|
PR VAGNC PRTL RMVL VAG WALL W/RMVL PARAVAGINAL TISS
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 57107
|
| Min. Negotiated Rate |
$935.28 |
| Max. Negotiated Rate |
$259,425.00 |
| Rate for Payer: Aetna Commercial |
$1,874.71
|
| Rate for Payer: Aetna Medicare |
$1,455.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,874.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,014.62
|
| Rate for Payer: BCBS Complete |
$982.04
|
| Rate for Payer: BCBS MAPPO |
$1,399.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,758.85
|
| Rate for Payer: BCN Commercial |
$2,129.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.04
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cofinity Commercial |
$2,014.62
|
| Rate for Payer: Cofinity Commercial |
$1,874.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.04
|
| Rate for Payer: Healthscope Commercial |
$2,588.22
|
| Rate for Payer: Healthscope Commercial |
$2,238.46
|
| Rate for Payer: Mclaren Medicaid |
$935.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,468.99
|
| Rate for Payer: Meridian Medicaid |
$982.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259,425.00
|
| Rate for Payer: Nomi Health Commercial |
$1,678.85
|
| Rate for Payer: PACE SWMI |
$1,399.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,180.62
|
| Rate for Payer: Priority Health Medicare |
$1,399.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,180.62
|
| Rate for Payer: Priority Health SBD |
$2,180.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,522.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,399.04
|
| Rate for Payer: UHC Exchange |
$1,522.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,399.04
|
| Rate for Payer: UHCCP Medicaid |
$935.28
|
|
|
PR VAGOTOMY PFRMD W/PRTL DSTL GSTRCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 43635
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$20,191.00 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$113.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.46
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$109.35
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$163.22
|
| Rate for Payer: BCN Medicare Advantage |
$109.35
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$157.46
|
| Rate for Payer: Cofinity Commercial |
$146.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.35
|
| Rate for Payer: Healthscope Commercial |
$202.30
|
| Rate for Payer: Healthscope Commercial |
$174.96
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.82
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,191.00
|
| Rate for Payer: Nomi Health Commercial |
$131.22
|
| Rate for Payer: PACE SWMI |
$109.35
|
| Rate for Payer: PHP Medicare Advantage |
$109.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.26
|
| Rate for Payer: Priority Health Medicare |
$109.35
|
| Rate for Payer: Priority Health Narrow Network |
$199.26
|
| Rate for Payer: Priority Health SBD |
$199.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.35
|
| Rate for Payer: UHC Exchange |
$146.29
|
| Rate for Payer: UHC Medicare Advantage |
$109.35
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
PR VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 33460
|
| Min. Negotiated Rate |
$1,500.37 |
| Max. Negotiated Rate |
$423,925.00 |
| Rate for Payer: Aetna Commercial |
$3,069.82
|
| Rate for Payer: Aetna Medicare |
$2,382.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,069.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,298.91
|
| Rate for Payer: BCBS Complete |
$1,575.39
|
| Rate for Payer: BCBS MAPPO |
$2,290.91
|
| Rate for Payer: BCN Commercial |
$3,425.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,290.91
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cofinity Commercial |
$3,298.91
|
| Rate for Payer: Cofinity Commercial |
$3,069.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,290.91
|
| Rate for Payer: Healthscope Commercial |
$4,238.18
|
| Rate for Payer: Healthscope Commercial |
$3,665.46
|
| Rate for Payer: Mclaren Medicaid |
$1,500.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,405.46
|
| Rate for Payer: Meridian Medicaid |
$1,575.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423,925.00
|
| Rate for Payer: Nomi Health Commercial |
$2,749.09
|
| Rate for Payer: PACE SWMI |
$2,290.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,290.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,500.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,158.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,731.81
|
| Rate for Payer: Priority Health Medicare |
$2,290.91
|
| Rate for Payer: Priority Health Narrow Network |
$3,731.81
|
| Rate for Payer: Priority Health SBD |
$3,731.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,542.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,290.91
|
| Rate for Payer: UHC Exchange |
$2,542.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,290.91
|
| Rate for Payer: UHCCP Medicaid |
$1,500.37
|
|
|
PR VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS
|
Professional
|
Both
|
$8,923.00
|
|
|
Service Code
|
HCPCS 33422
|
| Min. Negotiated Rate |
$495.02 |
| Max. Negotiated Rate |
$293,834.00 |
| Rate for Payer: Aetna Commercial |
$2,131.89
|
| Rate for Payer: Aetna Medicare |
$1,654.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,131.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,290.98
|
| Rate for Payer: BCBS Complete |
$1,098.79
|
| Rate for Payer: BCBS MAPPO |
$1,590.96
|
| Rate for Payer: BCBS Trust/PPO |
$495.02
|
| Rate for Payer: BCN Commercial |
$2,382.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,590.96
|
| Rate for Payer: Cash Price |
$7,138.40
|
| Rate for Payer: Cash Price |
$7,138.40
|
| Rate for Payer: Cofinity Commercial |
$2,290.98
|
| Rate for Payer: Cofinity Commercial |
$2,131.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,590.96
|
| Rate for Payer: Healthscope Commercial |
$2,943.28
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Mclaren Medicaid |
$1,046.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,670.51
|
| Rate for Payer: Meridian Medicaid |
$1,098.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293,834.00
|
| Rate for Payer: Nomi Health Commercial |
$1,909.15
|
| Rate for Payer: PACE SWMI |
$1,590.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,590.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,799.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,597.96
|
| Rate for Payer: Priority Health Medicare |
$1,590.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.96
|
| Rate for Payer: Priority Health SBD |
$2,597.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,960.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,590.96
|
| Rate for Payer: UHC Exchange |
$2,960.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,590.96
|
| Rate for Payer: UHCCP Medicaid |
$1,046.47
|
|
|
PR VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS
|
Professional
|
Both
|
$8,513.00
|
|
|
Service Code
|
HCPCS 33425
|
| Min. Negotiated Rate |
$763.39 |
| Max. Negotiated Rate |
$483,145.00 |
| Rate for Payer: Aetna Commercial |
$3,500.62
|
| Rate for Payer: Aetna Medicare |
$2,716.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,500.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,761.86
|
| Rate for Payer: BCBS Complete |
$1,797.47
|
| Rate for Payer: BCBS MAPPO |
$2,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCN Commercial |
$3,906.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,612.40
|
| Rate for Payer: Cash Price |
$6,810.40
|
| Rate for Payer: Cash Price |
$6,810.40
|
| Rate for Payer: Cofinity Commercial |
$3,761.86
|
| Rate for Payer: Cofinity Commercial |
$3,500.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,612.40
|
| Rate for Payer: Healthscope Commercial |
$4,832.94
|
| Rate for Payer: Healthscope Commercial |
$4,179.84
|
| Rate for Payer: Mclaren Medicaid |
$1,711.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,743.02
|
| Rate for Payer: Meridian Medicaid |
$1,797.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$483,145.00
|
| Rate for Payer: Nomi Health Commercial |
$3,134.88
|
| Rate for Payer: PACE SWMI |
$2,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,711.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,533.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,266.83
|
| Rate for Payer: Priority Health Medicare |
$2,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$4,266.83
|
| Rate for Payer: Priority Health SBD |
$4,266.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,716.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,612.40
|
| Rate for Payer: UHC Exchange |
$2,716.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,711.88
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION
|
Professional
|
Both
|
$7,544.00
|
|
|
Service Code
|
HCPCS 33463
|
| Min. Negotiated Rate |
$1,183.92 |
| Max. Negotiated Rate |
$542,763.00 |
| Rate for Payer: Aetna Commercial |
$3,943.97
|
| Rate for Payer: Aetna Medicare |
$3,060.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,943.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,238.29
|
| Rate for Payer: BCBS Complete |
$2,024.92
|
| Rate for Payer: BCBS MAPPO |
$2,943.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$4,392.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,943.26
|
| Rate for Payer: Cash Price |
$6,035.20
|
| Rate for Payer: Cash Price |
$6,035.20
|
| Rate for Payer: Cofinity Commercial |
$4,238.29
|
| Rate for Payer: Cofinity Commercial |
$3,943.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,943.26
|
| Rate for Payer: Healthscope Commercial |
$5,445.03
|
| Rate for Payer: Healthscope Commercial |
$4,709.22
|
| Rate for Payer: Mclaren Medicaid |
$1,928.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,090.42
|
| Rate for Payer: Meridian Medicaid |
$2,024.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542,763.00
|
| Rate for Payer: Nomi Health Commercial |
$3,531.91
|
| Rate for Payer: PACE SWMI |
$2,943.26
|
| Rate for Payer: PHP Medicare Advantage |
$2,943.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,928.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,903.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,801.85
|
| Rate for Payer: Priority Health Medicare |
$2,943.26
|
| Rate for Payer: Priority Health Narrow Network |
$4,801.85
|
| Rate for Payer: Priority Health SBD |
$4,801.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,050.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,943.26
|
| Rate for Payer: UHC Exchange |
$3,050.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,943.26
|
| Rate for Payer: UHCCP Medicaid |
$1,928.50
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION
|
Professional
|
Both
|
$5,116.00
|
|
|
Service Code
|
HCPCS 33464
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$430,974.00 |
| Rate for Payer: Aetna Commercial |
$3,125.93
|
| Rate for Payer: Aetna Medicare |
$2,426.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,125.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,359.20
|
| Rate for Payer: BCBS Complete |
$1,607.15
|
| Rate for Payer: BCBS MAPPO |
$2,332.78
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$3,487.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,332.78
|
| Rate for Payer: Cash Price |
$4,092.80
|
| Rate for Payer: Cash Price |
$4,092.80
|
| Rate for Payer: Cofinity Commercial |
$3,359.20
|
| Rate for Payer: Cofinity Commercial |
$3,125.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,332.78
|
| Rate for Payer: Healthscope Commercial |
$4,315.64
|
| Rate for Payer: Healthscope Commercial |
$3,732.45
|
| Rate for Payer: Mclaren Medicaid |
$1,530.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,449.42
|
| Rate for Payer: Meridian Medicaid |
$1,607.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430,974.00
|
| Rate for Payer: Nomi Health Commercial |
$2,799.34
|
| Rate for Payer: PACE SWMI |
$2,332.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,332.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,325.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,809.45
|
| Rate for Payer: Priority Health Medicare |
$2,332.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,809.45
|
| Rate for Payer: Priority Health SBD |
$3,809.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,131.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,332.78
|
| Rate for Payer: UHC Exchange |
$3,131.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,332.78
|
| Rate for Payer: UHCCP Medicaid |
$1,530.62
|
|
|
PR VANTAS IMPLANT
|
Professional
|
Both
|
$3,401.00
|
|
|
Service Code
|
HCPCS J9225
|
| Min. Negotiated Rate |
$1,360.40 |
| Max. Negotiated Rate |
$497,134.00 |
| Rate for Payer: Aetna Commercial |
$4,678.90
|
| Rate for Payer: Aetna Medicare |
$1,700.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,678.90
|
| Rate for Payer: BCBS Complete |
$1,360.40
|
| Rate for Payer: BCBS Trust/PPO |
$5,264.35
|
| Rate for Payer: BCN Commercial |
$5,264.35
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497,134.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,210.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.29
|
| Rate for Payer: UHC Exchange |
$5,166.29
|
|
|
PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 90716
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$17,768.00 |
| Rate for Payer: Aetna Commercial |
$177.68
|
| Rate for Payer: Aetna Medicare |
$108.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.68
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS Trust/PPO |
$160.76
|
| Rate for Payer: BCN Commercial |
$157.78
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,768.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.98
|
| Rate for Payer: UHC Exchange |
$193.98
|
|
|
PR VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX
|
Professional
|
Both
|
$1,335.00
|
|
|
Service Code
|
HCPCS 37500
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$111,818.00 |
| Rate for Payer: Aetna Commercial |
$813.25
|
| Rate for Payer: Aetna Medicare |
$631.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.94
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.20
|
| Rate for Payer: BCN Commercial |
$902.59
|
| Rate for Payer: BCN Medicare Advantage |
$606.90
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cofinity Commercial |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$813.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.90
|
| Rate for Payer: Healthscope Commercial |
$971.04
|
| Rate for Payer: Healthscope Commercial |
$1,122.76
|
| Rate for Payer: Mclaren Medicaid |
$396.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.24
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,818.00
|
| Rate for Payer: Nomi Health Commercial |
$728.28
|
| Rate for Payer: PACE SWMI |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$606.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$867.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.60
|
| Rate for Payer: Priority Health Medicare |
$606.90
|
| Rate for Payer: Priority Health Narrow Network |
$987.60
|
| Rate for Payer: Priority Health SBD |
$987.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.90
|
| Rate for Payer: UHC Exchange |
$813.95
|
| Rate for Payer: UHC Medicare Advantage |
$606.90
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 37242
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$83,912.00 |
| Rate for Payer: Aetna Commercial |
$603.31
|
| Rate for Payer: Aetna Medicare |
$468.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.33
|
| Rate for Payer: BCBS Complete |
$310.65
|
| Rate for Payer: BCBS MAPPO |
$450.23
|
| Rate for Payer: BCBS Trust/PPO |
$658.79
|
| Rate for Payer: BCN Commercial |
$10,507.06
|
| Rate for Payer: BCN Medicare Advantage |
$450.23
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cofinity Commercial |
$648.33
|
| Rate for Payer: Cofinity Commercial |
$603.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.23
|
| Rate for Payer: Healthscope Commercial |
$720.37
|
| Rate for Payer: Healthscope Commercial |
$832.93
|
| Rate for Payer: Mclaren Medicaid |
$295.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.74
|
| Rate for Payer: Meridian Medicaid |
$310.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,912.00
|
| Rate for Payer: Nomi Health Commercial |
$540.28
|
| Rate for Payer: PACE SWMI |
$450.23
|
| Rate for Payer: PHP Medicare Advantage |
$450.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$736.05
|
| Rate for Payer: Priority Health Medicare |
$450.23
|
| Rate for Payer: Priority Health Narrow Network |
$736.05
|
| Rate for Payer: Priority Health SBD |
$736.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.23
|
| Rate for Payer: UHC Medicare Advantage |
$450.23
|
| Rate for Payer: UHCCP Medicaid |
$295.86
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE
|
Professional
|
Both
|
$9,702.00
|
|
|
Service Code
|
HCPCS 37244
|
| Min. Negotiated Rate |
$410.88 |
| Max. Negotiated Rate |
$116,005.00 |
| Rate for Payer: Aetna Commercial |
$831.43
|
| Rate for Payer: Aetna Medicare |
$645.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.48
|
| Rate for Payer: BCBS Complete |
$431.42
|
| Rate for Payer: BCBS MAPPO |
$620.47
|
| Rate for Payer: BCBS Trust/PPO |
$624.45
|
| Rate for Payer: BCN Commercial |
$9,737.39
|
| Rate for Payer: BCN Medicare Advantage |
$620.47
|
| Rate for Payer: Cash Price |
$7,761.60
|
| Rate for Payer: Cash Price |
$7,761.60
|
| Rate for Payer: Cofinity Commercial |
$893.48
|
| Rate for Payer: Cofinity Commercial |
$831.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.47
|
| Rate for Payer: Healthscope Commercial |
$1,147.87
|
| Rate for Payer: Healthscope Commercial |
$992.75
|
| Rate for Payer: Mclaren Medicaid |
$410.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.49
|
| Rate for Payer: Meridian Medicaid |
$431.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,005.00
|
| Rate for Payer: Nomi Health Commercial |
$744.56
|
| Rate for Payer: PACE SWMI |
$620.47
|
| Rate for Payer: PHP Medicare Advantage |
$620.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,306.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.51
|
| Rate for Payer: Priority Health Medicare |
$620.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.51
|
| Rate for Payer: Priority Health SBD |
$1,019.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.47
|
| Rate for Payer: UHC Medicare Advantage |
$620.47
|
| Rate for Payer: UHCCP Medicaid |
$410.88
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 37241
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$75,584.00 |
| Rate for Payer: Aetna Commercial |
$540.85
|
| Rate for Payer: Aetna Medicare |
$419.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.21
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS MAPPO |
$403.62
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$6,882.05
|
| Rate for Payer: BCN Medicare Advantage |
$403.62
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$581.21
|
| Rate for Payer: Cofinity Commercial |
$540.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.62
|
| Rate for Payer: Healthscope Commercial |
$645.79
|
| Rate for Payer: Healthscope Commercial |
$746.70
|
| Rate for Payer: Mclaren Medicaid |
$265.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.80
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,584.00
|
| Rate for Payer: Nomi Health Commercial |
$484.34
|
| Rate for Payer: PACE SWMI |
$403.62
|
| Rate for Payer: PHP Medicare Advantage |
$403.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.05
|
| Rate for Payer: Priority Health Medicare |
$403.62
|
| Rate for Payer: Priority Health Narrow Network |
$661.05
|
| Rate for Payer: Priority Health SBD |
$661.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.62
|
| Rate for Payer: UHC Medicare Advantage |
$403.62
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
|
|
PR VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 37243
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$98,213.00 |
| Rate for Payer: Aetna Commercial |
$706.96
|
| Rate for Payer: Aetna Medicare |
$548.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.72
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS MAPPO |
$527.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCN Commercial |
$12,761.33
|
| Rate for Payer: BCN Medicare Advantage |
$527.58
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$759.72
|
| Rate for Payer: Cofinity Commercial |
$706.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.58
|
| Rate for Payer: Healthscope Commercial |
$844.13
|
| Rate for Payer: Healthscope Commercial |
$976.02
|
| Rate for Payer: Mclaren Medicaid |
$349.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.96
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,213.00
|
| Rate for Payer: Nomi Health Commercial |
$633.10
|
| Rate for Payer: PACE SWMI |
$527.58
|
| Rate for Payer: PHP Medicare Advantage |
$527.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$864.74
|
| Rate for Payer: Priority Health Medicare |
$527.58
|
| Rate for Payer: Priority Health Narrow Network |
$864.74
|
| Rate for Payer: Priority Health SBD |
$864.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.58
|
| Rate for Payer: UHC Medicare Advantage |
$527.58
|
| Rate for Payer: UHCCP Medicaid |
$349.32
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$562.59 |
| Max. Negotiated Rate |
$803.70 |
| Rate for Payer: Aetna Commercial |
$759.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.45
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$625.10
|
| Rate for Payer: Cofinity Commercial |
$767.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$625.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.40
|
| Rate for Payer: Healthscope Commercial |
$803.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.05
|
| Rate for Payer: PHP Commercial |
$759.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health SBD |
$562.59
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 55250
|
| Hospital Charge Code |
55250
|
| Min. Negotiated Rate |
$148.89 |
| Max. Negotiated Rate |
$40,018.00 |
| Rate for Payer: Aetna Commercial |
$293.55
|
| Rate for Payer: Aetna Medicare |
$227.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.46
|
| Rate for Payer: BCBS Complete |
$156.33
|
| Rate for Payer: BCBS MAPPO |
$219.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,543.69
|
| Rate for Payer: BCN Commercial |
$393.05
|
| Rate for Payer: BCN Medicare Advantage |
$219.07
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$315.46
|
| Rate for Payer: Cofinity Commercial |
$293.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.07
|
| Rate for Payer: Healthscope Commercial |
$405.28
|
| Rate for Payer: Healthscope Commercial |
$350.51
|
| Rate for Payer: Mclaren Medicaid |
$148.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.02
|
| Rate for Payer: Meridian Medicaid |
$156.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,018.00
|
| Rate for Payer: Nomi Health Commercial |
$262.88
|
| Rate for Payer: PACE SWMI |
$219.07
|
| Rate for Payer: PHP Medicare Advantage |
$219.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.09
|
| Rate for Payer: Priority Health Medicare |
$219.07
|
| Rate for Payer: Priority Health Narrow Network |
$369.09
|
| Rate for Payer: Priority Health SBD |
$369.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.07
|
| Rate for Payer: UHC Exchange |
$576.07
|
| Rate for Payer: UHC Medicare Advantage |
$219.07
|
| Rate for Payer: UHCCP Medicaid |
$148.89
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 55250
|
| Min. Negotiated Rate |
$148.89 |
| Max. Negotiated Rate |
$40,018.00 |
| Rate for Payer: Aetna Commercial |
$293.55
|
| Rate for Payer: Aetna Medicare |
$227.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.46
|
| Rate for Payer: BCBS Complete |
$156.33
|
| Rate for Payer: BCBS MAPPO |
$219.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,543.69
|
| Rate for Payer: BCN Commercial |
$393.05
|
| Rate for Payer: BCN Medicare Advantage |
$219.07
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$315.46
|
| Rate for Payer: Cofinity Commercial |
$293.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.07
|
| Rate for Payer: Healthscope Commercial |
$405.28
|
| Rate for Payer: Healthscope Commercial |
$350.51
|
| Rate for Payer: Mclaren Medicaid |
$148.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.02
|
| Rate for Payer: Meridian Medicaid |
$156.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,018.00
|
| Rate for Payer: Nomi Health Commercial |
$262.88
|
| Rate for Payer: PACE SWMI |
$219.07
|
| Rate for Payer: PHP Medicare Advantage |
$219.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.09
|
| Rate for Payer: Priority Health Medicare |
$219.07
|
| Rate for Payer: Priority Health Narrow Network |
$369.09
|
| Rate for Payer: Priority Health SBD |
$369.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.07
|
| Rate for Payer: UHC Exchange |
$576.07
|
| Rate for Payer: UHC Medicare Advantage |
$219.07
|
| Rate for Payer: UHCCP Medicaid |
$148.89
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
OP
|
$893.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$562.59 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna Commercial |
$759.05
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$786.18
|
| Rate for Payer: BCN Commercial |
$786.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$767.98
|
| Rate for Payer: Cofinity Commercial |
$625.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$625.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$803.70
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.05
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$759.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$562.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,649.76
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,129.99
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
PR VASOVASOSTOMY VASOVASORRHAPHY
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 55400
|
| Min. Negotiated Rate |
$380.80 |
| Max. Negotiated Rate |
$87,831.00 |
| Rate for Payer: Aetna Commercial |
$640.88
|
| Rate for Payer: Aetna Medicare |
$497.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.71
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$478.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.67
|
| Rate for Payer: BCN Commercial |
$722.27
|
| Rate for Payer: BCN Medicare Advantage |
$478.27
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$688.71
|
| Rate for Payer: Cofinity Commercial |
$640.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.27
|
| Rate for Payer: Healthscope Commercial |
$765.23
|
| Rate for Payer: Healthscope Commercial |
$884.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87,831.00
|
| Rate for Payer: Nomi Health Commercial |
$573.92
|
| Rate for Payer: PACE SWMI |
$478.27
|
| Rate for Payer: PHP Medicare Advantage |
$478.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.44
|
| Rate for Payer: Priority Health Medicare |
$478.27
|
| Rate for Payer: Priority Health Narrow Network |
$799.44
|
| Rate for Payer: Priority Health SBD |
$799.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.27
|
| Rate for Payer: UHC Exchange |
$657.66
|
| Rate for Payer: UHC Medicare Advantage |
$478.27
|
|
|
PR VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG
|
Professional
|
Both
|
$2,770.00
|
|
|
Service Code
|
HCPCS 63103
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$52,985.00 |
| Rate for Payer: Aetna Commercial |
$383.56
|
| Rate for Payer: Aetna Medicare |
$297.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.19
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$286.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,342.63
|
| Rate for Payer: BCN Commercial |
$429.06
|
| Rate for Payer: BCN Medicare Advantage |
$286.24
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cash Price |
$2,216.00
|
| Rate for Payer: Cofinity Commercial |
$412.19
|
| Rate for Payer: Cofinity Commercial |
$383.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.24
|
| Rate for Payer: Healthscope Commercial |
$529.54
|
| Rate for Payer: Healthscope Commercial |
$457.98
|
| Rate for Payer: Mclaren Medicaid |
$187.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.55
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,985.00
|
| Rate for Payer: Nomi Health Commercial |
$343.49
|
| Rate for Payer: PACE SWMI |
$286.24
|
| Rate for Payer: PHP Medicare Advantage |
$286.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,800.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.32
|
| Rate for Payer: Priority Health Medicare |
$286.24
|
| Rate for Payer: Priority Health Narrow Network |
$499.32
|
| Rate for Payer: Priority Health SBD |
$499.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.24
|
| Rate for Payer: UHC Exchange |
$337.32
|
| Rate for Payer: UHC Medicare Advantage |
$286.24
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR VCRPEC LES 1 SGM XDRL CERVICAL
|
Professional
|
Both
|
$4,705.00
|
|
|
Service Code
|
HCPCS 63300
|
| Min. Negotiated Rate |
$519.85 |
| Max. Negotiated Rate |
$327,312.00 |
| Rate for Payer: Aetna Commercial |
$2,400.78
|
| Rate for Payer: Aetna Medicare |
$1,863.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,579.95
|
| Rate for Payer: BCBS Complete |
$1,241.48
|
| Rate for Payer: BCBS MAPPO |
$1,791.63
|
| Rate for Payer: BCBS Trust/PPO |
$519.85
|
| Rate for Payer: BCN Commercial |
$2,941.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,791.63
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cofinity Commercial |
$2,579.95
|
| Rate for Payer: Cofinity Commercial |
$2,400.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,791.63
|
| Rate for Payer: Healthscope Commercial |
$3,314.52
|
| Rate for Payer: Healthscope Commercial |
$2,866.61
|
| Rate for Payer: Mclaren Medicaid |
$1,182.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.21
|
| Rate for Payer: Meridian Medicaid |
$1,241.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327,312.00
|
| Rate for Payer: Nomi Health Commercial |
$2,149.96
|
| Rate for Payer: PACE SWMI |
$1,791.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,791.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,182.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,058.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,125.09
|
| Rate for Payer: Priority Health Medicare |
$1,791.63
|
| Rate for Payer: Priority Health Narrow Network |
$3,125.09
|
| Rate for Payer: Priority Health SBD |
$3,125.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,007.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,791.63
|
| Rate for Payer: UHC Exchange |
$2,007.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,791.63
|
| Rate for Payer: UHCCP Medicaid |
$1,182.36
|
|
|
PR VCRPEC LES 1 SGM XDRL THORACIC TTHRC
|
Professional
|
Both
|
$4,655.00
|
|
|
Service Code
|
HCPCS 63301
|
| Min. Negotiated Rate |
$1,378.75 |
| Max. Negotiated Rate |
$400,262.00 |
| Rate for Payer: Aetna Commercial |
$2,807.22
|
| Rate for Payer: Aetna Medicare |
$2,178.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,807.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,016.71
|
| Rate for Payer: BCBS Complete |
$1,447.69
|
| Rate for Payer: BCBS MAPPO |
$2,094.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,593.88
|
| Rate for Payer: BCN Commercial |
$3,585.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,094.94
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cofinity Commercial |
$3,016.71
|
| Rate for Payer: Cofinity Commercial |
$2,807.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,094.94
|
| Rate for Payer: Healthscope Commercial |
$3,875.64
|
| Rate for Payer: Healthscope Commercial |
$3,351.90
|
| Rate for Payer: Mclaren Medicaid |
$1,378.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,199.69
|
| Rate for Payer: Meridian Medicaid |
$1,447.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400,262.00
|
| Rate for Payer: Nomi Health Commercial |
$2,513.93
|
| Rate for Payer: PACE SWMI |
$2,094.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,094.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,378.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,025.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,822.91
|
| Rate for Payer: Priority Health Medicare |
$2,094.94
|
| Rate for Payer: Priority Health Narrow Network |
$3,822.91
|
| Rate for Payer: Priority Health SBD |
$3,822.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,281.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,094.94
|
| Rate for Payer: UHC Exchange |
$2,281.85
|
| Rate for Payer: UHC Medicare Advantage |
$2,094.94
|
| Rate for Payer: UHCCP Medicaid |
$1,378.75
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG
|
Professional
|
Both
|
$9,223.00
|
|
|
Service Code
|
HCPCS 63087
|
| Min. Negotiated Rate |
$232.45 |
| Max. Negotiated Rate |
$433,964.00 |
| Rate for Payer: Aetna Commercial |
$3,187.73
|
| Rate for Payer: Aetna Medicare |
$2,474.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,187.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,425.62
|
| Rate for Payer: BCBS Complete |
$1,646.52
|
| Rate for Payer: BCBS MAPPO |
$2,378.90
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$3,891.88
|
| Rate for Payer: BCN Medicare Advantage |
$2,378.90
|
| Rate for Payer: Cash Price |
$7,378.40
|
| Rate for Payer: Cash Price |
$7,378.40
|
| Rate for Payer: Cofinity Commercial |
$3,425.62
|
| Rate for Payer: Cofinity Commercial |
$3,187.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,378.90
|
| Rate for Payer: Healthscope Commercial |
$4,400.96
|
| Rate for Payer: Healthscope Commercial |
$3,806.24
|
| Rate for Payer: Mclaren Medicaid |
$1,568.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,497.84
|
| Rate for Payer: Meridian Medicaid |
$1,646.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433,964.00
|
| Rate for Payer: Nomi Health Commercial |
$2,854.68
|
| Rate for Payer: PACE SWMI |
$2,378.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,378.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,568.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,994.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,157.88
|
| Rate for Payer: Priority Health Medicare |
$2,378.90
|
| Rate for Payer: Priority Health Narrow Network |
$4,157.88
|
| Rate for Payer: Priority Health SBD |
$4,157.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,147.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,378.90
|
| Rate for Payer: UHC Exchange |
$3,147.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,378.90
|
| Rate for Payer: UHCCP Medicaid |
$1,568.11
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 63088
|
| Min. Negotiated Rate |
$165.29 |
| Max. Negotiated Rate |
$46,445.00 |
| Rate for Payer: Aetna Commercial |
$338.87
|
| Rate for Payer: Aetna Medicare |
$263.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.16
|
| Rate for Payer: BCBS Complete |
$173.55
|
| Rate for Payer: BCBS MAPPO |
$252.89
|
| Rate for Payer: BCBS Trust/PPO |
$342.34
|
| Rate for Payer: BCN Commercial |
$375.79
|
| Rate for Payer: BCN Medicare Advantage |
$252.89
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$364.16
|
| Rate for Payer: Cofinity Commercial |
$338.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.89
|
| Rate for Payer: Healthscope Commercial |
$467.85
|
| Rate for Payer: Healthscope Commercial |
$404.62
|
| Rate for Payer: Mclaren Medicaid |
$165.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.53
|
| Rate for Payer: Meridian Medicaid |
$173.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,445.00
|
| Rate for Payer: Nomi Health Commercial |
$303.47
|
| Rate for Payer: PACE SWMI |
$252.89
|
| Rate for Payer: PHP Medicare Advantage |
$252.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.76
|
| Rate for Payer: Priority Health Medicare |
$252.89
|
| Rate for Payer: Priority Health Narrow Network |
$440.76
|
| Rate for Payer: Priority Health SBD |
$440.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.89
|
| Rate for Payer: UHC Exchange |
$364.33
|
| Rate for Payer: UHC Medicare Advantage |
$252.89
|
| Rate for Payer: UHCCP Medicaid |
$165.29
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG
|
Professional
|
Both
|
$7,274.00
|
|
|
Service Code
|
HCPCS 63090
|
| Min. Negotiated Rate |
$1,253.29 |
| Max. Negotiated Rate |
$348,658.00 |
| Rate for Payer: Aetna Commercial |
$2,535.27
|
| Rate for Payer: Aetna Medicare |
$1,967.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,535.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,724.47
|
| Rate for Payer: BCBS Complete |
$1,315.95
|
| Rate for Payer: BCBS MAPPO |
$1,891.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,683.69
|
| Rate for Payer: BCN Commercial |
$3,133.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,891.99
|
| Rate for Payer: Cash Price |
$5,819.20
|
| Rate for Payer: Cash Price |
$5,819.20
|
| Rate for Payer: Cofinity Commercial |
$2,724.47
|
| Rate for Payer: Cofinity Commercial |
$2,535.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,891.99
|
| Rate for Payer: Healthscope Commercial |
$3,500.18
|
| Rate for Payer: Healthscope Commercial |
$3,027.18
|
| Rate for Payer: Mclaren Medicaid |
$1,253.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,986.59
|
| Rate for Payer: Meridian Medicaid |
$1,315.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348,658.00
|
| Rate for Payer: Nomi Health Commercial |
$2,270.39
|
| Rate for Payer: PACE SWMI |
$1,891.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,891.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,253.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,728.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,336.08
|
| Rate for Payer: Priority Health Medicare |
$1,891.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,336.08
|
| Rate for Payer: Priority Health SBD |
$3,336.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,473.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,891.99
|
| Rate for Payer: UHC Exchange |
$2,473.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,891.99
|
| Rate for Payer: UHCCP Medicaid |
$1,253.29
|
|
