|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$125.60 |
| Max. Negotiated Rate |
$266.79 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.56
|
| Rate for Payer: BCBS Complete |
$125.60
|
| Rate for Payer: BCBS MAPPO |
$133.72
|
| Rate for Payer: BCN Commercial |
$221.60
|
| Rate for Payer: BCN Medicare Advantage |
$133.72
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Cofinity Commercial |
$179.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.72
|
| Rate for Payer: Healthscope Commercial |
$247.38
|
| Rate for Payer: Healthscope Commercial |
$213.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.91
|
| Rate for Payer: Nomi Health Commercial |
$160.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$133.72
|
| Rate for Payer: PHP Medicare Advantage |
$133.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.68
|
| Rate for Payer: Priority Health Medicare |
$133.72
|
| Rate for Payer: Priority Health SBD |
$208.68
|
| Rate for Payer: Priority Health Tiered Network |
$208.68
|
| Rate for Payer: Railroad Medicare Medicare |
$133.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.79
|
| Rate for Payer: UHC Core |
$266.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.72
|
| Rate for Payer: UHC Exchange |
$266.79
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$1,280.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$960.00 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna Medicare |
$132.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.54
|
| Rate for Payer: BCBS Complete |
$84.77
|
| Rate for Payer: BCBS MAPPO |
$127.46
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$127.46
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cofinity Commercial |
$183.54
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.46
|
| Rate for Payer: Healthscope Commercial |
$235.80
|
| Rate for Payer: Healthscope Commercial |
$203.94
|
| Rate for Payer: Mclaren Medicaid |
$80.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.83
|
| Rate for Payer: Meridian Medicaid |
$84.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.70
|
| Rate for Payer: Nomi Health Commercial |
$152.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.00
|
| Rate for Payer: PACE SWMI |
$127.46
|
| Rate for Payer: PHP Medicare Advantage |
$127.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$127.46
|
| Rate for Payer: Priority Health SBD |
$254.85
|
| Rate for Payer: Priority Health Tiered Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$127.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.71
|
| Rate for Payer: UHC Core |
$255.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.46
|
| Rate for Payer: UHC Exchange |
$255.71
|
| Rate for Payer: UHC Medicaid |
$80.73
|
| Rate for Payer: UHCCP Medicaid |
$80.73
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Medicare |
$148.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.05
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Healthscope Commercial |
$264.72
|
| Rate for Payer: Healthscope Commercial |
$228.94
|
| Rate for Payer: Mclaren Medicaid |
$91.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.34
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$465.00
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$216.19
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health SBD |
$216.19
|
| Rate for Payer: Priority Health Tiered Network |
$216.19
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.03
|
| Rate for Payer: UHC Core |
$281.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Exchange |
$281.03
|
| Rate for Payer: UHC Medicaid |
$91.16
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,703.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$681.20 |
| Max. Negotiated Rate |
$1,627.69 |
| Rate for Payer: Aetna Commercial |
$1,066.32
|
| Rate for Payer: Aetna Medicare |
$827.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.89
|
| Rate for Payer: BCBS Complete |
$681.20
|
| Rate for Payer: BCBS MAPPO |
$795.76
|
| Rate for Payer: BCN Commercial |
$1,362.98
|
| Rate for Payer: BCN Medicare Advantage |
$795.76
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,145.89
|
| Rate for Payer: Cofinity Commercial |
$1,066.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.76
|
| Rate for Payer: Healthscope Commercial |
$1,472.16
|
| Rate for Payer: Healthscope Commercial |
$1,273.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$875.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,627.69
|
| Rate for Payer: Nomi Health Commercial |
$954.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,277.25
|
| Rate for Payer: PACE SWMI |
$795.76
|
| Rate for Payer: PHP Medicare Advantage |
$795.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,380.39
|
| Rate for Payer: Priority Health Medicare |
$795.76
|
| Rate for Payer: Priority Health SBD |
$1,380.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,380.39
|
| Rate for Payer: Railroad Medicare Medicare |
$795.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,611.05
|
| Rate for Payer: UHC Core |
$1,611.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$795.76
|
| Rate for Payer: UHC Exchange |
$1,611.05
|
|
|
PR TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA
|
Professional
|
Both
|
$4,027.00
|
|
|
Service Code
|
HCPCS 61108
|
| Min. Negotiated Rate |
$592.35 |
| Max. Negotiated Rate |
$3,020.25 |
| Rate for Payer: Aetna Commercial |
$1,224.88
|
| Rate for Payer: Aetna Medicare |
$950.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,224.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,316.29
|
| Rate for Payer: BCBS Complete |
$621.97
|
| Rate for Payer: BCBS MAPPO |
$914.09
|
| Rate for Payer: BCN Commercial |
$1,920.82
|
| Rate for Payer: BCN Medicare Advantage |
$914.09
|
| Rate for Payer: Cash Price |
$3,221.60
|
| Rate for Payer: Cash Price |
$3,221.60
|
| Rate for Payer: Cofinity Commercial |
$1,316.29
|
| Rate for Payer: Cofinity Commercial |
$1,224.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.09
|
| Rate for Payer: Healthscope Commercial |
$1,691.07
|
| Rate for Payer: Healthscope Commercial |
$1,462.54
|
| Rate for Payer: Mclaren Medicaid |
$592.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$959.79
|
| Rate for Payer: Meridian Medicaid |
$621.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,005.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,635.44
|
| Rate for Payer: Nomi Health Commercial |
$1,096.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,020.25
|
| Rate for Payer: PACE SWMI |
$914.09
|
| Rate for Payer: PHP Medicare Advantage |
$914.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.87
|
| Rate for Payer: Priority Health Medicare |
$914.09
|
| Rate for Payer: Priority Health SBD |
$1,614.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.87
|
| Rate for Payer: Railroad Medicare Medicare |
$914.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.64
|
| Rate for Payer: UHC Core |
$1,567.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$914.09
|
| Rate for Payer: UHC Exchange |
$1,567.64
|
| Rate for Payer: UHC Medicaid |
$592.35
|
| Rate for Payer: UHCCP Medicaid |
$592.35
|
|
|
PR TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Professional
|
Both
|
$2,553.00
|
|
|
Service Code
|
HCPCS 61107
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,914.75 |
| Rate for Payer: Aetna Commercial |
$390.52
|
| Rate for Payer: Aetna Medicare |
$303.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.66
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$291.43
|
| Rate for Payer: BCN Commercial |
$649.45
|
| Rate for Payer: BCN Medicare Advantage |
$291.43
|
| Rate for Payer: Cash Price |
$2,042.40
|
| Rate for Payer: Cash Price |
$2,042.40
|
| Rate for Payer: Cofinity Commercial |
$419.66
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.43
|
| Rate for Payer: Healthscope Commercial |
$539.15
|
| Rate for Payer: Healthscope Commercial |
$466.29
|
| Rate for Payer: Mclaren Medicaid |
$183.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.00
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$320.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.48
|
| Rate for Payer: Nomi Health Commercial |
$349.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.75
|
| Rate for Payer: PACE SWMI |
$291.43
|
| Rate for Payer: PHP Medicare Advantage |
$291.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$546.00
|
| Rate for Payer: Priority Health Medicare |
$291.43
|
| Rate for Payer: Priority Health SBD |
$546.00
|
| Rate for Payer: Priority Health Tiered Network |
$546.00
|
| Rate for Payer: Railroad Medicare Medicare |
$291.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.84
|
| Rate for Payer: UHC Core |
$557.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$291.43
|
| Rate for Payer: UHC Exchange |
$557.84
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
PR TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 61105
|
| Min. Negotiated Rate |
$317.80 |
| Max. Negotiated Rate |
$1,659.75 |
| Rate for Payer: Aetna Commercial |
$651.91
|
| Rate for Payer: Aetna Medicare |
$505.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.56
|
| Rate for Payer: BCBS Complete |
$333.69
|
| Rate for Payer: BCBS MAPPO |
$486.50
|
| Rate for Payer: BCN Commercial |
$992.05
|
| Rate for Payer: BCN Medicare Advantage |
$486.50
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$700.56
|
| Rate for Payer: Cofinity Commercial |
$651.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.50
|
| Rate for Payer: Healthscope Commercial |
$900.02
|
| Rate for Payer: Healthscope Commercial |
$778.40
|
| Rate for Payer: Mclaren Medicaid |
$317.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.82
|
| Rate for Payer: Meridian Medicaid |
$333.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$535.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.66
|
| Rate for Payer: Nomi Health Commercial |
$583.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,659.75
|
| Rate for Payer: PACE SWMI |
$486.50
|
| Rate for Payer: PHP Medicare Advantage |
$486.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$834.05
|
| Rate for Payer: Priority Health Medicare |
$486.50
|
| Rate for Payer: Priority Health SBD |
$834.05
|
| Rate for Payer: Priority Health Tiered Network |
$834.05
|
| Rate for Payer: Railroad Medicare Medicare |
$486.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.90
|
| Rate for Payer: UHC Core |
$800.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$486.50
|
| Rate for Payer: UHC Exchange |
$800.90
|
| Rate for Payer: UHC Medicaid |
$317.80
|
| Rate for Payer: UHCCP Medicaid |
$317.80
|
|
|
PR TWO AREA LIPOSUCTION - 2 AREA 2.0 HR
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$1,509.00
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$1,131.75 |
| Rate for Payer: Aetna Commercial |
$625.95
|
| Rate for Payer: Aetna Medicare |
$485.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.67
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$467.13
|
| Rate for Payer: BCN Commercial |
$730.53
|
| Rate for Payer: BCN Medicare Advantage |
$467.13
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Cofinity Commercial |
$672.67
|
| Rate for Payer: Cofinity Commercial |
$625.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.13
|
| Rate for Payer: Healthscope Commercial |
$747.41
|
| Rate for Payer: Healthscope Commercial |
$864.19
|
| Rate for Payer: Mclaren Medicaid |
$307.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.49
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.83
|
| Rate for Payer: Nomi Health Commercial |
$560.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.75
|
| Rate for Payer: PACE SWMI |
$467.13
|
| Rate for Payer: PHP Medicare Advantage |
$467.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$890.11
|
| Rate for Payer: Priority Health Medicare |
$467.13
|
| Rate for Payer: Priority Health SBD |
$890.11
|
| Rate for Payer: Priority Health Tiered Network |
$890.11
|
| Rate for Payer: Railroad Medicare Medicare |
$467.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.51
|
| Rate for Payer: UHC Core |
$827.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.13
|
| Rate for Payer: UHC Exchange |
$827.51
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
|
|
PR TX ECTOPIC PREGNANCY ABDL PREGNANCY
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 59130
|
| Min. Negotiated Rate |
$543.58 |
| Max. Negotiated Rate |
$1,715.96 |
| Rate for Payer: Aetna Commercial |
$1,145.70
|
| Rate for Payer: Aetna Medicare |
$889.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.20
|
| Rate for Payer: BCBS Complete |
$570.76
|
| Rate for Payer: BCBS MAPPO |
$855.00
|
| Rate for Payer: BCN Commercial |
$1,426.22
|
| Rate for Payer: BCN Medicare Advantage |
$855.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.20
|
| Rate for Payer: Cofinity Commercial |
$1,145.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.00
|
| Rate for Payer: Healthscope Commercial |
$1,581.75
|
| Rate for Payer: Healthscope Commercial |
$1,368.00
|
| Rate for Payer: Mclaren Medicaid |
$543.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.75
|
| Rate for Payer: Meridian Medicaid |
$570.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$940.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,715.96
|
| Rate for Payer: Nomi Health Commercial |
$1,026.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,162.50
|
| Rate for Payer: PACE SWMI |
$855.00
|
| Rate for Payer: PHP Medicare Advantage |
$855.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$543.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.35
|
| Rate for Payer: Priority Health Medicare |
$855.00
|
| Rate for Payer: Priority Health SBD |
$1,346.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.35
|
| Rate for Payer: Railroad Medicare Medicare |
$855.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.64
|
| Rate for Payer: UHC Core |
$1,675.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.00
|
| Rate for Payer: UHC Exchange |
$1,675.64
|
| Rate for Payer: UHC Medicaid |
$543.58
|
| Rate for Payer: UHCCP Medicaid |
$543.58
|
|
|
PR TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 59120
|
| Min. Negotiated Rate |
$468.60 |
| Max. Negotiated Rate |
$1,474.92 |
| Rate for Payer: Aetna Commercial |
$985.28
|
| Rate for Payer: Aetna Medicare |
$764.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.28
|
| Rate for Payer: BCBS Complete |
$492.03
|
| Rate for Payer: BCBS MAPPO |
$735.28
|
| Rate for Payer: BCN Commercial |
$1,229.02
|
| Rate for Payer: BCN Medicare Advantage |
$735.28
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$985.28
|
| Rate for Payer: Cofinity Commercial |
$1,058.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.28
|
| Rate for Payer: Healthscope Commercial |
$1,360.27
|
| Rate for Payer: Healthscope Commercial |
$1,176.45
|
| Rate for Payer: Mclaren Medicaid |
$468.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.04
|
| Rate for Payer: Meridian Medicaid |
$492.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$808.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.92
|
| Rate for Payer: Nomi Health Commercial |
$882.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: PACE SWMI |
$735.28
|
| Rate for Payer: PHP Medicare Advantage |
$735.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,160.19
|
| Rate for Payer: Priority Health Medicare |
$735.28
|
| Rate for Payer: Priority Health SBD |
$1,160.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,160.19
|
| Rate for Payer: Railroad Medicare Medicare |
$735.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,435.73
|
| Rate for Payer: UHC Core |
$1,435.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$735.28
|
| Rate for Payer: UHC Exchange |
$1,435.73
|
| Rate for Payer: UHC Medicaid |
$468.60
|
| Rate for Payer: UHCCP Medicaid |
$468.60
|
|
|
PR TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 59136
|
| Min. Negotiated Rate |
$515.25 |
| Max. Negotiated Rate |
$1,626.59 |
| Rate for Payer: Aetna Commercial |
$1,085.68
|
| Rate for Payer: Aetna Medicare |
$842.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.70
|
| Rate for Payer: BCBS Complete |
$541.01
|
| Rate for Payer: BCBS MAPPO |
$810.21
|
| Rate for Payer: BCN Commercial |
$1,354.01
|
| Rate for Payer: BCN Medicare Advantage |
$810.21
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$1,166.70
|
| Rate for Payer: Cofinity Commercial |
$1,085.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.21
|
| Rate for Payer: Healthscope Commercial |
$1,498.89
|
| Rate for Payer: Healthscope Commercial |
$1,296.34
|
| Rate for Payer: Mclaren Medicaid |
$515.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.72
|
| Rate for Payer: Meridian Medicaid |
$541.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$891.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,626.59
|
| Rate for Payer: Nomi Health Commercial |
$972.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,404.00
|
| Rate for Payer: PACE SWMI |
$810.21
|
| Rate for Payer: PHP Medicare Advantage |
$810.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,278.19
|
| Rate for Payer: Priority Health Medicare |
$810.21
|
| Rate for Payer: Priority Health SBD |
$1,278.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,278.19
|
| Rate for Payer: Railroad Medicare Medicare |
$810.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.46
|
| Rate for Payer: UHC Core |
$1,588.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$810.21
|
| Rate for Payer: UHC Exchange |
$1,588.46
|
| Rate for Payer: UHC Medicaid |
$515.25
|
| Rate for Payer: UHCCP Medicaid |
$515.25
|
|
|
PR TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,511.00
|
|
|
Service Code
|
HCPCS 59121
|
| Min. Negotiated Rate |
$468.81 |
| Max. Negotiated Rate |
$1,475.30 |
| Rate for Payer: Aetna Commercial |
$986.24
|
| Rate for Payer: Aetna Medicare |
$765.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.24
|
| Rate for Payer: BCBS Complete |
$492.25
|
| Rate for Payer: BCBS MAPPO |
$736.00
|
| Rate for Payer: BCN Commercial |
$1,229.52
|
| Rate for Payer: BCN Medicare Advantage |
$736.00
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cofinity Commercial |
$986.24
|
| Rate for Payer: Cofinity Commercial |
$1,059.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.00
|
| Rate for Payer: Healthscope Commercial |
$1,361.60
|
| Rate for Payer: Healthscope Commercial |
$1,177.60
|
| Rate for Payer: Mclaren Medicaid |
$468.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.80
|
| Rate for Payer: Meridian Medicaid |
$492.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$809.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,475.30
|
| Rate for Payer: Nomi Health Commercial |
$883.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,133.25
|
| Rate for Payer: PACE SWMI |
$736.00
|
| Rate for Payer: PHP Medicare Advantage |
$736.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,160.67
|
| Rate for Payer: Priority Health Medicare |
$736.00
|
| Rate for Payer: Priority Health SBD |
$1,160.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,160.67
|
| Rate for Payer: Railroad Medicare Medicare |
$736.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,437.94
|
| Rate for Payer: UHC Core |
$1,437.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.00
|
| Rate for Payer: UHC Exchange |
$1,437.94
|
| Rate for Payer: UHC Medicaid |
$468.81
|
| Rate for Payer: UHCCP Medicaid |
$468.81
|
|
|
PR TX HUMRL SHFT FX W/INSJ IMED IMPLT W/WO CERCLAGE
|
Professional
|
Both
|
$3,619.00
|
|
|
Service Code
|
HCPCS 24516
|
| Min. Negotiated Rate |
$508.64 |
| Max. Negotiated Rate |
$2,714.25 |
| Rate for Payer: Aetna Commercial |
$1,046.29
|
| Rate for Payer: Aetna Medicare |
$812.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.37
|
| Rate for Payer: BCBS Complete |
$534.07
|
| Rate for Payer: BCBS MAPPO |
$780.81
|
| Rate for Payer: BCN Commercial |
$1,306.20
|
| Rate for Payer: BCN Medicare Advantage |
$780.81
|
| Rate for Payer: Cash Price |
$2,895.20
|
| Rate for Payer: Cash Price |
$2,895.20
|
| Rate for Payer: Cofinity Commercial |
$1,124.37
|
| Rate for Payer: Cofinity Commercial |
$1,046.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.81
|
| Rate for Payer: Healthscope Commercial |
$1,444.50
|
| Rate for Payer: Healthscope Commercial |
$1,249.30
|
| Rate for Payer: Mclaren Medicaid |
$508.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.85
|
| Rate for Payer: Meridian Medicaid |
$534.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$858.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.98
|
| Rate for Payer: Nomi Health Commercial |
$936.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,714.25
|
| Rate for Payer: PACE SWMI |
$780.81
|
| Rate for Payer: PHP Medicare Advantage |
$780.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,396.30
|
| Rate for Payer: Priority Health Medicare |
$780.81
|
| Rate for Payer: Priority Health SBD |
$1,396.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,396.30
|
| Rate for Payer: Railroad Medicare Medicare |
$780.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,502.52
|
| Rate for Payer: UHC Core |
$1,502.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$780.81
|
| Rate for Payer: UHC Exchange |
$1,502.52
|
| Rate for Payer: UHC Medicaid |
$508.64
|
| Rate for Payer: UHCCP Medicaid |
$508.64
|
|
|
PR TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 59812
|
| Min. Negotiated Rate |
$178.28 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$372.13
|
| Rate for Payer: Aetna Medicare |
$288.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.90
|
| Rate for Payer: BCBS Complete |
$187.19
|
| Rate for Payer: BCBS MAPPO |
$277.71
|
| Rate for Payer: BCN Commercial |
$464.62
|
| Rate for Payer: BCN Medicare Advantage |
$277.71
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$399.90
|
| Rate for Payer: Cofinity Commercial |
$372.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.71
|
| Rate for Payer: Healthscope Commercial |
$513.76
|
| Rate for Payer: Healthscope Commercial |
$444.34
|
| Rate for Payer: Mclaren Medicaid |
$178.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.60
|
| Rate for Payer: Meridian Medicaid |
$187.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.31
|
| Rate for Payer: Nomi Health Commercial |
$333.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$277.71
|
| Rate for Payer: PHP Medicare Advantage |
$277.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$438.60
|
| Rate for Payer: Priority Health Medicare |
$277.71
|
| Rate for Payer: Priority Health SBD |
$438.60
|
| Rate for Payer: Priority Health Tiered Network |
$438.60
|
| Rate for Payer: Railroad Medicare Medicare |
$277.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.19
|
| Rate for Payer: UHC Core |
$535.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$277.71
|
| Rate for Payer: UHC Exchange |
$535.19
|
| Rate for Payer: UHC Medicaid |
$178.28
|
| Rate for Payer: UHCCP Medicaid |
$178.28
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
|
Professional
|
Both
|
$4,229.00
|
|
|
Service Code
|
HCPCS 27245
|
| Min. Negotiated Rate |
$713.12 |
| Max. Negotiated Rate |
$3,171.75 |
| Rate for Payer: Aetna Commercial |
$1,473.01
|
| Rate for Payer: Aetna Medicare |
$1,143.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.93
|
| Rate for Payer: BCBS Complete |
$748.78
|
| Rate for Payer: BCBS MAPPO |
$1,099.26
|
| Rate for Payer: BCN Commercial |
$1,854.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.26
|
| Rate for Payer: Cash Price |
$3,383.20
|
| Rate for Payer: Cash Price |
$3,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,582.93
|
| Rate for Payer: Cofinity Commercial |
$1,473.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.26
|
| Rate for Payer: Healthscope Commercial |
$2,033.63
|
| Rate for Payer: Healthscope Commercial |
$1,758.82
|
| Rate for Payer: Mclaren Medicaid |
$713.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.22
|
| Rate for Payer: Meridian Medicaid |
$748.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,209.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,173.72
|
| Rate for Payer: Nomi Health Commercial |
$1,319.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,171.75
|
| Rate for Payer: PACE SWMI |
$1,099.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,982.93
|
| Rate for Payer: Priority Health Medicare |
$1,099.26
|
| Rate for Payer: Priority Health SBD |
$1,982.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,982.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,099.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,155.53
|
| Rate for Payer: UHC Core |
$2,155.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,099.26
|
| Rate for Payer: UHC Exchange |
$2,155.53
|
| Rate for Payer: UHC Medicaid |
$713.12
|
| Rate for Payer: UHCCP Medicaid |
$713.12
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT
|
Professional
|
Both
|
$3,575.00
|
|
|
Service Code
|
HCPCS 27244
|
| Min. Negotiated Rate |
$715.04 |
| Max. Negotiated Rate |
$2,681.25 |
| Rate for Payer: Aetna Commercial |
$1,477.07
|
| Rate for Payer: Aetna Medicare |
$1,146.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.30
|
| Rate for Payer: BCBS Complete |
$750.79
|
| Rate for Payer: BCBS MAPPO |
$1,102.29
|
| Rate for Payer: BCN Commercial |
$2,040.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,102.29
|
| Rate for Payer: Cash Price |
$2,860.00
|
| Rate for Payer: Cash Price |
$2,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,587.30
|
| Rate for Payer: Cofinity Commercial |
$1,477.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,102.29
|
| Rate for Payer: Healthscope Commercial |
$2,039.24
|
| Rate for Payer: Healthscope Commercial |
$1,763.66
|
| Rate for Payer: Mclaren Medicaid |
$715.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,157.40
|
| Rate for Payer: Meridian Medicaid |
$750.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,212.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.25
|
| Rate for Payer: Nomi Health Commercial |
$1,322.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,681.25
|
| Rate for Payer: PACE SWMI |
$1,102.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,102.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,985.58
|
| Rate for Payer: Priority Health Medicare |
$1,102.29
|
| Rate for Payer: Priority Health SBD |
$1,985.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,985.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,102.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,157.98
|
| Rate for Payer: UHC Core |
$2,157.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,102.29
|
| Rate for Payer: UHC Exchange |
$2,157.98
|
| Rate for Payer: UHC Medicaid |
$715.04
|
| Rate for Payer: UHCCP Medicaid |
$715.04
|
|
|
PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 59820
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$689.26 |
| Rate for Payer: Aetna Commercial |
$462.77
|
| Rate for Payer: Aetna Medicare |
$359.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.30
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$345.35
|
| Rate for Payer: BCN Commercial |
$584.13
|
| Rate for Payer: BCN Medicare Advantage |
$345.35
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$497.30
|
| Rate for Payer: Cofinity Commercial |
$462.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.35
|
| Rate for Payer: Healthscope Commercial |
$638.90
|
| Rate for Payer: Healthscope Commercial |
$552.56
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.62
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.26
|
| Rate for Payer: Nomi Health Commercial |
$414.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$630.00
|
| Rate for Payer: PACE SWMI |
$345.35
|
| Rate for Payer: PHP Medicare Advantage |
$345.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$551.42
|
| Rate for Payer: Priority Health Medicare |
$345.35
|
| Rate for Payer: Priority Health SBD |
$551.42
|
| Rate for Payer: Priority Health Tiered Network |
$551.42
|
| Rate for Payer: Railroad Medicare Medicare |
$345.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.06
|
| Rate for Payer: UHC Core |
$651.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$345.35
|
| Rate for Payer: UHC Exchange |
$651.06
|
| Rate for Payer: UHC Medicaid |
$224.08
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
|
|
PR TX MISSED ABORTION SECOND TRIMESTER SURGICAL
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 59821
|
| Min. Negotiated Rate |
$219.39 |
| Max. Negotiated Rate |
$677.07 |
| Rate for Payer: Aetna Commercial |
$455.57
|
| Rate for Payer: Aetna Medicare |
$353.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.57
|
| Rate for Payer: BCBS Complete |
$230.36
|
| Rate for Payer: BCBS MAPPO |
$339.98
|
| Rate for Payer: BCN Commercial |
$570.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.98
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$489.57
|
| Rate for Payer: Cofinity Commercial |
$455.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.98
|
| Rate for Payer: Healthscope Commercial |
$628.96
|
| Rate for Payer: Healthscope Commercial |
$543.97
|
| Rate for Payer: Mclaren Medicaid |
$219.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.98
|
| Rate for Payer: Meridian Medicaid |
$230.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$373.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$677.07
|
| Rate for Payer: Nomi Health Commercial |
$407.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$630.00
|
| Rate for Payer: PACE SWMI |
$339.98
|
| Rate for Payer: PHP Medicare Advantage |
$339.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$538.73
|
| Rate for Payer: Priority Health Medicare |
$339.98
|
| Rate for Payer: Priority Health SBD |
$538.73
|
| Rate for Payer: Priority Health Tiered Network |
$538.73
|
| Rate for Payer: Railroad Medicare Medicare |
$339.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.11
|
| Rate for Payer: UHC Core |
$647.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$339.98
|
| Rate for Payer: UHC Exchange |
$647.11
|
| Rate for Payer: UHC Medicaid |
$219.39
|
| Rate for Payer: UHCCP Medicaid |
$219.39
|
|
|
PR TX OPEN TENDON FLEXOR TOE 1 TENDON SPX
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 28232
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$490.50 |
| Rate for Payer: Aetna Commercial |
$299.38
|
| Rate for Payer: Aetna Medicare |
$232.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.72
|
| Rate for Payer: BCBS Complete |
$154.77
|
| Rate for Payer: BCBS MAPPO |
$223.42
|
| Rate for Payer: BCN Commercial |
$366.51
|
| Rate for Payer: BCN Medicare Advantage |
$223.42
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$321.72
|
| Rate for Payer: Cofinity Commercial |
$299.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.42
|
| Rate for Payer: Healthscope Commercial |
$413.33
|
| Rate for Payer: Healthscope Commercial |
$357.47
|
| Rate for Payer: Mclaren Medicaid |
$147.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.59
|
| Rate for Payer: Meridian Medicaid |
$154.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$245.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.94
|
| Rate for Payer: Nomi Health Commercial |
$268.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.50
|
| Rate for Payer: PACE SWMI |
$223.42
|
| Rate for Payer: PHP Medicare Advantage |
$223.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$391.79
|
| Rate for Payer: Priority Health Medicare |
$223.42
|
| Rate for Payer: Priority Health SBD |
$391.79
|
| Rate for Payer: Priority Health Tiered Network |
$391.79
|
| Rate for Payer: Railroad Medicare Medicare |
$223.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.76
|
| Rate for Payer: UHC Core |
$419.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.42
|
| Rate for Payer: UHC Exchange |
$419.76
|
| Rate for Payer: UHC Medicaid |
$147.40
|
| Rate for Payer: UHCCP Medicaid |
$147.40
|
|
|
PR TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX
|
Professional
|
Both
|
$640.00
|
|
|
Service Code
|
HCPCS 28230
|
| Min. Negotiated Rate |
$172.10 |
| Max. Negotiated Rate |
$500.22 |
| Rate for Payer: Aetna Commercial |
$350.88
|
| Rate for Payer: Aetna Medicare |
$272.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.06
|
| Rate for Payer: BCBS Complete |
$180.71
|
| Rate for Payer: BCBS MAPPO |
$261.85
|
| Rate for Payer: BCN Commercial |
$434.74
|
| Rate for Payer: BCN Medicare Advantage |
$261.85
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cash Price |
$512.00
|
| Rate for Payer: Cofinity Commercial |
$377.06
|
| Rate for Payer: Cofinity Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.85
|
| Rate for Payer: Healthscope Commercial |
$484.42
|
| Rate for Payer: Healthscope Commercial |
$418.96
|
| Rate for Payer: Mclaren Medicaid |
$172.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$274.94
|
| Rate for Payer: Meridian Medicaid |
$180.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$288.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$500.22
|
| Rate for Payer: Nomi Health Commercial |
$314.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.00
|
| Rate for Payer: PACE SWMI |
$261.85
|
| Rate for Payer: PHP Medicare Advantage |
$261.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$464.71
|
| Rate for Payer: Priority Health Medicare |
$261.85
|
| Rate for Payer: Priority Health SBD |
$464.71
|
| Rate for Payer: Priority Health Tiered Network |
$464.71
|
| Rate for Payer: Railroad Medicare Medicare |
$261.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.30
|
| Rate for Payer: UHC Core |
$494.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$261.85
|
| Rate for Payer: UHC Exchange |
$494.30
|
| Rate for Payer: UHC Medicaid |
$172.10
|
| Rate for Payer: UHCCP Medicaid |
$172.10
|
|
|
PR TX SEPTIC ABORTION SURGICAL
|
Professional
|
Both
|
$1,030.00
|
|
|
Service Code
|
HCPCS 59830
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$835.22 |
| Rate for Payer: Aetna Commercial |
$557.79
|
| Rate for Payer: Aetna Medicare |
$432.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.41
|
| Rate for Payer: BCBS Complete |
$280.69
|
| Rate for Payer: BCBS MAPPO |
$416.26
|
| Rate for Payer: BCN Commercial |
$698.67
|
| Rate for Payer: BCN Medicare Advantage |
$416.26
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cofinity Commercial |
$599.41
|
| Rate for Payer: Cofinity Commercial |
$557.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.26
|
| Rate for Payer: Healthscope Commercial |
$770.08
|
| Rate for Payer: Healthscope Commercial |
$666.02
|
| Rate for Payer: Mclaren Medicaid |
$267.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.07
|
| Rate for Payer: Meridian Medicaid |
$280.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$835.22
|
| Rate for Payer: Nomi Health Commercial |
$499.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$772.50
|
| Rate for Payer: PACE SWMI |
$416.26
|
| Rate for Payer: PHP Medicare Advantage |
$416.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$659.54
|
| Rate for Payer: Priority Health Medicare |
$416.26
|
| Rate for Payer: Priority Health SBD |
$659.54
|
| Rate for Payer: Priority Health Tiered Network |
$659.54
|
| Rate for Payer: Railroad Medicare Medicare |
$416.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.57
|
| Rate for Payer: UHC Core |
$798.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.26
|
| Rate for Payer: UHC Exchange |
$798.57
|
| Rate for Payer: UHC Medicaid |
$267.32
|
| Rate for Payer: UHCCP Medicaid |
$267.32
|
|
|
PR TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU
|
Professional
|
Both
|
$6,649.00
|
|
|
Service Code
|
HCPCS 27176
|
| Min. Negotiated Rate |
$546.35 |
| Max. Negotiated Rate |
$4,986.75 |
| Rate for Payer: Aetna Commercial |
$1,123.12
|
| Rate for Payer: Aetna Medicare |
$871.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.94
|
| Rate for Payer: BCBS Complete |
$573.67
|
| Rate for Payer: BCBS MAPPO |
$838.15
|
| Rate for Payer: BCN Commercial |
$1,403.31
|
| Rate for Payer: BCN Medicare Advantage |
$838.15
|
| Rate for Payer: Cash Price |
$5,319.20
|
| Rate for Payer: Cash Price |
$5,319.20
|
| Rate for Payer: Cofinity Commercial |
$1,206.94
|
| Rate for Payer: Cofinity Commercial |
$1,123.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.15
|
| Rate for Payer: Healthscope Commercial |
$1,550.58
|
| Rate for Payer: Healthscope Commercial |
$1,341.04
|
| Rate for Payer: Mclaren Medicaid |
$546.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.06
|
| Rate for Payer: Meridian Medicaid |
$573.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$921.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.32
|
| Rate for Payer: Nomi Health Commercial |
$1,005.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,986.75
|
| Rate for Payer: PACE SWMI |
$838.15
|
| Rate for Payer: PHP Medicare Advantage |
$838.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,500.09
|
| Rate for Payer: Priority Health Medicare |
$838.15
|
| Rate for Payer: Priority Health SBD |
$1,500.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,500.09
|
| Rate for Payer: Railroad Medicare Medicare |
$838.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.13
|
| Rate for Payer: UHC Core |
$1,609.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$838.15
|
| Rate for Payer: UHC Exchange |
$1,609.13
|
| Rate for Payer: UHC Medicaid |
$546.35
|
| Rate for Payer: UHCCP Medicaid |
$546.35
|
|
|
PR TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 27257
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$674.25 |
| Rate for Payer: Aetna Commercial |
$434.59
|
| Rate for Payer: Aetna Medicare |
$337.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.02
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$324.32
|
| Rate for Payer: BCN Commercial |
$547.78
|
| Rate for Payer: BCN Medicare Advantage |
$324.32
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cofinity Commercial |
$467.02
|
| Rate for Payer: Cofinity Commercial |
$434.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.32
|
| Rate for Payer: Healthscope Commercial |
$599.99
|
| Rate for Payer: Healthscope Commercial |
$518.91
|
| Rate for Payer: Mclaren Medicaid |
$210.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.54
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$356.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.32
|
| Rate for Payer: Nomi Health Commercial |
$389.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$674.25
|
| Rate for Payer: PACE SWMI |
$324.32
|
| Rate for Payer: PHP Medicare Advantage |
$324.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$585.56
|
| Rate for Payer: Priority Health Medicare |
$324.32
|
| Rate for Payer: Priority Health SBD |
$585.56
|
| Rate for Payer: Priority Health Tiered Network |
$585.56
|
| Rate for Payer: Railroad Medicare Medicare |
$324.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.13
|
| Rate for Payer: UHC Core |
$634.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$324.32
|
| Rate for Payer: UHC Exchange |
$634.13
|
| Rate for Payer: UHC Medicaid |
$210.23
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
HCPCS 12020
|
| Hospital Charge Code |
12020
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$363.00 |
| Rate for Payer: Aetna Commercial |
$232.91
|
| Rate for Payer: Aetna Medicare |
$180.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.29
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCBS MAPPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$284.85
|
| Rate for Payer: BCN Medicare Advantage |
$173.81
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cofinity Commercial |
$250.29
|
| Rate for Payer: Cofinity Commercial |
$232.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.81
|
| Rate for Payer: Healthscope Commercial |
$321.55
|
| Rate for Payer: Healthscope Commercial |
$278.10
|
| Rate for Payer: Mclaren Medicaid |
$113.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.50
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.11
|
| Rate for Payer: Nomi Health Commercial |
$208.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.00
|
| Rate for Payer: PACE SWMI |
$173.81
|
| Rate for Payer: PHP Medicare Advantage |
$173.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$260.70
|
| Rate for Payer: Priority Health Medicare |
$173.81
|
| Rate for Payer: Priority Health SBD |
$260.70
|
| Rate for Payer: Priority Health Tiered Network |
$260.70
|
| Rate for Payer: Railroad Medicare Medicare |
$173.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.51
|
| Rate for Payer: UHC Core |
$328.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.81
|
| Rate for Payer: UHC Exchange |
$328.51
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
