|
PR THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR
|
Professional
|
Both
|
$3,317.00
|
|
|
Service Code
|
HCPCS 32110
|
| Min. Negotiated Rate |
$1,326.80 |
| Max. Negotiated Rate |
$2,635.86 |
| Rate for Payer: Aetna Commercial |
$1,909.22
|
| Rate for Payer: Aetna Medicare |
$1,481.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,051.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,909.22
|
| Rate for Payer: BCBS Complete |
$1,326.80
|
| Rate for Payer: BCBS MAPPO |
$1,424.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,424.79
|
| Rate for Payer: Cash Price |
$2,653.60
|
| Rate for Payer: Cash Price |
$2,653.60
|
| Rate for Payer: Cofinity Commercial |
$2,051.70
|
| Rate for Payer: Cofinity Commercial |
$1,909.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,424.79
|
| Rate for Payer: Healthscope Commercial |
$2,635.86
|
| Rate for Payer: Healthscope Commercial |
$2,279.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,496.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,156.05
|
| Rate for Payer: Nomi Health Commercial |
$1,709.75
|
| Rate for Payer: PACE SWMI |
$1,424.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,424.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,156.05
|
| Rate for Payer: Priority Health Medicare |
$1,424.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,424.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,424.79
|
|
|
PR THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 38746
|
| Min. Negotiated Rate |
$205.98 |
| Max. Negotiated Rate |
$987.35 |
| Rate for Payer: Aetna Commercial |
$276.01
|
| Rate for Payer: Aetna Medicare |
$214.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.01
|
| Rate for Payer: BCBS Complete |
$607.60
|
| Rate for Payer: BCBS MAPPO |
$205.98
|
| Rate for Payer: BCN Medicare Advantage |
$205.98
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$296.61
|
| Rate for Payer: Cofinity Commercial |
$276.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.98
|
| Rate for Payer: Healthscope Commercial |
$329.57
|
| Rate for Payer: Healthscope Commercial |
$381.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.35
|
| Rate for Payer: Nomi Health Commercial |
$247.18
|
| Rate for Payer: PACE SWMI |
$205.98
|
| Rate for Payer: PHP Medicare Advantage |
$205.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$987.35
|
| Rate for Payer: Priority Health Medicare |
$205.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.98
|
| Rate for Payer: UHC Medicare Advantage |
$205.98
|
|
|
PR THORCOM W/REMOVAL OF CYST
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 32140
|
| Min. Negotiated Rate |
$942.40 |
| Max. Negotiated Rate |
$1,764.33 |
| Rate for Payer: Aetna Commercial |
$1,277.94
|
| Rate for Payer: Aetna Medicare |
$991.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.94
|
| Rate for Payer: BCBS Complete |
$942.40
|
| Rate for Payer: BCBS MAPPO |
$953.69
|
| Rate for Payer: BCN Medicare Advantage |
$953.69
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$1,373.31
|
| Rate for Payer: Cofinity Commercial |
$1,277.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.69
|
| Rate for Payer: Healthscope Commercial |
$1,764.33
|
| Rate for Payer: Healthscope Commercial |
$1,525.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.40
|
| Rate for Payer: Nomi Health Commercial |
$1,144.43
|
| Rate for Payer: PACE SWMI |
$953.69
|
| Rate for Payer: PHP Medicare Advantage |
$953.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,531.40
|
| Rate for Payer: Priority Health Medicare |
$953.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.69
|
| Rate for Payer: UHC Medicare Advantage |
$953.69
|
|
|
PR THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP
|
Professional
|
Both
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32150
|
| Min. Negotiated Rate |
$977.42 |
| Max. Negotiated Rate |
$1,808.23 |
| Rate for Payer: Aetna Commercial |
$1,309.74
|
| Rate for Payer: Aetna Medicare |
$1,016.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.74
|
| Rate for Payer: BCBS Complete |
$1,052.80
|
| Rate for Payer: BCBS MAPPO |
$977.42
|
| Rate for Payer: BCN Medicare Advantage |
$977.42
|
| Rate for Payer: Cash Price |
$2,105.60
|
| Rate for Payer: Cash Price |
$2,105.60
|
| Rate for Payer: Cofinity Commercial |
$1,407.48
|
| Rate for Payer: Cofinity Commercial |
$1,309.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.42
|
| Rate for Payer: Healthscope Commercial |
$1,563.87
|
| Rate for Payer: Healthscope Commercial |
$1,808.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,026.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,710.80
|
| Rate for Payer: Nomi Health Commercial |
$1,172.90
|
| Rate for Payer: PACE SWMI |
$977.42
|
| Rate for Payer: PHP Medicare Advantage |
$977.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,710.80
|
| Rate for Payer: Priority Health Medicare |
$977.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.42
|
| Rate for Payer: UHC Medicare Advantage |
$977.42
|
|
|
PR THORCOM W/RMVL IPUL FB
|
Professional
|
Both
|
$2,474.00
|
|
|
Service Code
|
HCPCS 32151
|
| Min. Negotiated Rate |
$967.00 |
| Max. Negotiated Rate |
$1,788.95 |
| Rate for Payer: Aetna Commercial |
$1,295.78
|
| Rate for Payer: Aetna Medicare |
$1,005.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.78
|
| Rate for Payer: BCBS Complete |
$989.60
|
| Rate for Payer: BCBS MAPPO |
$967.00
|
| Rate for Payer: BCN Medicare Advantage |
$967.00
|
| Rate for Payer: Cash Price |
$1,979.20
|
| Rate for Payer: Cash Price |
$1,979.20
|
| Rate for Payer: Cofinity Commercial |
$1,392.48
|
| Rate for Payer: Cofinity Commercial |
$1,295.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.00
|
| Rate for Payer: Healthscope Commercial |
$1,788.95
|
| Rate for Payer: Healthscope Commercial |
$1,547.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,015.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.10
|
| Rate for Payer: Nomi Health Commercial |
$1,160.40
|
| Rate for Payer: PACE SWMI |
$967.00
|
| Rate for Payer: PHP Medicare Advantage |
$967.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,608.10
|
| Rate for Payer: Priority Health Medicare |
$967.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.00
|
| Rate for Payer: UHC Medicare Advantage |
$967.00
|
|
|
PR THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 32674
|
| Min. Negotiated Rate |
$206.36 |
| Max. Negotiated Rate |
$564.20 |
| Rate for Payer: Aetna Commercial |
$276.52
|
| Rate for Payer: Aetna Medicare |
$214.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.52
|
| Rate for Payer: BCBS Complete |
$347.20
|
| Rate for Payer: BCBS MAPPO |
$206.36
|
| Rate for Payer: BCN Medicare Advantage |
$206.36
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$297.16
|
| Rate for Payer: Cofinity Commercial |
$276.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.36
|
| Rate for Payer: Healthscope Commercial |
$330.18
|
| Rate for Payer: Healthscope Commercial |
$381.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.20
|
| Rate for Payer: Nomi Health Commercial |
$247.63
|
| Rate for Payer: PACE SWMI |
$206.36
|
| Rate for Payer: PHP Medicare Advantage |
$206.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health Medicare |
$206.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.36
|
| Rate for Payer: UHC Medicare Advantage |
$206.36
|
|
|
PR THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX
|
Professional
|
Both
|
$1,060.00
|
|
|
Service Code
|
HCPCS 32601
|
| Min. Negotiated Rate |
$295.89 |
| Max. Negotiated Rate |
$689.00 |
| Rate for Payer: Aetna Commercial |
$396.49
|
| Rate for Payer: Aetna Medicare |
$307.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.49
|
| Rate for Payer: BCBS Complete |
$424.00
|
| Rate for Payer: BCBS MAPPO |
$295.89
|
| Rate for Payer: BCN Medicare Advantage |
$295.89
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cofinity Commercial |
$426.08
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.89
|
| Rate for Payer: Healthscope Commercial |
$473.42
|
| Rate for Payer: Healthscope Commercial |
$547.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.00
|
| Rate for Payer: Nomi Health Commercial |
$355.07
|
| Rate for Payer: PACE SWMI |
$295.89
|
| Rate for Payer: PHP Medicare Advantage |
$295.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.00
|
| Rate for Payer: Priority Health Medicare |
$295.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.89
|
| Rate for Payer: UHC Medicare Advantage |
$295.89
|
|
|
PR THREE AREA LIPOSUCTION - 3 AREA 3.0 HR
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 00529
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,264.80 |
| Max. Negotiated Rate |
$2,055.30 |
| Rate for Payer: Aetna Medicare |
$1,581.00
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,055.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
|
|
PR THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL
|
Professional
|
Both
|
$2,019.00
|
|
|
Service Code
|
HCPCS 35875
|
| Min. Negotiated Rate |
$564.62 |
| Max. Negotiated Rate |
$1,312.35 |
| Rate for Payer: Aetna Commercial |
$756.59
|
| Rate for Payer: Aetna Medicare |
$587.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.05
|
| Rate for Payer: BCBS Complete |
$807.60
|
| Rate for Payer: BCBS MAPPO |
$564.62
|
| Rate for Payer: BCN Medicare Advantage |
$564.62
|
| Rate for Payer: Cash Price |
$1,615.20
|
| Rate for Payer: Cash Price |
$1,615.20
|
| Rate for Payer: Cofinity Commercial |
$756.59
|
| Rate for Payer: Cofinity Commercial |
$813.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.62
|
| Rate for Payer: Healthscope Commercial |
$1,044.55
|
| Rate for Payer: Healthscope Commercial |
$903.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.35
|
| Rate for Payer: Nomi Health Commercial |
$677.54
|
| Rate for Payer: PACE SWMI |
$564.62
|
| Rate for Payer: PHP Medicare Advantage |
$564.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.35
|
| Rate for Payer: Priority Health Medicare |
$564.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.62
|
| Rate for Payer: UHC Medicare Advantage |
$564.62
|
|
|
PR THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF
|
Professional
|
Both
|
$2,817.00
|
|
|
Service Code
|
HCPCS 35876
|
| Min. Negotiated Rate |
$902.69 |
| Max. Negotiated Rate |
$1,831.05 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| Rate for Payer: Aetna Medicare |
$938.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.60
|
| Rate for Payer: BCBS Complete |
$1,126.80
|
| Rate for Payer: BCBS MAPPO |
$902.69
|
| Rate for Payer: BCN Medicare Advantage |
$902.69
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cash Price |
$2,253.60
|
| Rate for Payer: Cofinity Commercial |
$1,299.87
|
| Rate for Payer: Cofinity Commercial |
$1,209.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.69
|
| Rate for Payer: Healthscope Commercial |
$1,669.98
|
| Rate for Payer: Healthscope Commercial |
$1,444.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,831.05
|
| Rate for Payer: Nomi Health Commercial |
$1,083.23
|
| Rate for Payer: PACE SWMI |
$902.69
|
| Rate for Payer: PHP Medicare Advantage |
$902.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,831.05
|
| Rate for Payer: Priority Health Medicare |
$902.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.69
|
| Rate for Payer: UHC Medicare Advantage |
$902.69
|
|
|
PR THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 34490
|
| Min. Negotiated Rate |
$514.00 |
| Max. Negotiated Rate |
$1,024.55 |
| Rate for Payer: Aetna Commercial |
$742.11
|
| Rate for Payer: Aetna Medicare |
$575.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.11
|
| Rate for Payer: BCBS Complete |
$514.00
|
| Rate for Payer: BCBS MAPPO |
$553.81
|
| Rate for Payer: BCN Medicare Advantage |
$553.81
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$797.49
|
| Rate for Payer: Cofinity Commercial |
$742.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.81
|
| Rate for Payer: Healthscope Commercial |
$1,024.55
|
| Rate for Payer: Healthscope Commercial |
$886.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$835.25
|
| Rate for Payer: Nomi Health Commercial |
$664.57
|
| Rate for Payer: PACE SWMI |
$553.81
|
| Rate for Payer: PHP Medicare Advantage |
$553.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.25
|
| Rate for Payer: Priority Health Medicare |
$553.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$553.81
|
| Rate for Payer: UHC Medicare Advantage |
$553.81
|
|
|
PR THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF
|
Professional
|
Both
|
$2,115.00
|
|
|
Service Code
|
HCPCS 36831
|
| Min. Negotiated Rate |
$591.41 |
| Max. Negotiated Rate |
$1,374.75 |
| Rate for Payer: Aetna Commercial |
$792.49
|
| Rate for Payer: Aetna Medicare |
$615.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.49
|
| Rate for Payer: BCBS Complete |
$846.00
|
| Rate for Payer: BCBS MAPPO |
$591.41
|
| Rate for Payer: BCN Medicare Advantage |
$591.41
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cofinity Commercial |
$851.63
|
| Rate for Payer: Cofinity Commercial |
$792.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.41
|
| Rate for Payer: Healthscope Commercial |
$1,094.11
|
| Rate for Payer: Healthscope Commercial |
$946.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,374.75
|
| Rate for Payer: Nomi Health Commercial |
$709.69
|
| Rate for Payer: PACE SWMI |
$591.41
|
| Rate for Payer: PHP Medicare Advantage |
$591.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.75
|
| Rate for Payer: Priority Health Medicare |
$591.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.41
|
| Rate for Payer: UHC Medicare Advantage |
$591.41
|
|
|
PR THROMBECTOMY,ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,910.00
|
|
|
Service Code
|
HCPCS 36870
|
| Min. Negotiated Rate |
$764.00 |
| Max. Negotiated Rate |
$1,241.50 |
| Rate for Payer: Aetna Medicare |
$955.00
|
| Rate for Payer: BCBS Complete |
$764.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,241.50
|
|
|
PR THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX
|
Professional
|
Both
|
$622.00
|
|
|
Service Code
|
HCPCS 37211
|
| Min. Negotiated Rate |
$248.80 |
| Max. Negotiated Rate |
$681.43 |
| Rate for Payer: Aetna Commercial |
$493.58
|
| Rate for Payer: Aetna Medicare |
$383.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.41
|
| Rate for Payer: BCBS Complete |
$248.80
|
| Rate for Payer: BCBS MAPPO |
$368.34
|
| Rate for Payer: BCN Medicare Advantage |
$368.34
|
| Rate for Payer: Cash Price |
$497.60
|
| Rate for Payer: Cash Price |
$497.60
|
| Rate for Payer: Cofinity Commercial |
$493.58
|
| Rate for Payer: Cofinity Commercial |
$530.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.34
|
| Rate for Payer: Healthscope Commercial |
$589.34
|
| Rate for Payer: Healthscope Commercial |
$681.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$404.30
|
| Rate for Payer: Nomi Health Commercial |
$442.01
|
| Rate for Payer: PACE SWMI |
$368.34
|
| Rate for Payer: PHP Medicare Advantage |
$368.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.30
|
| Rate for Payer: Priority Health Medicare |
$368.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.34
|
| Rate for Payer: UHC Medicare Advantage |
$368.34
|
|
|
PR THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX
|
Professional
|
Both
|
$1,091.00
|
|
|
Service Code
|
HCPCS 37213
|
| Min. Negotiated Rate |
$219.91 |
| Max. Negotiated Rate |
$709.15 |
| Rate for Payer: Aetna Commercial |
$294.68
|
| Rate for Payer: Aetna Medicare |
$228.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.68
|
| Rate for Payer: BCBS Complete |
$436.40
|
| Rate for Payer: BCBS MAPPO |
$219.91
|
| Rate for Payer: BCN Medicare Advantage |
$219.91
|
| Rate for Payer: Cash Price |
$872.80
|
| Rate for Payer: Cash Price |
$872.80
|
| Rate for Payer: Cofinity Commercial |
$316.67
|
| Rate for Payer: Cofinity Commercial |
$294.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.91
|
| Rate for Payer: Healthscope Commercial |
$351.86
|
| Rate for Payer: Healthscope Commercial |
$406.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$709.15
|
| Rate for Payer: Nomi Health Commercial |
$263.89
|
| Rate for Payer: PACE SWMI |
$219.91
|
| Rate for Payer: PHP Medicare Advantage |
$219.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.15
|
| Rate for Payer: Priority Health Medicare |
$219.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.91
|
| Rate for Payer: UHC Medicare Advantage |
$219.91
|
|
|
PR THROMBOLYSIS CEREBRAL IV INFUSION
|
Professional
|
Both
|
$1,409.00
|
|
|
Service Code
|
HCPCS 37195
|
| Min. Negotiated Rate |
$563.60 |
| Max. Negotiated Rate |
$915.85 |
| Rate for Payer: Aetna Medicare |
$704.50
|
| Rate for Payer: BCBS Complete |
$563.60
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$915.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.85
|
|
|
PR THROMBOLYSIS CORONARY INTRAVENOUS INFUSION
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 92977
|
| Min. Negotiated Rate |
$50.78 |
| Max. Negotiated Rate |
$414.70 |
| Rate for Payer: Aetna Commercial |
$68.05
|
| Rate for Payer: Aetna Medicare |
$52.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.12
|
| Rate for Payer: BCBS Complete |
$255.20
|
| Rate for Payer: BCBS MAPPO |
$50.78
|
| Rate for Payer: BCN Medicare Advantage |
$50.78
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cofinity Commercial |
$68.05
|
| Rate for Payer: Cofinity Commercial |
$73.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.78
|
| Rate for Payer: Healthscope Commercial |
$81.25
|
| Rate for Payer: Healthscope Commercial |
$93.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.70
|
| Rate for Payer: Nomi Health Commercial |
$60.94
|
| Rate for Payer: PACE SWMI |
$50.78
|
| Rate for Payer: PHP Medicare Advantage |
$50.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
| Rate for Payer: Priority Health Medicare |
$50.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.78
|
| Rate for Payer: UHC Medicare Advantage |
$50.78
|
|
|
PR THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 92975
|
| Min. Negotiated Rate |
$317.20 |
| Max. Negotiated Rate |
$661.99 |
| Rate for Payer: Aetna Commercial |
$479.49
|
| Rate for Payer: Aetna Medicare |
$372.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.49
|
| Rate for Payer: BCBS Complete |
$317.20
|
| Rate for Payer: BCBS MAPPO |
$357.83
|
| Rate for Payer: BCN Medicare Advantage |
$357.83
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$515.28
|
| Rate for Payer: Cofinity Commercial |
$479.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.83
|
| Rate for Payer: Healthscope Commercial |
$661.99
|
| Rate for Payer: Healthscope Commercial |
$572.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.45
|
| Rate for Payer: Nomi Health Commercial |
$429.40
|
| Rate for Payer: PACE SWMI |
$357.83
|
| Rate for Payer: PHP Medicare Advantage |
$357.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health Medicare |
$357.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.83
|
| Rate for Payer: UHC Medicare Advantage |
$357.83
|
|
|
PR THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 37212
|
| Min. Negotiated Rate |
$320.96 |
| Max. Negotiated Rate |
$1,047.15 |
| Rate for Payer: Aetna Commercial |
$430.09
|
| Rate for Payer: Aetna Medicare |
$333.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.09
|
| Rate for Payer: BCBS Complete |
$644.40
|
| Rate for Payer: BCBS MAPPO |
$320.96
|
| Rate for Payer: BCN Medicare Advantage |
$320.96
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$462.18
|
| Rate for Payer: Cofinity Commercial |
$430.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.96
|
| Rate for Payer: Healthscope Commercial |
$513.54
|
| Rate for Payer: Healthscope Commercial |
$593.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.15
|
| Rate for Payer: Nomi Health Commercial |
$385.15
|
| Rate for Payer: PACE SWMI |
$320.96
|
| Rate for Payer: PHP Medicare Advantage |
$320.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health Medicare |
$320.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.96
|
| Rate for Payer: UHC Medicare Advantage |
$320.96
|
|
|
PR THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC
|
Professional
|
Both
|
$3,708.00
|
|
|
Service Code
|
HCPCS 32659
|
| Min. Negotiated Rate |
$705.39 |
| Max. Negotiated Rate |
$2,410.20 |
| Rate for Payer: Aetna Commercial |
$945.22
|
| Rate for Payer: Aetna Medicare |
$733.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$945.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.76
|
| Rate for Payer: BCBS Complete |
$1,483.20
|
| Rate for Payer: BCBS MAPPO |
$705.39
|
| Rate for Payer: BCN Medicare Advantage |
$705.39
|
| Rate for Payer: Cash Price |
$2,966.40
|
| Rate for Payer: Cash Price |
$2,966.40
|
| Rate for Payer: Cofinity Commercial |
$945.22
|
| Rate for Payer: Cofinity Commercial |
$1,015.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.39
|
| Rate for Payer: Healthscope Commercial |
$1,304.97
|
| Rate for Payer: Healthscope Commercial |
$1,128.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,410.20
|
| Rate for Payer: Nomi Health Commercial |
$846.47
|
| Rate for Payer: PACE SWMI |
$705.39
|
| Rate for Payer: PHP Medicare Advantage |
$705.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,410.20
|
| Rate for Payer: Priority Health Medicare |
$705.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$705.39
|
| Rate for Payer: UHC Medicare Advantage |
$705.39
|
|
|
PR THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS
|
Professional
|
Both
|
$4,459.00
|
|
|
Service Code
|
HCPCS 32652
|
| Min. Negotiated Rate |
$1,596.19 |
| Max. Negotiated Rate |
$2,952.95 |
| Rate for Payer: Aetna Commercial |
$2,138.89
|
| Rate for Payer: Aetna Medicare |
$1,660.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,138.89
|
| Rate for Payer: BCBS Complete |
$1,783.60
|
| Rate for Payer: BCBS MAPPO |
$1,596.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,596.19
|
| Rate for Payer: Cash Price |
$3,567.20
|
| Rate for Payer: Cash Price |
$3,567.20
|
| Rate for Payer: Cofinity Commercial |
$2,298.51
|
| Rate for Payer: Cofinity Commercial |
$2,138.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,596.19
|
| Rate for Payer: Healthscope Commercial |
$2,553.90
|
| Rate for Payer: Healthscope Commercial |
$2,952.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,676.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,898.35
|
| Rate for Payer: Nomi Health Commercial |
$1,915.43
|
| Rate for Payer: PACE SWMI |
$1,596.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,596.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,898.35
|
| Rate for Payer: Priority Health Medicare |
$1,596.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,596.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,596.19
|
|
|
PR THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$2,559.00
|
|
|
Service Code
|
HCPCS 60522
|
| Min. Negotiated Rate |
$1,023.60 |
| Max. Negotiated Rate |
$2,430.92 |
| Rate for Payer: Aetna Commercial |
$1,760.77
|
| Rate for Payer: Aetna Medicare |
$1,366.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,892.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,760.77
|
| Rate for Payer: BCBS Complete |
$1,023.60
|
| Rate for Payer: BCBS MAPPO |
$1,314.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,314.01
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Commercial |
$1,892.17
|
| Rate for Payer: Cofinity Commercial |
$1,760.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,314.01
|
| Rate for Payer: Healthscope Commercial |
$2,430.92
|
| Rate for Payer: Healthscope Commercial |
$2,102.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,379.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,663.35
|
| Rate for Payer: Nomi Health Commercial |
$1,576.81
|
| Rate for Payer: PACE SWMI |
$1,314.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,314.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,663.35
|
| Rate for Payer: Priority Health Medicare |
$1,314.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,314.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,314.01
|
|
|
PR THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX
|
Professional
|
Both
|
$3,531.00
|
|
|
Service Code
|
HCPCS 60520
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$2,295.15 |
| Rate for Payer: Aetna Commercial |
$1,363.58
|
| Rate for Payer: Aetna Medicare |
$1,058.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,363.58
|
| Rate for Payer: BCBS Complete |
$1,412.40
|
| Rate for Payer: BCBS MAPPO |
$1,017.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.60
|
| Rate for Payer: Cash Price |
$2,824.80
|
| Rate for Payer: Cash Price |
$2,824.80
|
| Rate for Payer: Cofinity Commercial |
$1,465.34
|
| Rate for Payer: Cofinity Commercial |
$1,363.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.60
|
| Rate for Payer: Healthscope Commercial |
$1,628.16
|
| Rate for Payer: Healthscope Commercial |
$1,882.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,295.15
|
| Rate for Payer: Nomi Health Commercial |
$1,221.12
|
| Rate for Payer: PACE SWMI |
$1,017.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,295.15
|
| Rate for Payer: Priority Health Medicare |
$1,017.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,017.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,017.60
|
|
|
PR THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$3,947.00
|
|
|
Service Code
|
HCPCS 60521
|
| Min. Negotiated Rate |
$1,085.03 |
| Max. Negotiated Rate |
$2,565.55 |
| Rate for Payer: Aetna Commercial |
$1,453.94
|
| Rate for Payer: Aetna Medicare |
$1,128.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,562.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,453.94
|
| Rate for Payer: BCBS Complete |
$1,578.80
|
| Rate for Payer: BCBS MAPPO |
$1,085.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,085.03
|
| Rate for Payer: Cash Price |
$3,157.60
|
| Rate for Payer: Cash Price |
$3,157.60
|
| Rate for Payer: Cofinity Commercial |
$1,562.44
|
| Rate for Payer: Cofinity Commercial |
$1,453.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,085.03
|
| Rate for Payer: Healthscope Commercial |
$2,007.31
|
| Rate for Payer: Healthscope Commercial |
$1,736.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,139.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,565.55
|
| Rate for Payer: Nomi Health Commercial |
$1,302.04
|
| Rate for Payer: PACE SWMI |
$1,085.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,085.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.55
|
| Rate for Payer: Priority Health Medicare |
$1,085.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,085.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,085.03
|
|
|
PR THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 60260
|
| Min. Negotiated Rate |
$1,048.26 |
| Max. Negotiated Rate |
$2,074.15 |
| Rate for Payer: Aetna Commercial |
$1,404.67
|
| Rate for Payer: Aetna Medicare |
$1,090.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.67
|
| Rate for Payer: BCBS Complete |
$1,276.40
|
| Rate for Payer: BCBS MAPPO |
$1,048.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.26
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,509.49
|
| Rate for Payer: Cofinity Commercial |
$1,404.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.26
|
| Rate for Payer: Healthscope Commercial |
$1,677.22
|
| Rate for Payer: Healthscope Commercial |
$1,939.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,074.15
|
| Rate for Payer: Nomi Health Commercial |
$1,257.91
|
| Rate for Payer: PACE SWMI |
$1,048.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health Medicare |
$1,048.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.26
|
|
