|
PR CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 52354
|
| Min. Negotiated Rate |
$263.48 |
| Max. Negotiated Rate |
$72,815.00 |
| Rate for Payer: Aetna Commercial |
$530.44
|
| Rate for Payer: Aetna Medicare |
$411.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.02
|
| Rate for Payer: BCBS Complete |
$276.65
|
| Rate for Payer: BCBS MAPPO |
$395.85
|
| Rate for Payer: BCBS Trust/PPO |
$475.77
|
| Rate for Payer: BCN Commercial |
$593.74
|
| Rate for Payer: BCN Medicare Advantage |
$395.85
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cofinity Commercial |
$570.02
|
| Rate for Payer: Cofinity Commercial |
$530.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.85
|
| Rate for Payer: Healthscope Commercial |
$732.32
|
| Rate for Payer: Healthscope Commercial |
$633.36
|
| Rate for Payer: Mclaren Medicaid |
$263.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.64
|
| Rate for Payer: Meridian Medicaid |
$276.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,815.00
|
| Rate for Payer: Nomi Health Commercial |
$475.02
|
| Rate for Payer: PACE SWMI |
$395.85
|
| Rate for Payer: PHP Medicare Advantage |
$395.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.03
|
| Rate for Payer: Priority Health Medicare |
$395.85
|
| Rate for Payer: Priority Health Narrow Network |
$654.03
|
| Rate for Payer: Priority Health SBD |
$654.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.85
|
| Rate for Payer: UHC Exchange |
$515.77
|
| Rate for Payer: UHC Medicare Advantage |
$395.85
|
| Rate for Payer: UHCCP Medicaid |
$263.48
|
|
|
PR CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 52355
|
| Min. Negotiated Rate |
$295.22 |
| Max. Negotiated Rate |
$81,581.00 |
| Rate for Payer: Aetna Commercial |
$594.49
|
| Rate for Payer: Aetna Medicare |
$461.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$638.86
|
| Rate for Payer: BCBS Complete |
$309.98
|
| Rate for Payer: BCBS MAPPO |
$443.65
|
| Rate for Payer: BCBS Trust/PPO |
$7,524.58
|
| Rate for Payer: BCN Commercial |
$665.09
|
| Rate for Payer: BCN Medicare Advantage |
$443.65
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cofinity Commercial |
$638.86
|
| Rate for Payer: Cofinity Commercial |
$594.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.65
|
| Rate for Payer: Healthscope Commercial |
$820.75
|
| Rate for Payer: Healthscope Commercial |
$709.84
|
| Rate for Payer: Mclaren Medicaid |
$295.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.83
|
| Rate for Payer: Meridian Medicaid |
$309.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,581.00
|
| Rate for Payer: Nomi Health Commercial |
$532.38
|
| Rate for Payer: PACE SWMI |
$443.65
|
| Rate for Payer: PHP Medicare Advantage |
$443.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.86
|
| Rate for Payer: Priority Health Medicare |
$443.65
|
| Rate for Payer: Priority Health Narrow Network |
$732.86
|
| Rate for Payer: Priority Health SBD |
$732.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.65
|
| Rate for Payer: UHC Exchange |
$606.83
|
| Rate for Payer: UHC Medicare Advantage |
$443.65
|
| Rate for Payer: UHCCP Medicaid |
$295.22
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED
|
Professional
|
Both
|
$3,197.00
|
|
|
Service Code
|
HCPCS 51865
|
| Min. Negotiated Rate |
$571.91 |
| Max. Negotiated Rate |
$157,932.00 |
| Rate for Payer: Aetna Commercial |
$1,145.35
|
| Rate for Payer: Aetna Medicare |
$888.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,230.83
|
| Rate for Payer: BCBS Complete |
$600.51
|
| Rate for Payer: BCBS MAPPO |
$854.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.07
|
| Rate for Payer: BCN Commercial |
$1,294.51
|
| Rate for Payer: BCN Medicare Advantage |
$854.74
|
| Rate for Payer: Cash Price |
$2,557.60
|
| Rate for Payer: Cash Price |
$2,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,230.83
|
| Rate for Payer: Cofinity Commercial |
$1,145.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.74
|
| Rate for Payer: Healthscope Commercial |
$1,581.27
|
| Rate for Payer: Healthscope Commercial |
$1,367.58
|
| Rate for Payer: Mclaren Medicaid |
$571.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.48
|
| Rate for Payer: Meridian Medicaid |
$600.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157,932.00
|
| Rate for Payer: Nomi Health Commercial |
$1,025.69
|
| Rate for Payer: PACE SWMI |
$854.74
|
| Rate for Payer: PHP Medicare Advantage |
$854.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,424.70
|
| Rate for Payer: Priority Health Medicare |
$854.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,424.70
|
| Rate for Payer: Priority Health SBD |
$1,424.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.74
|
| Rate for Payer: UHC Exchange |
$1,204.48
|
| Rate for Payer: UHC Medicare Advantage |
$854.74
|
| Rate for Payer: UHCCP Medicaid |
$571.91
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 51860
|
| Min. Negotiated Rate |
$476.91 |
| Max. Negotiated Rate |
$131,679.00 |
| Rate for Payer: Aetna Commercial |
$954.40
|
| Rate for Payer: Aetna Medicare |
$740.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.40
|
| Rate for Payer: BCBS Complete |
$500.76
|
| Rate for Payer: BCBS MAPPO |
$712.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,379.46
|
| Rate for Payer: BCN Commercial |
$1,080.96
|
| Rate for Payer: BCN Medicare Advantage |
$712.24
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.24
|
| Rate for Payer: Healthscope Commercial |
$1,317.64
|
| Rate for Payer: Healthscope Commercial |
$1,139.58
|
| Rate for Payer: Mclaren Medicaid |
$476.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.85
|
| Rate for Payer: Meridian Medicaid |
$500.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,679.00
|
| Rate for Payer: Nomi Health Commercial |
$854.69
|
| Rate for Payer: PACE SWMI |
$712.24
|
| Rate for Payer: PHP Medicare Advantage |
$712.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,189.82
|
| Rate for Payer: Priority Health Medicare |
$712.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,189.82
|
| Rate for Payer: Priority Health SBD |
$1,189.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.24
|
| Rate for Payer: UHC Exchange |
$1,006.48
|
| Rate for Payer: UHC Medicare Advantage |
$712.24
|
| Rate for Payer: UHCCP Medicaid |
$476.91
|
|
|
PR CYSTOSTOMY CYSTOTOMY W/DRAINAGE
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 51040
|
| Min. Negotiated Rate |
$188.72 |
| Max. Negotiated Rate |
$50,992.00 |
| Rate for Payer: Aetna Commercial |
$373.42
|
| Rate for Payer: Aetna Medicare |
$289.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.28
|
| Rate for Payer: BCBS Complete |
$198.16
|
| Rate for Payer: BCBS MAPPO |
$278.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,051.99
|
| Rate for Payer: BCN Commercial |
$422.22
|
| Rate for Payer: BCN Medicare Advantage |
$278.67
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$401.28
|
| Rate for Payer: Cofinity Commercial |
$373.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.67
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Healthscope Commercial |
$445.87
|
| Rate for Payer: Mclaren Medicaid |
$188.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.60
|
| Rate for Payer: Meridian Medicaid |
$198.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,992.00
|
| Rate for Payer: Nomi Health Commercial |
$334.40
|
| Rate for Payer: PACE SWMI |
$278.67
|
| Rate for Payer: PHP Medicare Advantage |
$278.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.69
|
| Rate for Payer: Priority Health Medicare |
$278.67
|
| Rate for Payer: Priority Health Narrow Network |
$468.69
|
| Rate for Payer: Priority Health SBD |
$468.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$400.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.67
|
| Rate for Payer: UHC Exchange |
$400.52
|
| Rate for Payer: UHC Medicare Advantage |
$278.67
|
| Rate for Payer: UHCCP Medicaid |
$188.72
|
|
|
PR CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
|
Professional
|
Both
|
$2,450.00
|
|
|
Service Code
|
HCPCS 51020
|
| Min. Negotiated Rate |
$303.10 |
| Max. Negotiated Rate |
$82,498.00 |
| Rate for Payer: Aetna Commercial |
$601.90
|
| Rate for Payer: Aetna Medicare |
$467.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.82
|
| Rate for Payer: BCBS Complete |
$318.26
|
| Rate for Payer: BCBS MAPPO |
$449.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,049.88
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: BCN Medicare Advantage |
$449.18
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cofinity Commercial |
$646.82
|
| Rate for Payer: Cofinity Commercial |
$601.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.18
|
| Rate for Payer: Healthscope Commercial |
$830.98
|
| Rate for Payer: Healthscope Commercial |
$718.69
|
| Rate for Payer: Mclaren Medicaid |
$303.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.64
|
| Rate for Payer: Meridian Medicaid |
$318.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,498.00
|
| Rate for Payer: Nomi Health Commercial |
$539.02
|
| Rate for Payer: PACE SWMI |
$449.18
|
| Rate for Payer: PHP Medicare Advantage |
$449.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,592.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.16
|
| Rate for Payer: Priority Health Medicare |
$449.18
|
| Rate for Payer: Priority Health Narrow Network |
$754.16
|
| Rate for Payer: Priority Health SBD |
$754.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.18
|
| Rate for Payer: UHC Exchange |
$557.06
|
| Rate for Payer: UHC Medicare Advantage |
$449.18
|
| Rate for Payer: UHCCP Medicaid |
$303.10
|
|
|
PR CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 51525
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$151,225.00 |
| Rate for Payer: Aetna Commercial |
$1,097.85
|
| Rate for Payer: Aetna Medicare |
$852.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,179.78
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCBS MAPPO |
$819.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,181.95
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: BCN Medicare Advantage |
$819.29
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$1,179.78
|
| Rate for Payer: Cofinity Commercial |
$1,097.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.29
|
| Rate for Payer: Healthscope Commercial |
$1,515.69
|
| Rate for Payer: Healthscope Commercial |
$1,310.86
|
| Rate for Payer: Mclaren Medicaid |
$548.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.25
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,225.00
|
| Rate for Payer: Nomi Health Commercial |
$983.15
|
| Rate for Payer: PACE SWMI |
$819.29
|
| Rate for Payer: PHP Medicare Advantage |
$819.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.38
|
| Rate for Payer: Priority Health Medicare |
$819.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,362.38
|
| Rate for Payer: Priority Health SBD |
$1,362.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$819.29
|
| Rate for Payer: UHC Exchange |
$1,056.47
|
| Rate for Payer: UHC Medicare Advantage |
$819.29
|
| Rate for Payer: UHCCP Medicaid |
$548.48
|
|
|
PR CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 51535
|
| Min. Negotiated Rate |
$499.49 |
| Max. Negotiated Rate |
$137,079.00 |
| Rate for Payer: Aetna Commercial |
$998.77
|
| Rate for Payer: Aetna Medicare |
$775.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.77
|
| Rate for Payer: BCBS Complete |
$524.46
|
| Rate for Payer: BCBS MAPPO |
$745.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,177.20
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: BCN Medicare Advantage |
$745.35
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$998.77
|
| Rate for Payer: Cofinity Commercial |
$1,073.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.35
|
| Rate for Payer: Healthscope Commercial |
$1,378.90
|
| Rate for Payer: Healthscope Commercial |
$1,192.56
|
| Rate for Payer: Mclaren Medicaid |
$499.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.62
|
| Rate for Payer: Meridian Medicaid |
$524.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137,079.00
|
| Rate for Payer: Nomi Health Commercial |
$894.42
|
| Rate for Payer: PACE SWMI |
$745.35
|
| Rate for Payer: PHP Medicare Advantage |
$745.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.89
|
| Rate for Payer: Priority Health Medicare |
$745.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.89
|
| Rate for Payer: Priority Health SBD |
$1,239.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$975.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.35
|
| Rate for Payer: UHC Exchange |
$975.50
|
| Rate for Payer: UHC Medicare Advantage |
$745.35
|
| Rate for Payer: UHCCP Medicaid |
$499.49
|
|
|
PR CYSTOTOMY EXCISION BLADDER TUMOR
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 51530
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$135,335.00 |
| Rate for Payer: Aetna Commercial |
$985.74
|
| Rate for Payer: Aetna Medicare |
$765.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.74
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$735.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,404.29
|
| Rate for Payer: BCN Commercial |
$1,110.28
|
| Rate for Payer: BCN Medicare Advantage |
$735.63
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$985.74
|
| Rate for Payer: Cofinity Commercial |
$1,059.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.63
|
| Rate for Payer: Healthscope Commercial |
$1,360.92
|
| Rate for Payer: Healthscope Commercial |
$1,177.01
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.41
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135,335.00
|
| Rate for Payer: Nomi Health Commercial |
$882.76
|
| Rate for Payer: PACE SWMI |
$735.63
|
| Rate for Payer: PHP Medicare Advantage |
$735.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.98
|
| Rate for Payer: Priority Health Medicare |
$735.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,224.98
|
| Rate for Payer: Priority Health SBD |
$1,224.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.63
|
| Rate for Payer: UHC Exchange |
$1,006.72
|
| Rate for Payer: UHC Medicare Advantage |
$735.63
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR CYSTOTOMY SIMPLE EXCISION VESICAL NECK
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 51520
|
| Min. Negotiated Rate |
$383.19 |
| Max. Negotiated Rate |
$104,672.00 |
| Rate for Payer: Aetna Commercial |
$763.83
|
| Rate for Payer: Aetna Medicare |
$592.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.83
|
| Rate for Payer: BCBS Complete |
$402.35
|
| Rate for Payer: BCBS MAPPO |
$570.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.82
|
| Rate for Payer: BCN Commercial |
$861.05
|
| Rate for Payer: BCN Medicare Advantage |
$570.02
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$820.83
|
| Rate for Payer: Cofinity Commercial |
$763.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.02
|
| Rate for Payer: Healthscope Commercial |
$912.03
|
| Rate for Payer: Healthscope Commercial |
$1,054.54
|
| Rate for Payer: Mclaren Medicaid |
$383.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.52
|
| Rate for Payer: Meridian Medicaid |
$402.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104,672.00
|
| Rate for Payer: Nomi Health Commercial |
$684.02
|
| Rate for Payer: PACE SWMI |
$570.02
|
| Rate for Payer: PHP Medicare Advantage |
$570.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$951.22
|
| Rate for Payer: Priority Health Medicare |
$570.02
|
| Rate for Payer: Priority Health Narrow Network |
$951.22
|
| Rate for Payer: Priority Health SBD |
$951.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.02
|
| Rate for Payer: UHC Exchange |
$749.81
|
| Rate for Payer: UHC Medicare Advantage |
$570.02
|
| Rate for Payer: UHCCP Medicaid |
$383.19
|
|
|
PR CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 51065
|
| Min. Negotiated Rate |
$373.39 |
| Max. Negotiated Rate |
$102,010.00 |
| Rate for Payer: Aetna Commercial |
$744.33
|
| Rate for Payer: Aetna Medicare |
$577.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.88
|
| Rate for Payer: BCBS Complete |
$392.06
|
| Rate for Payer: BCBS MAPPO |
$555.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,864.97
|
| Rate for Payer: BCN Commercial |
$839.06
|
| Rate for Payer: BCN Medicare Advantage |
$555.47
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$799.88
|
| Rate for Payer: Cofinity Commercial |
$744.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.47
|
| Rate for Payer: Healthscope Commercial |
$888.75
|
| Rate for Payer: Healthscope Commercial |
$1,027.62
|
| Rate for Payer: Mclaren Medicaid |
$373.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.24
|
| Rate for Payer: Meridian Medicaid |
$392.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,010.00
|
| Rate for Payer: Nomi Health Commercial |
$666.56
|
| Rate for Payer: PACE SWMI |
$555.47
|
| Rate for Payer: PHP Medicare Advantage |
$555.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.26
|
| Rate for Payer: Priority Health Medicare |
$555.47
|
| Rate for Payer: Priority Health Narrow Network |
$927.26
|
| Rate for Payer: Priority Health SBD |
$927.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.47
|
| Rate for Payer: UHC Exchange |
$753.05
|
| Rate for Payer: UHC Medicare Advantage |
$555.47
|
| Rate for Payer: UHCCP Medicaid |
$373.39
|
|
|
PR CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX
|
Professional
|
Both
|
$1,032.00
|
|
|
Service Code
|
HCPCS 51045
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$88,366.00 |
| Rate for Payer: Aetna Commercial |
$630.30
|
| Rate for Payer: Aetna Medicare |
$489.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.33
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS MAPPO |
$470.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,133.88
|
| Rate for Payer: BCN Commercial |
$728.13
|
| Rate for Payer: BCN Medicare Advantage |
$470.37
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$677.33
|
| Rate for Payer: Cofinity Commercial |
$630.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.37
|
| Rate for Payer: Healthscope Commercial |
$870.18
|
| Rate for Payer: Healthscope Commercial |
$752.59
|
| Rate for Payer: Mclaren Medicaid |
$316.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.89
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88,366.00
|
| Rate for Payer: Nomi Health Commercial |
$564.44
|
| Rate for Payer: PACE SWMI |
$470.37
|
| Rate for Payer: PHP Medicare Advantage |
$470.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.84
|
| Rate for Payer: Priority Health Medicare |
$470.37
|
| Rate for Payer: Priority Health Narrow Network |
$797.84
|
| Rate for Payer: Priority Health SBD |
$797.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$546.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$470.37
|
| Rate for Payer: UHC Exchange |
$546.78
|
| Rate for Payer: UHC Medicare Advantage |
$470.37
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 52356
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$72,592.00 |
| Rate for Payer: Aetna Commercial |
$528.35
|
| Rate for Payer: Aetna Medicare |
$410.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.78
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$394.29
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$591.79
|
| Rate for Payer: BCN Medicare Advantage |
$394.29
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$567.78
|
| Rate for Payer: Cofinity Commercial |
$528.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.29
|
| Rate for Payer: Healthscope Commercial |
$630.86
|
| Rate for Payer: Healthscope Commercial |
$729.44
|
| Rate for Payer: Mclaren Medicaid |
$262.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.00
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,592.00
|
| Rate for Payer: Nomi Health Commercial |
$473.15
|
| Rate for Payer: PACE SWMI |
$394.29
|
| Rate for Payer: PHP Medicare Advantage |
$394.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.90
|
| Rate for Payer: Priority Health Medicare |
$394.29
|
| Rate for Payer: Priority Health Narrow Network |
$651.90
|
| Rate for Payer: Priority Health SBD |
$651.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.29
|
| Rate for Payer: UHC Medicare Advantage |
$394.29
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR CYSTOURETHROSCOPY
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 52000
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$14,135.00 |
| Rate for Payer: Aetna Commercial |
$102.32
|
| Rate for Payer: Aetna Medicare |
$79.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.96
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS MAPPO |
$76.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$352.33
|
| Rate for Payer: BCN Medicare Advantage |
$76.36
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Cofinity Commercial |
$102.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.36
|
| Rate for Payer: Healthscope Commercial |
$141.27
|
| Rate for Payer: Healthscope Commercial |
$122.18
|
| Rate for Payer: Mclaren Medicaid |
$50.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.18
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,135.00
|
| Rate for Payer: Nomi Health Commercial |
$91.63
|
| Rate for Payer: PACE SWMI |
$76.36
|
| Rate for Payer: PHP Medicare Advantage |
$76.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.75
|
| Rate for Payer: Priority Health Medicare |
$76.36
|
| Rate for Payer: Priority Health Narrow Network |
$126.75
|
| Rate for Payer: Priority Health SBD |
$126.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.36
|
| Rate for Payer: UHC Exchange |
$266.94
|
| Rate for Payer: UHC Medicare Advantage |
$76.36
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 52287
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$29,711.00 |
| Rate for Payer: Aetna Commercial |
$216.13
|
| Rate for Payer: Aetna Medicare |
$167.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.26
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$161.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,222.49
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: BCN Medicare Advantage |
$161.29
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$232.26
|
| Rate for Payer: Cofinity Commercial |
$216.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.29
|
| Rate for Payer: Healthscope Commercial |
$258.06
|
| Rate for Payer: Healthscope Commercial |
$298.39
|
| Rate for Payer: Mclaren Medicaid |
$107.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.35
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,711.00
|
| Rate for Payer: Nomi Health Commercial |
$193.55
|
| Rate for Payer: PACE SWMI |
$161.29
|
| Rate for Payer: PHP Medicare Advantage |
$161.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.76
|
| Rate for Payer: Priority Health Medicare |
$161.29
|
| Rate for Payer: Priority Health Narrow Network |
$265.76
|
| Rate for Payer: Priority Health SBD |
$265.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.29
|
| Rate for Payer: UHC Medicare Advantage |
$161.29
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 52282
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$58,822.00 |
| Rate for Payer: Aetna Commercial |
$428.72
|
| Rate for Payer: Aetna Medicare |
$332.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.71
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$319.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.86
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: BCN Medicare Advantage |
$319.94
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$460.71
|
| Rate for Payer: Cofinity Commercial |
$428.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.94
|
| Rate for Payer: Healthscope Commercial |
$591.89
|
| Rate for Payer: Healthscope Commercial |
$511.90
|
| Rate for Payer: Mclaren Medicaid |
$213.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.94
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,822.00
|
| Rate for Payer: Nomi Health Commercial |
$383.93
|
| Rate for Payer: PACE SWMI |
$319.94
|
| Rate for Payer: PHP Medicare Advantage |
$319.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.41
|
| Rate for Payer: Priority Health Medicare |
$319.94
|
| Rate for Payer: Priority Health Narrow Network |
$529.41
|
| Rate for Payer: Priority Health SBD |
$529.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.94
|
| Rate for Payer: UHC Exchange |
$746.68
|
| Rate for Payer: UHC Medicare Advantage |
$319.94
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
|
PR CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 52250
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$41,823.00 |
| Rate for Payer: Aetna Commercial |
$304.21
|
| Rate for Payer: Aetna Medicare |
$236.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.91
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS MAPPO |
$227.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,966.55
|
| Rate for Payer: BCN Commercial |
$341.58
|
| Rate for Payer: BCN Medicare Advantage |
$227.02
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$326.91
|
| Rate for Payer: Cofinity Commercial |
$304.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.02
|
| Rate for Payer: Healthscope Commercial |
$419.99
|
| Rate for Payer: Healthscope Commercial |
$363.23
|
| Rate for Payer: Mclaren Medicaid |
$151.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.37
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,823.00
|
| Rate for Payer: Nomi Health Commercial |
$272.42
|
| Rate for Payer: PACE SWMI |
$227.02
|
| Rate for Payer: PHP Medicare Advantage |
$227.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.49
|
| Rate for Payer: Priority Health Medicare |
$227.02
|
| Rate for Payer: Priority Health Narrow Network |
$375.49
|
| Rate for Payer: Priority Health SBD |
$375.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.02
|
| Rate for Payer: UHC Exchange |
$300.00
|
| Rate for Payer: UHC Medicare Advantage |
$227.02
|
| Rate for Payer: UHCCP Medicaid |
$151.44
|
|
|
PR CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 52285
|
| Min. Negotiated Rate |
$125.03 |
| Max. Negotiated Rate |
$34,182.00 |
| Rate for Payer: Aetna Commercial |
$251.36
|
| Rate for Payer: Aetna Medicare |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.12
|
| Rate for Payer: BCBS Complete |
$131.28
|
| Rate for Payer: BCBS MAPPO |
$187.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.99
|
| Rate for Payer: BCN Commercial |
$513.12
|
| Rate for Payer: BCN Medicare Advantage |
$187.58
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$270.12
|
| Rate for Payer: Cofinity Commercial |
$251.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.58
|
| Rate for Payer: Healthscope Commercial |
$347.02
|
| Rate for Payer: Healthscope Commercial |
$300.13
|
| Rate for Payer: Mclaren Medicaid |
$125.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.96
|
| Rate for Payer: Meridian Medicaid |
$131.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,182.00
|
| Rate for Payer: Nomi Health Commercial |
$225.10
|
| Rate for Payer: PACE SWMI |
$187.58
|
| Rate for Payer: PHP Medicare Advantage |
$187.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.91
|
| Rate for Payer: Priority Health Medicare |
$187.58
|
| Rate for Payer: Priority Health Narrow Network |
$308.91
|
| Rate for Payer: Priority Health SBD |
$308.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.58
|
| Rate for Payer: UHC Exchange |
$406.38
|
| Rate for Payer: UHC Medicare Advantage |
$187.58
|
| Rate for Payer: UHCCP Medicaid |
$125.03
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 52235
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$50,396.00 |
| Rate for Payer: Aetna Commercial |
$365.98
|
| Rate for Payer: Aetna Medicare |
$284.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.29
|
| Rate for Payer: BCBS Complete |
$191.23
|
| Rate for Payer: BCBS MAPPO |
$273.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,767.31
|
| Rate for Payer: BCN Commercial |
$411.47
|
| Rate for Payer: BCN Medicare Advantage |
$273.12
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cofinity Commercial |
$393.29
|
| Rate for Payer: Cofinity Commercial |
$365.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.12
|
| Rate for Payer: Healthscope Commercial |
$505.27
|
| Rate for Payer: Healthscope Commercial |
$436.99
|
| Rate for Payer: Mclaren Medicaid |
$182.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.78
|
| Rate for Payer: Meridian Medicaid |
$191.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,396.00
|
| Rate for Payer: Nomi Health Commercial |
$327.74
|
| Rate for Payer: PACE SWMI |
$273.12
|
| Rate for Payer: PHP Medicare Advantage |
$273.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.25
|
| Rate for Payer: Priority Health Medicare |
$273.12
|
| Rate for Payer: Priority Health Narrow Network |
$453.25
|
| Rate for Payer: Priority Health SBD |
$453.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.12
|
| Rate for Payer: UHC Exchange |
$499.91
|
| Rate for Payer: UHC Medicare Advantage |
$273.12
|
| Rate for Payer: UHCCP Medicaid |
$182.12
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 52240
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$68,492.00 |
| Rate for Payer: Aetna Commercial |
$497.09
|
| Rate for Payer: Aetna Medicare |
$385.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.18
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCBS MAPPO |
$370.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,858.78
|
| Rate for Payer: BCN Commercial |
$558.56
|
| Rate for Payer: BCN Medicare Advantage |
$370.96
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cofinity Commercial |
$534.18
|
| Rate for Payer: Cofinity Commercial |
$497.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.96
|
| Rate for Payer: Healthscope Commercial |
$686.28
|
| Rate for Payer: Healthscope Commercial |
$593.54
|
| Rate for Payer: Mclaren Medicaid |
$247.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.51
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,492.00
|
| Rate for Payer: Nomi Health Commercial |
$445.15
|
| Rate for Payer: PACE SWMI |
$370.96
|
| Rate for Payer: PHP Medicare Advantage |
$370.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.15
|
| Rate for Payer: Priority Health Medicare |
$370.96
|
| Rate for Payer: Priority Health Narrow Network |
$615.15
|
| Rate for Payer: Priority Health SBD |
$615.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$885.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.96
|
| Rate for Payer: UHC Exchange |
$885.91
|
| Rate for Payer: UHC Medicare Advantage |
$370.96
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 52260
|
| Min. Negotiated Rate |
$133.34 |
| Max. Negotiated Rate |
$36,911.00 |
| Rate for Payer: Aetna Commercial |
$267.95
|
| Rate for Payer: Aetna Medicare |
$207.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.94
|
| Rate for Payer: BCBS Complete |
$140.01
|
| Rate for Payer: BCBS MAPPO |
$199.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.13
|
| Rate for Payer: BCN Commercial |
$418.29
|
| Rate for Payer: BCN Medicare Advantage |
$199.96
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cofinity Commercial |
$287.94
|
| Rate for Payer: Cofinity Commercial |
$267.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.96
|
| Rate for Payer: Healthscope Commercial |
$369.93
|
| Rate for Payer: Healthscope Commercial |
$319.94
|
| Rate for Payer: Mclaren Medicaid |
$133.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.96
|
| Rate for Payer: Meridian Medicaid |
$140.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,911.00
|
| Rate for Payer: Nomi Health Commercial |
$239.95
|
| Rate for Payer: PACE SWMI |
$199.96
|
| Rate for Payer: PHP Medicare Advantage |
$199.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.28
|
| Rate for Payer: Priority Health Medicare |
$199.96
|
| Rate for Payer: Priority Health Narrow Network |
$331.28
|
| Rate for Payer: Priority Health SBD |
$331.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.96
|
| Rate for Payer: UHC Exchange |
$269.67
|
| Rate for Payer: UHC Medicare Advantage |
$199.96
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 52265
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$28,429.00 |
| Rate for Payer: Aetna Commercial |
$207.00
|
| Rate for Payer: Aetna Medicare |
$160.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.45
|
| Rate for Payer: BCBS Complete |
$108.24
|
| Rate for Payer: BCBS MAPPO |
$154.48
|
| Rate for Payer: BCBS Trust/PPO |
$5,029.94
|
| Rate for Payer: BCN Commercial |
$549.27
|
| Rate for Payer: BCN Medicare Advantage |
$154.48
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cofinity Commercial |
$222.45
|
| Rate for Payer: Cofinity Commercial |
$207.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.48
|
| Rate for Payer: Healthscope Commercial |
$285.79
|
| Rate for Payer: Healthscope Commercial |
$247.17
|
| Rate for Payer: Mclaren Medicaid |
$103.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.20
|
| Rate for Payer: Meridian Medicaid |
$108.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,429.00
|
| Rate for Payer: Nomi Health Commercial |
$185.38
|
| Rate for Payer: PACE SWMI |
$154.48
|
| Rate for Payer: PHP Medicare Advantage |
$154.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.18
|
| Rate for Payer: Priority Health Medicare |
$154.48
|
| Rate for Payer: Priority Health Narrow Network |
$256.18
|
| Rate for Payer: Priority Health SBD |
$256.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.48
|
| Rate for Payer: UHC Exchange |
$360.95
|
| Rate for Payer: UHC Medicare Advantage |
$154.48
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 52276
|
| Min. Negotiated Rate |
$167.21 |
| Max. Negotiated Rate |
$46,147.00 |
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: Aetna Medicare |
$260.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.11
|
| Rate for Payer: BCBS Complete |
$175.57
|
| Rate for Payer: BCBS MAPPO |
$250.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,759.84
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$250.77
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cofinity Commercial |
$361.11
|
| Rate for Payer: Cofinity Commercial |
$336.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.77
|
| Rate for Payer: Healthscope Commercial |
$463.92
|
| Rate for Payer: Healthscope Commercial |
$401.23
|
| Rate for Payer: Mclaren Medicaid |
$167.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.31
|
| Rate for Payer: Meridian Medicaid |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,147.00
|
| Rate for Payer: Nomi Health Commercial |
$300.92
|
| Rate for Payer: PACE SWMI |
$250.77
|
| Rate for Payer: PHP Medicare Advantage |
$250.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.90
|
| Rate for Payer: Priority Health Medicare |
$250.77
|
| Rate for Payer: Priority Health Narrow Network |
$414.90
|
| Rate for Payer: Priority Health SBD |
$414.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.77
|
| Rate for Payer: UHC Exchange |
$534.35
|
| Rate for Payer: UHC Medicare Advantage |
$250.77
|
| Rate for Payer: UHCCP Medicaid |
$167.21
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 52270
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$31,678.00 |
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna Medicare |
$179.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.05
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$172.95
|
| Rate for Payer: BCBS Trust/PPO |
$4,237.49
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$172.95
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$249.05
|
| Rate for Payer: Cofinity Commercial |
$231.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.95
|
| Rate for Payer: Healthscope Commercial |
$319.96
|
| Rate for Payer: Healthscope Commercial |
$276.72
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.60
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,678.00
|
| Rate for Payer: Nomi Health Commercial |
$207.54
|
| Rate for Payer: PACE SWMI |
$172.95
|
| Rate for Payer: PHP Medicare Advantage |
$172.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.47
|
| Rate for Payer: Priority Health Medicare |
$172.95
|
| Rate for Payer: Priority Health Narrow Network |
$285.47
|
| Rate for Payer: Priority Health SBD |
$285.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.95
|
| Rate for Payer: UHC Exchange |
$398.40
|
| Rate for Payer: UHC Medicare Advantage |
$172.95
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE
|
Professional
|
Both
|
$977.00
|
|
|
Service Code
|
HCPCS 52275
|
| Min. Negotiated Rate |
$157.41 |
| Max. Negotiated Rate |
$43,331.00 |
| Rate for Payer: Aetna Commercial |
$316.48
|
| Rate for Payer: Aetna Medicare |
$245.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.10
|
| Rate for Payer: BCBS Complete |
$165.28
|
| Rate for Payer: BCBS MAPPO |
$236.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,563.53
|
| Rate for Payer: BCN Commercial |
$790.68
|
| Rate for Payer: BCN Medicare Advantage |
$236.18
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cofinity Commercial |
$340.10
|
| Rate for Payer: Cofinity Commercial |
$316.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.18
|
| Rate for Payer: Healthscope Commercial |
$436.93
|
| Rate for Payer: Healthscope Commercial |
$377.89
|
| Rate for Payer: Mclaren Medicaid |
$157.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.99
|
| Rate for Payer: Meridian Medicaid |
$165.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,331.00
|
| Rate for Payer: Nomi Health Commercial |
$283.42
|
| Rate for Payer: PACE SWMI |
$236.18
|
| Rate for Payer: PHP Medicare Advantage |
$236.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$236.18
|
| Rate for Payer: Priority Health Narrow Network |
$389.86
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.18
|
| Rate for Payer: UHC Exchange |
$485.95
|
| Rate for Payer: UHC Medicare Advantage |
$236.18
|
| Rate for Payer: UHCCP Medicaid |
$157.41
|
|
