|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 50785
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$213,669.00 |
| Rate for Payer: Aetna Commercial |
$1,556.52
|
| Rate for Payer: Aetna Medicare |
$1,208.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,672.68
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,161.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,101.12
|
| Rate for Payer: BCN Commercial |
$1,747.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,161.58
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,672.68
|
| Rate for Payer: Cofinity Commercial |
$1,556.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,161.58
|
| Rate for Payer: Healthscope Commercial |
$2,148.92
|
| Rate for Payer: Healthscope Commercial |
$1,858.53
|
| Rate for Payer: Mclaren Medicaid |
$775.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,219.66
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213,669.00
|
| Rate for Payer: Nomi Health Commercial |
$1,393.90
|
| Rate for Payer: PACE SWMI |
$1,161.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,161.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.56
|
| Rate for Payer: Priority Health Medicare |
$1,161.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.56
|
| Rate for Payer: Priority Health SBD |
$1,920.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,522.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,161.58
|
| Rate for Payer: UHC Exchange |
$1,522.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,161.58
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 53000
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$25,931.00 |
| Rate for Payer: Aetna Commercial |
$189.46
|
| Rate for Payer: Aetna Medicare |
$147.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.60
|
| Rate for Payer: BCBS Complete |
$100.42
|
| Rate for Payer: BCBS MAPPO |
$141.39
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: BCN Medicare Advantage |
$141.39
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$203.60
|
| Rate for Payer: Cofinity Commercial |
$189.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.39
|
| Rate for Payer: Healthscope Commercial |
$261.57
|
| Rate for Payer: Healthscope Commercial |
$226.22
|
| Rate for Payer: Mclaren Medicaid |
$95.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.46
|
| Rate for Payer: Meridian Medicaid |
$100.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,931.00
|
| Rate for Payer: Nomi Health Commercial |
$169.67
|
| Rate for Payer: PACE SWMI |
$141.39
|
| Rate for Payer: PHP Medicare Advantage |
$141.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.08
|
| Rate for Payer: Priority Health Medicare |
$141.39
|
| Rate for Payer: Priority Health Narrow Network |
$238.08
|
| Rate for Payer: Priority Health SBD |
$238.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.39
|
| Rate for Payer: UHC Exchange |
$329.38
|
| Rate for Payer: UHC Medicare Advantage |
$141.39
|
| Rate for Payer: UHCCP Medicaid |
$95.64
|
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 93352
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$4,779.00 |
| Rate for Payer: Aetna Commercial |
$42.42
|
| Rate for Payer: Aetna Medicare |
$32.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.59
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$31.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: BCN Medicare Advantage |
$31.66
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.59
|
| Rate for Payer: Cofinity Commercial |
$42.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.66
|
| Rate for Payer: Healthscope Commercial |
$50.66
|
| Rate for Payer: Healthscope Commercial |
$58.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,779.00
|
| Rate for Payer: Nomi Health Commercial |
$37.99
|
| Rate for Payer: PACE SWMI |
$31.66
|
| Rate for Payer: PHP Medicare Advantage |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.97
|
| Rate for Payer: Priority Health Medicare |
$31.66
|
| Rate for Payer: Priority Health Narrow Network |
$48.97
|
| Rate for Payer: Priority Health SBD |
$48.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.66
|
| Rate for Payer: UHC Medicare Advantage |
$31.66
|
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$1,482.00 |
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.23
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$9.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.66
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: BCN Medicare Advantage |
$9.13
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Cofinity Commercial |
$12.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.13
|
| Rate for Payer: Healthscope Commercial |
$14.61
|
| Rate for Payer: Healthscope Commercial |
$16.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,482.00
|
| Rate for Payer: Nomi Health Commercial |
$10.96
|
| Rate for Payer: PACE SWMI |
$9.13
|
| Rate for Payer: PHP Medicare Advantage |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.47
|
| Rate for Payer: Priority Health Medicare |
$9.13
|
| Rate for Payer: Priority Health Narrow Network |
$14.47
|
| Rate for Payer: Priority Health SBD |
$2.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.13
|
| Rate for Payer: UHC Exchange |
$55.03
|
| Rate for Payer: UHC Medicare Advantage |
$9.13
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$95,848.00 |
| Rate for Payer: Aetna Commercial |
$687.23
|
| Rate for Payer: Aetna Medicare |
$533.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.52
|
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: BCBS MAPPO |
$512.86
|
| Rate for Payer: BCBS Trust/PPO |
$547.32
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$512.86
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cofinity Commercial |
$738.52
|
| Rate for Payer: Cofinity Commercial |
$687.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.86
|
| Rate for Payer: Healthscope Commercial |
$948.79
|
| Rate for Payer: Healthscope Commercial |
$820.58
|
| Rate for Payer: Mclaren Medicaid |
$344.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.50
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,848.00
|
| Rate for Payer: Nomi Health Commercial |
$615.43
|
| Rate for Payer: PACE SWMI |
$512.86
|
| Rate for Payer: PHP Medicare Advantage |
$512.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.12
|
| Rate for Payer: Priority Health Medicare |
$512.86
|
| Rate for Payer: Priority Health Narrow Network |
$760.12
|
| Rate for Payer: Priority Health SBD |
$760.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.86
|
| Rate for Payer: UHC Exchange |
$454.65
|
| Rate for Payer: UHC Medicare Advantage |
$512.86
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$296.50 |
| Max. Negotiated Rate |
$82,350.00 |
| Rate for Payer: Aetna Commercial |
$589.12
|
| Rate for Payer: Aetna Medicare |
$457.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.08
|
| Rate for Payer: BCBS Complete |
$311.32
|
| Rate for Payer: BCBS MAPPO |
$439.64
|
| Rate for Payer: BCBS Trust/PPO |
$568.45
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: BCN Medicare Advantage |
$439.64
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$633.08
|
| Rate for Payer: Cofinity Commercial |
$589.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.64
|
| Rate for Payer: Healthscope Commercial |
$813.33
|
| Rate for Payer: Healthscope Commercial |
$703.42
|
| Rate for Payer: Mclaren Medicaid |
$296.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.62
|
| Rate for Payer: Meridian Medicaid |
$311.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,350.00
|
| Rate for Payer: Nomi Health Commercial |
$527.57
|
| Rate for Payer: PACE SWMI |
$439.64
|
| Rate for Payer: PHP Medicare Advantage |
$439.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.95
|
| Rate for Payer: Priority Health Medicare |
$439.64
|
| Rate for Payer: Priority Health Narrow Network |
$695.95
|
| Rate for Payer: Priority Health SBD |
$695.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.64
|
| Rate for Payer: UHC Exchange |
$582.75
|
| Rate for Payer: UHC Medicare Advantage |
$439.64
|
| Rate for Payer: UHCCP Medicaid |
$296.50
|
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$272,983.00 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,068.89
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.42
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272,983.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,472.83
|
| Rate for Payer: UHC Exchange |
$1,472.83
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$28,292.00 |
| Rate for Payer: Aetna Commercial |
$205.93
|
| Rate for Payer: Aetna Medicare |
$159.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.30
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$153.68
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$153.68
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.68
|
| Rate for Payer: Healthscope Commercial |
$284.31
|
| Rate for Payer: Healthscope Commercial |
$245.89
|
| Rate for Payer: Mclaren Medicaid |
$106.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.36
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,292.00
|
| Rate for Payer: Nomi Health Commercial |
$184.42
|
| Rate for Payer: PACE SWMI |
$153.68
|
| Rate for Payer: PHP Medicare Advantage |
$153.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.31
|
| Rate for Payer: Priority Health Medicare |
$153.68
|
| Rate for Payer: Priority Health Narrow Network |
$295.31
|
| Rate for Payer: Priority Health SBD |
$295.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.68
|
| Rate for Payer: UHC Exchange |
$261.64
|
| Rate for Payer: UHC Medicare Advantage |
$153.68
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,124.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$190.19 |
| Max. Negotiated Rate |
$222,975.00 |
| Rate for Payer: Aetna Commercial |
$1,601.43
|
| Rate for Payer: Aetna Medicare |
$1,242.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,720.94
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,195.10
|
| Rate for Payer: BCBS Trust/PPO |
$190.19
|
| Rate for Payer: BCN Commercial |
$1,823.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.10
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cofinity Commercial |
$1,720.94
|
| Rate for Payer: Cofinity Commercial |
$1,601.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.10
|
| Rate for Payer: Healthscope Commercial |
$2,210.94
|
| Rate for Payer: Healthscope Commercial |
$1,912.16
|
| Rate for Payer: Mclaren Medicaid |
$795.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,254.86
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222,975.00
|
| Rate for Payer: Nomi Health Commercial |
$1,434.12
|
| Rate for Payer: PACE SWMI |
$1,195.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,030.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.72
|
| Rate for Payer: Priority Health Medicare |
$1,195.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,855.72
|
| Rate for Payer: Priority Health SBD |
$1,855.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.10
|
| Rate for Payer: UHC Exchange |
$1,381.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,195.10
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,457.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$235,066.00 |
| Rate for Payer: Aetna Commercial |
$1,687.26
|
| Rate for Payer: Aetna Medicare |
$1,309.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,813.18
|
| Rate for Payer: BCBS Complete |
$879.62
|
| Rate for Payer: BCBS MAPPO |
$1,259.15
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$1,921.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,259.15
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Cofinity Commercial |
$1,813.18
|
| Rate for Payer: Cofinity Commercial |
$1,687.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,259.15
|
| Rate for Payer: Healthscope Commercial |
$2,329.43
|
| Rate for Payer: Healthscope Commercial |
$2,014.64
|
| Rate for Payer: Mclaren Medicaid |
$837.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,322.11
|
| Rate for Payer: Meridian Medicaid |
$879.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235,066.00
|
| Rate for Payer: Nomi Health Commercial |
$1,510.98
|
| Rate for Payer: PACE SWMI |
$1,259.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,259.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,955.41
|
| Rate for Payer: Priority Health Medicare |
$1,259.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,955.41
|
| Rate for Payer: Priority Health SBD |
$1,955.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,464.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,259.15
|
| Rate for Payer: UHC Exchange |
$1,464.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,259.15
|
| Rate for Payer: UHCCP Medicaid |
$837.73
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$2,973.00
|
|
|
Service Code
|
HCPCS 58262
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$165,775.00 |
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: Aetna Medicare |
$926.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,282.80
|
| Rate for Payer: BCBS Complete |
$624.44
|
| Rate for Payer: BCBS MAPPO |
$890.83
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$1,359.01
|
| Rate for Payer: BCN Medicare Advantage |
$890.83
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Cofinity Commercial |
$1,282.80
|
| Rate for Payer: Cofinity Commercial |
$1,193.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.83
|
| Rate for Payer: Healthscope Commercial |
$1,648.04
|
| Rate for Payer: Healthscope Commercial |
$1,425.33
|
| Rate for Payer: Mclaren Medicaid |
$594.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$935.37
|
| Rate for Payer: Meridian Medicaid |
$624.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165,775.00
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE SWMI |
$890.83
|
| Rate for Payer: PHP Medicare Advantage |
$890.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,386.95
|
| Rate for Payer: Priority Health Medicare |
$890.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.95
|
| Rate for Payer: Priority Health SBD |
$1,386.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.83
|
| Rate for Payer: UHC Exchange |
$1,408.21
|
| Rate for Payer: UHC Medicare Advantage |
$890.83
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,245.00
|
|
|
Service Code
|
HCPCS 58263
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$177,932.00 |
| Rate for Payer: Aetna Commercial |
$1,281.68
|
| Rate for Payer: Aetna Medicare |
$994.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.33
|
| Rate for Payer: BCBS Complete |
$669.84
|
| Rate for Payer: BCBS MAPPO |
$956.48
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$1,457.73
|
| Rate for Payer: BCN Medicare Advantage |
$956.48
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,377.33
|
| Rate for Payer: Cofinity Commercial |
$1,281.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.48
|
| Rate for Payer: Healthscope Commercial |
$1,769.49
|
| Rate for Payer: Healthscope Commercial |
$1,530.37
|
| Rate for Payer: Mclaren Medicaid |
$637.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.30
|
| Rate for Payer: Meridian Medicaid |
$669.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177,932.00
|
| Rate for Payer: Nomi Health Commercial |
$1,147.78
|
| Rate for Payer: PACE SWMI |
$956.48
|
| Rate for Payer: PHP Medicare Advantage |
$956.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.15
|
| Rate for Payer: Priority Health Medicare |
$956.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,486.15
|
| Rate for Payer: Priority Health SBD |
$1,486.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,500.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.48
|
| Rate for Payer: UHC Exchange |
$1,500.20
|
| Rate for Payer: UHC Medicare Advantage |
$956.48
|
| Rate for Payer: UHCCP Medicaid |
$637.94
|
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 58280
|
| Min. Negotiated Rate |
$237.74 |
| Max. Negotiated Rate |
$189,819.00 |
| Rate for Payer: Aetna Commercial |
$1,362.99
|
| Rate for Payer: Aetna Medicare |
$1,057.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.71
|
| Rate for Payer: BCBS Complete |
$712.33
|
| Rate for Payer: BCBS MAPPO |
$1,017.16
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: BCN Commercial |
$1,554.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.16
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,464.71
|
| Rate for Payer: Cofinity Commercial |
$1,362.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.16
|
| Rate for Payer: Healthscope Commercial |
$1,881.75
|
| Rate for Payer: Healthscope Commercial |
$1,627.46
|
| Rate for Payer: Mclaren Medicaid |
$678.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.02
|
| Rate for Payer: Meridian Medicaid |
$712.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189,819.00
|
| Rate for Payer: Nomi Health Commercial |
$1,220.59
|
| Rate for Payer: PACE SWMI |
$1,017.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,584.37
|
| Rate for Payer: Priority Health Medicare |
$1,017.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,584.37
|
| Rate for Payer: Priority Health SBD |
$1,584.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,544.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,017.16
|
| Rate for Payer: UHC Exchange |
$1,544.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,017.16
|
| Rate for Payer: UHCCP Medicaid |
$678.41
|
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 59612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$164,277.00 |
| Rate for Payer: Aetna Commercial |
$1,191.25
|
| Rate for Payer: Aetna Medicare |
$924.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,280.15
|
| Rate for Payer: BCBS Complete |
$886.77
|
| Rate for Payer: BCBS MAPPO |
$888.99
|
| Rate for Payer: BCBS Trust/PPO |
$187.55
|
| Rate for Payer: BCN Commercial |
$1,636.60
|
| Rate for Payer: BCN Medicare Advantage |
$888.99
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cofinity Commercial |
$1,280.15
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.99
|
| Rate for Payer: Healthscope Commercial |
$1,644.63
|
| Rate for Payer: Healthscope Commercial |
$1,422.38
|
| Rate for Payer: Mclaren Medicaid |
$844.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.44
|
| Rate for Payer: Meridian Medicaid |
$886.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164,277.00
|
| Rate for Payer: Nomi Health Commercial |
$1,066.79
|
| Rate for Payer: PACE SWMI |
$888.99
|
| Rate for Payer: PHP Medicare Advantage |
$888.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,267.33
|
| Rate for Payer: Priority Health Medicare |
$888.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,267.33
|
| Rate for Payer: Priority Health SBD |
$1,267.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$888.99
|
| Rate for Payer: UHC Exchange |
$1,357.03
|
| Rate for Payer: UHC Medicare Advantage |
$888.99
|
| Rate for Payer: UHCCP Medicaid |
$844.54
|
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
HCPCS 59409
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$144,797.00 |
| Rate for Payer: Aetna Commercial |
$1,046.55
|
| Rate for Payer: Aetna Medicare |
$812.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.65
|
| Rate for Payer: BCBS Complete |
$779.06
|
| Rate for Payer: BCBS MAPPO |
$781.01
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: BCN Commercial |
$1,558.66
|
| Rate for Payer: BCN Medicare Advantage |
$781.01
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cofinity Commercial |
$1,124.65
|
| Rate for Payer: Cofinity Commercial |
$1,046.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.01
|
| Rate for Payer: Healthscope Commercial |
$1,444.87
|
| Rate for Payer: Healthscope Commercial |
$1,249.62
|
| Rate for Payer: Mclaren Medicaid |
$741.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.06
|
| Rate for Payer: Meridian Medicaid |
$779.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,797.00
|
| Rate for Payer: Nomi Health Commercial |
$937.21
|
| Rate for Payer: PACE SWMI |
$781.01
|
| Rate for Payer: PHP Medicare Advantage |
$781.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.29
|
| Rate for Payer: Priority Health Medicare |
$781.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.29
|
| Rate for Payer: Priority Health SBD |
$1,118.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,212.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.01
|
| Rate for Payer: UHC Exchange |
$1,212.34
|
| Rate for Payer: UHC Medicare Advantage |
$781.01
|
| Rate for Payer: UHCCP Medicaid |
$741.96
|
|
|
PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 59410
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$191,302.00 |
| Rate for Payer: Aetna Commercial |
$1,413.43
|
| Rate for Payer: Aetna Medicare |
$1,096.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,518.91
|
| Rate for Payer: BCBS Complete |
$1,052.16
|
| Rate for Payer: BCBS MAPPO |
$1,054.80
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: BCN Commercial |
$1,809.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,054.80
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$1,518.91
|
| Rate for Payer: Cofinity Commercial |
$1,413.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.80
|
| Rate for Payer: Healthscope Commercial |
$1,951.38
|
| Rate for Payer: Healthscope Commercial |
$1,687.68
|
| Rate for Payer: Mclaren Medicaid |
$1,002.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.54
|
| Rate for Payer: Meridian Medicaid |
$1,052.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191,302.00
|
| Rate for Payer: Nomi Health Commercial |
$1,265.76
|
| Rate for Payer: PACE SWMI |
$1,054.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,054.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,002.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.19
|
| Rate for Payer: Priority Health Medicare |
$1,054.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,514.19
|
| Rate for Payer: Priority Health SBD |
$1,514.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,384.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,054.80
|
| Rate for Payer: UHC Exchange |
$1,384.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,054.80
|
| Rate for Payer: UHCCP Medicaid |
$1,002.06
|
|
|
PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 59614
|
| Min. Negotiated Rate |
$325.96 |
| Max. Negotiated Rate |
$207,527.00 |
| Rate for Payer: Aetna Commercial |
$1,537.32
|
| Rate for Payer: Aetna Medicare |
$1,193.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,652.04
|
| Rate for Payer: BCBS Complete |
$1,144.38
|
| Rate for Payer: BCBS MAPPO |
$1,147.25
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCN Commercial |
$1,899.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.25
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cofinity Commercial |
$1,652.04
|
| Rate for Payer: Cofinity Commercial |
$1,537.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.25
|
| Rate for Payer: Healthscope Commercial |
$2,122.41
|
| Rate for Payer: Healthscope Commercial |
$1,835.60
|
| Rate for Payer: Mclaren Medicaid |
$1,089.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,204.61
|
| Rate for Payer: Meridian Medicaid |
$1,144.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207,527.00
|
| Rate for Payer: Nomi Health Commercial |
$1,376.70
|
| Rate for Payer: PACE SWMI |
$1,147.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,637.16
|
| Rate for Payer: Priority Health Medicare |
$1,147.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,637.16
|
| Rate for Payer: Priority Health SBD |
$1,637.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,486.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,147.25
|
| Rate for Payer: UHC Exchange |
$1,486.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,147.25
|
| Rate for Payer: UHCCP Medicaid |
$1,089.89
|
|
|
PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 58294
|
| Min. Negotiated Rate |
$327.55 |
| Max. Negotiated Rate |
$218,227.00 |
| Rate for Payer: Aetna Commercial |
$1,567.37
|
| Rate for Payer: Aetna Medicare |
$1,216.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,567.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,684.34
|
| Rate for Payer: BCBS Complete |
$817.45
|
| Rate for Payer: BCBS MAPPO |
$1,169.68
|
| Rate for Payer: BCBS Trust/PPO |
$327.55
|
| Rate for Payer: BCN Commercial |
$1,784.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.68
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cofinity Commercial |
$1,684.34
|
| Rate for Payer: Cofinity Commercial |
$1,567.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.68
|
| Rate for Payer: Healthscope Commercial |
$2,163.91
|
| Rate for Payer: Healthscope Commercial |
$1,871.49
|
| Rate for Payer: Mclaren Medicaid |
$778.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,228.16
|
| Rate for Payer: Meridian Medicaid |
$817.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,227.00
|
| Rate for Payer: Nomi Health Commercial |
$1,403.62
|
| Rate for Payer: PACE SWMI |
$1,169.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,816.03
|
| Rate for Payer: Priority Health Medicare |
$1,169.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,816.03
|
| Rate for Payer: Priority Health SBD |
$1,816.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,169.68
|
| Rate for Payer: UHC Exchange |
$1,347.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,169.68
|
| Rate for Payer: UHCCP Medicaid |
$778.52
|
|
|
PR VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE
|
Professional
|
Both
|
$2,757.00
|
|
|
Service Code
|
HCPCS 58270
|
| Min. Negotiated Rate |
$233.51 |
| Max. Negotiated Rate |
$160,189.00 |
| Rate for Payer: Aetna Commercial |
$1,150.51
|
| Rate for Payer: Aetna Medicare |
$892.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.37
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$858.59
|
| Rate for Payer: BCBS Trust/PPO |
$233.51
|
| Rate for Payer: BCN Commercial |
$1,313.56
|
| Rate for Payer: BCN Medicare Advantage |
$858.59
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cofinity Commercial |
$1,236.37
|
| Rate for Payer: Cofinity Commercial |
$1,150.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.59
|
| Rate for Payer: Healthscope Commercial |
$1,588.39
|
| Rate for Payer: Healthscope Commercial |
$1,373.74
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.52
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160,189.00
|
| Rate for Payer: Nomi Health Commercial |
$1,030.31
|
| Rate for Payer: PACE SWMI |
$858.59
|
| Rate for Payer: PHP Medicare Advantage |
$858.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.85
|
| Rate for Payer: Priority Health Medicare |
$858.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.85
|
| Rate for Payer: Priority Health SBD |
$1,336.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.59
|
| Rate for Payer: UHC Exchange |
$1,487.94
|
| Rate for Payer: UHC Medicare Advantage |
$858.59
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS > 250 GM
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 58290
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$206,253.00 |
| Rate for Payer: Aetna Commercial |
$1,482.36
|
| Rate for Payer: Aetna Medicare |
$1,150.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,592.99
|
| Rate for Payer: BCBS Complete |
$773.38
|
| Rate for Payer: BCBS MAPPO |
$1,106.24
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$1,687.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.24
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,592.99
|
| Rate for Payer: Cofinity Commercial |
$1,482.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.24
|
| Rate for Payer: Healthscope Commercial |
$2,046.54
|
| Rate for Payer: Healthscope Commercial |
$1,769.98
|
| Rate for Payer: Mclaren Medicaid |
$736.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.55
|
| Rate for Payer: Meridian Medicaid |
$773.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206,253.00
|
| Rate for Payer: Nomi Health Commercial |
$1,327.49
|
| Rate for Payer: PACE SWMI |
$1,106.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.31
|
| Rate for Payer: Priority Health Medicare |
$1,106.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.31
|
| Rate for Payer: Priority Health SBD |
$1,718.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,254.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.24
|
| Rate for Payer: UHC Exchange |
$1,254.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.24
|
| Rate for Payer: UHCCP Medicaid |
$736.55
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,684.00
|
|
|
Service Code
|
HCPCS 58260
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$150,048.00 |
| Rate for Payer: Aetna Commercial |
$1,078.59
|
| Rate for Payer: Aetna Medicare |
$837.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,159.08
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS MAPPO |
$804.92
|
| Rate for Payer: BCBS Trust/PPO |
$240.90
|
| Rate for Payer: BCN Commercial |
$1,231.47
|
| Rate for Payer: BCN Medicare Advantage |
$804.92
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,159.08
|
| Rate for Payer: Cofinity Commercial |
$1,078.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.92
|
| Rate for Payer: Healthscope Commercial |
$1,489.10
|
| Rate for Payer: Healthscope Commercial |
$1,287.87
|
| Rate for Payer: Mclaren Medicaid |
$538.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.17
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150,048.00
|
| Rate for Payer: Nomi Health Commercial |
$965.90
|
| Rate for Payer: PACE SWMI |
$804.92
|
| Rate for Payer: PHP Medicare Advantage |
$804.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.50
|
| Rate for Payer: Priority Health Medicare |
$804.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,255.50
|
| Rate for Payer: Priority Health SBD |
$1,255.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.92
|
| Rate for Payer: UHC Exchange |
$1,321.95
|
| Rate for Payer: UHC Medicare Advantage |
$804.92
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
|
|
PR VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 58275
|
| Min. Negotiated Rate |
$263.09 |
| Max. Negotiated Rate |
$176,767.00 |
| Rate for Payer: Aetna Commercial |
$1,277.02
|
| Rate for Payer: Aetna Medicare |
$991.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.32
|
| Rate for Payer: BCBS Complete |
$667.82
|
| Rate for Payer: BCBS MAPPO |
$953.00
|
| Rate for Payer: BCBS Trust/PPO |
$263.09
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$953.00
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,372.32
|
| Rate for Payer: Cofinity Commercial |
$1,277.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.00
|
| Rate for Payer: Healthscope Commercial |
$1,763.05
|
| Rate for Payer: Healthscope Commercial |
$1,524.80
|
| Rate for Payer: Mclaren Medicaid |
$636.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.65
|
| Rate for Payer: Meridian Medicaid |
$667.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,767.00
|
| Rate for Payer: Nomi Health Commercial |
$1,143.60
|
| Rate for Payer: PACE SWMI |
$953.00
|
| Rate for Payer: PHP Medicare Advantage |
$953.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,481.19
|
| Rate for Payer: Priority Health Medicare |
$953.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,481.19
|
| Rate for Payer: Priority Health SBD |
$1,481.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,515.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.00
|
| Rate for Payer: UHC Exchange |
$1,515.00
|
| Rate for Payer: UHC Medicare Advantage |
$953.00
|
| Rate for Payer: UHCCP Medicaid |
$636.02
|
|
|
PR VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57110
|
| Min. Negotiated Rate |
$578.51 |
| Max. Negotiated Rate |
$161,600.00 |
| Rate for Payer: Aetna Commercial |
$1,160.33
|
| Rate for Payer: Aetna Medicare |
$900.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,246.92
|
| Rate for Payer: BCBS Complete |
$607.44
|
| Rate for Payer: BCBS MAPPO |
$865.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.07
|
| Rate for Payer: BCN Commercial |
$1,325.29
|
| Rate for Payer: BCN Medicare Advantage |
$865.92
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,246.92
|
| Rate for Payer: Cofinity Commercial |
$1,160.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$865.92
|
| Rate for Payer: Healthscope Commercial |
$1,601.95
|
| Rate for Payer: Healthscope Commercial |
$1,385.47
|
| Rate for Payer: Mclaren Medicaid |
$578.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.22
|
| Rate for Payer: Meridian Medicaid |
$607.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161,600.00
|
| Rate for Payer: Nomi Health Commercial |
$1,039.10
|
| Rate for Payer: PACE SWMI |
$865.92
|
| Rate for Payer: PHP Medicare Advantage |
$865.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.25
|
| Rate for Payer: Priority Health Medicare |
$865.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.25
|
| Rate for Payer: Priority Health SBD |
$1,350.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,013.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$865.92
|
| Rate for Payer: UHC Exchange |
$1,013.00
|
| Rate for Payer: UHC Medicare Advantage |
$865.92
|
| Rate for Payer: UHCCP Medicaid |
$578.51
|
|
|
PR VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$1,993.00
|
|
|
Service Code
|
HCPCS 57106
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$94,966.00 |
| Rate for Payer: Aetna Commercial |
$683.78
|
| Rate for Payer: Aetna Medicare |
$530.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.80
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS MAPPO |
$510.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,372.14
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$510.28
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cofinity Commercial |
$734.80
|
| Rate for Payer: Cofinity Commercial |
$683.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.28
|
| Rate for Payer: Healthscope Commercial |
$944.02
|
| Rate for Payer: Healthscope Commercial |
$816.45
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.79
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,966.00
|
| Rate for Payer: Nomi Health Commercial |
$612.34
|
| Rate for Payer: PACE SWMI |
$510.28
|
| Rate for Payer: PHP Medicare Advantage |
$510.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.56
|
| Rate for Payer: Priority Health Medicare |
$510.28
|
| Rate for Payer: Priority Health Narrow Network |
$807.56
|
| Rate for Payer: Priority Health SBD |
$807.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$460.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.28
|
| Rate for Payer: UHC Exchange |
$460.36
|
| Rate for Payer: UHC Medicare Advantage |
$510.28
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
|
|
PR VAGINOPLASTY INTERSEX STATE
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 57335
|
| Min. Negotiated Rate |
$753.17 |
| Max. Negotiated Rate |
$210,623.00 |
| Rate for Payer: Aetna Commercial |
$1,511.52
|
| Rate for Payer: Aetna Medicare |
$1,173.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,624.32
|
| Rate for Payer: BCBS Complete |
$790.83
|
| Rate for Payer: BCBS MAPPO |
$1,128.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.54
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.00
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,624.32
|
| Rate for Payer: Cofinity Commercial |
$1,511.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.00
|
| Rate for Payer: Healthscope Commercial |
$2,086.80
|
| Rate for Payer: Healthscope Commercial |
$1,804.80
|
| Rate for Payer: Mclaren Medicaid |
$753.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.40
|
| Rate for Payer: Meridian Medicaid |
$790.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210,623.00
|
| Rate for Payer: Nomi Health Commercial |
$1,353.60
|
| Rate for Payer: PACE SWMI |
$1,128.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$753.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,759.48
|
| Rate for Payer: Priority Health Medicare |
$1,128.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,759.48
|
| Rate for Payer: Priority Health SBD |
$1,759.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,256.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.00
|
| Rate for Payer: UHC Exchange |
$1,256.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.00
|
| Rate for Payer: UHCCP Medicaid |
$753.17
|
|
