|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$382.40 |
| Max. Negotiated Rate |
$717.00 |
| Rate for Payer: Aetna Medicare |
$478.00
|
| Rate for Payer: BCBS Complete |
$382.40
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$621.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.00
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,771.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$708.40 |
| Max. Negotiated Rate |
$1,328.25 |
| Rate for Payer: Aetna Medicare |
$885.50
|
| Rate for Payer: BCBS Complete |
$708.40
|
| Rate for Payer: Cash Price |
$1,416.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,151.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.25
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,655.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,332.53 |
| Max. Negotiated Rate |
$4,334.67 |
| Rate for Payer: Aetna Commercial |
$2,760.23
|
| Rate for Payer: Aetna Medicare |
$2,142.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,760.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,966.21
|
| Rate for Payer: BCBS Complete |
$1,399.16
|
| Rate for Payer: BCBS MAPPO |
$2,059.87
|
| Rate for Payer: BCN Commercial |
$3,633.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,059.87
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cofinity Commercial |
$2,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,760.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,059.87
|
| Rate for Payer: Healthscope Commercial |
$3,810.76
|
| Rate for Payer: Healthscope Commercial |
$3,295.79
|
| Rate for Payer: Mclaren Medicaid |
$1,332.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,162.86
|
| Rate for Payer: Meridian Medicaid |
$1,399.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,265.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,334.67
|
| Rate for Payer: Nomi Health Commercial |
$2,471.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,491.25
|
| Rate for Payer: PACE SWMI |
$2,059.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,059.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,332.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,219.97
|
| Rate for Payer: Priority Health Medicare |
$2,059.87
|
| Rate for Payer: Priority Health SBD |
$4,219.97
|
| Rate for Payer: Priority Health Tiered Network |
$4,219.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,059.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,266.15
|
| Rate for Payer: UHC Core |
$4,266.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,059.87
|
| Rate for Payer: UHC Exchange |
$4,266.15
|
| Rate for Payer: UHC Medicaid |
$1,332.53
|
| Rate for Payer: UHCCP Medicaid |
$1,332.53
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$127.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$95.25 |
| Max. Negotiated Rate |
$524.83 |
| Rate for Payer: Aetna Commercial |
$380.14
|
| Rate for Payer: Aetna Medicare |
$295.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.51
|
| Rate for Payer: BCBS MAPPO |
$283.69
|
| Rate for Payer: BCN Commercial |
$436.73
|
| Rate for Payer: BCN Medicare Advantage |
$283.69
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$408.51
|
| Rate for Payer: Cofinity Commercial |
$380.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.69
|
| Rate for Payer: Healthscope Commercial |
$524.83
|
| Rate for Payer: Healthscope Commercial |
$453.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$312.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.32
|
| Rate for Payer: Nomi Health Commercial |
$340.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.25
|
| Rate for Payer: PACE SWMI |
$283.69
|
| Rate for Payer: PHP Medicare Advantage |
$283.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$402.76
|
| Rate for Payer: Priority Health Medicare |
$283.69
|
| Rate for Payer: Priority Health SBD |
$402.76
|
| Rate for Payer: Priority Health Tiered Network |
$402.76
|
| Rate for Payer: Railroad Medicare Medicare |
$283.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.60
|
| Rate for Payer: UHC Core |
$474.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$283.69
|
| Rate for Payer: UHC Exchange |
$474.60
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$90.75 |
| Max. Negotiated Rate |
$461.78 |
| Rate for Payer: Aetna Commercial |
$334.48
|
| Rate for Payer: Aetna Commercial |
$334.48
|
| Rate for Payer: Aetna Medicare |
$259.59
|
| Rate for Payer: Aetna Medicare |
$259.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.44
|
| Rate for Payer: BCBS MAPPO |
$249.61
|
| Rate for Payer: BCBS MAPPO |
$249.61
|
| Rate for Payer: BCN Commercial |
$382.45
|
| Rate for Payer: BCN Commercial |
$382.45
|
| Rate for Payer: BCN Medicare Advantage |
$249.61
|
| Rate for Payer: BCN Medicare Advantage |
$249.61
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$334.48
|
| Rate for Payer: Cofinity Commercial |
$359.44
|
| Rate for Payer: Cofinity Commercial |
$334.48
|
| Rate for Payer: Cofinity Commercial |
$359.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.61
|
| Rate for Payer: Healthscope Commercial |
$461.78
|
| Rate for Payer: Healthscope Commercial |
$461.78
|
| Rate for Payer: Healthscope Commercial |
$399.38
|
| Rate for Payer: Healthscope Commercial |
$399.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.41
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$488.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$249.61
|
| Rate for Payer: PACE SWMI |
$249.61
|
| Rate for Payer: PHP Medicare Advantage |
$249.61
|
| Rate for Payer: PHP Medicare Advantage |
$249.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.70
|
| Rate for Payer: Priority Health Medicare |
$249.61
|
| Rate for Payer: Priority Health Medicare |
$249.61
|
| Rate for Payer: Priority Health SBD |
$352.70
|
| Rate for Payer: Priority Health SBD |
$352.70
|
| Rate for Payer: Priority Health Tiered Network |
$352.70
|
| Rate for Payer: Priority Health Tiered Network |
$352.70
|
| Rate for Payer: Railroad Medicare Medicare |
$249.61
|
| Rate for Payer: Railroad Medicare Medicare |
$249.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.25
|
| Rate for Payer: UHC Core |
$414.25
|
| Rate for Payer: UHC Core |
$414.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.61
|
| Rate for Payer: UHC Exchange |
$414.25
|
| Rate for Payer: UHC Exchange |
$414.25
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$158.02 |
| Max. Negotiated Rate |
$292.34 |
| Rate for Payer: Aetna Commercial |
$211.75
|
| Rate for Payer: Aetna Medicare |
$164.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.75
|
| Rate for Payer: BCBS MAPPO |
$158.02
|
| Rate for Payer: BCN Commercial |
$240.53
|
| Rate for Payer: BCN Medicare Advantage |
$158.02
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$227.55
|
| Rate for Payer: Cofinity Commercial |
$211.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.02
|
| Rate for Payer: Healthscope Commercial |
$252.83
|
| Rate for Payer: Healthscope Commercial |
$292.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.36
|
| Rate for Payer: Nomi Health Commercial |
$189.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.25
|
| Rate for Payer: PACE SWMI |
$158.02
|
| Rate for Payer: PHP Medicare Advantage |
$158.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.81
|
| Rate for Payer: Priority Health Medicare |
$158.02
|
| Rate for Payer: Priority Health SBD |
$221.81
|
| Rate for Payer: Priority Health Tiered Network |
$221.81
|
| Rate for Payer: Railroad Medicare Medicare |
$158.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.85
|
| Rate for Payer: UHC Core |
$246.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.02
|
| Rate for Payer: UHC Exchange |
$246.85
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$976.99 |
| Rate for Payer: Aetna Commercial |
$707.65
|
| Rate for Payer: Aetna Medicare |
$549.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.46
|
| Rate for Payer: BCBS Complete |
$362.99
|
| Rate for Payer: BCBS MAPPO |
$528.10
|
| Rate for Payer: BCN Commercial |
$857.25
|
| Rate for Payer: BCN Medicare Advantage |
$528.10
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$760.46
|
| Rate for Payer: Cofinity Commercial |
$707.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.10
|
| Rate for Payer: Healthscope Commercial |
$976.99
|
| Rate for Payer: Healthscope Commercial |
$844.96
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.50
|
| Rate for Payer: Meridian Medicaid |
$362.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.48
|
| Rate for Payer: Nomi Health Commercial |
$633.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.75
|
| Rate for Payer: PACE SWMI |
$528.10
|
| Rate for Payer: PHP Medicare Advantage |
$528.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$906.35
|
| Rate for Payer: Priority Health Medicare |
$528.10
|
| Rate for Payer: Priority Health SBD |
$906.35
|
| Rate for Payer: Priority Health Tiered Network |
$906.35
|
| Rate for Payer: Railroad Medicare Medicare |
$528.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.12
|
| Rate for Payer: UHC Core |
$862.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$528.10
|
| Rate for Payer: UHC Exchange |
$862.12
|
| Rate for Payer: UHC Medicaid |
$345.70
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,009.50 |
| Rate for Payer: Aetna Commercial |
$675.32
|
| Rate for Payer: Aetna Medicare |
$524.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.72
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$503.97
|
| Rate for Payer: BCN Commercial |
$930.57
|
| Rate for Payer: BCN Medicare Advantage |
$503.97
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$725.72
|
| Rate for Payer: Cofinity Commercial |
$675.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.97
|
| Rate for Payer: Healthscope Commercial |
$932.34
|
| Rate for Payer: Healthscope Commercial |
$806.35
|
| Rate for Payer: Mclaren Medicaid |
$329.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.17
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$994.39
|
| Rate for Payer: Nomi Health Commercial |
$604.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,009.50
|
| Rate for Payer: PACE SWMI |
$503.97
|
| Rate for Payer: PHP Medicare Advantage |
$503.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$983.84
|
| Rate for Payer: Priority Health Medicare |
$503.97
|
| Rate for Payer: Priority Health SBD |
$983.84
|
| Rate for Payer: Priority Health Tiered Network |
$983.84
|
| Rate for Payer: Railroad Medicare Medicare |
$503.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.61
|
| Rate for Payer: UHC Core |
$984.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.97
|
| Rate for Payer: UHC Exchange |
$984.61
|
| Rate for Payer: UHC Medicaid |
$329.30
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,093.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$930.73 |
| Rate for Payer: Aetna Commercial |
$672.76
|
| Rate for Payer: Aetna Medicare |
$522.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.97
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$502.06
|
| Rate for Payer: BCN Commercial |
$790.79
|
| Rate for Payer: BCN Medicare Advantage |
$502.06
|
| Rate for Payer: Cash Price |
$874.40
|
| Rate for Payer: Cash Price |
$874.40
|
| Rate for Payer: Cofinity Commercial |
$722.97
|
| Rate for Payer: Cofinity Commercial |
$672.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.06
|
| Rate for Payer: Healthscope Commercial |
$928.81
|
| Rate for Payer: Healthscope Commercial |
$803.30
|
| Rate for Payer: Mclaren Medicaid |
$325.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.16
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$552.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.73
|
| Rate for Payer: Nomi Health Commercial |
$602.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.75
|
| Rate for Payer: PACE SWMI |
$502.06
|
| Rate for Payer: PHP Medicare Advantage |
$502.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$918.49
|
| Rate for Payer: Priority Health Medicare |
$502.06
|
| Rate for Payer: Priority Health SBD |
$918.49
|
| Rate for Payer: Priority Health Tiered Network |
$918.49
|
| Rate for Payer: Railroad Medicare Medicare |
$502.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$913.29
|
| Rate for Payer: UHC Core |
$913.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$502.06
|
| Rate for Payer: UHC Exchange |
$913.29
|
| Rate for Payer: UHC Medicaid |
$325.68
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$419.61 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Aetna Commercial |
$859.06
|
| Rate for Payer: Aetna Medicare |
$666.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.17
|
| Rate for Payer: BCBS Complete |
$440.59
|
| Rate for Payer: BCBS MAPPO |
$641.09
|
| Rate for Payer: BCN Commercial |
$1,065.18
|
| Rate for Payer: BCN Medicare Advantage |
$641.09
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Cofinity Commercial |
$859.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.09
|
| Rate for Payer: Healthscope Commercial |
$1,186.02
|
| Rate for Payer: Healthscope Commercial |
$1,025.74
|
| Rate for Payer: Mclaren Medicaid |
$419.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.14
|
| Rate for Payer: Meridian Medicaid |
$440.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,236.46
|
| Rate for Payer: Nomi Health Commercial |
$769.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.75
|
| Rate for Payer: PACE SWMI |
$641.09
|
| Rate for Payer: PHP Medicare Advantage |
$641.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,138.65
|
| Rate for Payer: Priority Health Medicare |
$641.09
|
| Rate for Payer: Priority Health SBD |
$1,138.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,138.65
|
| Rate for Payer: Railroad Medicare Medicare |
$641.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,210.97
|
| Rate for Payer: UHC Core |
$1,210.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.09
|
| Rate for Payer: UHC Exchange |
$1,210.97
|
| Rate for Payer: UHC Medicaid |
$419.61
|
| Rate for Payer: UHCCP Medicaid |
$419.61
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$759.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$244.10 |
| Max. Negotiated Rate |
$705.15 |
| Rate for Payer: Aetna Commercial |
$494.81
|
| Rate for Payer: Aetna Medicare |
$384.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.73
|
| Rate for Payer: BCBS Complete |
$256.31
|
| Rate for Payer: BCBS MAPPO |
$369.26
|
| Rate for Payer: BCN Commercial |
$613.51
|
| Rate for Payer: BCN Medicare Advantage |
$369.26
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cofinity Commercial |
$531.73
|
| Rate for Payer: Cofinity Commercial |
$494.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.26
|
| Rate for Payer: Healthscope Commercial |
$683.13
|
| Rate for Payer: Healthscope Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$244.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.72
|
| Rate for Payer: Meridian Medicaid |
$256.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.15
|
| Rate for Payer: Nomi Health Commercial |
$443.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$569.25
|
| Rate for Payer: PACE SWMI |
$369.26
|
| Rate for Payer: PHP Medicare Advantage |
$369.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$561.52
|
| Rate for Payer: Priority Health Medicare |
$369.26
|
| Rate for Payer: Priority Health SBD |
$561.52
|
| Rate for Payer: Priority Health Tiered Network |
$561.52
|
| Rate for Payer: Railroad Medicare Medicare |
$369.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.76
|
| Rate for Payer: UHC Core |
$656.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$369.26
|
| Rate for Payer: UHC Exchange |
$656.76
|
| Rate for Payer: UHC Medicaid |
$244.10
|
| Rate for Payer: UHCCP Medicaid |
$244.10
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$7,157.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$5,367.75 |
| Rate for Payer: Aetna Commercial |
$1,179.99
|
| Rate for Payer: Aetna Medicare |
$915.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,179.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,268.05
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$880.59
|
| Rate for Payer: BCN Commercial |
$1,475.02
|
| Rate for Payer: BCN Medicare Advantage |
$880.59
|
| Rate for Payer: Cash Price |
$5,725.60
|
| Rate for Payer: Cash Price |
$5,725.60
|
| Rate for Payer: Cofinity Commercial |
$1,268.05
|
| Rate for Payer: Cofinity Commercial |
$1,179.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$880.59
|
| Rate for Payer: Healthscope Commercial |
$1,629.09
|
| Rate for Payer: Healthscope Commercial |
$1,408.94
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$924.62
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$968.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,723.55
|
| Rate for Payer: Nomi Health Commercial |
$1,056.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,367.75
|
| Rate for Payer: PACE SWMI |
$880.59
|
| Rate for Payer: PHP Medicare Advantage |
$880.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,576.75
|
| Rate for Payer: Priority Health Medicare |
$880.59
|
| Rate for Payer: Priority Health SBD |
$1,576.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,576.75
|
| Rate for Payer: Railroad Medicare Medicare |
$880.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.50
|
| Rate for Payer: UHC Core |
$1,698.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$880.59
|
| Rate for Payer: UHC Exchange |
$1,698.50
|
| Rate for Payer: UHC Medicaid |
$573.40
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,746.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$2,059.50 |
| Rate for Payer: Aetna Commercial |
$1,031.41
|
| Rate for Payer: Aetna Medicare |
$800.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.38
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$769.71
|
| Rate for Payer: BCN Commercial |
$1,259.89
|
| Rate for Payer: BCN Medicare Advantage |
$769.71
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cofinity Commercial |
$1,108.38
|
| Rate for Payer: Cofinity Commercial |
$1,031.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.71
|
| Rate for Payer: Healthscope Commercial |
$1,423.96
|
| Rate for Payer: Healthscope Commercial |
$1,231.54
|
| Rate for Payer: Mclaren Medicaid |
$514.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$808.20
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$846.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,470.53
|
| Rate for Payer: Nomi Health Commercial |
$923.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,059.50
|
| Rate for Payer: PACE SWMI |
$769.71
|
| Rate for Payer: PHP Medicare Advantage |
$769.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.80
|
| Rate for Payer: Priority Health Medicare |
$769.71
|
| Rate for Payer: Priority Health SBD |
$1,346.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.80
|
| Rate for Payer: Railroad Medicare Medicare |
$769.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,396.37
|
| Rate for Payer: UHC Core |
$1,396.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$769.71
|
| Rate for Payer: UHC Exchange |
$1,396.37
|
| Rate for Payer: UHC Medicaid |
$514.61
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$43.52 |
| Max. Negotiated Rate |
$80.51 |
| Rate for Payer: Aetna Commercial |
$58.32
|
| Rate for Payer: Aetna Medicare |
$45.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.32
|
| Rate for Payer: BCBS MAPPO |
$43.52
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$43.52
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$62.67
|
| Rate for Payer: Cofinity Commercial |
$58.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.52
|
| Rate for Payer: Healthscope Commercial |
$69.63
|
| Rate for Payer: Healthscope Commercial |
$80.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.21
|
| Rate for Payer: Nomi Health Commercial |
$52.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$43.52
|
| Rate for Payer: PHP Medicare Advantage |
$43.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.09
|
| Rate for Payer: Priority Health Medicare |
$43.52
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$69.09
|
| Rate for Payer: Railroad Medicare Medicare |
$43.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.99
|
| Rate for Payer: UHC Core |
$56.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.52
|
| Rate for Payer: UHC Exchange |
$56.99
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$400.02
|
| Rate for Payer: Aetna Medicare |
$310.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.87
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$298.52
|
| Rate for Payer: BCN Commercial |
$509.43
|
| Rate for Payer: BCN Medicare Advantage |
$298.52
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$429.87
|
| Rate for Payer: Cofinity Commercial |
$400.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.52
|
| Rate for Payer: Healthscope Commercial |
$552.26
|
| Rate for Payer: Healthscope Commercial |
$477.63
|
| Rate for Payer: Mclaren Medicaid |
$189.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.45
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.26
|
| Rate for Payer: Nomi Health Commercial |
$358.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.50
|
| Rate for Payer: PACE SWMI |
$298.52
|
| Rate for Payer: PHP Medicare Advantage |
$298.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$547.82
|
| Rate for Payer: Priority Health Medicare |
$298.52
|
| Rate for Payer: Priority Health SBD |
$547.82
|
| Rate for Payer: Priority Health Tiered Network |
$547.82
|
| Rate for Payer: Railroad Medicare Medicare |
$298.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.94
|
| Rate for Payer: UHC Core |
$620.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$298.52
|
| Rate for Payer: UHC Exchange |
$620.94
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$304.53 |
| Rate for Payer: Aetna Commercial |
$220.58
|
| Rate for Payer: Aetna Medicare |
$171.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.04
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$164.61
|
| Rate for Payer: BCN Commercial |
$204.87
|
| Rate for Payer: BCN Medicare Advantage |
$164.61
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$237.04
|
| Rate for Payer: Cofinity Commercial |
$220.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.61
|
| Rate for Payer: Healthscope Commercial |
$304.53
|
| Rate for Payer: Healthscope Commercial |
$263.38
|
| Rate for Payer: Mclaren Medicaid |
$106.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.84
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$181.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.95
|
| Rate for Payer: Nomi Health Commercial |
$197.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.75
|
| Rate for Payer: PACE SWMI |
$164.61
|
| Rate for Payer: PHP Medicare Advantage |
$164.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$252.63
|
| Rate for Payer: Priority Health Medicare |
$164.61
|
| Rate for Payer: Priority Health SBD |
$252.63
|
| Rate for Payer: Priority Health Tiered Network |
$252.63
|
| Rate for Payer: Railroad Medicare Medicare |
$164.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.56
|
| Rate for Payer: UHC Core |
$229.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$164.61
|
| Rate for Payer: UHC Exchange |
$229.56
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 99495
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$223.96 |
| Rate for Payer: Aetna Commercial |
$162.22
|
| Rate for Payer: Aetna Medicare |
$125.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.33
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$121.06
|
| Rate for Payer: BCN Commercial |
$150.75
|
| Rate for Payer: BCN Medicare Advantage |
$121.06
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$162.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.06
|
| Rate for Payer: Healthscope Commercial |
$223.96
|
| Rate for Payer: Healthscope Commercial |
$193.70
|
| Rate for Payer: Mclaren Medicaid |
$77.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.11
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.34
|
| Rate for Payer: Nomi Health Commercial |
$145.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$121.06
|
| Rate for Payer: PHP Medicare Advantage |
$121.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$185.89
|
| Rate for Payer: Priority Health Medicare |
$121.06
|
| Rate for Payer: Priority Health SBD |
$185.89
|
| Rate for Payer: Priority Health Tiered Network |
$185.89
|
| Rate for Payer: Railroad Medicare Medicare |
$121.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.02
|
| Rate for Payer: UHC Core |
$174.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.06
|
| Rate for Payer: UHC Exchange |
$174.02
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75962
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
|
|
PR TRANSMASTOID ANTROTOMY
|
Professional
|
Both
|
$1,833.00
|
|
|
Service Code
|
HCPCS 69501
|
| Min. Negotiated Rate |
$405.34 |
| Max. Negotiated Rate |
$1,374.75 |
| Rate for Payer: Aetna Commercial |
$825.27
|
| Rate for Payer: Aetna Medicare |
$640.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.85
|
| Rate for Payer: BCBS Complete |
$425.61
|
| Rate for Payer: BCBS MAPPO |
$615.87
|
| Rate for Payer: BCN Commercial |
$1,063.19
|
| Rate for Payer: BCN Medicare Advantage |
$615.87
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cofinity Commercial |
$886.85
|
| Rate for Payer: Cofinity Commercial |
$825.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.87
|
| Rate for Payer: Healthscope Commercial |
$1,139.36
|
| Rate for Payer: Healthscope Commercial |
$985.39
|
| Rate for Payer: Mclaren Medicaid |
$405.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.66
|
| Rate for Payer: Meridian Medicaid |
$425.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.80
|
| Rate for Payer: Nomi Health Commercial |
$739.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.75
|
| Rate for Payer: PACE SWMI |
$615.87
|
| Rate for Payer: PHP Medicare Advantage |
$615.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,050.54
|
| Rate for Payer: Priority Health Medicare |
$615.87
|
| Rate for Payer: Priority Health SBD |
$1,050.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,050.54
|
| Rate for Payer: Railroad Medicare Medicare |
$615.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,227.33
|
| Rate for Payer: UHC Core |
$1,227.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.87
|
| Rate for Payer: UHC Exchange |
$1,227.33
|
| Rate for Payer: UHC Medicaid |
$405.34
|
| Rate for Payer: UHCCP Medicaid |
$405.34
|
|
|
PR TRANSMETACARPAL AMPUTATION RE-AMPUTATION
|
Professional
|
Both
|
$2,332.00
|
|
|
Service Code
|
HCPCS 25931
|
| Min. Negotiated Rate |
$498.85 |
| Max. Negotiated Rate |
$1,749.00 |
| Rate for Payer: Aetna Commercial |
$1,003.69
|
| Rate for Payer: Aetna Medicare |
$778.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.59
|
| Rate for Payer: BCBS Complete |
$523.79
|
| Rate for Payer: BCBS MAPPO |
$749.02
|
| Rate for Payer: BCN Commercial |
$1,202.63
|
| Rate for Payer: BCN Medicare Advantage |
$749.02
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Cofinity Commercial |
$1,078.59
|
| Rate for Payer: Cofinity Commercial |
$1,003.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.02
|
| Rate for Payer: Healthscope Commercial |
$1,385.69
|
| Rate for Payer: Healthscope Commercial |
$1,198.43
|
| Rate for Payer: Mclaren Medicaid |
$498.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.47
|
| Rate for Payer: Meridian Medicaid |
$523.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$823.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,407.94
|
| Rate for Payer: Nomi Health Commercial |
$898.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.00
|
| Rate for Payer: PACE SWMI |
$749.02
|
| Rate for Payer: PHP Medicare Advantage |
$749.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,285.57
|
| Rate for Payer: Priority Health Medicare |
$749.02
|
| Rate for Payer: Priority Health SBD |
$1,285.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,285.57
|
| Rate for Payer: Railroad Medicare Medicare |
$749.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.38
|
| Rate for Payer: UHC Core |
$1,322.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$749.02
|
| Rate for Payer: UHC Exchange |
$1,322.38
|
| Rate for Payer: UHC Medicaid |
$498.85
|
| Rate for Payer: UHCCP Medicaid |
$498.85
|
|
|
PR TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ
|
Professional
|
Both
|
$1,099.00
|
|
|
Service Code
|
HCPCS 25929
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$1,065.15 |
| Rate for Payer: Aetna Commercial |
$745.01
|
| Rate for Payer: Aetna Medicare |
$578.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.61
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS MAPPO |
$555.98
|
| Rate for Payer: BCN Commercial |
$920.26
|
| Rate for Payer: BCN Medicare Advantage |
$555.98
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Cofinity Commercial |
$800.61
|
| Rate for Payer: Cofinity Commercial |
$745.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.98
|
| Rate for Payer: Healthscope Commercial |
$889.57
|
| Rate for Payer: Healthscope Commercial |
$1,028.56
|
| Rate for Payer: Mclaren Medicaid |
$364.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.78
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$611.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.15
|
| Rate for Payer: Nomi Health Commercial |
$667.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$824.25
|
| Rate for Payer: PACE SWMI |
$555.98
|
| Rate for Payer: PHP Medicare Advantage |
$555.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$983.74
|
| Rate for Payer: Priority Health Medicare |
$555.98
|
| Rate for Payer: Priority Health SBD |
$983.74
|
| Rate for Payer: Priority Health Tiered Network |
$983.74
|
| Rate for Payer: Railroad Medicare Medicare |
$555.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.93
|
| Rate for Payer: UHC Core |
$1,039.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$555.98
|
| Rate for Payer: UHC Exchange |
$1,039.93
|
| Rate for Payer: UHC Medicaid |
$364.66
|
| Rate for Payer: UHCCP Medicaid |
$364.66
|
|
|
PR TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 33141
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$448.50 |
| Rate for Payer: Aetna Commercial |
$161.94
|
| Rate for Payer: Aetna Medicare |
$125.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.02
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$120.85
|
| Rate for Payer: BCN Commercial |
$193.22
|
| Rate for Payer: BCN Medicare Advantage |
$120.85
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$174.02
|
| Rate for Payer: Cofinity Commercial |
$161.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.85
|
| Rate for Payer: Healthscope Commercial |
$223.57
|
| Rate for Payer: Healthscope Commercial |
$193.36
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.89
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.77
|
| Rate for Payer: Nomi Health Commercial |
$145.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$448.50
|
| Rate for Payer: PACE SWMI |
$120.85
|
| Rate for Payer: PHP Medicare Advantage |
$120.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$207.77
|
| Rate for Payer: Priority Health Medicare |
$120.85
|
| Rate for Payer: Priority Health SBD |
$207.77
|
| Rate for Payer: Priority Health Tiered Network |
$207.77
|
| Rate for Payer: Railroad Medicare Medicare |
$120.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.05
|
| Rate for Payer: UHC Core |
$236.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.85
|
| Rate for Payer: UHC Exchange |
$236.05
|
| Rate for Payer: UHC Medicaid |
$76.25
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR TRANSORAL LOWER ESOPHAGEAL MYOTOMY
|
Professional
|
Both
|
$1,684.00
|
|
|
Service Code
|
HCPCS 43497
|
| Min. Negotiated Rate |
$458.16 |
| Max. Negotiated Rate |
$1,430.13 |
| Rate for Payer: Aetna Commercial |
$946.83
|
| Rate for Payer: Aetna Medicare |
$734.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.83
|
| Rate for Payer: BCBS Complete |
$481.07
|
| Rate for Payer: BCBS MAPPO |
$706.59
|
| Rate for Payer: BCN Commercial |
$1,173.74
|
| Rate for Payer: BCN Medicare Advantage |
$706.59
|
| Rate for Payer: Cash Price |
$1,347.20
|
| Rate for Payer: Cash Price |
$1,347.20
|
| Rate for Payer: Cofinity Commercial |
$946.83
|
| Rate for Payer: Cofinity Commercial |
$1,017.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.59
|
| Rate for Payer: Healthscope Commercial |
$1,307.19
|
| Rate for Payer: Healthscope Commercial |
$1,130.54
|
| Rate for Payer: Mclaren Medicaid |
$458.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$741.92
|
| Rate for Payer: Meridian Medicaid |
$481.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$777.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,398.83
|
| Rate for Payer: Nomi Health Commercial |
$847.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.00
|
| Rate for Payer: PACE SWMI |
$706.59
|
| Rate for Payer: PHP Medicare Advantage |
$706.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,430.13
|
| Rate for Payer: Priority Health Medicare |
$706.59
|
| Rate for Payer: Priority Health SBD |
$1,430.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,430.13
|
| Rate for Payer: Railroad Medicare Medicare |
$706.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.69
|
| Rate for Payer: UHC Core |
$1,425.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$706.59
|
| Rate for Payer: UHC Exchange |
$1,425.69
|
| Rate for Payer: UHC Medicaid |
$458.16
|
| Rate for Payer: UHCCP Medicaid |
$458.16
|
|
|
PR TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR
|
Professional
|
Both
|
$2,548.00
|
|
|
Service Code
|
HCPCS 63057
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,911.00 |
| Rate for Payer: Aetna Commercial |
$388.79
|
| Rate for Payer: Aetna Medicare |
$301.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.80
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$290.14
|
| Rate for Payer: BCN Commercial |
$530.11
|
| Rate for Payer: BCN Medicare Advantage |
$290.14
|
| Rate for Payer: Cash Price |
$2,038.40
|
| Rate for Payer: Cash Price |
$2,038.40
|
| Rate for Payer: Cofinity Commercial |
$417.80
|
| Rate for Payer: Cofinity Commercial |
$388.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.14
|
| Rate for Payer: Healthscope Commercial |
$536.76
|
| Rate for Payer: Healthscope Commercial |
$464.22
|
| Rate for Payer: Mclaren Medicaid |
$183.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.65
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.36
|
| Rate for Payer: Nomi Health Commercial |
$348.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,911.00
|
| Rate for Payer: PACE SWMI |
$290.14
|
| Rate for Payer: PHP Medicare Advantage |
$290.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$560.47
|
| Rate for Payer: Priority Health Medicare |
$290.14
|
| Rate for Payer: Priority Health SBD |
$560.47
|
| Rate for Payer: Priority Health Tiered Network |
$560.47
|
| Rate for Payer: Railroad Medicare Medicare |
$290.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.26
|
| Rate for Payer: UHC Core |
$569.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$290.14
|
| Rate for Payer: UHC Exchange |
$569.26
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR
|
Professional
|
Both
|
$7,286.00
|
|
|
Service Code
|
HCPCS 63056
|
| Min. Negotiated Rate |
$895.88 |
| Max. Negotiated Rate |
$5,464.50 |
| Rate for Payer: Aetna Commercial |
$1,870.91
|
| Rate for Payer: Aetna Medicare |
$1,452.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,870.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,010.53
|
| Rate for Payer: BCBS Complete |
$940.67
|
| Rate for Payer: BCBS MAPPO |
$1,396.20
|
| Rate for Payer: BCN Commercial |
$2,479.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,396.20
|
| Rate for Payer: Cash Price |
$5,828.80
|
| Rate for Payer: Cash Price |
$5,828.80
|
| Rate for Payer: Cofinity Commercial |
$2,010.53
|
| Rate for Payer: Cofinity Commercial |
$1,870.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,396.20
|
| Rate for Payer: Healthscope Commercial |
$2,582.97
|
| Rate for Payer: Healthscope Commercial |
$2,233.92
|
| Rate for Payer: Mclaren Medicaid |
$895.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,466.01
|
| Rate for Payer: Meridian Medicaid |
$940.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,535.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,685.15
|
| Rate for Payer: Nomi Health Commercial |
$1,675.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,464.50
|
| Rate for Payer: PACE SWMI |
$1,396.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,396.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,621.87
|
| Rate for Payer: Priority Health Medicare |
$1,396.20
|
| Rate for Payer: Priority Health SBD |
$2,621.87
|
| Rate for Payer: Priority Health Tiered Network |
$2,621.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,396.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,626.32
|
| Rate for Payer: UHC Core |
$2,626.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,396.20
|
| Rate for Payer: UHC Exchange |
$2,626.32
|
| Rate for Payer: UHC Medicaid |
$895.88
|
| Rate for Payer: UHCCP Medicaid |
$895.88
|
|
