|
PR URETEROLYSIS FOR OVARIAN VEIN SYNDROME
|
Professional
|
Both
|
$2,633.00
|
|
|
Service Code
|
HCPCS 50722
|
| Min. Negotiated Rate |
$652.63 |
| Max. Negotiated Rate |
$182,095.00 |
| Rate for Payer: Aetna Commercial |
$1,313.19
|
| Rate for Payer: Aetna Medicare |
$1,019.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,411.19
|
| Rate for Payer: BCBS Complete |
$685.26
|
| Rate for Payer: BCBS MAPPO |
$979.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,734.10
|
| Rate for Payer: BCN Commercial |
$1,489.49
|
| Rate for Payer: BCN Medicare Advantage |
$979.99
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cofinity Commercial |
$1,411.19
|
| Rate for Payer: Cofinity Commercial |
$1,313.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.99
|
| Rate for Payer: Healthscope Commercial |
$1,812.98
|
| Rate for Payer: Healthscope Commercial |
$1,567.98
|
| Rate for Payer: Mclaren Medicaid |
$652.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.99
|
| Rate for Payer: Meridian Medicaid |
$685.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,095.00
|
| Rate for Payer: Nomi Health Commercial |
$1,175.99
|
| Rate for Payer: PACE SWMI |
$979.99
|
| Rate for Payer: PHP Medicare Advantage |
$979.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,711.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.36
|
| Rate for Payer: Priority Health Medicare |
$979.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,631.36
|
| Rate for Payer: Priority Health SBD |
$1,631.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.99
|
| Rate for Payer: UHC Exchange |
$1,200.15
|
| Rate for Payer: UHC Medicare Advantage |
$979.99
|
| Rate for Payer: UHCCP Medicaid |
$652.63
|
|
|
PR URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS
|
Professional
|
Both
|
$2,270.00
|
|
|
Service Code
|
HCPCS 50715
|
| Min. Negotiated Rate |
$774.89 |
| Max. Negotiated Rate |
$213,748.00 |
| Rate for Payer: Aetna Commercial |
$1,558.85
|
| Rate for Payer: Aetna Medicare |
$1,209.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,675.18
|
| Rate for Payer: BCBS Complete |
$813.63
|
| Rate for Payer: BCBS MAPPO |
$1,163.32
|
| Rate for Payer: BCBS Trust/PPO |
$4,058.93
|
| Rate for Payer: BCN Commercial |
$1,749.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.32
|
| Rate for Payer: Cash Price |
$1,816.00
|
| Rate for Payer: Cash Price |
$1,816.00
|
| Rate for Payer: Cofinity Commercial |
$1,675.18
|
| Rate for Payer: Cofinity Commercial |
$1,558.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.32
|
| Rate for Payer: Healthscope Commercial |
$2,152.14
|
| Rate for Payer: Healthscope Commercial |
$1,861.31
|
| Rate for Payer: Mclaren Medicaid |
$774.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,221.49
|
| Rate for Payer: Meridian Medicaid |
$813.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213,748.00
|
| Rate for Payer: Nomi Health Commercial |
$1,395.98
|
| Rate for Payer: PACE SWMI |
$1,163.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,925.89
|
| Rate for Payer: Priority Health Medicare |
$1,163.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,925.89
|
| Rate for Payer: Priority Health SBD |
$1,925.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,450.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,163.32
|
| Rate for Payer: UHC Exchange |
$1,450.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.32
|
| Rate for Payer: UHCCP Medicaid |
$774.89
|
|
|
PR URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER
|
Professional
|
Both
|
$2,093.00
|
|
|
Service Code
|
HCPCS 50780
|
| Min. Negotiated Rate |
$711.21 |
| Max. Negotiated Rate |
$195,665.00 |
| Rate for Payer: Aetna Commercial |
$1,428.69
|
| Rate for Payer: Aetna Medicare |
$1,108.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,428.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,535.31
|
| Rate for Payer: BCBS Complete |
$746.77
|
| Rate for Payer: BCBS MAPPO |
$1,066.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,795.76
|
| Rate for Payer: BCN Commercial |
$1,600.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,066.19
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cofinity Commercial |
$1,535.31
|
| Rate for Payer: Cofinity Commercial |
$1,428.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,066.19
|
| Rate for Payer: Healthscope Commercial |
$1,972.45
|
| Rate for Payer: Healthscope Commercial |
$1,705.90
|
| Rate for Payer: Mclaren Medicaid |
$711.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,119.50
|
| Rate for Payer: Meridian Medicaid |
$746.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195,665.00
|
| Rate for Payer: Nomi Health Commercial |
$1,279.43
|
| Rate for Payer: PACE SWMI |
$1,066.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,066.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,767.17
|
| Rate for Payer: Priority Health Medicare |
$1,066.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,767.17
|
| Rate for Payer: Priority Health SBD |
$1,767.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,066.19
|
| Rate for Payer: UHC Exchange |
$1,379.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,066.19
|
| Rate for Payer: UHCCP Medicaid |
$711.21
|
|
|
PR URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR
|
Professional
|
Both
|
$2,236.00
|
|
|
Service Code
|
HCPCS 50782
|
| Min. Negotiated Rate |
$685.43 |
| Max. Negotiated Rate |
$188,680.00 |
| Rate for Payer: Aetna Commercial |
$1,373.55
|
| Rate for Payer: Aetna Medicare |
$1,066.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,476.06
|
| Rate for Payer: BCBS Complete |
$719.70
|
| Rate for Payer: BCBS MAPPO |
$1,025.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.25
|
| Rate for Payer: BCN Commercial |
$1,544.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.04
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cofinity Commercial |
$1,476.06
|
| Rate for Payer: Cofinity Commercial |
$1,373.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.04
|
| Rate for Payer: Healthscope Commercial |
$1,896.32
|
| Rate for Payer: Healthscope Commercial |
$1,640.06
|
| Rate for Payer: Mclaren Medicaid |
$685.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.29
|
| Rate for Payer: Meridian Medicaid |
$719.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188,680.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.05
|
| Rate for Payer: PACE SWMI |
$1,025.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,453.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,702.72
|
| Rate for Payer: Priority Health Medicare |
$1,025.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,702.72
|
| Rate for Payer: Priority Health SBD |
$1,702.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,593.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.04
|
| Rate for Payer: UHC Exchange |
$1,593.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.04
|
| Rate for Payer: UHCCP Medicaid |
$685.43
|
|
|
PR URETERONEOCYSTOSTOMY W/URETERAL TAILORING
|
Professional
|
Both
|
$2,345.00
|
|
|
Service Code
|
HCPCS 50783
|
| Min. Negotiated Rate |
$717.81 |
| Max. Negotiated Rate |
$197,811.00 |
| Rate for Payer: Aetna Commercial |
$1,438.72
|
| Rate for Payer: Aetna Medicare |
$1,116.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,438.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,546.08
|
| Rate for Payer: BCBS Complete |
$753.70
|
| Rate for Payer: BCBS MAPPO |
$1,073.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.82
|
| Rate for Payer: BCN Commercial |
$1,618.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,073.67
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cofinity Commercial |
$1,546.08
|
| Rate for Payer: Cofinity Commercial |
$1,438.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,073.67
|
| Rate for Payer: Healthscope Commercial |
$1,986.29
|
| Rate for Payer: Healthscope Commercial |
$1,717.87
|
| Rate for Payer: Mclaren Medicaid |
$717.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,127.35
|
| Rate for Payer: Meridian Medicaid |
$753.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197,811.00
|
| Rate for Payer: Nomi Health Commercial |
$1,288.40
|
| Rate for Payer: PACE SWMI |
$1,073.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,073.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$717.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,524.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,784.74
|
| Rate for Payer: Priority Health Medicare |
$1,073.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.74
|
| Rate for Payer: Priority Health SBD |
$1,784.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,637.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,073.67
|
| Rate for Payer: UHC Exchange |
$1,637.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,073.67
|
| Rate for Payer: UHCCP Medicaid |
$717.81
|
|
|
PR URETEROPYELOSTOMY ANAST URETER RENAL PELVIS
|
Professional
|
Both
|
$2,563.00
|
|
|
Service Code
|
HCPCS 50740
|
| Min. Negotiated Rate |
$788.74 |
| Max. Negotiated Rate |
$219,262.00 |
| Rate for Payer: Aetna Commercial |
$1,597.64
|
| Rate for Payer: Aetna Medicare |
$1,239.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,716.87
|
| Rate for Payer: BCBS Complete |
$828.18
|
| Rate for Payer: BCBS MAPPO |
$1,192.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,670.03
|
| Rate for Payer: BCN Commercial |
$1,788.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.27
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Cash Price |
$2,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,716.87
|
| Rate for Payer: Cofinity Commercial |
$1,597.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.27
|
| Rate for Payer: Healthscope Commercial |
$2,205.70
|
| Rate for Payer: Healthscope Commercial |
$1,907.63
|
| Rate for Payer: Mclaren Medicaid |
$788.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.88
|
| Rate for Payer: Meridian Medicaid |
$828.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219,262.00
|
| Rate for Payer: Nomi Health Commercial |
$1,430.72
|
| Rate for Payer: PACE SWMI |
$1,192.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,961.57
|
| Rate for Payer: Priority Health Medicare |
$1,192.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,961.57
|
| Rate for Payer: Priority Health SBD |
$1,961.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,192.27
|
| Rate for Payer: UHC Exchange |
$1,397.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,192.27
|
| Rate for Payer: UHCCP Medicaid |
$788.74
|
|
|
PR URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,769.00
|
|
|
Service Code
|
HCPCS 50900
|
| Min. Negotiated Rate |
$539.32 |
| Max. Negotiated Rate |
$148,043.00 |
| Rate for Payer: Aetna Commercial |
$1,078.26
|
| Rate for Payer: Aetna Medicare |
$836.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.72
|
| Rate for Payer: BCBS Complete |
$566.29
|
| Rate for Payer: BCBS MAPPO |
$804.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.84
|
| Rate for Payer: BCN Commercial |
$1,214.37
|
| Rate for Payer: BCN Medicare Advantage |
$804.67
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cofinity Commercial |
$1,158.72
|
| Rate for Payer: Cofinity Commercial |
$1,078.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.67
|
| Rate for Payer: Healthscope Commercial |
$1,488.64
|
| Rate for Payer: Healthscope Commercial |
$1,287.47
|
| Rate for Payer: Mclaren Medicaid |
$539.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$844.90
|
| Rate for Payer: Meridian Medicaid |
$566.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148,043.00
|
| Rate for Payer: Nomi Health Commercial |
$965.60
|
| Rate for Payer: PACE SWMI |
$804.67
|
| Rate for Payer: PHP Medicare Advantage |
$804.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,340.02
|
| Rate for Payer: Priority Health Medicare |
$804.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.02
|
| Rate for Payer: Priority Health SBD |
$1,340.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.67
|
| Rate for Payer: UHC Exchange |
$1,130.83
|
| Rate for Payer: UHC Medicare Advantage |
$804.67
|
| Rate for Payer: UHCCP Medicaid |
$539.32
|
|
|
PR URETEROTOMY INSERTION INDWELLING STENT ALL TYPES
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 50605
|
| Min. Negotiated Rate |
$646.03 |
| Max. Negotiated Rate |
$179,428.00 |
| Rate for Payer: Aetna Commercial |
$1,305.32
|
| Rate for Payer: Aetna Medicare |
$1,013.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.73
|
| Rate for Payer: BCBS Complete |
$678.33
|
| Rate for Payer: BCBS MAPPO |
$974.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.98
|
| Rate for Payer: BCN Commercial |
$1,464.57
|
| Rate for Payer: BCN Medicare Advantage |
$974.12
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cofinity Commercial |
$1,402.73
|
| Rate for Payer: Cofinity Commercial |
$1,305.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.12
|
| Rate for Payer: Healthscope Commercial |
$1,802.12
|
| Rate for Payer: Healthscope Commercial |
$1,558.59
|
| Rate for Payer: Mclaren Medicaid |
$646.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.83
|
| Rate for Payer: Meridian Medicaid |
$678.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179,428.00
|
| Rate for Payer: Nomi Health Commercial |
$1,168.94
|
| Rate for Payer: PACE SWMI |
$974.12
|
| Rate for Payer: PHP Medicare Advantage |
$974.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$646.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,322.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,609.52
|
| Rate for Payer: Priority Health Medicare |
$974.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,609.52
|
| Rate for Payer: Priority Health SBD |
$1,609.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.12
|
| Rate for Payer: UHC Exchange |
$1,054.91
|
| Rate for Payer: UHC Medicare Advantage |
$974.12
|
| Rate for Payer: UHCCP Medicaid |
$646.03
|
|
|
PR URETEROURETEROSTOMY
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 50760
|
| Min. Negotiated Rate |
$720.79 |
| Max. Negotiated Rate |
$200,356.00 |
| Rate for Payer: Aetna Commercial |
$1,448.86
|
| Rate for Payer: Aetna Medicare |
$1,124.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.99
|
| Rate for Payer: BCBS Complete |
$756.83
|
| Rate for Payer: BCBS MAPPO |
$1,081.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,592.37
|
| Rate for Payer: BCN Commercial |
$1,637.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,081.24
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$1,556.99
|
| Rate for Payer: Cofinity Commercial |
$1,448.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,081.24
|
| Rate for Payer: Healthscope Commercial |
$2,000.29
|
| Rate for Payer: Healthscope Commercial |
$1,729.98
|
| Rate for Payer: Mclaren Medicaid |
$720.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,135.30
|
| Rate for Payer: Meridian Medicaid |
$756.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200,356.00
|
| Rate for Payer: Nomi Health Commercial |
$1,297.49
|
| Rate for Payer: PACE SWMI |
$1,081.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,081.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,795.92
|
| Rate for Payer: Priority Health Medicare |
$1,081.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,795.92
|
| Rate for Payer: Priority Health SBD |
$1,795.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,392.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,081.24
|
| Rate for Payer: UHC Exchange |
$1,392.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.24
|
| Rate for Payer: UHCCP Medicaid |
$720.79
|
|
|
PR URETHRECTOMY TOT W/CYSTOST MALE
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS 53215
|
| Min. Negotiated Rate |
$397.81 |
| Max. Negotiated Rate |
$163,048.00 |
| Rate for Payer: Aetna Commercial |
$1,186.92
|
| Rate for Payer: Aetna Medicare |
$921.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,275.49
|
| Rate for Payer: BCBS Complete |
$622.20
|
| Rate for Payer: BCBS MAPPO |
$885.76
|
| Rate for Payer: BCBS Trust/PPO |
$397.81
|
| Rate for Payer: BCN Commercial |
$1,335.55
|
| Rate for Payer: BCN Medicare Advantage |
$885.76
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cofinity Commercial |
$1,275.49
|
| Rate for Payer: Cofinity Commercial |
$1,186.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.76
|
| Rate for Payer: Healthscope Commercial |
$1,638.66
|
| Rate for Payer: Healthscope Commercial |
$1,417.22
|
| Rate for Payer: Mclaren Medicaid |
$592.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$930.05
|
| Rate for Payer: Meridian Medicaid |
$622.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163,048.00
|
| Rate for Payer: Nomi Health Commercial |
$1,062.91
|
| Rate for Payer: PACE SWMI |
$885.76
|
| Rate for Payer: PHP Medicare Advantage |
$885.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,253.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,469.98
|
| Rate for Payer: Priority Health Medicare |
$885.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,469.98
|
| Rate for Payer: Priority Health SBD |
$1,469.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$885.76
|
| Rate for Payer: UHC Exchange |
$1,155.28
|
| Rate for Payer: UHC Medicare Advantage |
$885.76
|
| Rate for Payer: UHCCP Medicaid |
$592.57
|
|
|
PR URETHROLSS TRVG SEC OPN W/CSTO
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 53500
|
| Min. Negotiated Rate |
$479.25 |
| Max. Negotiated Rate |
$132,448.00 |
| Rate for Payer: Aetna Commercial |
$960.06
|
| Rate for Payer: Aetna Medicare |
$745.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.06
|
| Rate for Payer: BCBS Complete |
$503.21
|
| Rate for Payer: BCBS MAPPO |
$716.46
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,086.33
|
| Rate for Payer: BCN Medicare Advantage |
$716.46
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$960.06
|
| Rate for Payer: Cofinity Commercial |
$1,031.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.46
|
| Rate for Payer: Healthscope Commercial |
$1,325.45
|
| Rate for Payer: Healthscope Commercial |
$1,146.34
|
| Rate for Payer: Mclaren Medicaid |
$479.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.28
|
| Rate for Payer: Meridian Medicaid |
$503.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,448.00
|
| Rate for Payer: Nomi Health Commercial |
$859.75
|
| Rate for Payer: PACE SWMI |
$716.46
|
| Rate for Payer: PHP Medicare Advantage |
$716.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,194.10
|
| Rate for Payer: Priority Health Medicare |
$716.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,194.10
|
| Rate for Payer: Priority Health SBD |
$1,194.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.46
|
| Rate for Payer: UHC Exchange |
$867.92
|
| Rate for Payer: UHC Medicare Advantage |
$716.46
|
| Rate for Payer: UHCCP Medicaid |
$479.25
|
|
|
PR URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 53450
|
| Min. Negotiated Rate |
$264.33 |
| Max. Negotiated Rate |
$71,829.00 |
| Rate for Payer: Aetna Commercial |
$525.45
|
| Rate for Payer: Aetna Medicare |
$407.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.67
|
| Rate for Payer: BCBS Complete |
$277.55
|
| Rate for Payer: BCBS MAPPO |
$392.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,193.96
|
| Rate for Payer: BCN Commercial |
$592.28
|
| Rate for Payer: BCN Medicare Advantage |
$392.13
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$564.67
|
| Rate for Payer: Cofinity Commercial |
$525.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.13
|
| Rate for Payer: Healthscope Commercial |
$725.44
|
| Rate for Payer: Healthscope Commercial |
$627.41
|
| Rate for Payer: Mclaren Medicaid |
$264.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.74
|
| Rate for Payer: Meridian Medicaid |
$277.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,829.00
|
| Rate for Payer: Nomi Health Commercial |
$470.56
|
| Rate for Payer: PACE SWMI |
$392.13
|
| Rate for Payer: PHP Medicare Advantage |
$392.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.10
|
| Rate for Payer: Priority Health Medicare |
$392.13
|
| Rate for Payer: Priority Health Narrow Network |
$655.10
|
| Rate for Payer: Priority Health SBD |
$655.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.13
|
| Rate for Payer: UHC Exchange |
$463.31
|
| Rate for Payer: UHC Medicare Advantage |
$392.13
|
| Rate for Payer: UHCCP Medicaid |
$264.33
|
|
|
PR URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM
|
Professional
|
Both
|
$1,575.00
|
|
|
Service Code
|
HCPCS 53460
|
| Min. Negotiated Rate |
$294.58 |
| Max. Negotiated Rate |
$80,363.00 |
| Rate for Payer: Aetna Commercial |
$586.45
|
| Rate for Payer: Aetna Medicare |
$455.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.22
|
| Rate for Payer: BCBS Complete |
$309.31
|
| Rate for Payer: BCBS MAPPO |
$437.65
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Medicare Advantage |
$437.65
|
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cofinity Commercial |
$630.22
|
| Rate for Payer: Cofinity Commercial |
$586.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.65
|
| Rate for Payer: Healthscope Commercial |
$809.65
|
| Rate for Payer: Healthscope Commercial |
$700.24
|
| Rate for Payer: Mclaren Medicaid |
$294.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.53
|
| Rate for Payer: Meridian Medicaid |
$309.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,363.00
|
| Rate for Payer: Nomi Health Commercial |
$525.18
|
| Rate for Payer: PACE SWMI |
$437.65
|
| Rate for Payer: PHP Medicare Advantage |
$437.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,023.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.86
|
| Rate for Payer: Priority Health Medicare |
$437.65
|
| Rate for Payer: Priority Health Narrow Network |
$732.86
|
| Rate for Payer: Priority Health SBD |
$732.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.65
|
| Rate for Payer: UHC Exchange |
$523.31
|
| Rate for Payer: UHC Medicare Advantage |
$437.65
|
| Rate for Payer: UHCCP Medicaid |
$294.58
|
|
|
PR URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA
|
Professional
|
Both
|
$2,033.00
|
|
|
Service Code
|
HCPCS 53410
|
| Min. Negotiated Rate |
$625.16 |
| Max. Negotiated Rate |
$171,970.00 |
| Rate for Payer: Aetna Commercial |
$1,251.44
|
| Rate for Payer: Aetna Medicare |
$971.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.83
|
| Rate for Payer: BCBS Complete |
$656.42
|
| Rate for Payer: BCBS MAPPO |
$933.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: BCN Commercial |
$1,409.35
|
| Rate for Payer: BCN Medicare Advantage |
$933.91
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cofinity Commercial |
$1,344.83
|
| Rate for Payer: Cofinity Commercial |
$1,251.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.91
|
| Rate for Payer: Healthscope Commercial |
$1,727.73
|
| Rate for Payer: Healthscope Commercial |
$1,494.26
|
| Rate for Payer: Mclaren Medicaid |
$625.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.61
|
| Rate for Payer: Meridian Medicaid |
$656.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171,970.00
|
| Rate for Payer: Nomi Health Commercial |
$1,120.69
|
| Rate for Payer: PACE SWMI |
$933.91
|
| Rate for Payer: PHP Medicare Advantage |
$933.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$625.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,555.20
|
| Rate for Payer: Priority Health Medicare |
$933.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,555.20
|
| Rate for Payer: Priority Health SBD |
$1,555.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.91
|
| Rate for Payer: UHC Exchange |
$1,085.12
|
| Rate for Payer: UHC Medicare Advantage |
$933.91
|
| Rate for Payer: UHCCP Medicaid |
$625.16
|
|
|
PR URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 53400
|
| Min. Negotiated Rate |
$513.54 |
| Max. Negotiated Rate |
$140,645.00 |
| Rate for Payer: Aetna Commercial |
$1,026.40
|
| Rate for Payer: Aetna Medicare |
$796.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.00
|
| Rate for Payer: BCBS Complete |
$539.22
|
| Rate for Payer: BCBS MAPPO |
$765.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.20
|
| Rate for Payer: BCN Commercial |
$1,154.25
|
| Rate for Payer: BCN Medicare Advantage |
$765.97
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,103.00
|
| Rate for Payer: Cofinity Commercial |
$1,026.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.97
|
| Rate for Payer: Healthscope Commercial |
$1,417.04
|
| Rate for Payer: Healthscope Commercial |
$1,225.55
|
| Rate for Payer: Mclaren Medicaid |
$513.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$804.27
|
| Rate for Payer: Meridian Medicaid |
$539.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,645.00
|
| Rate for Payer: Nomi Health Commercial |
$919.16
|
| Rate for Payer: PACE SWMI |
$765.97
|
| Rate for Payer: PHP Medicare Advantage |
$765.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,272.91
|
| Rate for Payer: Priority Health Medicare |
$765.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,272.91
|
| Rate for Payer: Priority Health SBD |
$1,272.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.97
|
| Rate for Payer: UHC Exchange |
$866.31
|
| Rate for Payer: UHC Medicare Advantage |
$765.97
|
| Rate for Payer: UHCCP Medicaid |
$513.54
|
|
|
PR URETHROPLASTY 2ND STAGE W/URINARY DIVERSION
|
Professional
|
Both
|
$1,814.00
|
|
|
Service Code
|
HCPCS 53405
|
| Min. Negotiated Rate |
$558.70 |
| Max. Negotiated Rate |
$153,472.00 |
| Rate for Payer: Aetna Commercial |
$1,117.72
|
| Rate for Payer: Aetna Medicare |
$867.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,117.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,201.13
|
| Rate for Payer: BCBS Complete |
$586.64
|
| Rate for Payer: BCBS MAPPO |
$834.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.99
|
| Rate for Payer: BCN Commercial |
$1,258.34
|
| Rate for Payer: BCN Medicare Advantage |
$834.12
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,201.13
|
| Rate for Payer: Cofinity Commercial |
$1,117.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.12
|
| Rate for Payer: Healthscope Commercial |
$1,543.12
|
| Rate for Payer: Healthscope Commercial |
$1,334.59
|
| Rate for Payer: Mclaren Medicaid |
$558.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$875.83
|
| Rate for Payer: Meridian Medicaid |
$586.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153,472.00
|
| Rate for Payer: Nomi Health Commercial |
$1,000.94
|
| Rate for Payer: PACE SWMI |
$834.12
|
| Rate for Payer: PHP Medicare Advantage |
$834.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,387.42
|
| Rate for Payer: Priority Health Medicare |
$834.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,387.42
|
| Rate for Payer: Priority Health SBD |
$1,387.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.12
|
| Rate for Payer: UHC Exchange |
$1,002.00
|
| Rate for Payer: UHC Medicare Advantage |
$834.12
|
| Rate for Payer: UHCCP Medicaid |
$558.70
|
|
|
PR URETHROPLASTY RCNSTJ FEMALE URETHRA
|
Professional
|
Both
|
$1,764.00
|
|
|
Service Code
|
HCPCS 53430
|
| Min. Negotiated Rate |
$622.17 |
| Max. Negotiated Rate |
$171,783.00 |
| Rate for Payer: Aetna Commercial |
$1,247.55
|
| Rate for Payer: Aetna Medicare |
$968.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.65
|
| Rate for Payer: BCBS Complete |
$653.28
|
| Rate for Payer: BCBS MAPPO |
$931.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,049.80
|
| Rate for Payer: BCN Commercial |
$1,406.42
|
| Rate for Payer: BCN Medicare Advantage |
$931.01
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cofinity Commercial |
$1,340.65
|
| Rate for Payer: Cofinity Commercial |
$1,247.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.01
|
| Rate for Payer: Healthscope Commercial |
$1,722.37
|
| Rate for Payer: Healthscope Commercial |
$1,489.62
|
| Rate for Payer: Mclaren Medicaid |
$622.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.56
|
| Rate for Payer: Meridian Medicaid |
$653.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171,783.00
|
| Rate for Payer: Nomi Health Commercial |
$1,117.21
|
| Rate for Payer: PACE SWMI |
$931.01
|
| Rate for Payer: PHP Medicare Advantage |
$931.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$622.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,146.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,548.80
|
| Rate for Payer: Priority Health Medicare |
$931.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.80
|
| Rate for Payer: Priority Health SBD |
$1,548.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.01
|
| Rate for Payer: UHC Exchange |
$1,098.33
|
| Rate for Payer: UHC Medicare Advantage |
$931.01
|
| Rate for Payer: UHCCP Medicaid |
$622.17
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE
|
Professional
|
Both
|
$977.00
|
|
|
Service Code
|
HCPCS 53502
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$85,378.00 |
| Rate for Payer: Aetna Commercial |
$624.19
|
| Rate for Payer: Aetna Medicare |
$484.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.77
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCBS MAPPO |
$465.81
|
| Rate for Payer: BCBS Trust/PPO |
$701.05
|
| Rate for Payer: BCN Commercial |
$702.72
|
| Rate for Payer: BCN Medicare Advantage |
$465.81
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cofinity Commercial |
$670.77
|
| Rate for Payer: Cofinity Commercial |
$624.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.81
|
| Rate for Payer: Healthscope Commercial |
$861.75
|
| Rate for Payer: Healthscope Commercial |
$745.30
|
| Rate for Payer: Mclaren Medicaid |
$313.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.10
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,378.00
|
| Rate for Payer: Nomi Health Commercial |
$558.97
|
| Rate for Payer: PACE SWMI |
$465.81
|
| Rate for Payer: PHP Medicare Advantage |
$465.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.13
|
| Rate for Payer: Priority Health Medicare |
$465.81
|
| Rate for Payer: Priority Health Narrow Network |
$778.13
|
| Rate for Payer: Priority Health SBD |
$778.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.81
|
| Rate for Payer: UHC Exchange |
$607.14
|
| Rate for Payer: UHC Medicare Advantage |
$465.81
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 53505
|
| Min. Negotiated Rate |
$288.98 |
| Max. Negotiated Rate |
$85,322.00 |
| Rate for Payer: Aetna Commercial |
$623.78
|
| Rate for Payer: Aetna Medicare |
$484.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.33
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCBS MAPPO |
$465.51
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: BCN Medicare Advantage |
$465.51
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cofinity Commercial |
$670.33
|
| Rate for Payer: Cofinity Commercial |
$623.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.51
|
| Rate for Payer: Healthscope Commercial |
$861.19
|
| Rate for Payer: Healthscope Commercial |
$744.82
|
| Rate for Payer: Mclaren Medicaid |
$313.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.79
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,322.00
|
| Rate for Payer: Nomi Health Commercial |
$558.61
|
| Rate for Payer: PACE SWMI |
$465.51
|
| Rate for Payer: PHP Medicare Advantage |
$465.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.60
|
| Rate for Payer: Priority Health Medicare |
$465.51
|
| Rate for Payer: Priority Health Narrow Network |
$777.60
|
| Rate for Payer: Priority Health SBD |
$777.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.51
|
| Rate for Payer: UHC Exchange |
$613.02
|
| Rate for Payer: UHC Medicare Advantage |
$465.51
|
| Rate for Payer: UHCCP Medicaid |
$313.11
|
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 53010
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$51,905.00 |
| Rate for Payer: Aetna Commercial |
$381.16
|
| Rate for Payer: Aetna Medicare |
$295.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.61
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$284.45
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$430.52
|
| Rate for Payer: BCN Medicare Advantage |
$284.45
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$409.61
|
| Rate for Payer: Cofinity Commercial |
$381.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.45
|
| Rate for Payer: Healthscope Commercial |
$526.23
|
| Rate for Payer: Healthscope Commercial |
$455.12
|
| Rate for Payer: Mclaren Medicaid |
$192.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.67
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,905.00
|
| Rate for Payer: Nomi Health Commercial |
$341.34
|
| Rate for Payer: PACE SWMI |
$284.45
|
| Rate for Payer: PHP Medicare Advantage |
$284.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.27
|
| Rate for Payer: Priority Health Medicare |
$284.45
|
| Rate for Payer: Priority Health Narrow Network |
$478.27
|
| Rate for Payer: Priority Health SBD |
$478.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.45
|
| Rate for Payer: UHC Exchange |
$328.94
|
| Rate for Payer: UHC Medicare Advantage |
$284.45
|
| Rate for Payer: UHCCP Medicaid |
$192.98
|
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 50650
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$182,146.00 |
| Rate for Payer: Aetna Commercial |
$1,327.22
|
| Rate for Payer: Aetna Medicare |
$1,030.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,327.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,426.26
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$990.46
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$990.46
|
| Rate for Payer: Cash Price |
$2,680.00
|
| Rate for Payer: Cash Price |
$2,680.00
|
| Rate for Payer: Cofinity Commercial |
$1,426.26
|
| Rate for Payer: Cofinity Commercial |
$1,327.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$990.46
|
| Rate for Payer: Healthscope Commercial |
$1,832.35
|
| Rate for Payer: Healthscope Commercial |
$1,584.74
|
| Rate for Payer: Mclaren Medicaid |
$662.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.98
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,146.00
|
| Rate for Payer: Nomi Health Commercial |
$1,188.55
|
| Rate for Payer: PACE SWMI |
$990.46
|
| Rate for Payer: PHP Medicare Advantage |
$990.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.40
|
| Rate for Payer: Priority Health Medicare |
$990.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.40
|
| Rate for Payer: Priority Health SBD |
$1,648.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,306.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$990.46
|
| Rate for Payer: UHC Exchange |
$1,306.54
|
| Rate for Payer: UHC Medicare Advantage |
$990.46
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4358
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$780.00 |
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
|
|
PR URINARY SUSPENSORY
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS A5105
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$5,422.00 |
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCN Commercial |
$44.89
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,422.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 53431
|
| Min. Negotiated Rate |
$734.64 |
| Max. Negotiated Rate |
$202,345.00 |
| Rate for Payer: Aetna Commercial |
$1,472.67
|
| Rate for Payer: Aetna Medicare |
$1,142.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.57
|
| Rate for Payer: BCBS Complete |
$771.37
|
| Rate for Payer: BCBS MAPPO |
$1,099.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,997.57
|
| Rate for Payer: BCN Commercial |
$1,656.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.01
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$1,582.57
|
| Rate for Payer: Cofinity Commercial |
$1,472.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.01
|
| Rate for Payer: Healthscope Commercial |
$2,033.17
|
| Rate for Payer: Healthscope Commercial |
$1,758.42
|
| Rate for Payer: Mclaren Medicaid |
$734.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,153.96
|
| Rate for Payer: Meridian Medicaid |
$771.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202,345.00
|
| Rate for Payer: Nomi Health Commercial |
$1,318.81
|
| Rate for Payer: PACE SWMI |
$1,099.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,825.76
|
| Rate for Payer: Priority Health Medicare |
$1,099.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,825.76
|
| Rate for Payer: Priority Health SBD |
$1,825.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.01
|
| Rate for Payer: UHC Exchange |
$1,284.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.01
|
| Rate for Payer: UHCCP Medicaid |
$734.64
|
|
|
PR URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 50620
|
| Min. Negotiated Rate |
$576.59 |
| Max. Negotiated Rate |
$158,648.00 |
| Rate for Payer: Aetna Commercial |
$1,154.77
|
| Rate for Payer: Aetna Medicare |
$896.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,154.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.95
|
| Rate for Payer: BCBS Complete |
$605.42
|
| Rate for Payer: BCBS MAPPO |
$861.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.73
|
| Rate for Payer: BCN Commercial |
$1,299.39
|
| Rate for Payer: BCN Medicare Advantage |
$861.77
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,240.95
|
| Rate for Payer: Cofinity Commercial |
$1,154.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$861.77
|
| Rate for Payer: Healthscope Commercial |
$1,594.27
|
| Rate for Payer: Healthscope Commercial |
$1,378.83
|
| Rate for Payer: Mclaren Medicaid |
$576.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$904.86
|
| Rate for Payer: Meridian Medicaid |
$605.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158,648.00
|
| Rate for Payer: Nomi Health Commercial |
$1,034.12
|
| Rate for Payer: PACE SWMI |
$861.77
|
| Rate for Payer: PHP Medicare Advantage |
$861.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,432.69
|
| Rate for Payer: Priority Health Medicare |
$861.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,432.69
|
| Rate for Payer: Priority Health SBD |
$1,432.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,133.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$861.77
|
| Rate for Payer: UHC Exchange |
$1,133.86
|
| Rate for Payer: UHC Medicare Advantage |
$861.77
|
| Rate for Payer: UHCCP Medicaid |
$576.59
|
|
