|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$66.89
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.88
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$49.92
|
| Rate for Payer: BCN Commercial |
$84.16
|
| Rate for Payer: BCN Medicare Advantage |
$49.92
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$66.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.92
|
| Rate for Payer: Healthscope Commercial |
$92.35
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Mclaren Medicaid |
$31.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.42
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.79
|
| Rate for Payer: Nomi Health Commercial |
$59.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.00
|
| Rate for Payer: PACE SWMI |
$49.92
|
| Rate for Payer: PHP Medicare Advantage |
$49.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79.26
|
| Rate for Payer: Priority Health Medicare |
$49.92
|
| Rate for Payer: Priority Health SBD |
$79.26
|
| Rate for Payer: Priority Health Tiered Network |
$79.26
|
| Rate for Payer: Railroad Medicare Medicare |
$49.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.06
|
| Rate for Payer: UHC Core |
$101.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.92
|
| Rate for Payer: UHC Exchange |
$101.06
|
| Rate for Payer: UHC Medicaid |
$31.74
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$297.32 |
| Rate for Payer: Aetna Commercial |
$190.78
|
| Rate for Payer: Aetna Medicare |
$148.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.01
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$142.37
|
| Rate for Payer: BCN Commercial |
$244.01
|
| Rate for Payer: BCN Medicare Advantage |
$142.37
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$205.01
|
| Rate for Payer: Cofinity Commercial |
$190.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.37
|
| Rate for Payer: Healthscope Commercial |
$263.38
|
| Rate for Payer: Healthscope Commercial |
$227.79
|
| Rate for Payer: Mclaren Medicaid |
$92.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.49
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.77
|
| Rate for Payer: Nomi Health Commercial |
$170.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.00
|
| Rate for Payer: PACE SWMI |
$142.37
|
| Rate for Payer: PHP Medicare Advantage |
$142.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$297.32
|
| Rate for Payer: Priority Health Medicare |
$142.37
|
| Rate for Payer: Priority Health SBD |
$297.32
|
| Rate for Payer: Priority Health Tiered Network |
$297.32
|
| Rate for Payer: Railroad Medicare Medicare |
$142.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.16
|
| Rate for Payer: UHC Core |
$286.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.37
|
| Rate for Payer: UHC Exchange |
$286.16
|
| Rate for Payer: UHC Medicaid |
$92.87
|
| Rate for Payer: UHCCP Medicaid |
$92.87
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,159.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$80.51 |
| Max. Negotiated Rate |
$1,619.25 |
| Rate for Payer: Aetna Commercial |
$169.46
|
| Rate for Payer: Aetna Medicare |
$131.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.10
|
| Rate for Payer: BCBS Complete |
$84.54
|
| Rate for Payer: BCBS MAPPO |
$126.46
|
| Rate for Payer: BCN Commercial |
$214.13
|
| Rate for Payer: BCN Medicare Advantage |
$126.46
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cofinity Commercial |
$182.10
|
| Rate for Payer: Cofinity Commercial |
$169.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.46
|
| Rate for Payer: Healthscope Commercial |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$202.34
|
| Rate for Payer: Mclaren Medicaid |
$80.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.78
|
| Rate for Payer: Meridian Medicaid |
$84.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.56
|
| Rate for Payer: Nomi Health Commercial |
$151.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,619.25
|
| Rate for Payer: PACE SWMI |
$126.46
|
| Rate for Payer: PHP Medicare Advantage |
$126.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$260.91
|
| Rate for Payer: Priority Health Medicare |
$126.46
|
| Rate for Payer: Priority Health SBD |
$260.91
|
| Rate for Payer: Priority Health Tiered Network |
$260.91
|
| Rate for Payer: Railroad Medicare Medicare |
$126.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.83
|
| Rate for Payer: UHC Core |
$264.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.46
|
| Rate for Payer: UHC Exchange |
$264.83
|
| Rate for Payer: UHC Medicaid |
$80.51
|
| Rate for Payer: UHCCP Medicaid |
$80.51
|
|
|
PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,559.00
|
|
|
Service Code
|
HCPCS 27132
|
| Min. Negotiated Rate |
$959.14 |
| Max. Negotiated Rate |
$2,962.48 |
| Rate for Payer: Aetna Commercial |
$1,988.95
|
| Rate for Payer: Aetna Medicare |
$1,543.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,988.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.38
|
| Rate for Payer: BCBS Complete |
$1,007.10
|
| Rate for Payer: BCBS MAPPO |
$1,484.29
|
| Rate for Payer: BCN Commercial |
$2,517.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.29
|
| Rate for Payer: Cash Price |
$2,847.20
|
| Rate for Payer: Cash Price |
$2,847.20
|
| Rate for Payer: Cofinity Commercial |
$2,137.38
|
| Rate for Payer: Cofinity Commercial |
$1,988.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.29
|
| Rate for Payer: Healthscope Commercial |
$2,745.94
|
| Rate for Payer: Healthscope Commercial |
$2,374.86
|
| Rate for Payer: Mclaren Medicaid |
$959.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,558.50
|
| Rate for Payer: Meridian Medicaid |
$1,007.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,632.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.48
|
| Rate for Payer: Nomi Health Commercial |
$1,781.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,669.25
|
| Rate for Payer: PACE SWMI |
$1,484.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$959.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,690.92
|
| Rate for Payer: Priority Health Medicare |
$1,484.29
|
| Rate for Payer: Priority Health SBD |
$2,690.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,690.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,484.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,947.72
|
| Rate for Payer: UHC Core |
$2,947.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,484.29
|
| Rate for Payer: UHC Exchange |
$2,947.72
|
| Rate for Payer: UHC Medicaid |
$959.14
|
| Rate for Payer: UHCCP Medicaid |
$959.14
|
|
|
PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY
|
Professional
|
Both
|
$1,828.00
|
|
|
Service Code
|
HCPCS 23415
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$1,371.00 |
| Rate for Payer: Aetna Commercial |
$858.35
|
| Rate for Payer: Aetna Medicare |
$666.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.41
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$640.56
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: BCN Medicare Advantage |
$640.56
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cofinity Commercial |
$922.41
|
| Rate for Payer: Cofinity Commercial |
$858.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.56
|
| Rate for Payer: Healthscope Commercial |
$1,185.04
|
| Rate for Payer: Healthscope Commercial |
$1,024.90
|
| Rate for Payer: Mclaren Medicaid |
$419.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.59
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$704.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,240.11
|
| Rate for Payer: Nomi Health Commercial |
$768.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.00
|
| Rate for Payer: PACE SWMI |
$640.56
|
| Rate for Payer: PHP Medicare Advantage |
$640.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,146.10
|
| Rate for Payer: Priority Health Medicare |
$640.56
|
| Rate for Payer: Priority Health SBD |
$1,146.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,146.10
|
| Rate for Payer: Railroad Medicare Medicare |
$640.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.29
|
| Rate for Payer: UHC Core |
$1,214.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$640.56
|
| Rate for Payer: UHC Exchange |
$1,214.29
|
| Rate for Payer: UHC Medicaid |
$419.82
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR CORDOCENTESIS INTRAUTERINE
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 59012
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: Aetna Commercial |
$243.33
|
| Rate for Payer: Aetna Medicare |
$188.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.49
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$181.59
|
| Rate for Payer: BCN Commercial |
$300.28
|
| Rate for Payer: BCN Medicare Advantage |
$181.59
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$261.49
|
| Rate for Payer: Cofinity Commercial |
$243.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.59
|
| Rate for Payer: Healthscope Commercial |
$335.94
|
| Rate for Payer: Healthscope Commercial |
$290.54
|
| Rate for Payer: Mclaren Medicaid |
$114.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.67
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.01
|
| Rate for Payer: Nomi Health Commercial |
$217.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.00
|
| Rate for Payer: PACE SWMI |
$181.59
|
| Rate for Payer: PHP Medicare Advantage |
$181.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$283.47
|
| Rate for Payer: Priority Health Medicare |
$181.59
|
| Rate for Payer: Priority Health SBD |
$283.47
|
| Rate for Payer: Priority Health Tiered Network |
$283.47
|
| Rate for Payer: Railroad Medicare Medicare |
$181.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.65
|
| Rate for Payer: UHC Core |
$360.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.59
|
| Rate for Payer: UHC Exchange |
$360.65
|
| Rate for Payer: UHC Medicaid |
$114.59
|
| Rate for Payer: UHCCP Medicaid |
$114.59
|
|
|
PR CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 32408
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$175.14
|
| Rate for Payer: Aetna Medicare |
$135.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.21
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$130.70
|
| Rate for Payer: BCN Commercial |
$222.60
|
| Rate for Payer: BCN Medicare Advantage |
$130.70
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$188.21
|
| Rate for Payer: Cofinity Commercial |
$175.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.70
|
| Rate for Payer: Healthscope Commercial |
$241.79
|
| Rate for Payer: Healthscope Commercial |
$209.12
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.24
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.67
|
| Rate for Payer: Nomi Health Commercial |
$156.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$130.70
|
| Rate for Payer: PHP Medicare Advantage |
$130.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$209.62
|
| Rate for Payer: Priority Health Medicare |
$130.70
|
| Rate for Payer: Priority Health SBD |
$209.62
|
| Rate for Payer: Priority Health Tiered Network |
$209.62
|
| Rate for Payer: Railroad Medicare Medicare |
$130.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.56
|
| Rate for Payer: UHC Core |
$273.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.70
|
| Rate for Payer: UHC Exchange |
$273.56
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR CORF RELATED SERV 15 MINS EA
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS G0409
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$40.76 |
| Rate for Payer: Aetna Commercial |
$29.52
|
| Rate for Payer: Aetna Medicare |
$22.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Medicare Advantage |
$22.03
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$40.76
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.58
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$22.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.03
|
| Rate for Payer: Priority Health Medicare |
$22.03
|
| Rate for Payer: Railroad Medicare Medicare |
$22.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.72
|
| Rate for Payer: UHC Core |
$19.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.03
|
| Rate for Payer: UHC Exchange |
$19.72
|
|
|
PR CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$4,167.00
|
|
|
Service Code
|
HCPCS 33510
|
| Min. Negotiated Rate |
$1,157.23 |
| Max. Negotiated Rate |
$3,448.51 |
| Rate for Payer: Aetna Commercial |
$2,433.84
|
| Rate for Payer: Aetna Medicare |
$1,888.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,433.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,615.47
|
| Rate for Payer: BCBS Complete |
$1,215.09
|
| Rate for Payer: BCBS MAPPO |
$1,816.30
|
| Rate for Payer: BCN Commercial |
$2,842.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,816.30
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cofinity Commercial |
$2,615.47
|
| Rate for Payer: Cofinity Commercial |
$2,433.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,816.30
|
| Rate for Payer: Healthscope Commercial |
$3,360.16
|
| Rate for Payer: Healthscope Commercial |
$2,906.08
|
| Rate for Payer: Mclaren Medicaid |
$1,157.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,907.12
|
| Rate for Payer: Meridian Medicaid |
$1,215.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,997.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,422.45
|
| Rate for Payer: Nomi Health Commercial |
$2,179.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,125.25
|
| Rate for Payer: PACE SWMI |
$1,816.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,816.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,057.26
|
| Rate for Payer: Priority Health Medicare |
$1,816.30
|
| Rate for Payer: Priority Health SBD |
$3,057.26
|
| Rate for Payer: Priority Health Tiered Network |
$3,057.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,816.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,448.51
|
| Rate for Payer: UHC Core |
$3,448.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,816.30
|
| Rate for Payer: UHC Exchange |
$3,448.51
|
| Rate for Payer: UHC Medicaid |
$1,157.23
|
| Rate for Payer: UHCCP Medicaid |
$1,157.23
|
|
|
PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$4,577.00
|
|
|
Service Code
|
HCPCS 33511
|
| Min. Negotiated Rate |
$1,272.04 |
| Max. Negotiated Rate |
$3,785.49 |
| Rate for Payer: Aetna Commercial |
$2,675.86
|
| Rate for Payer: Aetna Medicare |
$2,076.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,675.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,875.55
|
| Rate for Payer: BCBS Complete |
$1,335.64
|
| Rate for Payer: BCBS MAPPO |
$1,996.91
|
| Rate for Payer: BCN Commercial |
$3,122.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,996.91
|
| Rate for Payer: Cash Price |
$3,661.60
|
| Rate for Payer: Cash Price |
$3,661.60
|
| Rate for Payer: Cofinity Commercial |
$2,875.55
|
| Rate for Payer: Cofinity Commercial |
$2,675.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,996.91
|
| Rate for Payer: Healthscope Commercial |
$3,694.28
|
| Rate for Payer: Healthscope Commercial |
$3,195.06
|
| Rate for Payer: Mclaren Medicaid |
$1,272.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,096.76
|
| Rate for Payer: Meridian Medicaid |
$1,335.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,196.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,756.53
|
| Rate for Payer: Nomi Health Commercial |
$2,396.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,432.75
|
| Rate for Payer: PACE SWMI |
$1,996.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,996.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,272.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,358.22
|
| Rate for Payer: Priority Health Medicare |
$1,996.91
|
| Rate for Payer: Priority Health SBD |
$3,358.22
|
| Rate for Payer: Priority Health Tiered Network |
$3,358.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,996.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,785.49
|
| Rate for Payer: UHC Core |
$3,785.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,996.91
|
| Rate for Payer: UHC Exchange |
$3,785.49
|
| Rate for Payer: UHC Medicaid |
$1,272.04
|
| Rate for Payer: UHCCP Medicaid |
$1,272.04
|
|
|
PR CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$10,215.00
|
|
|
Service Code
|
HCPCS 33512
|
| Min. Negotiated Rate |
$1,440.09 |
| Max. Negotiated Rate |
$7,661.25 |
| Rate for Payer: Aetna Commercial |
$3,031.44
|
| Rate for Payer: Aetna Medicare |
$2,352.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,031.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,257.67
|
| Rate for Payer: BCBS Complete |
$1,512.09
|
| Rate for Payer: BCBS MAPPO |
$2,262.27
|
| Rate for Payer: BCN Commercial |
$3,553.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,262.27
|
| Rate for Payer: Cash Price |
$8,172.00
|
| Rate for Payer: Cash Price |
$8,172.00
|
| Rate for Payer: Cofinity Commercial |
$3,257.67
|
| Rate for Payer: Cofinity Commercial |
$3,031.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,262.27
|
| Rate for Payer: Healthscope Commercial |
$4,185.20
|
| Rate for Payer: Healthscope Commercial |
$3,619.63
|
| Rate for Payer: Mclaren Medicaid |
$1,440.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,375.38
|
| Rate for Payer: Meridian Medicaid |
$1,512.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,488.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,284.83
|
| Rate for Payer: Nomi Health Commercial |
$2,714.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,661.25
|
| Rate for Payer: PACE SWMI |
$2,262.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,262.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,820.90
|
| Rate for Payer: Priority Health Medicare |
$2,262.27
|
| Rate for Payer: Priority Health SBD |
$3,820.90
|
| Rate for Payer: Priority Health Tiered Network |
$3,820.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,262.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,312.82
|
| Rate for Payer: UHC Core |
$4,312.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,262.27
|
| Rate for Payer: UHC Exchange |
$4,312.82
|
| Rate for Payer: UHC Medicaid |
$1,440.09
|
| Rate for Payer: UHCCP Medicaid |
$1,440.09
|
|
|
PR CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$10,424.00
|
|
|
Service Code
|
HCPCS 33513
|
| Min. Negotiated Rate |
$1,469.06 |
| Max. Negotiated Rate |
$7,818.00 |
| Rate for Payer: Aetna Commercial |
$3,094.64
|
| Rate for Payer: Aetna Medicare |
$2,401.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,094.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,325.58
|
| Rate for Payer: BCBS Complete |
$1,542.51
|
| Rate for Payer: BCBS MAPPO |
$2,309.43
|
| Rate for Payer: BCN Commercial |
$3,630.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,309.43
|
| Rate for Payer: Cash Price |
$8,339.20
|
| Rate for Payer: Cash Price |
$8,339.20
|
| Rate for Payer: Cofinity Commercial |
$3,325.58
|
| Rate for Payer: Cofinity Commercial |
$3,094.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,309.43
|
| Rate for Payer: Healthscope Commercial |
$4,272.45
|
| Rate for Payer: Healthscope Commercial |
$3,695.09
|
| Rate for Payer: Mclaren Medicaid |
$1,469.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,424.90
|
| Rate for Payer: Meridian Medicaid |
$1,542.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,540.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,386.38
|
| Rate for Payer: Nomi Health Commercial |
$2,771.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,818.00
|
| Rate for Payer: PACE SWMI |
$2,309.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,309.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,469.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,903.91
|
| Rate for Payer: Priority Health Medicare |
$2,309.43
|
| Rate for Payer: Priority Health SBD |
$3,903.91
|
| Rate for Payer: Priority Health Tiered Network |
$3,903.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,309.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,428.00
|
| Rate for Payer: UHC Core |
$4,428.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,309.43
|
| Rate for Payer: UHC Exchange |
$4,428.00
|
| Rate for Payer: UHC Medicaid |
$1,469.06
|
| Rate for Payer: UHCCP Medicaid |
$1,469.06
|
|
|
PR CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$11,723.00
|
|
|
Service Code
|
HCPCS 33516
|
| Min. Negotiated Rate |
$1,619.65 |
| Max. Negotiated Rate |
$8,792.25 |
| Rate for Payer: Aetna Commercial |
$3,408.91
|
| Rate for Payer: Aetna Medicare |
$2,645.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,408.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,663.30
|
| Rate for Payer: BCBS Complete |
$1,700.63
|
| Rate for Payer: BCBS MAPPO |
$2,543.96
|
| Rate for Payer: BCN Commercial |
$3,953.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,543.96
|
| Rate for Payer: Cash Price |
$9,378.40
|
| Rate for Payer: Cash Price |
$9,378.40
|
| Rate for Payer: Cofinity Commercial |
$3,663.30
|
| Rate for Payer: Cofinity Commercial |
$3,408.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,543.96
|
| Rate for Payer: Healthscope Commercial |
$4,706.33
|
| Rate for Payer: Healthscope Commercial |
$4,070.34
|
| Rate for Payer: Mclaren Medicaid |
$1,619.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,671.16
|
| Rate for Payer: Meridian Medicaid |
$1,700.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,798.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,770.63
|
| Rate for Payer: Nomi Health Commercial |
$3,052.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,792.25
|
| Rate for Payer: PACE SWMI |
$2,543.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,543.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,619.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,251.46
|
| Rate for Payer: Priority Health Medicare |
$2,543.96
|
| Rate for Payer: Priority Health SBD |
$4,251.46
|
| Rate for Payer: Priority Health Tiered Network |
$4,251.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,543.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,830.24
|
| Rate for Payer: UHC Core |
$4,830.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,543.96
|
| Rate for Payer: UHC Exchange |
$4,830.24
|
| Rate for Payer: UHC Medicaid |
$1,619.65
|
| Rate for Payer: UHCCP Medicaid |
$1,619.65
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 33517
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Aetna Commercial |
$230.52
|
| Rate for Payer: Aetna Medicare |
$178.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.72
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$172.03
|
| Rate for Payer: BCN Commercial |
$272.89
|
| Rate for Payer: BCN Medicare Advantage |
$172.03
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$247.72
|
| Rate for Payer: Cofinity Commercial |
$230.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.03
|
| Rate for Payer: Healthscope Commercial |
$318.26
|
| Rate for Payer: Healthscope Commercial |
$275.25
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.80
|
| Rate for Payer: Nomi Health Commercial |
$206.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.00
|
| Rate for Payer: PACE SWMI |
$172.03
|
| Rate for Payer: PHP Medicare Advantage |
$172.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$293.46
|
| Rate for Payer: Priority Health Medicare |
$172.03
|
| Rate for Payer: Priority Health SBD |
$293.46
|
| Rate for Payer: Priority Health Tiered Network |
$293.46
|
| Rate for Payer: Railroad Medicare Medicare |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.12
|
| Rate for Payer: UHC Core |
$336.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.03
|
| Rate for Payer: UHC Exchange |
$336.12
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 33518
|
| Min. Negotiated Rate |
$238.35 |
| Max. Negotiated Rate |
$1,023.75 |
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: Aetna Medicare |
$392.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.57
|
| Rate for Payer: BCBS Complete |
$250.27
|
| Rate for Payer: BCBS MAPPO |
$377.48
|
| Rate for Payer: BCN Commercial |
$600.57
|
| Rate for Payer: BCN Medicare Advantage |
$377.48
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$543.57
|
| Rate for Payer: Cofinity Commercial |
$505.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.48
|
| Rate for Payer: Healthscope Commercial |
$698.34
|
| Rate for Payer: Healthscope Commercial |
$603.97
|
| Rate for Payer: Mclaren Medicaid |
$238.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.35
|
| Rate for Payer: Meridian Medicaid |
$250.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.14
|
| Rate for Payer: Nomi Health Commercial |
$452.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,023.75
|
| Rate for Payer: PACE SWMI |
$377.48
|
| Rate for Payer: PHP Medicare Advantage |
$377.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$645.83
|
| Rate for Payer: Priority Health Medicare |
$377.48
|
| Rate for Payer: Priority Health SBD |
$645.83
|
| Rate for Payer: Priority Health Tiered Network |
$645.83
|
| Rate for Payer: Railroad Medicare Medicare |
$377.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.46
|
| Rate for Payer: UHC Core |
$738.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.48
|
| Rate for Payer: UHC Exchange |
$738.46
|
| Rate for Payer: UHC Medicaid |
$238.35
|
| Rate for Payer: UHCCP Medicaid |
$238.35
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN
|
Professional
|
Both
|
$1,988.00
|
|
|
Service Code
|
HCPCS 33519
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$1,491.00 |
| Rate for Payer: Aetna Commercial |
$668.57
|
| Rate for Payer: Aetna Medicare |
$518.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$668.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.46
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$498.93
|
| Rate for Payer: BCN Commercial |
$792.29
|
| Rate for Payer: BCN Medicare Advantage |
$498.93
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cofinity Commercial |
$718.46
|
| Rate for Payer: Cofinity Commercial |
$668.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.93
|
| Rate for Payer: Healthscope Commercial |
$923.02
|
| Rate for Payer: Healthscope Commercial |
$798.29
|
| Rate for Payer: Mclaren Medicaid |
$315.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.88
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$963.47
|
| Rate for Payer: Nomi Health Commercial |
$598.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.00
|
| Rate for Payer: PACE SWMI |
$498.93
|
| Rate for Payer: PHP Medicare Advantage |
$498.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$852.00
|
| Rate for Payer: Priority Health Medicare |
$498.93
|
| Rate for Payer: Priority Health SBD |
$852.00
|
| Rate for Payer: Priority Health Tiered Network |
$852.00
|
| Rate for Payer: Railroad Medicare Medicare |
$498.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$976.28
|
| Rate for Payer: UHC Core |
$976.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.93
|
| Rate for Payer: UHC Exchange |
$976.28
|
| Rate for Payer: UHC Medicaid |
$315.03
|
| Rate for Payer: UHCCP Medicaid |
$315.03
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN
|
Professional
|
Both
|
$2,669.00
|
|
|
Service Code
|
HCPCS 33521
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$2,001.75 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$623.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.76
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCN Commercial |
$951.15
|
| Rate for Payer: BCN Medicare Advantage |
$599.14
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cofinity Commercial |
$862.76
|
| Rate for Payer: Cofinity Commercial |
$802.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.14
|
| Rate for Payer: Healthscope Commercial |
$958.62
|
| Rate for Payer: Healthscope Commercial |
$1,108.41
|
| Rate for Payer: Mclaren Medicaid |
$378.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.10
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$659.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,154.65
|
| Rate for Payer: Nomi Health Commercial |
$718.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,001.75
|
| Rate for Payer: PACE SWMI |
$599.14
|
| Rate for Payer: PHP Medicare Advantage |
$599.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,022.84
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: Priority Health SBD |
$1,022.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,022.84
|
| Rate for Payer: Railroad Medicare Medicare |
$599.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.27
|
| Rate for Payer: UHC Core |
$1,172.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$599.14
|
| Rate for Payer: UHC Exchange |
$1,172.27
|
| Rate for Payer: UHC Medicaid |
$378.29
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN
|
Professional
|
Both
|
$3,391.00
|
|
|
Service Code
|
HCPCS 33522
|
| Min. Negotiated Rate |
$424.30 |
| Max. Negotiated Rate |
$2,543.25 |
| Rate for Payer: Aetna Commercial |
$900.47
|
| Rate for Payer: Aetna Medicare |
$698.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.67
|
| Rate for Payer: BCBS Complete |
$445.51
|
| Rate for Payer: BCBS MAPPO |
$671.99
|
| Rate for Payer: BCN Commercial |
$1,068.17
|
| Rate for Payer: BCN Medicare Advantage |
$671.99
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cofinity Commercial |
$967.67
|
| Rate for Payer: Cofinity Commercial |
$900.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.99
|
| Rate for Payer: Healthscope Commercial |
$1,243.18
|
| Rate for Payer: Healthscope Commercial |
$1,075.18
|
| Rate for Payer: Mclaren Medicaid |
$424.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.59
|
| Rate for Payer: Meridian Medicaid |
$445.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,297.48
|
| Rate for Payer: Nomi Health Commercial |
$806.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,543.25
|
| Rate for Payer: PACE SWMI |
$671.99
|
| Rate for Payer: PHP Medicare Advantage |
$671.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,148.68
|
| Rate for Payer: Priority Health Medicare |
$671.99
|
| Rate for Payer: Priority Health SBD |
$1,148.68
|
| Rate for Payer: Priority Health Tiered Network |
$1,148.68
|
| Rate for Payer: Railroad Medicare Medicare |
$671.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.86
|
| Rate for Payer: UHC Core |
$1,313.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$671.99
|
| Rate for Payer: UHC Exchange |
$1,313.86
|
| Rate for Payer: UHC Medicaid |
$424.30
|
| Rate for Payer: UHCCP Medicaid |
$424.30
|
|
|
PR CORONARY ENDARTERCOMY OPEN ANY METHOD
|
Professional
|
Both
|
$1,334.00
|
|
|
Service Code
|
HCPCS 33572
|
| Min. Negotiated Rate |
$133.55 |
| Max. Negotiated Rate |
$1,000.50 |
| Rate for Payer: Aetna Commercial |
$283.42
|
| Rate for Payer: Aetna Medicare |
$219.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.57
|
| Rate for Payer: BCBS Complete |
$140.23
|
| Rate for Payer: BCBS MAPPO |
$211.51
|
| Rate for Payer: BCN Commercial |
$335.14
|
| Rate for Payer: BCN Medicare Advantage |
$211.51
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$304.57
|
| Rate for Payer: Cofinity Commercial |
$283.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.51
|
| Rate for Payer: Healthscope Commercial |
$391.29
|
| Rate for Payer: Healthscope Commercial |
$338.42
|
| Rate for Payer: Mclaren Medicaid |
$133.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.09
|
| Rate for Payer: Meridian Medicaid |
$140.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$232.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.30
|
| Rate for Payer: Nomi Health Commercial |
$253.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: PACE SWMI |
$211.51
|
| Rate for Payer: PHP Medicare Advantage |
$211.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$360.40
|
| Rate for Payer: Priority Health Medicare |
$211.51
|
| Rate for Payer: Priority Health SBD |
$360.40
|
| Rate for Payer: Priority Health Tiered Network |
$360.40
|
| Rate for Payer: Railroad Medicare Medicare |
$211.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.85
|
| Rate for Payer: UHC Core |
$412.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.51
|
| Rate for Payer: UHC Exchange |
$412.85
|
| Rate for Payer: UHC Medicaid |
$133.55
|
| Rate for Payer: UHCCP Medicaid |
$133.55
|
|
|
PR CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 54430
|
| Min. Negotiated Rate |
$370.83 |
| Max. Negotiated Rate |
$1,447.50 |
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: Aetna Medicare |
$595.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$766.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.87
|
| Rate for Payer: BCBS Complete |
$389.37
|
| Rate for Payer: BCBS MAPPO |
$572.13
|
| Rate for Payer: BCN Commercial |
$960.10
|
| Rate for Payer: BCN Medicare Advantage |
$572.13
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$823.87
|
| Rate for Payer: Cofinity Commercial |
$766.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.13
|
| Rate for Payer: Healthscope Commercial |
$915.41
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$370.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.74
|
| Rate for Payer: Meridian Medicaid |
$389.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.35
|
| Rate for Payer: Nomi Health Commercial |
$686.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,447.50
|
| Rate for Payer: PACE SWMI |
$572.13
|
| Rate for Payer: PHP Medicare Advantage |
$572.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,045.87
|
| Rate for Payer: Priority Health Medicare |
$572.13
|
| Rate for Payer: Priority Health SBD |
$1,045.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,045.87
|
| Rate for Payer: Railroad Medicare Medicare |
$572.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,125.78
|
| Rate for Payer: UHC Core |
$1,125.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$572.13
|
| Rate for Payer: UHC Exchange |
$1,125.78
|
| Rate for Payer: UHC Medicaid |
$370.83
|
| Rate for Payer: UHCCP Medicaid |
$370.83
|
|
|
PR CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 54435
|
| Min. Negotiated Rate |
$244.74 |
| Max. Negotiated Rate |
$728.87 |
| Rate for Payer: Aetna Commercial |
$503.69
|
| Rate for Payer: Aetna Medicare |
$390.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.28
|
| Rate for Payer: BCBS Complete |
$256.98
|
| Rate for Payer: BCBS MAPPO |
$375.89
|
| Rate for Payer: BCN Commercial |
$625.47
|
| Rate for Payer: BCN Medicare Advantage |
$375.89
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$541.28
|
| Rate for Payer: Cofinity Commercial |
$503.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.89
|
| Rate for Payer: Healthscope Commercial |
$695.40
|
| Rate for Payer: Healthscope Commercial |
$601.42
|
| Rate for Payer: Mclaren Medicaid |
$244.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.68
|
| Rate for Payer: Meridian Medicaid |
$256.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.40
|
| Rate for Payer: Nomi Health Commercial |
$451.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.00
|
| Rate for Payer: PACE SWMI |
$375.89
|
| Rate for Payer: PHP Medicare Advantage |
$375.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$681.33
|
| Rate for Payer: Priority Health Medicare |
$375.89
|
| Rate for Payer: Priority Health SBD |
$681.33
|
| Rate for Payer: Priority Health Tiered Network |
$681.33
|
| Rate for Payer: Railroad Medicare Medicare |
$375.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.87
|
| Rate for Payer: UHC Core |
$728.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$375.89
|
| Rate for Payer: UHC Exchange |
$728.87
|
| Rate for Payer: UHC Medicaid |
$244.74
|
| Rate for Payer: UHCCP Medicaid |
$244.74
|
|
|
PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 54420
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$1,241.75 |
| Rate for Payer: Aetna Commercial |
$840.37
|
| Rate for Payer: Aetna Medicare |
$652.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$903.08
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$627.14
|
| Rate for Payer: BCN Commercial |
$1,053.23
|
| Rate for Payer: BCN Medicare Advantage |
$627.14
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$903.08
|
| Rate for Payer: Cofinity Commercial |
$840.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.14
|
| Rate for Payer: Healthscope Commercial |
$1,160.21
|
| Rate for Payer: Healthscope Commercial |
$1,003.42
|
| Rate for Payer: Mclaren Medicaid |
$405.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.50
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,235.20
|
| Rate for Payer: Nomi Health Commercial |
$752.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$627.14
|
| Rate for Payer: PHP Medicare Advantage |
$627.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,147.31
|
| Rate for Payer: Priority Health Medicare |
$627.14
|
| Rate for Payer: Priority Health SBD |
$1,147.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,147.31
|
| Rate for Payer: Railroad Medicare Medicare |
$627.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.75
|
| Rate for Payer: UHC Core |
$1,241.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$627.14
|
| Rate for Payer: UHC Exchange |
$1,241.75
|
| Rate for Payer: UHC Medicaid |
$405.77
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR CORRECT BUNION,SIMPLE
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
HCPCS 28290
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$1,069.50 |
| Rate for Payer: Aetna Medicare |
$713.00
|
| Rate for Payer: BCBS Complete |
$570.40
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,069.50
|
|
|
PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE
|
Professional
|
Both
|
$966.00
|
|
|
Service Code
|
HCPCS 28286
|
| Min. Negotiated Rate |
$177.22 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Aetna Commercial |
$361.68
|
| Rate for Payer: Aetna Medicare |
$280.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.67
|
| Rate for Payer: BCBS Complete |
$186.08
|
| Rate for Payer: BCBS MAPPO |
$269.91
|
| Rate for Payer: BCN Commercial |
$449.18
|
| Rate for Payer: BCN Medicare Advantage |
$269.91
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Cofinity Commercial |
$388.67
|
| Rate for Payer: Cofinity Commercial |
$361.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.91
|
| Rate for Payer: Healthscope Commercial |
$431.86
|
| Rate for Payer: Healthscope Commercial |
$499.33
|
| Rate for Payer: Mclaren Medicaid |
$177.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$283.41
|
| Rate for Payer: Meridian Medicaid |
$186.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$296.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$518.90
|
| Rate for Payer: Nomi Health Commercial |
$323.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$724.50
|
| Rate for Payer: PACE SWMI |
$269.91
|
| Rate for Payer: PHP Medicare Advantage |
$269.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$480.17
|
| Rate for Payer: Priority Health Medicare |
$269.91
|
| Rate for Payer: Priority Health SBD |
$480.17
|
| Rate for Payer: Priority Health Tiered Network |
$480.17
|
| Rate for Payer: Railroad Medicare Medicare |
$269.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$518.99
|
| Rate for Payer: UHC Core |
$518.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$269.91
|
| Rate for Payer: UHC Exchange |
$518.99
|
| Rate for Payer: UHC Medicaid |
$177.22
|
| Rate for Payer: UHCCP Medicaid |
$177.22
|
|
|
PR CORRECTION HAMMERTOE
|
Professional
|
Both
|
$985.00
|
|
|
Service Code
|
HCPCS 28285
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$738.75 |
| Rate for Payer: Aetna Commercial |
$480.91
|
| Rate for Payer: Aetna Medicare |
$373.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.80
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$358.89
|
| Rate for Payer: BCN Commercial |
$649.92
|
| Rate for Payer: BCN Medicare Advantage |
$358.89
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cofinity Commercial |
$516.80
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.89
|
| Rate for Payer: Healthscope Commercial |
$663.95
|
| Rate for Payer: Healthscope Commercial |
$574.22
|
| Rate for Payer: Mclaren Medicaid |
$236.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.83
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.26
|
| Rate for Payer: Nomi Health Commercial |
$430.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.75
|
| Rate for Payer: PACE SWMI |
$358.89
|
| Rate for Payer: PHP Medicare Advantage |
$358.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$632.41
|
| Rate for Payer: Priority Health Medicare |
$358.89
|
| Rate for Payer: Priority Health SBD |
$632.41
|
| Rate for Payer: Priority Health Tiered Network |
$632.41
|
| Rate for Payer: Railroad Medicare Medicare |
$358.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.55
|
| Rate for Payer: UHC Core |
$661.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.89
|
| Rate for Payer: UHC Exchange |
$661.55
|
| Rate for Payer: UHC Medicaid |
$236.43
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
