinity Commercial |
$1,316.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.49
|
| Rate for Payer: Healthscope Commercial |
$1,817.61
|
| Rate for Payer: Healthscope Commercial |
$1,571.98
|
| Rate for Payer: Mclaren Medicaid |
$658.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,031.61
|
| Rate for Payer: Meridian Medicaid |
$691.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181,022.00
|
| Rate for Payer: Nomi Health Commercial |
$1,178.99
|
| Rate for Payer: PACE SWMI |
$982.49
|
| Rate for Payer: PHP Medicare Advantage |
$982.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,385.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,635.09
|
| Rate for Payer: Priority Health Medicare |
$982.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,635.09
|
| Rate for Payer: Priority Health SBD |
$1,635.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$982.49
|
| Rate for Payer: UHC Exchange |
$1,081.15
|
| Rate for Payer: UHC Medicare Advantage |
$982.49
|
| Rate for Payer: UHCCP Medicaid |
$658.38
|
|
|
PR RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC
|
Professional
|
Both
|
$2,515.00
|
|
|
Service Code
|
HCPCS 53447
|
| Min. Negotiated Rate |
$516.10 |
| Max. Negotiated Rate |
$141,649.00 |
| Rate for Payer: Aetna Commercial |
$1,031.38
|
| Rate for Payer: Aetna Medicare |
$800.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.35
|
| Rate for Payer: BCBS Complete |
$541.90
|
| Rate for Payer: BCBS MAPPO |
$769.69
|
| Rate for Payer: BCBS Trust/PPO |
$790.34
|
| Rate for Payer: BCN Commercial |
$1,162.57
|
| Rate for Payer: BCN Medicare Advantage |
$769.69
|
| Rate for Payer: Cash Price |
$2,012.00
|
| Rate for Payer: Cash Price |
$2,012.00
|
| Rate for Payer: Cofinity Commercial |
$1,108.35
|
| Rate for Payer: Cofinity Commercial |
$1,031.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.69
|
| Rate for Payer: Healthscope Commercial |
$1,423.93
|
| Rate for Payer: Healthscope Commercial |
$1,231.50
|
| Rate for Payer: Mclaren Medicaid |
$516.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$808.17
|
| Rate for Payer: Meridian Medicaid |
$541.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,649.00
|
| Rate for Payer: Nomi Health Commercial |
$923.63
|
| Rate for Payer: PACE SWMI |
$769.69
|
| Rate for Payer: PHP Medicare Advantage |
$769.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,282.50
|
| Rate for Payer: Priority Health Medicare |
$769.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,282.50
|
| Rate for Payer: Priority Health SBD |
$1,282.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$881.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$769.69
|
| Rate for Payer: UHC Exchange |
$881.37
|
| Rate for Payer: UHC Medicare Advantage |
$769.69
|
| Rate for Payer: UHCCP Medicaid |
$516.10
|
|
