|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$2,229.60 |
| Max. Negotiated Rate |
$5,290.17 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,973.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,117.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,831.80
|
| Rate for Payer: BCBS Complete |
$2,229.60
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Healthscope Commercial |
$5,290.17
|
| Rate for Payer: Healthscope Commercial |
$4,575.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,623.10
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health Medicare |
$2,859.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$3,186.00 |
| Max. Negotiated Rate |
$6,769.54 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,805.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,269.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,903.34
|
| Rate for Payer: BCBS Complete |
$3,186.00
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Healthscope Commercial |
$5,854.74
|
| Rate for Payer: Healthscope Commercial |
$6,769.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,177.25
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health Medicare |
$3,659.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$190.04 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.65
|
| Rate for Payer: BCBS Complete |
$492.80
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Healthscope Commercial |
$351.57
|
| Rate for Payer: Healthscope Commercial |
$304.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$800.80
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health Medicare |
$190.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$115.05 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.47
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Healthscope Commercial |
$74.59
|
| Rate for Payer: Healthscope Commercial |
$86.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.05
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health Medicare |
$46.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$659.36 |
| Rate for Payer: Aetna Commercial |
$477.59
|
| Rate for Payer: Aetna Medicare |
$370.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.59
|
| Rate for Payer: BCBS Complete |
$232.40
|
| Rate for Payer: BCBS MAPPO |
$356.41
|
| Rate for Payer: BCN Medicare Advantage |
$356.41
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$513.23
|
| Rate for Payer: Cofinity Commercial |
$477.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.41
|
| Rate for Payer: Healthscope Commercial |
$659.36
|
| Rate for Payer: Healthscope Commercial |
$570.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.65
|
| Rate for Payer: Nomi Health Commercial |
$427.69
|
| Rate for Payer: PACE SWMI |
$356.41
|
| Rate for Payer: PHP Medicare Advantage |
$356.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health Medicare |
$356.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.41
|
| Rate for Payer: UHC Medicare Advantage |
$356.41
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$317.88 |
| Max. Negotiated Rate |
$618.80 |
| Rate for Payer: Aetna Commercial |
$425.96
|
| Rate for Payer: Aetna Medicare |
$330.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.96
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$317.88
|
| Rate for Payer: BCN Medicare Advantage |
$317.88
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$457.75
|
| Rate for Payer: Cofinity Commercial |
$425.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.88
|
| Rate for Payer: Healthscope Commercial |
$508.61
|
| Rate for Payer: Healthscope Commercial |
$588.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$618.80
|
| Rate for Payer: Nomi Health Commercial |
$381.46
|
| Rate for Payer: PACE SWMI |
$317.88
|
| Rate for Payer: PHP Medicare Advantage |
$317.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$317.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.88
|
| Rate for Payer: UHC Medicare Advantage |
$317.88
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$147.35
|
| Rate for Payer: Aetna Medicare |
$114.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.35
|
| Rate for Payer: BCBS Complete |
$184.80
|
| Rate for Payer: BCBS MAPPO |
$109.96
|
| Rate for Payer: BCN Medicare Advantage |
$109.96
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$147.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.96
|
| Rate for Payer: Healthscope Commercial |
$203.43
|
| Rate for Payer: Healthscope Commercial |
$175.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.30
|
| Rate for Payer: Nomi Health Commercial |
$131.95
|
| Rate for Payer: PACE SWMI |
$109.96
|
| Rate for Payer: PHP Medicare Advantage |
$109.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health Medicare |
$109.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.96
|
| Rate for Payer: UHC Medicare Advantage |
$109.96
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$1,257.95 |
| Max. Negotiated Rate |
$2,863.25 |
| Rate for Payer: Aetna Commercial |
$1,685.65
|
| Rate for Payer: Aetna Medicare |
$1,308.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.65
|
| Rate for Payer: BCBS Complete |
$1,762.00
|
| Rate for Payer: BCBS MAPPO |
$1,257.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.95
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cofinity Commercial |
$1,811.45
|
| Rate for Payer: Cofinity Commercial |
$1,685.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.95
|
| Rate for Payer: Healthscope Commercial |
$2,012.72
|
| Rate for Payer: Healthscope Commercial |
$2,327.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.25
|
| Rate for Payer: Nomi Health Commercial |
$1,509.54
|
| Rate for Payer: PACE SWMI |
$1,257.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health Medicare |
$1,257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.95
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$542.00 |
| Max. Negotiated Rate |
$1,233.12 |
| Rate for Payer: Aetna Commercial |
$893.18
|
| Rate for Payer: Aetna Medicare |
$693.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.18
|
| Rate for Payer: BCBS Complete |
$542.00
|
| Rate for Payer: BCBS MAPPO |
$666.55
|
| Rate for Payer: BCN Medicare Advantage |
$666.55
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$959.83
|
| Rate for Payer: Cofinity Commercial |
$893.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.55
|
| Rate for Payer: Healthscope Commercial |
$1,233.12
|
| Rate for Payer: Healthscope Commercial |
$1,066.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$880.75
|
| Rate for Payer: Nomi Health Commercial |
$799.86
|
| Rate for Payer: PACE SWMI |
$666.55
|
| Rate for Payer: PHP Medicare Advantage |
$666.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health Medicare |
$666.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$666.55
|
| Rate for Payer: UHC Medicare Advantage |
$666.55
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$729.49 |
| Rate for Payer: Aetna Commercial |
$528.39
|
| Rate for Payer: Aetna Medicare |
$410.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.39
|
| Rate for Payer: BCBS Complete |
$364.80
|
| Rate for Payer: BCBS MAPPO |
$394.32
|
| Rate for Payer: BCN Medicare Advantage |
$394.32
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$567.82
|
| Rate for Payer: Cofinity Commercial |
$528.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.32
|
| Rate for Payer: Healthscope Commercial |
$630.91
|
| Rate for Payer: Healthscope Commercial |
$729.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$592.80
|
| Rate for Payer: Nomi Health Commercial |
$473.18
|
| Rate for Payer: PACE SWMI |
$394.32
|
| Rate for Payer: PHP Medicare Advantage |
$394.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health Medicare |
$394.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.32
|
| Rate for Payer: UHC Medicare Advantage |
$394.32
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$592.33 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.04
|
| Rate for Payer: BCBS Complete |
$323.60
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Healthscope Commercial |
$592.33
|
| Rate for Payer: Healthscope Commercial |
$512.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.85
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$772.85 |
| Rate for Payer: Aetna Commercial |
$410.59
|
| Rate for Payer: Aetna Medicare |
$318.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.59
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| Rate for Payer: BCN Medicare Advantage |
$306.41
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$441.23
|
| Rate for Payer: Cofinity Commercial |
$410.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.41
|
| Rate for Payer: Healthscope Commercial |
$490.26
|
| Rate for Payer: Healthscope Commercial |
$566.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.85
|
| Rate for Payer: Nomi Health Commercial |
$367.69
|
| Rate for Payer: PACE SWMI |
$306.41
|
| Rate for Payer: PHP Medicare Advantage |
$306.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health Medicare |
$306.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.41
|
| Rate for Payer: UHC Medicare Advantage |
$306.41
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$619.60 |
| Max. Negotiated Rate |
$1,656.88 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$931.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,289.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.12
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$895.61
|
| Rate for Payer: BCN Medicare Advantage |
$895.61
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,289.68
|
| Rate for Payer: Cofinity Commercial |
$1,200.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.61
|
| Rate for Payer: Healthscope Commercial |
$1,656.88
|
| Rate for Payer: Healthscope Commercial |
$1,432.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.85
|
| Rate for Payer: Nomi Health Commercial |
$1,074.73
|
| Rate for Payer: PACE SWMI |
$895.61
|
| Rate for Payer: PHP Medicare Advantage |
$895.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$895.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.61
|
| Rate for Payer: UHC Medicare Advantage |
$895.61
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$292.39 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$391.80
|
| Rate for Payer: Aetna Medicare |
$304.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.80
|
| Rate for Payer: BCBS Complete |
$420.00
|
| Rate for Payer: BCBS MAPPO |
$292.39
|
| Rate for Payer: BCN Medicare Advantage |
$292.39
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$421.04
|
| Rate for Payer: Cofinity Commercial |
$391.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.39
|
| Rate for Payer: Healthscope Commercial |
$467.82
|
| Rate for Payer: Healthscope Commercial |
$540.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.50
|
| Rate for Payer: Nomi Health Commercial |
$350.87
|
| Rate for Payer: PACE SWMI |
$292.39
|
| Rate for Payer: PHP Medicare Advantage |
$292.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health Medicare |
$292.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.39
|
| Rate for Payer: UHC Medicare Advantage |
$292.39
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$793.48 |
| Rate for Payer: Aetna Commercial |
$574.74
|
| Rate for Payer: Aetna Medicare |
$446.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.74
|
| Rate for Payer: BCBS Complete |
$415.20
|
| Rate for Payer: BCBS MAPPO |
$428.91
|
| Rate for Payer: BCN Medicare Advantage |
$428.91
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$617.63
|
| Rate for Payer: Cofinity Commercial |
$574.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.91
|
| Rate for Payer: Healthscope Commercial |
$793.48
|
| Rate for Payer: Healthscope Commercial |
$686.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.70
|
| Rate for Payer: Nomi Health Commercial |
$514.69
|
| Rate for Payer: PACE SWMI |
$428.91
|
| Rate for Payer: PHP Medicare Advantage |
$428.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health Medicare |
$428.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.91
|
| Rate for Payer: UHC Medicare Advantage |
$428.91
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$44.09
|
| Rate for Payer: Aetna Medicare |
$34.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.09
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Cofinity Commercial |
$44.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$52.64
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Nomi Health Commercial |
$39.48
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$32.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$554.00 |
| Max. Negotiated Rate |
$1,157.23 |
| Rate for Payer: Aetna Commercial |
$838.21
|
| Rate for Payer: Aetna Medicare |
$650.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.21
|
| Rate for Payer: BCBS Complete |
$554.00
|
| Rate for Payer: BCBS MAPPO |
$625.53
|
| Rate for Payer: BCN Medicare Advantage |
$625.53
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$900.76
|
| Rate for Payer: Cofinity Commercial |
$838.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.53
|
| Rate for Payer: Healthscope Commercial |
$1,157.23
|
| Rate for Payer: Healthscope Commercial |
$1,000.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$900.25
|
| Rate for Payer: Nomi Health Commercial |
$750.64
|
| Rate for Payer: PACE SWMI |
$625.53
|
| Rate for Payer: PHP Medicare Advantage |
$625.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health Medicare |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.53
|
| Rate for Payer: UHC Medicare Advantage |
$625.53
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$1,500.62 |
| Max. Negotiated Rate |
$3,682.25 |
| Rate for Payer: Aetna Commercial |
$2,010.83
|
| Rate for Payer: Aetna Medicare |
$1,560.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,160.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,010.83
|
| Rate for Payer: BCBS Complete |
$2,266.00
|
| Rate for Payer: BCBS MAPPO |
$1,500.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,500.62
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cofinity Commercial |
$2,160.89
|
| Rate for Payer: Cofinity Commercial |
$2,010.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,500.62
|
| Rate for Payer: Healthscope Commercial |
$2,400.99
|
| Rate for Payer: Healthscope Commercial |
$2,776.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,575.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,682.25
|
| Rate for Payer: Nomi Health Commercial |
$1,800.74
|
| Rate for Payer: PACE SWMI |
$1,500.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,500.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health Medicare |
$1,500.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,500.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,500.62
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,630.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$652.00 |
| Max. Negotiated Rate |
$1,059.50 |
| Rate for Payer: Aetna Medicare |
$815.00
|
| Rate for Payer: BCBS Complete |
$652.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,059.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.50
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$77.35 |
| 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: Priority Health Cigna Priority Health |
$77.35
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$742.40 |
| Max. Negotiated Rate |
$1,206.40 |
| Rate for Payer: Aetna Medicare |
$928.00
|
| Rate for Payer: BCBS Complete |
$742.40
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,206.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.40
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,065.35 |
| Rate for Payer: Aetna Medicare |
$819.50
|
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.35
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$371.20 |
| Max. Negotiated Rate |
$603.20 |
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$371.20
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,719.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Aetna Medicare |
$859.50
|
| Rate for Payer: BCBS Complete |
$687.60
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,117.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.35
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,519.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,807.60 |
| Max. Negotiated Rate |
$4,276.63 |
| Rate for Payer: Aetna Commercial |
$3,097.66
|
| Rate for Payer: Aetna Medicare |
$2,404.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,097.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,328.83
|
| Rate for Payer: BCBS Complete |
$1,807.60
|
| Rate for Payer: BCBS MAPPO |
$2,311.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,311.69
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cofinity Commercial |
$3,097.66
|
| Rate for Payer: Cofinity Commercial |
$3,328.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,311.69
|
| Rate for Payer: Healthscope Commercial |
$3,698.70
|
| Rate for Payer: Healthscope Commercial |
$4,276.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,427.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,937.35
|
| Rate for Payer: Nomi Health Commercial |
$2,774.03
|
| Rate for Payer: PACE SWMI |
$2,311.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,311.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,937.35
|
| Rate for Payer: Priority Health Medicare |
$2,311.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,311.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,311.69
|
|
