|
PR SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 28072
|
| Min. Negotiated Rate |
$199.16 |
| Max. Negotiated Rate |
$784.50 |
| Rate for Payer: Aetna Commercial |
$405.30
|
| Rate for Payer: Aetna Medicare |
$314.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.54
|
| Rate for Payer: BCBS Complete |
$209.12
|
| Rate for Payer: BCBS MAPPO |
$302.46
|
| Rate for Payer: BCN Commercial |
$495.99
|
| Rate for Payer: BCN Medicare Advantage |
$302.46
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$435.54
|
| Rate for Payer: Cofinity Commercial |
$405.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.46
|
| Rate for Payer: Healthscope Commercial |
$559.55
|
| Rate for Payer: Healthscope Commercial |
$483.94
|
| Rate for Payer: Mclaren Medicaid |
$199.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.58
|
| Rate for Payer: Meridian Medicaid |
$209.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.08
|
| Rate for Payer: Nomi Health Commercial |
$362.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$784.50
|
| Rate for Payer: PACE SWMI |
$302.46
|
| Rate for Payer: PHP Medicare Advantage |
$302.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$530.20
|
| Rate for Payer: Priority Health Medicare |
$302.46
|
| Rate for Payer: Priority Health SBD |
$530.20
|
| Rate for Payer: Priority Health Tiered Network |
$530.20
|
| Rate for Payer: Railroad Medicare Medicare |
$302.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.23
|
| Rate for Payer: UHC Core |
$558.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.46
|
| Rate for Payer: UHC Exchange |
$558.23
|
| Rate for Payer: UHC Medicaid |
$199.16
|
| Rate for Payer: UHCCP Medicaid |
$199.16
|
|
|
PR SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD
|
Professional
|
Both
|
$1,778.00
|
|
|
Service Code
|
HCPCS 26135
|
| Min. Negotiated Rate |
$331.22 |
| Max. Negotiated Rate |
$1,333.50 |
| Rate for Payer: Aetna Commercial |
$675.25
|
| Rate for Payer: Aetna Medicare |
$524.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.64
|
| Rate for Payer: BCBS Complete |
$347.78
|
| Rate for Payer: BCBS MAPPO |
$503.92
|
| Rate for Payer: BCN Commercial |
$854.04
|
| Rate for Payer: BCN Medicare Advantage |
$503.92
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cofinity Commercial |
$725.64
|
| Rate for Payer: Cofinity Commercial |
$675.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.92
|
| Rate for Payer: Healthscope Commercial |
$932.25
|
| Rate for Payer: Healthscope Commercial |
$806.27
|
| Rate for Payer: Mclaren Medicaid |
$331.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.12
|
| Rate for Payer: Meridian Medicaid |
$347.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$985.54
|
| Rate for Payer: Nomi Health Commercial |
$604.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,333.50
|
| Rate for Payer: PACE SWMI |
$503.92
|
| Rate for Payer: PHP Medicare Advantage |
$503.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$912.94
|
| Rate for Payer: Priority Health Medicare |
$503.92
|
| Rate for Payer: Priority Health SBD |
$912.94
|
| Rate for Payer: Priority Health Tiered Network |
$912.94
|
| Rate for Payer: Railroad Medicare Medicare |
$503.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.49
|
| Rate for Payer: UHC Core |
$959.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.92
|
| Rate for Payer: UHC Exchange |
$959.49
|
| Rate for Payer: UHC Medicaid |
$331.22
|
| Rate for Payer: UHCCP Medicaid |
$331.22
|
|
|
PR SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 26140
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,140.00 |
| Rate for Payer: Aetna Commercial |
$623.60
|
| Rate for Payer: Aetna Medicare |
$483.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.13
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$465.37
|
| Rate for Payer: BCN Commercial |
$783.32
|
| Rate for Payer: BCN Medicare Advantage |
$465.37
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cofinity Commercial |
$670.13
|
| Rate for Payer: Cofinity Commercial |
$623.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.37
|
| Rate for Payer: Healthscope Commercial |
$860.93
|
| Rate for Payer: Healthscope Commercial |
$744.59
|
| Rate for Payer: Mclaren Medicaid |
$306.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.64
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$511.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$901.75
|
| Rate for Payer: Nomi Health Commercial |
$558.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.00
|
| Rate for Payer: PACE SWMI |
$465.37
|
| Rate for Payer: PHP Medicare Advantage |
$465.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$837.35
|
| Rate for Payer: Priority Health Medicare |
$465.37
|
| Rate for Payer: Priority Health SBD |
$837.35
|
| Rate for Payer: Priority Health Tiered Network |
$837.35
|
| Rate for Payer: Railroad Medicare Medicare |
$465.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.96
|
| Rate for Payer: UHC Core |
$876.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.37
|
| Rate for Payer: UHC Exchange |
$876.96
|
| Rate for Payer: UHC Medicaid |
$306.51
|
| Rate for Payer: UHCCP Medicaid |
$306.51
|
|
|
PR SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 26145
|
| Min. Negotiated Rate |
$310.55 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: PHP Medicare Advantage |
$471.74
|
| Rate for Payer: Aetna Commercial |
$632.13
|
| Rate for Payer: Aetna Medicare |
$490.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.31
|
| Rate for Payer: BCBS Complete |
$326.08
|
| Rate for Payer: BCBS MAPPO |
$471.74
|
| Rate for Payer: BCN Commercial |
$796.77
|
| Rate for Payer: BCN Medicare Advantage |
$471.74
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$679.31
|
| Rate for Payer: Cofinity Commercial |
$632.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.74
|
| Rate for Payer: Healthscope Commercial |
$872.72
|
| Rate for Payer: Healthscope Commercial |
$754.78
|
| Rate for Payer: Mclaren Medicaid |
$310.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.33
|
| Rate for Payer: Meridian Medicaid |
$326.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$916.96
|
| Rate for Payer: Nomi Health Commercial |
$566.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$471.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$851.72
|
| Rate for Payer: Priority Health Medicare |
$471.74
|
| Rate for Payer: Priority Health SBD |
$851.72
|
| Rate for Payer: Priority Health Tiered Network |
$851.72
|
| Rate for Payer: Railroad Medicare Medicare |
$471.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.77
|
| Rate for Payer: UHC Core |
$891.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.74
|
| Rate for Payer: UHC Exchange |
$891.77
|
| Rate for Payer: UHC Medicaid |
$310.55
|
| Rate for Payer: UHCCP Medicaid |
$310.55
|
|
|
PR SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA
|
Professional
|
Both
|
$1,850.00
|
|
|
Service Code
|
HCPCS 25119
|
| Min. Negotiated Rate |
$310.34 |
| Max. Negotiated Rate |
$1,387.50 |
| Rate for Payer: Aetna Commercial |
$631.50
|
| Rate for Payer: Aetna Medicare |
$490.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.63
|
| Rate for Payer: BCBS Complete |
$325.86
|
| Rate for Payer: BCBS MAPPO |
$471.27
|
| Rate for Payer: BCN Commercial |
$774.86
|
| Rate for Payer: BCN Medicare Advantage |
$471.27
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cofinity Commercial |
$678.63
|
| Rate for Payer: Cofinity Commercial |
$631.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.27
|
| Rate for Payer: Healthscope Commercial |
$871.85
|
| Rate for Payer: Healthscope Commercial |
$754.03
|
| Rate for Payer: Mclaren Medicaid |
$310.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.83
|
| Rate for Payer: Meridian Medicaid |
$325.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$893.70
|
| Rate for Payer: Nomi Health Commercial |
$565.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,387.50
|
| Rate for Payer: PACE SWMI |
$471.27
|
| Rate for Payer: PHP Medicare Advantage |
$471.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$828.30
|
| Rate for Payer: Priority Health Medicare |
$471.27
|
| Rate for Payer: Priority Health SBD |
$828.30
|
| Rate for Payer: Priority Health Tiered Network |
$828.30
|
| Rate for Payer: Railroad Medicare Medicare |
$471.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.98
|
| Rate for Payer: UHC Core |
$859.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.27
|
| Rate for Payer: UHC Exchange |
$859.98
|
| Rate for Payer: UHC Medicaid |
$310.34
|
| Rate for Payer: UHCCP Medicaid |
$310.34
|
|
|
PR SYNVISC OR SYNVISC-ONE
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS J7325
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$9.33
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.33
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$7.70
|
| Rate for Payer: BCN Commercial |
$10.87
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$9.33
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$11.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.77
|
| Rate for Payer: Nomi Health Commercial |
$8.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.56
|
| Rate for Payer: UHC Core |
$7.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.96
|
| Rate for Payer: UHC Exchange |
$7.56
|
|
|
PR TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 11103
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$23.49
|
| Rate for Payer: Aetna Medicare |
$18.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.24
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$25.53
|
| Rate for Payer: BCN Medicare Advantage |
$17.53
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$25.24
|
| Rate for Payer: Cofinity Commercial |
$23.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.53
|
| Rate for Payer: Healthscope Commercial |
$32.43
|
| Rate for Payer: Healthscope Commercial |
$28.05
|
| Rate for Payer: Mclaren Medicaid |
$11.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.41
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$17.53
|
| Rate for Payer: PHP Medicare Advantage |
$17.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.63
|
| Rate for Payer: Priority Health Medicare |
$17.53
|
| Rate for Payer: Priority Health SBD |
$29.63
|
| Rate for Payer: Priority Health Tiered Network |
$29.63
|
| Rate for Payer: Railroad Medicare Medicare |
$17.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.64
|
| Rate for Payer: UHC Core |
$39.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.53
|
| Rate for Payer: UHC Exchange |
$39.64
|
| Rate for Payer: UHC Medicaid |
$11.29
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
|
|
PR TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11102
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$39.85
|
| Rate for Payer: Aetna Medicare |
$30.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.83
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$43.98
|
| Rate for Payer: BCN Medicare Advantage |
$29.74
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$42.83
|
| Rate for Payer: Cofinity Commercial |
$39.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.74
|
| Rate for Payer: Healthscope Commercial |
$55.02
|
| Rate for Payer: Healthscope Commercial |
$47.58
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.23
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.53
|
| Rate for Payer: Nomi Health Commercial |
$35.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$29.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.05
|
| Rate for Payer: Priority Health Medicare |
$29.74
|
| Rate for Payer: Priority Health SBD |
$51.05
|
| Rate for Payer: Priority Health Tiered Network |
$51.05
|
| Rate for Payer: Railroad Medicare Medicare |
$29.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.30
|
| Rate for Payer: UHC Core |
$68.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.74
|
| Rate for Payer: UHC Exchange |
$68.30
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
PR TAP BLOCK UNILATERAL BY INJECTION(S)
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 64486
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$100.43 |
| Rate for Payer: Aetna Commercial |
$64.68
|
| Rate for Payer: Aetna Medicare |
$50.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.51
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$48.27
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.27
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$69.51
|
| Rate for Payer: Cofinity Commercial |
$64.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$89.30
|
| Rate for Payer: Healthscope Commercial |
$77.23
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.68
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: Nomi Health Commercial |
$57.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$48.27
|
| Rate for Payer: PHP Medicare Advantage |
$48.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.66
|
| Rate for Payer: Priority Health Medicare |
$48.27
|
| Rate for Payer: Priority Health SBD |
$89.66
|
| Rate for Payer: Priority Health Tiered Network |
$89.66
|
| Rate for Payer: Railroad Medicare Medicare |
$48.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.43
|
| Rate for Payer: UHC Core |
$100.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.27
|
| Rate for Payer: UHC Exchange |
$100.43
|
| Rate for Payer: UHC Medicaid |
$30.89
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR TATTOOING INCL MICROPIGMENTATION 6.0 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11920
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Aetna Commercial |
$134.27
|
| Rate for Payer: Aetna Medicare |
$104.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.29
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$100.20
|
| Rate for Payer: BCN Commercial |
$171.30
|
| Rate for Payer: BCN Medicare Advantage |
$100.20
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$144.29
|
| Rate for Payer: Cofinity Commercial |
$134.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.20
|
| Rate for Payer: Healthscope Commercial |
$185.37
|
| Rate for Payer: Healthscope Commercial |
$160.32
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.21
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.39
|
| Rate for Payer: Nomi Health Commercial |
$120.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.75
|
| Rate for Payer: PACE SWMI |
$100.20
|
| Rate for Payer: PHP Medicare Advantage |
$100.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$156.79
|
| Rate for Payer: Priority Health Medicare |
$100.20
|
| Rate for Payer: Priority Health SBD |
$156.79
|
| Rate for Payer: Priority Health Tiered Network |
$156.79
|
| Rate for Payer: Railroad Medicare Medicare |
$100.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.66
|
| Rate for Payer: UHC Core |
$195.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.20
|
| Rate for Payer: UHC Exchange |
$195.66
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 11921
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$287.25 |
| Rate for Payer: Aetna Commercial |
$152.51
|
| Rate for Payer: Aetna Medicare |
$118.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.89
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$113.81
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$113.81
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$152.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.81
|
| Rate for Payer: Healthscope Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$182.10
|
| Rate for Payer: Mclaren Medicaid |
$73.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.50
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.72
|
| Rate for Payer: Nomi Health Commercial |
$136.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.25
|
| Rate for Payer: PACE SWMI |
$113.81
|
| Rate for Payer: PHP Medicare Advantage |
$113.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$179.58
|
| Rate for Payer: Priority Health Medicare |
$113.81
|
| Rate for Payer: Priority Health SBD |
$179.58
|
| Rate for Payer: Priority Health Tiered Network |
$179.58
|
| Rate for Payer: Railroad Medicare Medicare |
$113.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.00
|
| Rate for Payer: UHC Core |
$231.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$113.81
|
| Rate for Payer: UHC Exchange |
$231.00
|
| Rate for Payer: UHC Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
|
|
PR TATTOOING INCL MICROPIGMENTATION EA 20.0 CM
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 11922
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.89
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$24.23
|
| Rate for Payer: BCN Commercial |
$42.33
|
| Rate for Payer: BCN Medicare Advantage |
$24.23
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$32.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.23
|
| Rate for Payer: Healthscope Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$38.77
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.00
|
| Rate for Payer: Nomi Health Commercial |
$29.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PACE SWMI |
$24.23
|
| Rate for Payer: PHP Medicare Advantage |
$24.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.74
|
| Rate for Payer: Priority Health Medicare |
$24.23
|
| Rate for Payer: Priority Health SBD |
$38.74
|
| Rate for Payer: Priority Health Tiered Network |
$38.74
|
| Rate for Payer: Railroad Medicare Medicare |
$24.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.50
|
| Rate for Payer: UHC Core |
$52.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.23
|
| Rate for Payer: UHC Exchange |
$52.50
|
| Rate for Payer: UHC Medicaid |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR TC99M DISOFENIN
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS A9510
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$67.20
|
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.20
|
| Rate for Payer: BCN Commercial |
$60.00
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.80
|
| Rate for Payer: UHC Core |
$79.80
|
| Rate for Payer: UHC Exchange |
$79.80
|
|
|
PR TC99M MEBROFENIN
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS A9537
|
| Min. Negotiated Rate |
$53.10 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.10
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.50
|
| Rate for Payer: UHC Core |
$56.50
|
| Rate for Payer: UHC Exchange |
$56.50
|
|
|
PR TC99M MEDRONATE
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS A9503
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$47.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.48
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.00
|
| Rate for Payer: UHC Core |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
|
|
PR TC99M PERTECHNETATE
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS A9512
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.50
|
| Rate for Payer: BCN Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.72
|
| Rate for Payer: UHC Core |
$1.72
|
| Rate for Payer: UHC Exchange |
$1.72
|
|
|
PR TC99M SESTAMIBI
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS A9500
|
| Min. Negotiated Rate |
$102.48 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.48
|
| Rate for Payer: BCN Commercial |
$128.10
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.58
|
| Rate for Payer: UHC Core |
$450.58
|
| Rate for Payer: UHC Exchange |
$450.58
|
|
|
PR TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 37218
|
| Min. Negotiated Rate |
$473.07 |
| Max. Negotiated Rate |
$1,460.92 |
| Rate for Payer: Aetna Commercial |
$998.18
|
| Rate for Payer: Aetna Medicare |
$774.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.67
|
| Rate for Payer: BCBS Complete |
$496.72
|
| Rate for Payer: BCBS MAPPO |
$744.91
|
| Rate for Payer: BCN Commercial |
$1,216.57
|
| Rate for Payer: BCN Medicare Advantage |
$744.91
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cofinity Commercial |
$998.18
|
| Rate for Payer: Cofinity Commercial |
$1,072.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.91
|
| Rate for Payer: Healthscope Commercial |
$1,378.08
|
| Rate for Payer: Healthscope Commercial |
$1,191.86
|
| Rate for Payer: Mclaren Medicaid |
$473.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.16
|
| Rate for Payer: Meridian Medicaid |
$496.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$819.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,455.55
|
| Rate for Payer: Nomi Health Commercial |
$893.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.00
|
| Rate for Payer: PACE SWMI |
$744.91
|
| Rate for Payer: PHP Medicare Advantage |
$744.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,308.26
|
| Rate for Payer: Priority Health Medicare |
$744.91
|
| Rate for Payer: Priority Health SBD |
$1,308.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,308.26
|
| Rate for Payer: Railroad Medicare Medicare |
$744.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,460.92
|
| Rate for Payer: UHC Core |
$1,460.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$744.91
|
| Rate for Payer: UHC Exchange |
$1,460.92
|
| Rate for Payer: UHC Medicaid |
$473.07
|
| Rate for Payer: UHCCP Medicaid |
$473.07
|
|
|
PR TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,808.00
|
|
|
Service Code
|
HCPCS 37217
|
| Min. Negotiated Rate |
$624.52 |
| Max. Negotiated Rate |
$1,935.99 |
| Rate for Payer: Aetna Commercial |
$1,324.01
|
| Rate for Payer: Aetna Medicare |
$1,027.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,324.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,422.82
|
| Rate for Payer: BCBS Complete |
$655.75
|
| Rate for Payer: BCBS MAPPO |
$988.07
|
| Rate for Payer: BCN Commercial |
$1,583.58
|
| Rate for Payer: BCN Medicare Advantage |
$988.07
|
| Rate for Payer: Cash Price |
$1,446.40
|
| Rate for Payer: Cash Price |
$1,446.40
|
| Rate for Payer: Cofinity Commercial |
$1,422.82
|
| Rate for Payer: Cofinity Commercial |
$1,324.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.07
|
| Rate for Payer: Healthscope Commercial |
$1,827.93
|
| Rate for Payer: Healthscope Commercial |
$1,580.91
|
| Rate for Payer: Mclaren Medicaid |
$624.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,037.47
|
| Rate for Payer: Meridian Medicaid |
$655.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,086.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,917.52
|
| Rate for Payer: Nomi Health Commercial |
$1,185.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,356.00
|
| Rate for Payer: PACE SWMI |
$988.07
|
| Rate for Payer: PHP Medicare Advantage |
$988.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,702.94
|
| Rate for Payer: Priority Health Medicare |
$988.07
|
| Rate for Payer: Priority Health SBD |
$1,702.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,702.94
|
| Rate for Payer: Railroad Medicare Medicare |
$988.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.99
|
| Rate for Payer: UHC Core |
$1,935.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$988.07
|
| Rate for Payer: UHC Exchange |
$1,935.99
|
| Rate for Payer: UHC Medicaid |
$624.52
|
| Rate for Payer: UHCCP Medicaid |
$624.52
|
|
|
PR TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 33289
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$588.20 |
| Rate for Payer: Aetna Commercial |
$382.03
|
| Rate for Payer: Aetna Medicare |
$296.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.54
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS MAPPO |
$285.10
|
| Rate for Payer: BCN Commercial |
$489.52
|
| Rate for Payer: BCN Medicare Advantage |
$285.10
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cofinity Commercial |
$410.54
|
| Rate for Payer: Cofinity Commercial |
$382.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.10
|
| Rate for Payer: Healthscope Commercial |
$527.43
|
| Rate for Payer: Healthscope Commercial |
$456.16
|
| Rate for Payer: Mclaren Medicaid |
$181.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.36
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.20
|
| Rate for Payer: Nomi Health Commercial |
$342.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$531.00
|
| Rate for Payer: PACE SWMI |
$285.10
|
| Rate for Payer: PHP Medicare Advantage |
$285.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$526.42
|
| Rate for Payer: Priority Health Medicare |
$285.10
|
| Rate for Payer: Priority Health SBD |
$526.42
|
| Rate for Payer: Priority Health Tiered Network |
$526.42
|
| Rate for Payer: Railroad Medicare Medicare |
$285.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.35
|
| Rate for Payer: UHC Core |
$587.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.10
|
| Rate for Payer: UHC Exchange |
$587.35
|
| Rate for Payer: UHC Medicaid |
$181.26
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
|
|
PR TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 0823T
|
| Min. Negotiated Rate |
$314.80 |
| Max. Negotiated Rate |
$17,831.53 |
| Rate for Payer: Aetna Medicare |
$393.50
|
| Rate for Payer: BCBS Complete |
$314.80
|
| Rate for Payer: BCN Commercial |
$17,831.53
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$590.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$645.32
|
| Rate for Payer: Priority Health SBD |
$645.32
|
| Rate for Payer: Priority Health Tiered Network |
$645.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.36
|
| Rate for Payer: UHC Core |
$868.36
|
| Rate for Payer: UHC Exchange |
$868.36
|
|
|
PR TCAT INSJ PERM DUAL CHAMBER LDLS PM COMPL SYS
|
Professional
|
Both
|
$25,536.00
|
|
|
Service Code
|
HCPCS 0795T
|
| Min. Negotiated Rate |
$868.36 |
| Max. Negotiated Rate |
$19,152.00 |
| Rate for Payer: Aetna Medicare |
$12,768.00
|
| Rate for Payer: BCBS Complete |
$10,214.40
|
| Rate for Payer: BCN Commercial |
$17,831.53
|
| Rate for Payer: Cash Price |
$20,428.80
|
| Rate for Payer: Cash Price |
$20,428.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,598.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,152.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.36
|
| Rate for Payer: UHC Core |
$868.36
|
| Rate for Payer: UHC Exchange |
$868.36
|
|
|
PR TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 33274
|
| Min. Negotiated Rate |
$267.53 |
| Max. Negotiated Rate |
$862.01 |
| Rate for Payer: Aetna Commercial |
$559.99
|
| Rate for Payer: Aetna Medicare |
$434.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.78
|
| Rate for Payer: BCBS Complete |
$280.91
|
| Rate for Payer: BCBS MAPPO |
$417.90
|
| Rate for Payer: BCN Commercial |
$702.65
|
| Rate for Payer: BCN Medicare Advantage |
$417.90
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$601.78
|
| Rate for Payer: Cofinity Commercial |
$559.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.90
|
| Rate for Payer: Healthscope Commercial |
$773.12
|
| Rate for Payer: Healthscope Commercial |
$668.64
|
| Rate for Payer: Mclaren Medicaid |
$267.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.80
|
| Rate for Payer: Meridian Medicaid |
$280.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$459.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$847.71
|
| Rate for Payer: Nomi Health Commercial |
$501.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.25
|
| Rate for Payer: PACE SWMI |
$417.90
|
| Rate for Payer: PHP Medicare Advantage |
$417.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$755.61
|
| Rate for Payer: Priority Health Medicare |
$417.90
|
| Rate for Payer: Priority Health SBD |
$755.61
|
| Rate for Payer: Priority Health Tiered Network |
$755.61
|
| Rate for Payer: Railroad Medicare Medicare |
$417.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.01
|
| Rate for Payer: UHC Core |
$862.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$417.90
|
| Rate for Payer: UHC Exchange |
$862.01
|
| Rate for Payer: UHC Medicaid |
$267.53
|
| Rate for Payer: UHCCP Medicaid |
$267.53
|
|
|
PR TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ
|
Professional
|
Both
|
$2,173.00
|
|
|
Service Code
|
HCPCS 37215
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$1,785.27 |
| Rate for Payer: Aetna Commercial |
$1,200.25
|
| Rate for Payer: Aetna Medicare |
$931.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,289.82
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$895.71
|
| Rate for Payer: BCN Commercial |
$1,444.64
|
| Rate for Payer: BCN Medicare Advantage |
$895.71
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cofinity Commercial |
$1,289.82
|
| Rate for Payer: Cofinity Commercial |
$1,200.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.71
|
| Rate for Payer: Healthscope Commercial |
$1,657.06
|
| Rate for Payer: Healthscope Commercial |
$1,433.14
|
| Rate for Payer: Mclaren Medicaid |
$567.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.50
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$985.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,752.98
|
| Rate for Payer: Nomi Health Commercial |
$1,074.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.75
|
| Rate for Payer: PACE SWMI |
$895.71
|
| Rate for Payer: PHP Medicare Advantage |
$895.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,553.53
|
| Rate for Payer: Priority Health Medicare |
$895.71
|
| Rate for Payer: Priority Health SBD |
$1,553.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,553.53
|
| Rate for Payer: Railroad Medicare Medicare |
$895.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,785.27
|
| Rate for Payer: UHC Core |
$1,785.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$895.71
|
| Rate for Payer: UHC Exchange |
$1,785.27
|
| Rate for Payer: UHC Medicaid |
$567.22
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
|
|
PR TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ
|
Professional
|
Both
|
$4,310.00
|
|
|
Service Code
|
HCPCS 37216
|
| Min. Negotiated Rate |
$1,302.62 |
| Max. Negotiated Rate |
$3,232.50 |
| Rate for Payer: Aetna Commercial |
$1,302.62
|
| Rate for Payer: Aetna Medicare |
$2,155.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.62
|
| Rate for Payer: BCBS Complete |
$1,724.00
|
| Rate for Payer: BCN Commercial |
$1,458.09
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,232.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,568.00
|
| Rate for Payer: Priority Health SBD |
$1,568.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,568.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.80
|
| Rate for Payer: UHC Core |
$1,727.80
|
| Rate for Payer: UHC Exchange |
$1,727.80
|
|
