|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$100,888.00 |
| Rate for Payer: Aetna Commercial |
$722.62
|
| Rate for Payer: Aetna Medicare |
$560.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.55
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$539.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.75
|
| Rate for Payer: BCN Commercial |
$831.73
|
| Rate for Payer: BCN Medicare Advantage |
$539.27
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$722.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.27
|
| Rate for Payer: Healthscope Commercial |
$997.65
|
| Rate for Payer: Healthscope Commercial |
$862.83
|
| Rate for Payer: Mclaren Medicaid |
$362.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.23
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,888.00
|
| Rate for Payer: Nomi Health Commercial |
$647.12
|
| Rate for Payer: PACE SWMI |
$539.27
|
| Rate for Payer: PHP Medicare Advantage |
$539.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$847.74
|
| Rate for Payer: Priority Health Medicare |
$539.27
|
| Rate for Payer: Priority Health Narrow Network |
$847.74
|
| Rate for Payer: Priority Health SBD |
$847.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.27
|
| Rate for Payer: UHC Exchange |
$649.01
|
| Rate for Payer: UHC Medicare Advantage |
$539.27
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$42,309.00 |
| Rate for Payer: Aetna Commercial |
$310.42
|
| Rate for Payer: Aetna Medicare |
$240.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.59
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$231.66
|
| Rate for Payer: BCBS Trust/PPO |
$393.06
|
| Rate for Payer: BCN Commercial |
$361.13
|
| Rate for Payer: BCN Medicare Advantage |
$231.66
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$333.59
|
| Rate for Payer: Cofinity Commercial |
$310.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.66
|
| Rate for Payer: Healthscope Commercial |
$428.57
|
| Rate for Payer: Healthscope Commercial |
$370.66
|
| Rate for Payer: Mclaren Medicaid |
$159.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.24
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,309.00
|
| Rate for Payer: Nomi Health Commercial |
$277.99
|
| Rate for Payer: PACE SWMI |
$231.66
|
| Rate for Payer: PHP Medicare Advantage |
$231.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378.09
|
| Rate for Payer: Priority Health Medicare |
$231.66
|
| Rate for Payer: Priority Health Narrow Network |
$378.09
|
| Rate for Payer: Priority Health SBD |
$378.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.66
|
| Rate for Payer: UHC Exchange |
$272.57
|
| Rate for Payer: UHC Medicare Advantage |
$231.66
|
| Rate for Payer: UHCCP Medicaid |
$159.54
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$155.49 |
| Max. Negotiated Rate |
$40,819.00 |
| Rate for Payer: Aetna Commercial |
$302.12
|
| Rate for Payer: Aetna Medicare |
$234.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.66
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$225.46
|
| Rate for Payer: BCBS Trust/PPO |
$226.26
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$225.46
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cofinity Commercial |
$324.66
|
| Rate for Payer: Cofinity Commercial |
$302.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.46
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Healthscope Commercial |
$360.74
|
| Rate for Payer: Mclaren Medicaid |
$155.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.73
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,819.00
|
| Rate for Payer: Nomi Health Commercial |
$270.55
|
| Rate for Payer: PACE SWMI |
$225.46
|
| Rate for Payer: PHP Medicare Advantage |
$225.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.36
|
| Rate for Payer: Priority Health Medicare |
$225.46
|
| Rate for Payer: Priority Health Narrow Network |
$365.36
|
| Rate for Payer: Priority Health SBD |
$365.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.46
|
| Rate for Payer: UHC Exchange |
$246.02
|
| Rate for Payer: UHC Medicare Advantage |
$225.46
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 24500
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$59,639.00 |
| Rate for Payer: Aetna Commercial |
$438.14
|
| Rate for Payer: Aetna Medicare |
$340.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.84
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$326.97
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$326.97
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cofinity Commercial |
$470.84
|
| Rate for Payer: Cofinity Commercial |
$438.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.97
|
| Rate for Payer: Healthscope Commercial |
$604.89
|
| Rate for Payer: Healthscope Commercial |
$523.15
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.32
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,639.00
|
| Rate for Payer: Nomi Health Commercial |
$392.36
|
| Rate for Payer: PACE SWMI |
$326.97
|
| Rate for Payer: PHP Medicare Advantage |
$326.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$326.97
|
| Rate for Payer: Priority Health Narrow Network |
$533.28
|
| Rate for Payer: Priority Health SBD |
$533.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.97
|
| Rate for Payer: UHC Exchange |
$360.16
|
| Rate for Payer: UHC Medicare Advantage |
$326.97
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$55,870.00 |
| Rate for Payer: Aetna Commercial |
$408.41
|
| Rate for Payer: Aetna Medicare |
$316.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.88
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$304.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.97
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$304.78
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Cofinity Commercial |
$408.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.78
|
| Rate for Payer: Healthscope Commercial |
$487.65
|
| Rate for Payer: Healthscope Commercial |
$563.84
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.02
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,870.00
|
| Rate for Payer: Nomi Health Commercial |
$365.74
|
| Rate for Payer: PACE SWMI |
$304.78
|
| Rate for Payer: PHP Medicare Advantage |
$304.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$304.78
|
| Rate for Payer: Priority Health Narrow Network |
$483.42
|
| Rate for Payer: Priority Health SBD |
$483.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.78
|
| Rate for Payer: UHC Medicare Advantage |
$304.78
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$23,470.00 |
| Rate for Payer: Aetna Commercial |
$168.33
|
| Rate for Payer: Aetna Medicare |
$130.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.89
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$125.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.62
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$125.62
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$180.89
|
| Rate for Payer: Cofinity Commercial |
$168.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.62
|
| Rate for Payer: Healthscope Commercial |
$200.99
|
| Rate for Payer: Healthscope Commercial |
$232.40
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.90
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,470.00
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: PACE SWMI |
$125.62
|
| Rate for Payer: PHP Medicare Advantage |
$125.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.58
|
| Rate for Payer: Priority Health Medicare |
$125.62
|
| Rate for Payer: Priority Health Narrow Network |
$205.58
|
| Rate for Payer: Priority Health SBD |
$205.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.62
|
| Rate for Payer: UHC Medicare Advantage |
$125.62
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$72,581.00 |
| Rate for Payer: Aetna Commercial |
$530.47
|
| Rate for Payer: Aetna Medicare |
$411.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.05
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS MAPPO |
$395.87
|
| Rate for Payer: BCBS Trust/PPO |
$372.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$395.87
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$570.05
|
| Rate for Payer: Cofinity Commercial |
$530.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.87
|
| Rate for Payer: Healthscope Commercial |
$732.36
|
| Rate for Payer: Healthscope Commercial |
$633.39
|
| Rate for Payer: Mclaren Medicaid |
$270.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.66
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,581.00
|
| Rate for Payer: Nomi Health Commercial |
$475.04
|
| Rate for Payer: PACE SWMI |
$395.87
|
| Rate for Payer: PHP Medicare Advantage |
$395.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.16
|
| Rate for Payer: Priority Health Medicare |
$395.87
|
| Rate for Payer: Priority Health Narrow Network |
$641.16
|
| Rate for Payer: Priority Health SBD |
$641.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.87
|
| Rate for Payer: UHC Exchange |
$377.46
|
| Rate for Payer: UHC Medicare Advantage |
$395.87
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$53,820.00 |
| Rate for Payer: Aetna Commercial |
$397.31
|
| Rate for Payer: Aetna Medicare |
$308.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.96
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$296.50
|
| Rate for Payer: BCBS Trust/PPO |
$328.60
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$296.50
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$426.96
|
| Rate for Payer: Cofinity Commercial |
$397.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.50
|
| Rate for Payer: Healthscope Commercial |
$548.52
|
| Rate for Payer: Healthscope Commercial |
$474.40
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.32
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,820.00
|
| Rate for Payer: Nomi Health Commercial |
$355.80
|
| Rate for Payer: PACE SWMI |
$296.50
|
| Rate for Payer: PHP Medicare Advantage |
$296.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.33
|
| Rate for Payer: Priority Health Medicare |
$296.50
|
| Rate for Payer: Priority Health Narrow Network |
$478.33
|
| Rate for Payer: Priority Health SBD |
$478.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.50
|
| Rate for Payer: UHC Exchange |
$360.72
|
| Rate for Payer: UHC Medicare Advantage |
$296.50
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$98,635.00 |
| Rate for Payer: Aetna Commercial |
$717.74
|
| Rate for Payer: Aetna Medicare |
$557.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.31
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$535.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$818.53
|
| Rate for Payer: BCN Medicare Advantage |
$535.63
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$771.31
|
| Rate for Payer: Cofinity Commercial |
$717.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.63
|
| Rate for Payer: Healthscope Commercial |
$990.92
|
| Rate for Payer: Healthscope Commercial |
$857.01
|
| Rate for Payer: Mclaren Medicaid |
$362.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.41
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,635.00
|
| Rate for Payer: Nomi Health Commercial |
$642.76
|
| Rate for Payer: PACE SWMI |
$535.63
|
| Rate for Payer: PHP Medicare Advantage |
$535.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.05
|
| Rate for Payer: Priority Health Medicare |
$535.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.05
|
| Rate for Payer: Priority Health SBD |
$1,007.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.63
|
| Rate for Payer: UHC Exchange |
$545.36
|
| Rate for Payer: UHC Medicare Advantage |
$535.63
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$573.18 |
| Max. Negotiated Rate |
$159,541.00 |
| Rate for Payer: Aetna Commercial |
$1,161.71
|
| Rate for Payer: Aetna Medicare |
$901.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,161.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.41
|
| Rate for Payer: BCBS Complete |
$601.84
|
| Rate for Payer: BCBS MAPPO |
$866.95
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,299.88
|
| Rate for Payer: BCN Medicare Advantage |
$866.95
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$1,248.41
|
| Rate for Payer: Cofinity Commercial |
$1,161.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.95
|
| Rate for Payer: Healthscope Commercial |
$1,603.86
|
| Rate for Payer: Healthscope Commercial |
$1,387.12
|
| Rate for Payer: Mclaren Medicaid |
$573.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.30
|
| Rate for Payer: Meridian Medicaid |
$601.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159,541.00
|
| Rate for Payer: Nomi Health Commercial |
$1,040.34
|
| Rate for Payer: PACE SWMI |
$866.95
|
| Rate for Payer: PHP Medicare Advantage |
$866.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.10
|
| Rate for Payer: Priority Health Medicare |
$866.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.10
|
| Rate for Payer: Priority Health SBD |
$1,242.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.95
|
| Rate for Payer: UHC Exchange |
$1,025.92
|
| Rate for Payer: UHC Medicare Advantage |
$866.95
|
| Rate for Payer: UHCCP Medicaid |
$573.18
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,579.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$245.13 |
| Max. Negotiated Rate |
$256,651.00 |
| Rate for Payer: Aetna Commercial |
$1,856.82
|
| Rate for Payer: Aetna Medicare |
$1,441.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,856.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,995.39
|
| Rate for Payer: BCBS Complete |
$962.59
|
| Rate for Payer: BCBS MAPPO |
$1,385.69
|
| Rate for Payer: BCBS Trust/PPO |
$245.13
|
| Rate for Payer: BCN Commercial |
$2,089.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,385.69
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cofinity Commercial |
$1,995.39
|
| Rate for Payer: Cofinity Commercial |
$1,856.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,385.69
|
| Rate for Payer: Healthscope Commercial |
$2,563.53
|
| Rate for Payer: Healthscope Commercial |
$2,217.10
|
| Rate for Payer: Mclaren Medicaid |
$916.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,454.97
|
| Rate for Payer: Meridian Medicaid |
$962.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256,651.00
|
| Rate for Payer: Nomi Health Commercial |
$1,662.83
|
| Rate for Payer: PACE SWMI |
$1,385.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,385.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,561.78
|
| Rate for Payer: Priority Health Medicare |
$1,385.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,561.78
|
| Rate for Payer: Priority Health SBD |
$2,561.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,385.69
|
| Rate for Payer: UHC Exchange |
$1,413.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,385.69
|
| Rate for Payer: UHCCP Medicaid |
$916.75
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$246.19 |
| Max. Negotiated Rate |
$275,107.00 |
| Rate for Payer: Aetna Commercial |
$1,995.19
|
| Rate for Payer: Aetna Medicare |
$1,548.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,995.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,144.09
|
| Rate for Payer: BCBS Complete |
$1,034.16
|
| Rate for Payer: BCBS MAPPO |
$1,488.95
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$2,239.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,488.95
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cofinity Commercial |
$2,144.09
|
| Rate for Payer: Cofinity Commercial |
$1,995.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,488.95
|
| Rate for Payer: Healthscope Commercial |
$2,754.56
|
| Rate for Payer: Healthscope Commercial |
$2,382.32
|
| Rate for Payer: Mclaren Medicaid |
$984.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,563.40
|
| Rate for Payer: Meridian Medicaid |
$1,034.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275,107.00
|
| Rate for Payer: Nomi Health Commercial |
$1,786.74
|
| Rate for Payer: PACE SWMI |
$1,488.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,488.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$984.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.56
|
| Rate for Payer: Priority Health Medicare |
$1,488.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.56
|
| Rate for Payer: Priority Health SBD |
$2,739.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,488.95
|
| Rate for Payer: UHC Exchange |
$1,543.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,488.95
|
| Rate for Payer: UHCCP Medicaid |
$984.91
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$237,283.00 |
| Rate for Payer: Aetna Commercial |
$1,727.31
|
| Rate for Payer: Aetna Medicare |
$1,340.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,727.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,856.22
|
| Rate for Payer: BCBS Complete |
$897.73
|
| Rate for Payer: BCBS MAPPO |
$1,289.04
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,934.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.04
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cofinity Commercial |
$1,856.22
|
| Rate for Payer: Cofinity Commercial |
$1,727.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.04
|
| Rate for Payer: Healthscope Commercial |
$2,384.72
|
| Rate for Payer: Healthscope Commercial |
$2,062.46
|
| Rate for Payer: Mclaren Medicaid |
$854.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.49
|
| Rate for Payer: Meridian Medicaid |
$897.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237,283.00
|
| Rate for Payer: Nomi Health Commercial |
$1,546.85
|
| Rate for Payer: PACE SWMI |
$1,289.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,730.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.58
|
| Rate for Payer: Priority Health Medicare |
$1,289.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,387.58
|
| Rate for Payer: Priority Health SBD |
$2,387.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,316.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,289.04
|
| Rate for Payer: UHC Exchange |
$1,316.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,289.04
|
| Rate for Payer: UHCCP Medicaid |
$854.98
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$654.12 |
| Max. Negotiated Rate |
$181,064.00 |
| Rate for Payer: Aetna Commercial |
$1,304.85
|
| Rate for Payer: Aetna Medicare |
$1,012.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.23
|
| Rate for Payer: BCBS Complete |
$686.83
|
| Rate for Payer: BCBS MAPPO |
$973.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,490.95
|
| Rate for Payer: BCN Medicare Advantage |
$973.77
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cofinity Commercial |
$1,402.23
|
| Rate for Payer: Cofinity Commercial |
$1,304.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.77
|
| Rate for Payer: Healthscope Commercial |
$1,801.47
|
| Rate for Payer: Healthscope Commercial |
$1,558.03
|
| Rate for Payer: Mclaren Medicaid |
$654.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.46
|
| Rate for Payer: Meridian Medicaid |
$686.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181,064.00
|
| Rate for Payer: Nomi Health Commercial |
$1,168.52
|
| Rate for Payer: PACE SWMI |
$973.77
|
| Rate for Payer: PHP Medicare Advantage |
$973.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,826.76
|
| Rate for Payer: Priority Health Medicare |
$973.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,826.76
|
| Rate for Payer: Priority Health SBD |
$1,826.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.77
|
| Rate for Payer: UHC Exchange |
$936.80
|
| Rate for Payer: UHC Medicare Advantage |
$973.77
|
| Rate for Payer: UHCCP Medicaid |
$654.12
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,177.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$256,216.00 |
| Rate for Payer: Aetna Commercial |
$1,862.05
|
| Rate for Payer: Aetna Medicare |
$1,445.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,862.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,001.01
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS MAPPO |
$1,389.59
|
| Rate for Payer: BCBS Trust/PPO |
$986.34
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.59
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cofinity Commercial |
$2,001.01
|
| Rate for Payer: Cofinity Commercial |
$1,862.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.59
|
| Rate for Payer: Healthscope Commercial |
$2,570.74
|
| Rate for Payer: Healthscope Commercial |
$2,223.34
|
| Rate for Payer: Mclaren Medicaid |
$914.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,459.07
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256,216.00
|
| Rate for Payer: Nomi Health Commercial |
$1,667.51
|
| Rate for Payer: PACE SWMI |
$1,389.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,715.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,552.82
|
| Rate for Payer: Priority Health Medicare |
$1,389.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.82
|
| Rate for Payer: Priority Health SBD |
$2,552.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.59
|
| Rate for Payer: UHC Exchange |
$1,352.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.59
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$20,072.00 |
| Rate for Payer: Aetna Commercial |
$144.04
|
| Rate for Payer: Aetna Medicare |
$111.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.79
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$107.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.77
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$107.49
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| Rate for Payer: Cofinity Commercial |
$144.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.49
|
| Rate for Payer: Healthscope Commercial |
$198.86
|
| Rate for Payer: Healthscope Commercial |
$171.98
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.86
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,072.00
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: PACE SWMI |
$107.49
|
| Rate for Payer: PHP Medicare Advantage |
$107.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.13
|
| Rate for Payer: Priority Health Medicare |
$107.49
|
| Rate for Payer: Priority Health Narrow Network |
$204.13
|
| Rate for Payer: Priority Health SBD |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.49
|
| Rate for Payer: UHC Exchange |
$191.96
|
| Rate for Payer: UHC Medicare Advantage |
$107.49
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT
|
Professional
|
Both
|
$2,913.00
|
|
|
Service Code
|
HCPCS 44625
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$179,674.00 |
| Rate for Payer: Aetna Commercial |
$1,301.43
|
| Rate for Payer: Aetna Medicare |
$1,010.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.56
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS MAPPO |
$971.22
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,467.49
|
| Rate for Payer: BCN Medicare Advantage |
$971.22
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Cofinity Commercial |
$1,398.56
|
| Rate for Payer: Cofinity Commercial |
$1,301.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.22
|
| Rate for Payer: Healthscope Commercial |
$1,796.76
|
| Rate for Payer: Healthscope Commercial |
$1,553.95
|
| Rate for Payer: Mclaren Medicaid |
$645.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,019.78
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179,674.00
|
| Rate for Payer: Nomi Health Commercial |
$1,165.46
|
| Rate for Payer: PACE SWMI |
$971.22
|
| Rate for Payer: PHP Medicare Advantage |
$971.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,893.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.53
|
| Rate for Payer: Priority Health Medicare |
$971.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.53
|
| Rate for Payer: Priority Health SBD |
$1,800.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,276.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$971.22
|
| Rate for Payer: UHC Exchange |
$1,276.55
|
| Rate for Payer: UHC Medicare Advantage |
$971.22
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS
|
Professional
|
Both
|
$2,972.00
|
|
|
Service Code
|
HCPCS 44626
|
| Min. Negotiated Rate |
$205.51 |
| Max. Negotiated Rate |
$284,143.00 |
| Rate for Payer: Aetna Commercial |
$2,055.79
|
| Rate for Payer: Aetna Medicare |
$1,595.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,055.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.20
|
| Rate for Payer: BCBS Complete |
$1,064.12
|
| Rate for Payer: BCBS MAPPO |
$1,534.17
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,534.17
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Cofinity Commercial |
$2,209.20
|
| Rate for Payer: Cofinity Commercial |
$2,055.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,534.17
|
| Rate for Payer: Healthscope Commercial |
$2,838.21
|
| Rate for Payer: Healthscope Commercial |
$2,454.67
|
| Rate for Payer: Mclaren Medicaid |
$1,013.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,610.88
|
| Rate for Payer: Meridian Medicaid |
$1,064.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284,143.00
|
| Rate for Payer: Nomi Health Commercial |
$1,841.00
|
| Rate for Payer: PACE SWMI |
$1,534.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,534.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,013.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,931.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,827.86
|
| Rate for Payer: Priority Health Medicare |
$1,534.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,827.86
|
| Rate for Payer: Priority Health SBD |
$2,827.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,994.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,534.17
|
| Rate for Payer: UHC Exchange |
$1,994.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,534.17
|
| Rate for Payer: UHCCP Medicaid |
$1,013.45
|
|
|
PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 57308
|
| Min. Negotiated Rate |
$427.49 |
| Max. Negotiated Rate |
$117,506.00 |
| Rate for Payer: Aetna Commercial |
$849.59
|
| Rate for Payer: Aetna Medicare |
$659.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.99
|
| Rate for Payer: BCBS Complete |
$448.86
|
| Rate for Payer: BCBS MAPPO |
$634.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,574.86
|
| Rate for Payer: BCN Commercial |
$970.51
|
| Rate for Payer: BCN Medicare Advantage |
$634.02
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cofinity Commercial |
$912.99
|
| Rate for Payer: Cofinity Commercial |
$849.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.02
|
| Rate for Payer: Healthscope Commercial |
$1,172.94
|
| Rate for Payer: Healthscope Commercial |
$1,014.43
|
| Rate for Payer: Mclaren Medicaid |
$427.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.72
|
| Rate for Payer: Meridian Medicaid |
$448.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,506.00
|
| Rate for Payer: Nomi Health Commercial |
$760.82
|
| Rate for Payer: PACE SWMI |
$634.02
|
| Rate for Payer: PHP Medicare Advantage |
$634.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.59
|
| Rate for Payer: Priority Health Medicare |
$634.02
|
| Rate for Payer: Priority Health Narrow Network |
$992.59
|
| Rate for Payer: Priority Health SBD |
$992.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.02
|
| Rate for Payer: UHC Exchange |
$806.48
|
| Rate for Payer: UHC Medicare Advantage |
$634.02
|
| Rate for Payer: UHCCP Medicaid |
$427.49
|
|
|
PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 57305
|
| Min. Negotiated Rate |
$623.88 |
| Max. Negotiated Rate |
$175,446.00 |
| Rate for Payer: Aetna Commercial |
$1,247.81
|
| Rate for Payer: Aetna Medicare |
$968.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.93
|
| Rate for Payer: BCBS Complete |
$655.07
|
| Rate for Payer: BCBS MAPPO |
$931.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.09
|
| Rate for Payer: BCN Commercial |
$1,444.05
|
| Rate for Payer: BCN Medicare Advantage |
$931.20
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$1,340.93
|
| Rate for Payer: Cofinity Commercial |
$1,247.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.20
|
| Rate for Payer: Healthscope Commercial |
$1,722.72
|
| Rate for Payer: Healthscope Commercial |
$1,489.92
|
| Rate for Payer: Mclaren Medicaid |
$623.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$977.76
|
| Rate for Payer: Meridian Medicaid |
$655.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,446.00
|
| Rate for Payer: Nomi Health Commercial |
$1,117.44
|
| Rate for Payer: PACE SWMI |
$931.20
|
| Rate for Payer: PHP Medicare Advantage |
$931.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,461.35
|
| Rate for Payer: Priority Health Medicare |
$931.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,461.35
|
| Rate for Payer: Priority Health SBD |
$1,461.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.20
|
| Rate for Payer: UHC Exchange |
$1,047.57
|
| Rate for Payer: UHC Medicare Advantage |
$931.20
|
| Rate for Payer: UHCCP Medicaid |
$623.88
|
|
|
PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR
|
Professional
|
Both
|
$1,321.00
|
|
|
Service Code
|
HCPCS 57300
|
| Min. Negotiated Rate |
$393.20 |
| Max. Negotiated Rate |
$108,409.00 |
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna Medicare |
$605.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.09
|
| Rate for Payer: BCBS Complete |
$412.86
|
| Rate for Payer: BCBS MAPPO |
$582.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,627.76
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$582.01
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Cofinity Commercial |
$838.09
|
| Rate for Payer: Cofinity Commercial |
$779.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.01
|
| Rate for Payer: Healthscope Commercial |
$931.22
|
| Rate for Payer: Healthscope Commercial |
$1,076.72
|
| Rate for Payer: Mclaren Medicaid |
$393.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.11
|
| Rate for Payer: Meridian Medicaid |
$412.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,409.00
|
| Rate for Payer: Nomi Health Commercial |
$698.41
|
| Rate for Payer: PACE SWMI |
$582.01
|
| Rate for Payer: PHP Medicare Advantage |
$582.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$920.16
|
| Rate for Payer: Priority Health Medicare |
$582.01
|
| Rate for Payer: Priority Health Narrow Network |
$920.16
|
| Rate for Payer: Priority Health SBD |
$920.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.01
|
| Rate for Payer: UHC Exchange |
$632.97
|
| Rate for Payer: UHC Medicare Advantage |
$582.01
|
| Rate for Payer: UHCCP Medicaid |
$393.20
|
|
|
PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 53520
|
| Min. Negotiated Rate |
$256.23 |
| Max. Negotiated Rate |
$98,194.00 |
| Rate for Payer: Aetna Commercial |
$716.56
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$716.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.04
|
| Rate for Payer: BCBS Complete |
$377.75
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$770.04
|
| Rate for Payer: Cofinity Commercial |
$716.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$989.29
|
| Rate for Payer: Healthscope Commercial |
$855.60
|
| Rate for Payer: Mclaren Medicaid |
$359.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$377.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,194.00
|
| Rate for Payer: Nomi Health Commercial |
$641.70
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.24
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow Network |
$894.24
|
| Rate for Payer: Priority Health SBD |
$894.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$619.56
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$359.76
|
|
|
PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 57311
|
| Min. Negotiated Rate |
$357.41 |
| Max. Negotiated Rate |
$97,814.00 |
| Rate for Payer: Aetna Commercial |
$709.11
|
| Rate for Payer: Aetna Medicare |
$550.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.03
|
| Rate for Payer: BCBS Complete |
$375.28
|
| Rate for Payer: BCBS MAPPO |
$529.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.05
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$529.19
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$762.03
|
| Rate for Payer: Cofinity Commercial |
$709.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.19
|
| Rate for Payer: Healthscope Commercial |
$979.00
|
| Rate for Payer: Healthscope Commercial |
$846.70
|
| Rate for Payer: Mclaren Medicaid |
$357.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.65
|
| Rate for Payer: Meridian Medicaid |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97,814.00
|
| Rate for Payer: Nomi Health Commercial |
$635.03
|
| Rate for Payer: PACE SWMI |
$529.19
|
| Rate for Payer: PHP Medicare Advantage |
$529.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.88
|
| Rate for Payer: Priority Health Medicare |
$529.19
|
| Rate for Payer: Priority Health Narrow Network |
$830.88
|
| Rate for Payer: Priority Health SBD |
$830.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.19
|
| Rate for Payer: UHC Exchange |
$611.86
|
| Rate for Payer: UHC Medicare Advantage |
$529.19
|
| Rate for Payer: UHCCP Medicaid |
$357.41
|
|
|
PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH
|
Professional
|
Both
|
$3,916.00
|
|
|
Service Code
|
HCPCS 51900
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$144,779.00 |
| Rate for Payer: Aetna Commercial |
$1,055.92
|
| Rate for Payer: Aetna Medicare |
$819.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.72
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS MAPPO |
$788.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,187.98
|
| Rate for Payer: BCN Medicare Advantage |
$788.00
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,134.72
|
| Rate for Payer: Cofinity Commercial |
$1,055.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.00
|
| Rate for Payer: Healthscope Commercial |
$1,457.80
|
| Rate for Payer: Healthscope Commercial |
$1,260.80
|
| Rate for Payer: Mclaren Medicaid |
$528.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.40
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,779.00
|
| Rate for Payer: Nomi Health Commercial |
$945.60
|
| Rate for Payer: PACE SWMI |
$788.00
|
| Rate for Payer: PHP Medicare Advantage |
$788.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,310.74
|
| Rate for Payer: Priority Health Medicare |
$788.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.74
|
| Rate for Payer: Priority Health SBD |
$1,310.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.00
|
| Rate for Payer: UHC Exchange |
$1,025.54
|
| Rate for Payer: UHC Medicare Advantage |
$788.00
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
|
|
PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$2,274.00
|
|
|
Service Code
|
HCPCS 27222
|
| Min. Negotiated Rate |
$637.08 |
| Max. Negotiated Rate |
$175,075.00 |
| Rate for Payer: Aetna Commercial |
$1,267.84
|
| Rate for Payer: Aetna Medicare |
$984.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.46
|
| Rate for Payer: BCBS Complete |
$668.93
|
| Rate for Payer: BCBS MAPPO |
$946.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$1,446.98
|
| Rate for Payer: BCN Medicare Advantage |
$946.15
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.46
|
| Rate for Payer: Cofinity Commercial |
$1,267.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.15
|
| Rate for Payer: Healthscope Commercial |
$1,750.38
|
| Rate for Payer: Healthscope Commercial |
$1,513.84
|
| Rate for Payer: Mclaren Medicaid |
$637.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.46
|
| Rate for Payer: Meridian Medicaid |
$668.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,075.00
|
| Rate for Payer: Nomi Health Commercial |
$1,135.38
|
| Rate for Payer: PACE SWMI |
$946.15
|
| Rate for Payer: PHP Medicare Advantage |
$946.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,508.26
|
| Rate for Payer: Priority Health Medicare |
$946.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.26
|
| Rate for Payer: Priority Health SBD |
$1,508.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.15
|
| Rate for Payer: UHC Exchange |
$984.00
|
| Rate for Payer: UHC Medicare Advantage |
$946.15
|
| Rate for Payer: UHCCP Medicaid |
$637.08
|
|
