|
PR TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 27397
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$1,636.08 |
| Rate for Payer: Aetna Commercial |
$1,185.06
|
| Rate for Payer: Aetna Medicare |
$919.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.06
|
| Rate for Payer: BCBS Complete |
$752.00
|
| Rate for Payer: BCBS MAPPO |
$884.37
|
| Rate for Payer: BCN Medicare Advantage |
$884.37
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$1,273.49
|
| Rate for Payer: Cofinity Commercial |
$1,185.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.37
|
| Rate for Payer: Healthscope Commercial |
$1,636.08
|
| Rate for Payer: Healthscope Commercial |
$1,414.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,222.00
|
| Rate for Payer: Nomi Health Commercial |
$1,061.24
|
| Rate for Payer: PACE SWMI |
$884.37
|
| Rate for Payer: PHP Medicare Advantage |
$884.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.00
|
| Rate for Payer: Priority Health Medicare |
$884.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$884.37
|
| Rate for Payer: UHC Medicare Advantage |
$884.37
|
|
|
PR TRANSPOSITION OVARY
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 58825
|
| Min. Negotiated Rate |
$585.20 |
| Max. Negotiated Rate |
$1,258.22 |
| Rate for Payer: Aetna Commercial |
$911.36
|
| Rate for Payer: Aetna Medicare |
$707.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$911.36
|
| Rate for Payer: BCBS Complete |
$585.20
|
| Rate for Payer: BCBS MAPPO |
$680.12
|
| Rate for Payer: BCN Medicare Advantage |
$680.12
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cofinity Commercial |
$979.37
|
| Rate for Payer: Cofinity Commercial |
$911.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.12
|
| Rate for Payer: Healthscope Commercial |
$1,088.19
|
| Rate for Payer: Healthscope Commercial |
$1,258.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.95
|
| Rate for Payer: Nomi Health Commercial |
$816.14
|
| Rate for Payer: PACE SWMI |
$680.12
|
| Rate for Payer: PHP Medicare Advantage |
$680.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.95
|
| Rate for Payer: Priority Health Medicare |
$680.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.12
|
| Rate for Payer: UHC Medicare Advantage |
$680.12
|
|
|
PR TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM
|
Professional
|
Both
|
$5,079.00
|
|
|
Service Code
|
HCPCS 61598
|
| Min. Negotiated Rate |
$2,031.60 |
| Max. Negotiated Rate |
$5,143.74 |
| Rate for Payer: Aetna Commercial |
$3,725.74
|
| Rate for Payer: Aetna Medicare |
$2,891.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,003.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,725.74
|
| Rate for Payer: BCBS Complete |
$2,031.60
|
| Rate for Payer: BCBS MAPPO |
$2,780.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,780.40
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cofinity Commercial |
$4,003.78
|
| Rate for Payer: Cofinity Commercial |
$3,725.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,780.40
|
| Rate for Payer: Healthscope Commercial |
$5,143.74
|
| Rate for Payer: Healthscope Commercial |
$4,448.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,919.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,301.35
|
| Rate for Payer: Nomi Health Commercial |
$3,336.48
|
| Rate for Payer: PACE SWMI |
$2,780.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,780.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,301.35
|
| Rate for Payer: Priority Health Medicare |
$2,780.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,780.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,780.40
|
|
|
PR TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 45000
|
| Min. Negotiated Rate |
$327.20 |
| Max. Negotiated Rate |
$760.52 |
| Rate for Payer: Aetna Commercial |
$550.86
|
| Rate for Payer: Aetna Medicare |
$427.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$591.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.86
|
| Rate for Payer: BCBS Complete |
$327.20
|
| Rate for Payer: BCBS MAPPO |
$411.09
|
| Rate for Payer: BCN Medicare Advantage |
$411.09
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$591.97
|
| Rate for Payer: Cofinity Commercial |
$550.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.09
|
| Rate for Payer: Healthscope Commercial |
$657.74
|
| Rate for Payer: Healthscope Commercial |
$760.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.70
|
| Rate for Payer: Nomi Health Commercial |
$493.31
|
| Rate for Payer: PACE SWMI |
$411.09
|
| Rate for Payer: PHP Medicare Advantage |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health Medicare |
$411.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.09
|
| Rate for Payer: UHC Medicare Advantage |
$411.09
|
|
|
PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 93293
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$50.38
|
| Rate for Payer: Aetna Medicare |
$39.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.38
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS MAPPO |
$37.60
|
| Rate for Payer: BCN Medicare Advantage |
$37.60
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$50.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$69.56
|
| Rate for Payer: Healthscope Commercial |
$60.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.65
|
| Rate for Payer: Nomi Health Commercial |
$45.12
|
| Rate for Payer: PACE SWMI |
$37.60
|
| Rate for Payer: PHP Medicare Advantage |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health Medicare |
$37.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.60
|
| Rate for Payer: UHC Medicare Advantage |
$37.60
|
|
|
PR TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV
|
Professional
|
Both
|
$6,249.00
|
|
|
Service Code
|
HCPCS 61595
|
| Min. Negotiated Rate |
$2,295.10 |
| Max. Negotiated Rate |
$4,245.94 |
| Rate for Payer: Aetna Commercial |
$3,075.43
|
| Rate for Payer: Aetna Medicare |
$2,386.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,075.43
|
| Rate for Payer: BCBS Complete |
$2,499.60
|
| Rate for Payer: BCBS MAPPO |
$2,295.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,295.10
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Cofinity Commercial |
$3,304.94
|
| Rate for Payer: Cofinity Commercial |
$3,075.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,295.10
|
| Rate for Payer: Healthscope Commercial |
$3,672.16
|
| Rate for Payer: Healthscope Commercial |
$4,245.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,409.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,061.85
|
| Rate for Payer: Nomi Health Commercial |
$2,754.12
|
| Rate for Payer: PACE SWMI |
$2,295.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,295.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,061.85
|
| Rate for Payer: Priority Health Medicare |
$2,295.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,295.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,295.10
|
|
|
PR TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 50770
|
| Min. Negotiated Rate |
$864.00 |
| Max. Negotiated Rate |
$2,033.37 |
| Rate for Payer: Aetna Commercial |
$1,472.82
|
| Rate for Payer: Aetna Medicare |
$1,143.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.82
|
| Rate for Payer: BCBS Complete |
$864.00
|
| Rate for Payer: BCBS MAPPO |
$1,099.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.12
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,582.73
|
| Rate for Payer: Cofinity Commercial |
$1,472.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.12
|
| Rate for Payer: Healthscope Commercial |
$2,033.37
|
| Rate for Payer: Healthscope Commercial |
$1,758.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,404.00
|
| Rate for Payer: Nomi Health Commercial |
$1,318.94
|
| Rate for Payer: PACE SWMI |
$1,099.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,404.00
|
| Rate for Payer: Priority Health Medicare |
$1,099.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.12
|
|
|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$454.40 |
| Max. Negotiated Rate |
$952.25 |
| Rate for Payer: Aetna Commercial |
$608.90
|
| Rate for Payer: Aetna Medicare |
$472.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.90
|
| Rate for Payer: BCBS Complete |
$586.00
|
| Rate for Payer: BCBS MAPPO |
$454.40
|
| Rate for Payer: BCN Medicare Advantage |
$454.40
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$654.34
|
| Rate for Payer: Cofinity Commercial |
$608.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.40
|
| Rate for Payer: Healthscope Commercial |
$727.04
|
| Rate for Payer: Healthscope Commercial |
$840.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$952.25
|
| Rate for Payer: Nomi Health Commercial |
$545.28
|
| Rate for Payer: PACE SWMI |
$454.40
|
| Rate for Payer: PHP Medicare Advantage |
$454.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health Medicare |
$454.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.40
|
| Rate for Payer: UHC Medicare Advantage |
$454.40
|
|
|
PR TRANSURETHRAL RESECTION BLADDER NECK
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 52500
|
| Min. Negotiated Rate |
$471.78 |
| Max. Negotiated Rate |
$1,096.55 |
| Rate for Payer: Aetna Commercial |
$632.19
|
| Rate for Payer: Aetna Medicare |
$490.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.19
|
| Rate for Payer: BCBS Complete |
$674.80
|
| Rate for Payer: BCBS MAPPO |
$471.78
|
| Rate for Payer: BCN Medicare Advantage |
$471.78
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$679.36
|
| Rate for Payer: Cofinity Commercial |
$632.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.78
|
| Rate for Payer: Healthscope Commercial |
$754.85
|
| Rate for Payer: Healthscope Commercial |
$872.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.55
|
| Rate for Payer: Nomi Health Commercial |
$566.14
|
| Rate for Payer: PACE SWMI |
$471.78
|
| Rate for Payer: PHP Medicare Advantage |
$471.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health Medicare |
$471.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.78
|
| Rate for Payer: UHC Medicare Advantage |
$471.78
|
|
|
PR TRANSV AORTIC ARCH GRAFT W BYPASS
|
Professional
|
Both
|
$10,285.00
|
|
|
Service Code
|
HCPCS 33870
|
| Min. Negotiated Rate |
$4,114.00 |
| Max. Negotiated Rate |
$6,685.25 |
| Rate for Payer: Aetna Medicare |
$5,142.50
|
| Rate for Payer: BCBS Complete |
$4,114.00
|
| Rate for Payer: Cash Price |
$8,228.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,685.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,685.25
|
|
|
PR TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA
|
Professional
|
Both
|
$5,629.00
|
|
|
Service Code
|
HCPCS 33871
|
| Min. Negotiated Rate |
$2,251.60 |
| Max. Negotiated Rate |
$5,764.62 |
| Rate for Payer: Aetna Commercial |
$4,175.45
|
| Rate for Payer: Aetna Medicare |
$3,240.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,175.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,487.05
|
| Rate for Payer: BCBS Complete |
$2,251.60
|
| Rate for Payer: BCBS MAPPO |
$3,116.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,116.01
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cofinity Commercial |
$4,175.45
|
| Rate for Payer: Cofinity Commercial |
$4,487.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,116.01
|
| Rate for Payer: Healthscope Commercial |
$4,985.62
|
| Rate for Payer: Healthscope Commercial |
$5,764.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.85
|
| Rate for Payer: Nomi Health Commercial |
$3,739.21
|
| Rate for Payer: PACE SWMI |
$3,116.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,116.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,658.85
|
| Rate for Payer: Priority Health Medicare |
$3,116.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,116.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,116.01
|
|
|
PR TRAY FEE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 00521
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$462.40 |
| Max. Negotiated Rate |
$855.44 |
| Rate for Payer: Aetna Commercial |
$619.62
|
| Rate for Payer: Aetna Medicare |
$480.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.86
|
| Rate for Payer: BCBS Complete |
$524.80
|
| Rate for Payer: BCBS MAPPO |
$462.40
|
| Rate for Payer: BCN Medicare Advantage |
$462.40
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$665.86
|
| Rate for Payer: Cofinity Commercial |
$619.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.40
|
| Rate for Payer: Healthscope Commercial |
$855.44
|
| Rate for Payer: Healthscope Commercial |
$739.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$852.80
|
| Rate for Payer: Nomi Health Commercial |
$554.88
|
| Rate for Payer: PACE SWMI |
$462.40
|
| Rate for Payer: PHP Medicare Advantage |
$462.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health Medicare |
$462.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.40
|
| Rate for Payer: UHC Medicare Advantage |
$462.40
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$624.89 |
| Rate for Payer: Aetna Commercial |
$452.63
|
| Rate for Payer: Aetna Medicare |
$351.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.40
|
| Rate for Payer: BCBS Complete |
$300.00
|
| Rate for Payer: BCBS MAPPO |
$337.78
|
| Rate for Payer: BCN Medicare Advantage |
$337.78
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$452.63
|
| Rate for Payer: Cofinity Commercial |
$486.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.78
|
| Rate for Payer: Healthscope Commercial |
$540.45
|
| Rate for Payer: Healthscope Commercial |
$624.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.50
|
| Rate for Payer: Nomi Health Commercial |
$405.34
|
| Rate for Payer: PACE SWMI |
$337.78
|
| Rate for Payer: PHP Medicare Advantage |
$337.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health Medicare |
$337.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.78
|
| Rate for Payer: UHC Medicare Advantage |
$337.78
|
|
|
PR TRIAMCINOLONE ACET INJ NOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$1.13
|
| Rate for Payer: Aetna Medicare |
$0.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.13
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$0.84
|
| Rate for Payer: BCN Medicare Advantage |
$0.84
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.84
|
| Rate for Payer: Healthscope Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$1.01
|
| Rate for Payer: PACE SWMI |
$0.84
|
| Rate for Payer: PHP Medicare Advantage |
$0.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$0.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.84
|
| Rate for Payer: UHC Medicare Advantage |
$0.84
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$106.39 |
| Rate for Payer: Aetna Commercial |
$77.06
|
| Rate for Payer: Aetna Medicare |
$59.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.06
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$57.51
|
| Rate for Payer: BCN Medicare Advantage |
$57.51
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$82.81
|
| Rate for Payer: Cofinity Commercial |
$77.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.51
|
| Rate for Payer: Healthscope Commercial |
$106.39
|
| Rate for Payer: Healthscope Commercial |
$92.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.60
|
| Rate for Payer: Nomi Health Commercial |
$69.01
|
| Rate for Payer: PACE SWMI |
$57.51
|
| Rate for Payer: PHP Medicare Advantage |
$57.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$57.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.51
|
| Rate for Payer: UHC Medicare Advantage |
$57.51
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$10.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$11.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$8.47
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$24.05 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$10.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$13.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Nomi Health Commercial |
$8.47
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37246
|
| Min. Negotiated Rate |
$332.08 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$444.99
|
| Rate for Payer: Aetna Medicare |
$345.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.99
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$332.08
|
| Rate for Payer: BCN Medicare Advantage |
$332.08
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$478.20
|
| Rate for Payer: Cofinity Commercial |
$444.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.08
|
| Rate for Payer: Healthscope Commercial |
$614.35
|
| Rate for Payer: Healthscope Commercial |
$531.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.70
|
| Rate for Payer: Nomi Health Commercial |
$398.50
|
| Rate for Payer: PACE SWMI |
$332.08
|
| Rate for Payer: PHP Medicare Advantage |
$332.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$332.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.08
|
| Rate for Payer: UHC Medicare Advantage |
$332.08
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$165.41 |
| Max. Negotiated Rate |
$543.40 |
| Rate for Payer: Aetna Commercial |
$221.65
|
| Rate for Payer: Aetna Medicare |
$172.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.65
|
| Rate for Payer: BCBS Complete |
$334.40
|
| Rate for Payer: BCBS MAPPO |
$165.41
|
| Rate for Payer: BCN Medicare Advantage |
$165.41
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cofinity Commercial |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$221.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.41
|
| Rate for Payer: Healthscope Commercial |
$264.66
|
| Rate for Payer: Healthscope Commercial |
$306.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$543.40
|
| Rate for Payer: Nomi Health Commercial |
$198.49
|
| Rate for Payer: PACE SWMI |
$165.41
|
| Rate for Payer: PHP Medicare Advantage |
$165.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health Medicare |
$165.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.41
|
| Rate for Payer: UHC Medicare Advantage |
$165.41
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$280.68 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$376.11
|
| Rate for Payer: Aetna Medicare |
$291.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.11
|
| Rate for Payer: BCBS Complete |
$377.60
|
| Rate for Payer: BCBS MAPPO |
$280.68
|
| Rate for Payer: BCN Medicare Advantage |
$280.68
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$404.18
|
| Rate for Payer: Cofinity Commercial |
$376.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.68
|
| Rate for Payer: Healthscope Commercial |
$519.26
|
| Rate for Payer: Healthscope Commercial |
$449.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.60
|
| Rate for Payer: Nomi Health Commercial |
$336.82
|
| Rate for Payer: PACE SWMI |
$280.68
|
| Rate for Payer: PHP Medicare Advantage |
$280.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health Medicare |
$280.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.68
|
| Rate for Payer: UHC Medicare Advantage |
$280.68
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN
|
Professional
|
Both
|
$463.00
|
|
|
Service Code
|
HCPCS 37249
|
| Min. Negotiated Rate |
$139.54 |
| Max. Negotiated Rate |
$300.95 |
| Rate for Payer: Aetna Commercial |
$186.98
|
| Rate for Payer: Aetna Medicare |
$145.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.98
|
| Rate for Payer: BCBS Complete |
$185.20
|
| Rate for Payer: BCBS MAPPO |
$139.54
|
| Rate for Payer: BCN Medicare Advantage |
$139.54
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cofinity Commercial |
$200.94
|
| Rate for Payer: Cofinity Commercial |
$186.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.54
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Healthscope Commercial |
$258.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.95
|
| Rate for Payer: Nomi Health Commercial |
$167.45
|
| Rate for Payer: PACE SWMI |
$139.54
|
| Rate for Payer: PHP Medicare Advantage |
$139.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.95
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.54
|
| Rate for Payer: UHC Medicare Advantage |
$139.54
|
|
|
PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 36907
|
| Min. Negotiated Rate |
$129.60 |
| Max. Negotiated Rate |
$257.93 |
| Rate for Payer: Aetna Commercial |
$186.82
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.82
|
| Rate for Payer: BCBS Complete |
$129.60
|
| Rate for Payer: BCBS MAPPO |
$139.42
|
| Rate for Payer: BCN Medicare Advantage |
$139.42
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$200.76
|
| Rate for Payer: Cofinity Commercial |
$186.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.42
|
| Rate for Payer: Healthscope Commercial |
$223.07
|
| Rate for Payer: Healthscope Commercial |
$257.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.60
|
| Rate for Payer: Nomi Health Commercial |
$167.30
|
| Rate for Payer: PACE SWMI |
$139.42
|
| Rate for Payer: PHP Medicare Advantage |
$139.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health Medicare |
$139.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.42
|
| Rate for Payer: UHC Medicare Advantage |
$139.42
|
|
|
PR TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL
|
Professional
|
Both
|
$9,821.00
|
|
|
Service Code
|
HCPCS 0237T
|
| Min. Negotiated Rate |
$3,928.40 |
| Max. Negotiated Rate |
$6,383.65 |
| Rate for Payer: Aetna Medicare |
$4,910.50
|
| Rate for Payer: BCBS Complete |
$3,928.40
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,383.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,383.65
|
|
|
PR TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL
|
Professional
|
Both
|
$8,756.00
|
|
|
Service Code
|
HCPCS 61597
|
| Min. Negotiated Rate |
$2,857.84 |
| Max. Negotiated Rate |
$5,691.40 |
| Rate for Payer: Aetna Commercial |
$3,829.51
|
| Rate for Payer: Aetna Medicare |
$2,972.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,829.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,115.29
|
| Rate for Payer: BCBS Complete |
$3,502.40
|
| Rate for Payer: BCBS MAPPO |
$2,857.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,857.84
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cofinity Commercial |
$3,829.51
|
| Rate for Payer: Cofinity Commercial |
$4,115.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,857.84
|
| Rate for Payer: Healthscope Commercial |
$4,572.54
|
| Rate for Payer: Healthscope Commercial |
$5,287.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,000.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,691.40
|
| Rate for Payer: Nomi Health Commercial |
$3,429.41
|
| Rate for Payer: PACE SWMI |
$2,857.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,857.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,691.40
|
| Rate for Payer: Priority Health Medicare |
$2,857.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,857.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,857.84
|
|
