|
PR SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB
|
Professional
|
Both
|
$2,066.00
|
|
|
Service Code
|
HCPCS 29819
|
| Min. Negotiated Rate |
$350.81 |
| Max. Negotiated Rate |
$1,549.50 |
| Rate for Payer: Aetna Commercial |
$717.11
|
| Rate for Payer: Aetna Medicare |
$556.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.63
|
| Rate for Payer: BCBS Complete |
$368.35
|
| Rate for Payer: BCBS MAPPO |
$535.16
|
| Rate for Payer: BCN Commercial |
$896.37
|
| Rate for Payer: BCN Medicare Advantage |
$535.16
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cofinity Commercial |
$770.63
|
| Rate for Payer: Cofinity Commercial |
$717.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.16
|
| Rate for Payer: Healthscope Commercial |
$990.05
|
| Rate for Payer: Healthscope Commercial |
$856.26
|
| Rate for Payer: Mclaren Medicaid |
$350.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.92
|
| Rate for Payer: Meridian Medicaid |
$368.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$588.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.05
|
| Rate for Payer: Nomi Health Commercial |
$642.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,549.50
|
| Rate for Payer: PACE SWMI |
$535.16
|
| Rate for Payer: PHP Medicare Advantage |
$535.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$958.19
|
| Rate for Payer: Priority Health Medicare |
$535.16
|
| Rate for Payer: Priority Health SBD |
$958.19
|
| Rate for Payer: Priority Health Tiered Network |
$958.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.12
|
| Rate for Payer: UHC Core |
$1,021.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$535.16
|
| Rate for Payer: UHC Exchange |
$1,021.12
|
| Rate for Payer: UHC Medicaid |
$350.81
|
| Rate for Payer: UHCCP Medicaid |
$350.81
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$3,166.00
|
|
|
Service Code
|
HCPCS 29807
|
| Min. Negotiated Rate |
$607.05 |
| Max. Negotiated Rate |
$2,374.50 |
| Rate for Payer: Aetna Commercial |
$1,248.61
|
| Rate for Payer: Aetna Medicare |
$969.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.79
|
| Rate for Payer: BCBS Complete |
$637.40
|
| Rate for Payer: BCBS MAPPO |
$931.80
|
| Rate for Payer: BCN Commercial |
$1,567.14
|
| Rate for Payer: BCN Medicare Advantage |
$931.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cofinity Commercial |
$1,341.79
|
| Rate for Payer: Cofinity Commercial |
$1,248.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.80
|
| Rate for Payer: Healthscope Commercial |
$1,723.83
|
| Rate for Payer: Healthscope Commercial |
$1,490.88
|
| Rate for Payer: Mclaren Medicaid |
$607.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$978.39
|
| Rate for Payer: Meridian Medicaid |
$637.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.82
|
| Rate for Payer: Nomi Health Commercial |
$1,118.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.50
|
| Rate for Payer: PACE SWMI |
$931.80
|
| Rate for Payer: PHP Medicare Advantage |
$931.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$607.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,675.23
|
| Rate for Payer: Priority Health Medicare |
$931.80
|
| Rate for Payer: Priority Health SBD |
$1,675.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,675.23
|
| Rate for Payer: Railroad Medicare Medicare |
$931.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,809.57
|
| Rate for Payer: UHC Core |
$1,809.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$931.80
|
| Rate for Payer: UHC Exchange |
$1,809.57
|
| Rate for Payer: UHC Medicaid |
$607.05
|
| Rate for Payer: UHCCP Medicaid |
$607.05
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$2,234.00
|
|
|
Service Code
|
HCPCS 29825
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,675.50 |
| Rate for Payer: Aetna Commercial |
$721.39
|
| Rate for Payer: Aetna Medicare |
$559.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.22
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$538.35
|
| Rate for Payer: BCN Commercial |
$896.86
|
| Rate for Payer: BCN Medicare Advantage |
$538.35
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cofinity Commercial |
$775.22
|
| Rate for Payer: Cofinity Commercial |
$721.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.35
|
| Rate for Payer: Healthscope Commercial |
$995.95
|
| Rate for Payer: Healthscope Commercial |
$861.36
|
| Rate for Payer: Mclaren Medicaid |
$352.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.27
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$592.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.05
|
| Rate for Payer: Nomi Health Commercial |
$646.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,675.50
|
| Rate for Payer: PACE SWMI |
$538.35
|
| Rate for Payer: PHP Medicare Advantage |
$538.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$958.72
|
| Rate for Payer: Priority Health Medicare |
$538.35
|
| Rate for Payer: Priority Health SBD |
$958.72
|
| Rate for Payer: Priority Health Tiered Network |
$958.72
|
| Rate for Payer: Railroad Medicare Medicare |
$538.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.12
|
| Rate for Payer: UHC Core |
$1,021.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$538.35
|
| Rate for Payer: UHC Exchange |
$1,021.12
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,501.00
|
|
|
Service Code
|
HCPCS 29827
|
| Min. Negotiated Rate |
$622.60 |
| Max. Negotiated Rate |
$2,625.75 |
| Rate for Payer: Aetna Commercial |
$1,283.10
|
| Rate for Payer: Aetna Medicare |
$995.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,283.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,378.86
|
| Rate for Payer: BCBS Complete |
$653.73
|
| Rate for Payer: BCBS MAPPO |
$957.54
|
| Rate for Payer: BCN Commercial |
$1,616.94
|
| Rate for Payer: BCN Medicare Advantage |
$957.54
|
| Rate for Payer: Cash Price |
$2,800.80
|
| Rate for Payer: Cash Price |
$2,800.80
|
| Rate for Payer: Cofinity Commercial |
$1,378.86
|
| Rate for Payer: Cofinity Commercial |
$1,283.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.54
|
| Rate for Payer: Healthscope Commercial |
$1,771.45
|
| Rate for Payer: Healthscope Commercial |
$1,532.06
|
| Rate for Payer: Mclaren Medicaid |
$622.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,005.42
|
| Rate for Payer: Meridian Medicaid |
$653.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,053.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,895.89
|
| Rate for Payer: Nomi Health Commercial |
$1,149.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,625.75
|
| Rate for Payer: PACE SWMI |
$957.54
|
| Rate for Payer: PHP Medicare Advantage |
$957.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,728.47
|
| Rate for Payer: Priority Health Medicare |
$957.54
|
| Rate for Payer: Priority Health SBD |
$1,728.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,728.47
|
| Rate for Payer: Railroad Medicare Medicare |
$957.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.97
|
| Rate for Payer: UHC Core |
$1,874.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$957.54
|
| Rate for Payer: UHC Exchange |
$1,874.97
|
| Rate for Payer: UHC Medicaid |
$622.60
|
| Rate for Payer: UHCCP Medicaid |
$622.60
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29823
|
| Min. Negotiated Rate |
$356.35 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$729.01
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.42
|
| Rate for Payer: BCBS Complete |
$374.17
|
| Rate for Payer: BCBS MAPPO |
$544.04
|
| Rate for Payer: BCN Commercial |
$994.03
|
| Rate for Payer: BCN Medicare Advantage |
$544.04
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$783.42
|
| Rate for Payer: Cofinity Commercial |
$729.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.04
|
| Rate for Payer: Healthscope Commercial |
$870.46
|
| Rate for Payer: Healthscope Commercial |
$1,006.47
|
| Rate for Payer: Mclaren Medicaid |
$356.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.24
|
| Rate for Payer: Meridian Medicaid |
$374.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,052.39
|
| Rate for Payer: Nomi Health Commercial |
$652.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$544.04
|
| Rate for Payer: PHP Medicare Advantage |
$544.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$544.04
|
| Rate for Payer: Priority Health SBD |
$967.25
|
| Rate for Payer: Priority Health Tiered Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$544.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.10
|
| Rate for Payer: UHC Core |
$1,093.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.04
|
| Rate for Payer: UHC Exchange |
$1,093.10
|
| Rate for Payer: UHC Medicaid |
$356.35
|
| Rate for Payer: UHCCP Medicaid |
$356.35
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$197.64
|
| Rate for Payer: Aetna Medicare |
$153.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.39
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$147.49
|
| Rate for Payer: BCN Commercial |
$202.24
|
| Rate for Payer: BCN Medicare Advantage |
$147.49
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$212.39
|
| Rate for Payer: Cofinity Commercial |
$197.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.49
|
| Rate for Payer: Healthscope Commercial |
$272.86
|
| Rate for Payer: Healthscope Commercial |
$235.98
|
| Rate for Payer: Mclaren Medicaid |
$94.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.86
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$162.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.07
|
| Rate for Payer: Nomi Health Commercial |
$176.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
| Rate for Payer: PACE SWMI |
$147.49
|
| Rate for Payer: PHP Medicare Advantage |
$147.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$274.14
|
| Rate for Payer: Priority Health Medicare |
$147.49
|
| Rate for Payer: Priority Health SBD |
$274.14
|
| Rate for Payer: Priority Health Tiered Network |
$274.14
|
| Rate for Payer: Railroad Medicare Medicare |
$147.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.18
|
| Rate for Payer: UHC Core |
$309.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.49
|
| Rate for Payer: UHC Exchange |
$309.18
|
| Rate for Payer: UHC Medicaid |
$94.15
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR SURGICAL TRAYS
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS A4550
|
| Min. Negotiated Rate |
$7.79 |
| Max. Negotiated Rate |
$27.32 |
| Rate for Payer: Aetna Commercial |
$15.00
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.00
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.79
|
| Rate for Payer: UHC Core |
$7.79
|
| Rate for Payer: UHC Exchange |
$7.79
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,843.00
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$4,382.25 |
| Rate for Payer: Aetna Commercial |
$273.31
|
| Rate for Payer: Aetna Medicare |
$212.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.70
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$203.96
|
| Rate for Payer: BCN Commercial |
$363.03
|
| Rate for Payer: BCN Medicare Advantage |
$203.96
|
| Rate for Payer: Cash Price |
$4,674.40
|
| Rate for Payer: Cash Price |
$4,674.40
|
| Rate for Payer: Cofinity Commercial |
$293.70
|
| Rate for Payer: Cofinity Commercial |
$273.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.96
|
| Rate for Payer: Healthscope Commercial |
$326.34
|
| Rate for Payer: Healthscope Commercial |
$377.33
|
| Rate for Payer: Mclaren Medicaid |
$131.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.16
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$224.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.97
|
| Rate for Payer: Nomi Health Commercial |
$244.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,382.25
|
| Rate for Payer: PACE SWMI |
$203.96
|
| Rate for Payer: PHP Medicare Advantage |
$203.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$358.71
|
| Rate for Payer: Priority Health Medicare |
$203.96
|
| Rate for Payer: Priority Health SBD |
$358.71
|
| Rate for Payer: Priority Health Tiered Network |
$358.71
|
| Rate for Payer: Railroad Medicare Medicare |
$203.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.19
|
| Rate for Payer: UHC Core |
$439.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$203.96
|
| Rate for Payer: UHC Exchange |
$439.19
|
| Rate for Payer: UHC Medicaid |
$131.00
|
| Rate for Payer: UHCCP Medicaid |
$131.00
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,653.00
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$4,239.75 |
| Rate for Payer: Aetna Commercial |
$196.99
|
| Rate for Payer: Aetna Medicare |
$152.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.69
|
| Rate for Payer: BCBS Complete |
$99.30
|
| Rate for Payer: BCBS MAPPO |
$147.01
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: BCN Medicare Advantage |
$147.01
|
| Rate for Payer: Cash Price |
$4,522.40
|
| Rate for Payer: Cash Price |
$4,522.40
|
| Rate for Payer: Cofinity Commercial |
$211.69
|
| Rate for Payer: Cofinity Commercial |
$196.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.01
|
| Rate for Payer: Healthscope Commercial |
$271.97
|
| Rate for Payer: Healthscope Commercial |
$235.22
|
| Rate for Payer: Mclaren Medicaid |
$94.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.36
|
| Rate for Payer: Meridian Medicaid |
$99.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.01
|
| Rate for Payer: Nomi Health Commercial |
$176.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,239.75
|
| Rate for Payer: PACE SWMI |
$147.01
|
| Rate for Payer: PHP Medicare Advantage |
$147.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$256.85
|
| Rate for Payer: Priority Health Medicare |
$147.01
|
| Rate for Payer: Priority Health SBD |
$256.85
|
| Rate for Payer: Priority Health Tiered Network |
$256.85
|
| Rate for Payer: Railroad Medicare Medicare |
$147.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.57
|
| Rate for Payer: UHC Core |
$313.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.01
|
| Rate for Payer: UHC Exchange |
$313.57
|
| Rate for Payer: UHC Medicaid |
$94.57
|
| Rate for Payer: UHCCP Medicaid |
$94.57
|
|
|
PR SURG OPENING,ESOPHAGUS,ABD APPRCH
|
Professional
|
Both
|
$2,871.00
|
|
|
Service Code
|
HCPCS 43350
|
| Min. Negotiated Rate |
$1,148.40 |
| Max. Negotiated Rate |
$2,153.25 |
| Rate for Payer: Aetna Medicare |
$1,435.50
|
| Rate for Payer: BCBS Complete |
$1,148.40
|
| Rate for Payer: Cash Price |
$2,296.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,866.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.25
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$272.21 |
| Max. Negotiated Rate |
$788.18 |
| Rate for Payer: Aetna Commercial |
$552.36
|
| Rate for Payer: Aetna Medicare |
$428.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.58
|
| Rate for Payer: BCBS Complete |
$285.82
|
| Rate for Payer: BCBS MAPPO |
$412.21
|
| Rate for Payer: BCN Commercial |
$646.88
|
| Rate for Payer: BCN Medicare Advantage |
$412.21
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cofinity Commercial |
$593.58
|
| Rate for Payer: Cofinity Commercial |
$552.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.21
|
| Rate for Payer: Healthscope Commercial |
$659.54
|
| Rate for Payer: Healthscope Commercial |
$762.59
|
| Rate for Payer: Mclaren Medicaid |
$272.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.82
|
| Rate for Payer: Meridian Medicaid |
$285.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$742.63
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.25
|
| Rate for Payer: PACE SWMI |
$412.21
|
| Rate for Payer: PHP Medicare Advantage |
$412.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.18
|
| Rate for Payer: Priority Health Medicare |
$412.21
|
| Rate for Payer: Priority Health SBD |
$788.18
|
| Rate for Payer: Priority Health Tiered Network |
$788.18
|
| Rate for Payer: Railroad Medicare Medicare |
$412.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.28
|
| Rate for Payer: UHC Core |
$724.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.21
|
| Rate for Payer: UHC Exchange |
$724.28
|
| Rate for Payer: UHC Medicaid |
$272.21
|
| Rate for Payer: UHCCP Medicaid |
$272.21
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,354.00
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$271.15 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$550.22
|
| Rate for Payer: Aetna Medicare |
$427.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$591.28
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS MAPPO |
$410.61
|
| Rate for Payer: BCN Commercial |
$642.90
|
| Rate for Payer: BCN Medicare Advantage |
$410.61
|
| Rate for Payer: Cash Price |
$1,083.20
|
| Rate for Payer: Cash Price |
$1,083.20
|
| Rate for Payer: Cofinity Commercial |
$591.28
|
| Rate for Payer: Cofinity Commercial |
$550.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.61
|
| Rate for Payer: Healthscope Commercial |
$759.63
|
| Rate for Payer: Healthscope Commercial |
$656.98
|
| Rate for Payer: Mclaren Medicaid |
$271.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.14
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$451.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$742.73
|
| Rate for Payer: Nomi Health Commercial |
$492.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,015.50
|
| Rate for Payer: PACE SWMI |
$410.61
|
| Rate for Payer: PHP Medicare Advantage |
$410.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$783.32
|
| Rate for Payer: Priority Health Medicare |
$410.61
|
| Rate for Payer: Priority Health SBD |
$783.32
|
| Rate for Payer: Priority Health Tiered Network |
$783.32
|
| Rate for Payer: Railroad Medicare Medicare |
$410.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.01
|
| Rate for Payer: UHC Core |
$725.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$410.61
|
| Rate for Payer: UHC Exchange |
$725.01
|
| Rate for Payer: UHC Medicaid |
$271.15
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$260.29 |
| Max. Negotiated Rate |
$746.31 |
| Rate for Payer: Aetna Commercial |
$527.61
|
| Rate for Payer: Aetna Medicare |
$409.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.99
|
| Rate for Payer: BCBS Complete |
$273.30
|
| Rate for Payer: BCBS MAPPO |
$393.74
|
| Rate for Payer: BCN Commercial |
$612.52
|
| Rate for Payer: BCN Medicare Advantage |
$393.74
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$566.99
|
| Rate for Payer: Cofinity Commercial |
$527.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.74
|
| Rate for Payer: Healthscope Commercial |
$728.42
|
| Rate for Payer: Healthscope Commercial |
$629.98
|
| Rate for Payer: Mclaren Medicaid |
$260.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.43
|
| Rate for Payer: Meridian Medicaid |
$273.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.87
|
| Rate for Payer: Nomi Health Commercial |
$472.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.00
|
| Rate for Payer: PACE SWMI |
$393.74
|
| Rate for Payer: PHP Medicare Advantage |
$393.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$746.31
|
| Rate for Payer: Priority Health Medicare |
$393.74
|
| Rate for Payer: Priority Health SBD |
$746.31
|
| Rate for Payer: Priority Health Tiered Network |
$746.31
|
| Rate for Payer: Railroad Medicare Medicare |
$393.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.01
|
| Rate for Payer: UHC Core |
$688.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$393.74
|
| Rate for Payer: UHC Exchange |
$688.01
|
| Rate for Payer: UHC Medicaid |
$260.29
|
| Rate for Payer: UHCCP Medicaid |
$260.29
|
|
|
PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD
|
Professional
|
Both
|
$11,674.00
|
|
|
Service Code
|
HCPCS 33548
|
| Min. Negotiated Rate |
$1,770.03 |
| Max. Negotiated Rate |
$8,755.50 |
| Rate for Payer: Aetna Commercial |
$3,723.89
|
| Rate for Payer: Aetna Medicare |
$2,890.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,723.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,001.79
|
| Rate for Payer: BCBS Complete |
$1,858.53
|
| Rate for Payer: BCBS MAPPO |
$2,779.02
|
| Rate for Payer: BCN Commercial |
$4,318.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,779.02
|
| Rate for Payer: Cash Price |
$9,339.20
|
| Rate for Payer: Cash Price |
$9,339.20
|
| Rate for Payer: Cofinity Commercial |
$4,001.79
|
| Rate for Payer: Cofinity Commercial |
$3,723.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,779.02
|
| Rate for Payer: Healthscope Commercial |
$5,141.19
|
| Rate for Payer: Healthscope Commercial |
$4,446.43
|
| Rate for Payer: Mclaren Medicaid |
$1,770.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,917.97
|
| Rate for Payer: Meridian Medicaid |
$1,858.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,056.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,210.01
|
| Rate for Payer: Nomi Health Commercial |
$3,334.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,755.50
|
| Rate for Payer: PACE SWMI |
$2,779.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,779.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,770.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,644.52
|
| Rate for Payer: Priority Health Medicare |
$2,779.02
|
| Rate for Payer: Priority Health SBD |
$4,644.52
|
| Rate for Payer: Priority Health Tiered Network |
$4,644.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,779.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,284.15
|
| Rate for Payer: UHC Core |
$5,284.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,779.02
|
| Rate for Payer: UHC Exchange |
$5,284.15
|
| Rate for Payer: UHC Medicaid |
$1,770.03
|
| Rate for Payer: UHCCP Medicaid |
$1,770.03
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$1,022.25 |
| Rate for Payer: Aetna Commercial |
$376.27
|
| Rate for Payer: Aetna Medicare |
$292.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.35
|
| Rate for Payer: BCBS Complete |
$188.54
|
| Rate for Payer: BCBS MAPPO |
$280.80
|
| Rate for Payer: BCN Commercial |
$493.00
|
| Rate for Payer: BCN Medicare Advantage |
$280.80
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$404.35
|
| Rate for Payer: Cofinity Commercial |
$376.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.80
|
| Rate for Payer: Healthscope Commercial |
$519.48
|
| Rate for Payer: Healthscope Commercial |
$449.28
|
| Rate for Payer: Mclaren Medicaid |
$179.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.84
|
| Rate for Payer: Meridian Medicaid |
$188.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.29
|
| Rate for Payer: Nomi Health Commercial |
$336.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,022.25
|
| Rate for Payer: PACE SWMI |
$280.80
|
| Rate for Payer: PHP Medicare Advantage |
$280.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$572.61
|
| Rate for Payer: Priority Health Medicare |
$280.80
|
| Rate for Payer: Priority Health SBD |
$572.61
|
| Rate for Payer: Priority Health Tiered Network |
$572.61
|
| Rate for Payer: Railroad Medicare Medicare |
$280.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.56
|
| Rate for Payer: UHC Core |
$594.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.80
|
| Rate for Payer: UHC Exchange |
$594.56
|
| Rate for Payer: UHC Medicaid |
$179.56
|
| Rate for Payer: UHCCP Medicaid |
$179.56
|
|
|
PR SUTR ESOPHGL WND/INJ CRV APPR
|
Professional
|
Both
|
$2,941.00
|
|
|
Service Code
|
HCPCS 43410
|
| Min. Negotiated Rate |
$575.31 |
| Max. Negotiated Rate |
$2,205.75 |
| Rate for Payer: Priority Health SBD |
$1,899.16
|
| Rate for Payer: Aetna Commercial |
$1,188.65
|
| Rate for Payer: Aetna Medicare |
$922.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.35
|
| Rate for Payer: BCBS Complete |
$604.08
|
| Rate for Payer: BCBS MAPPO |
$887.05
|
| Rate for Payer: BCN Commercial |
$1,558.68
|
| Rate for Payer: BCN Medicare Advantage |
$887.05
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cofinity Commercial |
$1,277.35
|
| Rate for Payer: Cofinity Commercial |
$1,188.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$887.05
|
| Rate for Payer: Healthscope Commercial |
$1,641.04
|
| Rate for Payer: Healthscope Commercial |
$1,419.28
|
| Rate for Payer: Mclaren Medicaid |
$575.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$931.40
|
| Rate for Payer: Meridian Medicaid |
$604.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$975.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.59
|
| Rate for Payer: Nomi Health Commercial |
$1,064.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,205.75
|
| Rate for Payer: PACE SWMI |
$887.05
|
| Rate for Payer: PHP Medicare Advantage |
$887.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,899.16
|
| Rate for Payer: Priority Health Medicare |
$887.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,899.16
|
| Rate for Payer: Railroad Medicare Medicare |
$887.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,786.91
|
| Rate for Payer: UHC Core |
$1,786.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$887.05
|
| Rate for Payer: UHC Exchange |
$1,786.91
|
| Rate for Payer: UHC Medicaid |
$575.31
|
| Rate for Payer: UHCCP Medicaid |
$575.31
|
|
|
PR SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,198.00
|
|
|
Service Code
|
HCPCS 43415
|
| Min. Negotiated Rate |
$1,539.78 |
| Max. Negotiated Rate |
$4,639.88 |
| Rate for Payer: Aetna Commercial |
$3,230.85
|
| Rate for Payer: Aetna Medicare |
$2,507.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,230.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,471.96
|
| Rate for Payer: BCBS Complete |
$1,616.77
|
| Rate for Payer: BCBS MAPPO |
$2,411.08
|
| Rate for Payer: BCN Commercial |
$3,808.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,411.08
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$3,471.96
|
| Rate for Payer: Cofinity Commercial |
$3,230.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,411.08
|
| Rate for Payer: Healthscope Commercial |
$4,460.50
|
| Rate for Payer: Healthscope Commercial |
$3,857.73
|
| Rate for Payer: Mclaren Medicaid |
$1,539.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,531.63
|
| Rate for Payer: Meridian Medicaid |
$1,616.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,652.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,576.68
|
| Rate for Payer: Nomi Health Commercial |
$2,893.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.50
|
| Rate for Payer: PACE SWMI |
$2,411.08
|
| Rate for Payer: PHP Medicare Advantage |
$2,411.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,539.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,639.88
|
| Rate for Payer: Priority Health Medicare |
$2,411.08
|
| Rate for Payer: Priority Health SBD |
$4,639.88
|
| Rate for Payer: Priority Health Tiered Network |
$4,639.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,411.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,576.83
|
| Rate for Payer: UHC Core |
$4,576.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,411.08
|
| Rate for Payer: UHC Exchange |
$4,576.83
|
| Rate for Payer: UHC Medicaid |
$1,539.78
|
| Rate for Payer: UHCCP Medicaid |
$1,539.78
|
|
|
PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 27381
|
| Min. Negotiated Rate |
$494.37 |
| Max. Negotiated Rate |
$1,455.43 |
| Rate for Payer: Aetna Commercial |
$1,010.45
|
| Rate for Payer: Aetna Medicare |
$784.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.86
|
| Rate for Payer: BCBS Complete |
$519.09
|
| Rate for Payer: BCBS MAPPO |
$754.07
|
| Rate for Payer: BCN Commercial |
$1,247.94
|
| Rate for Payer: BCN Medicare Advantage |
$754.07
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$1,085.86
|
| Rate for Payer: Cofinity Commercial |
$1,010.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.07
|
| Rate for Payer: Healthscope Commercial |
$1,395.03
|
| Rate for Payer: Healthscope Commercial |
$1,206.51
|
| Rate for Payer: Mclaren Medicaid |
$494.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$791.77
|
| Rate for Payer: Meridian Medicaid |
$519.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$829.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,455.43
|
| Rate for Payer: Nomi Health Commercial |
$904.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$754.07
|
| Rate for Payer: PHP Medicare Advantage |
$754.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,334.01
|
| Rate for Payer: Priority Health Medicare |
$754.07
|
| Rate for Payer: Priority Health SBD |
$1,334.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,334.01
|
| Rate for Payer: Railroad Medicare Medicare |
$754.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,410.01
|
| Rate for Payer: UHC Core |
$1,410.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$754.07
|
| Rate for Payer: UHC Exchange |
$1,410.01
|
| Rate for Payer: UHC Medicaid |
$494.37
|
| Rate for Payer: UHCCP Medicaid |
$494.37
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY
|
Professional
|
Both
|
$3,026.00
|
|
|
Service Code
|
HCPCS 44605
|
| Min. Negotiated Rate |
$776.60 |
| Max. Negotiated Rate |
$2,348.75 |
| Rate for Payer: Aetna Commercial |
$1,629.31
|
| Rate for Payer: Aetna Medicare |
$1,264.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,750.90
|
| Rate for Payer: BCBS Complete |
$815.43
|
| Rate for Payer: BCBS MAPPO |
$1,215.90
|
| Rate for Payer: BCN Commercial |
$1,927.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.90
|
| Rate for Payer: Cash Price |
$2,420.80
|
| Rate for Payer: Cash Price |
$2,420.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.90
|
| Rate for Payer: Cofinity Commercial |
$1,629.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.90
|
| Rate for Payer: Healthscope Commercial |
$2,249.41
|
| Rate for Payer: Healthscope Commercial |
$1,945.44
|
| Rate for Payer: Mclaren Medicaid |
$776.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.69
|
| Rate for Payer: Meridian Medicaid |
$815.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,337.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,313.50
|
| Rate for Payer: Nomi Health Commercial |
$1,459.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,269.50
|
| Rate for Payer: PACE SWMI |
$1,215.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$776.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,348.75
|
| Rate for Payer: Priority Health Medicare |
$1,215.90
|
| Rate for Payer: Priority Health SBD |
$2,348.75
|
| Rate for Payer: Priority Health Tiered Network |
$2,348.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,215.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,322.88
|
| Rate for Payer: UHC Core |
$2,322.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,215.90
|
| Rate for Payer: UHC Exchange |
$2,322.88
|
| Rate for Payer: UHC Medicaid |
$776.60
|
| Rate for Payer: UHCCP Medicaid |
$776.60
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$3,173.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$621.53 |
| Max. Negotiated Rate |
$2,379.75 |
| Rate for Payer: Aetna Commercial |
$1,302.63
|
| Rate for Payer: Aetna Medicare |
$1,010.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.84
|
| Rate for Payer: BCBS Complete |
$652.61
|
| Rate for Payer: BCBS MAPPO |
$972.11
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: BCN Medicare Advantage |
$972.11
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$1,399.84
|
| Rate for Payer: Cofinity Commercial |
$1,302.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.11
|
| Rate for Payer: Healthscope Commercial |
$1,798.40
|
| Rate for Payer: Healthscope Commercial |
$1,555.38
|
| Rate for Payer: Mclaren Medicaid |
$621.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,020.72
|
| Rate for Payer: Meridian Medicaid |
$652.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,069.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,885.55
|
| Rate for Payer: Nomi Health Commercial |
$1,166.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.75
|
| Rate for Payer: PACE SWMI |
$972.11
|
| Rate for Payer: PHP Medicare Advantage |
$972.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,921.59
|
| Rate for Payer: Priority Health Medicare |
$972.11
|
| Rate for Payer: Priority Health SBD |
$1,921.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,921.59
|
| Rate for Payer: Railroad Medicare Medicare |
$972.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,886.70
|
| Rate for Payer: UHC Core |
$1,886.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$972.11
|
| Rate for Payer: UHC Exchange |
$1,886.70
|
| Rate for Payer: UHC Medicaid |
$621.53
|
| Rate for Payer: UHCCP Medicaid |
$621.53
|
|
|
PR SUTR&/LIG THORACIC DUCT CERVICAL APPROACH
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 38380
|
| Min. Negotiated Rate |
$330.58 |
| Max. Negotiated Rate |
$1,166.19 |
| Rate for Payer: Aetna Commercial |
$679.18
|
| Rate for Payer: Aetna Medicare |
$527.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: BCBS Complete |
$347.11
|
| Rate for Payer: BCBS MAPPO |
$506.85
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$506.85
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$729.86
|
| Rate for Payer: Cofinity Commercial |
$679.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.85
|
| Rate for Payer: Healthscope Commercial |
$937.67
|
| Rate for Payer: Healthscope Commercial |
$810.96
|
| Rate for Payer: Mclaren Medicaid |
$330.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.19
|
| Rate for Payer: Meridian Medicaid |
$347.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,012.86
|
| Rate for Payer: Nomi Health Commercial |
$608.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$942.00
|
| Rate for Payer: PACE SWMI |
$506.85
|
| Rate for Payer: PHP Medicare Advantage |
$506.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,166.19
|
| Rate for Payer: Priority Health Medicare |
$506.85
|
| Rate for Payer: Priority Health SBD |
$1,166.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,166.19
|
| Rate for Payer: Railroad Medicare Medicare |
$506.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.39
|
| Rate for Payer: UHC Core |
$992.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.85
|
| Rate for Payer: UHC Exchange |
$992.39
|
| Rate for Payer: UHC Medicaid |
$330.58
|
| Rate for Payer: UHCCP Medicaid |
$330.58
|
|
|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$6,105.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$492.03 |
| Max. Negotiated Rate |
$4,578.75 |
| Rate for Payer: Aetna Commercial |
$1,025.80
|
| Rate for Payer: Aetna Medicare |
$796.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.35
|
| Rate for Payer: BCBS Complete |
$516.63
|
| Rate for Payer: BCBS MAPPO |
$765.52
|
| Rate for Payer: BCN Commercial |
$1,207.61
|
| Rate for Payer: BCN Medicare Advantage |
$765.52
|
| Rate for Payer: Cash Price |
$4,884.00
|
| Rate for Payer: Cash Price |
$4,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,102.35
|
| Rate for Payer: Cofinity Commercial |
$1,025.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.52
|
| Rate for Payer: Healthscope Commercial |
$1,416.21
|
| Rate for Payer: Healthscope Commercial |
$1,224.83
|
| Rate for Payer: Mclaren Medicaid |
$492.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.80
|
| Rate for Payer: Meridian Medicaid |
$516.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$842.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.06
|
| Rate for Payer: Nomi Health Commercial |
$918.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,578.75
|
| Rate for Payer: PACE SWMI |
$765.52
|
| Rate for Payer: PHP Medicare Advantage |
$765.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,606.81
|
| Rate for Payer: Priority Health Medicare |
$765.52
|
| Rate for Payer: Priority Health SBD |
$1,606.81
|
| Rate for Payer: Priority Health Tiered Network |
$1,606.81
|
| Rate for Payer: Railroad Medicare Medicare |
$765.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,422.31
|
| Rate for Payer: UHC Core |
$1,422.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$765.52
|
| Rate for Payer: UHC Exchange |
$1,422.31
|
| Rate for Payer: UHC Medicaid |
$492.03
|
| Rate for Payer: UHCCP Medicaid |
$492.03
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,117.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$2,055.46 |
| Rate for Payer: Priority Health SBD |
$1,711.36
|
| Rate for Payer: Aetna Commercial |
$1,330.93
|
| Rate for Payer: Aetna Medicare |
$1,032.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.25
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$993.23
|
| Rate for Payer: BCN Commercial |
$1,731.98
|
| Rate for Payer: BCN Medicare Advantage |
$993.23
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cash Price |
$1,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,430.25
|
| Rate for Payer: Cofinity Commercial |
$1,330.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.23
|
| Rate for Payer: Healthscope Commercial |
$1,837.48
|
| Rate for Payer: Healthscope Commercial |
$1,589.17
|
| Rate for Payer: Mclaren Medicaid |
$649.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.89
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,092.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,055.46
|
| Rate for Payer: Nomi Health Commercial |
$1,191.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.75
|
| Rate for Payer: PACE SWMI |
$993.23
|
| Rate for Payer: PHP Medicare Advantage |
$993.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,711.36
|
| Rate for Payer: Priority Health Medicare |
$993.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,711.36
|
| Rate for Payer: Railroad Medicare Medicare |
$993.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,999.80
|
| Rate for Payer: UHC Core |
$1,999.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$993.23
|
| Rate for Payer: UHC Exchange |
$1,999.80
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,270.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$602.58 |
| Max. Negotiated Rate |
$2,452.50 |
| Rate for Payer: Aetna Commercial |
$1,247.49
|
| Rate for Payer: Aetna Medicare |
$968.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.58
|
| Rate for Payer: BCBS Complete |
$632.71
|
| Rate for Payer: BCBS MAPPO |
$930.96
|
| Rate for Payer: BCN Commercial |
$1,582.09
|
| Rate for Payer: BCN Medicare Advantage |
$930.96
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cofinity Commercial |
$1,340.58
|
| Rate for Payer: Cofinity Commercial |
$1,247.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.96
|
| Rate for Payer: Healthscope Commercial |
$1,722.28
|
| Rate for Payer: Healthscope Commercial |
$1,489.54
|
| Rate for Payer: Mclaren Medicaid |
$602.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.51
|
| Rate for Payer: Meridian Medicaid |
$632.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,867.14
|
| Rate for Payer: Nomi Health Commercial |
$1,117.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,452.50
|
| Rate for Payer: PACE SWMI |
$930.96
|
| Rate for Payer: PHP Medicare Advantage |
$930.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,837.57
|
| Rate for Payer: Priority Health Medicare |
$930.96
|
| Rate for Payer: Priority Health SBD |
$1,837.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,837.57
|
| Rate for Payer: Railroad Medicare Medicare |
$930.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.45
|
| Rate for Payer: UHC Core |
$1,848.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$930.96
|
| Rate for Payer: UHC Exchange |
$1,848.45
|
| Rate for Payer: UHC Medicaid |
$602.58
|
| Rate for Payer: UHCCP Medicaid |
$602.58
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$4,072.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$586.39 |
| Max. Negotiated Rate |
$3,054.00 |
| Rate for Payer: Aetna Commercial |
$1,215.71
|
| Rate for Payer: Aetna Medicare |
$943.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,215.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.44
|
| Rate for Payer: BCBS Complete |
$615.71
|
| Rate for Payer: BCBS MAPPO |
$907.25
|
| Rate for Payer: BCN Commercial |
$1,526.31
|
| Rate for Payer: BCN Medicare Advantage |
$907.25
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cash Price |
$3,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,306.44
|
| Rate for Payer: Cofinity Commercial |
$1,215.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.25
|
| Rate for Payer: Healthscope Commercial |
$1,678.41
|
| Rate for Payer: Healthscope Commercial |
$1,451.60
|
| Rate for Payer: Mclaren Medicaid |
$586.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$952.61
|
| Rate for Payer: Meridian Medicaid |
$615.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,796.89
|
| Rate for Payer: Nomi Health Commercial |
$1,088.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,054.00
|
| Rate for Payer: PACE SWMI |
$907.25
|
| Rate for Payer: PHP Medicare Advantage |
$907.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$586.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,772.78
|
| Rate for Payer: Priority Health Medicare |
$907.25
|
| Rate for Payer: Priority Health SBD |
$1,772.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,772.78
|
| Rate for Payer: Railroad Medicare Medicare |
$907.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.71
|
| Rate for Payer: UHC Core |
$1,774.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$907.25
|
| Rate for Payer: UHC Exchange |
$1,774.71
|
| Rate for Payer: UHC Medicaid |
$586.39
|
| Rate for Payer: UHCCP Medicaid |
$586.39
|
|
