|
PR CYSTOURETHROSCOPY WITH BIOPSY
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 52204
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$24,602.00 |
| Rate for Payer: Aetna Commercial |
$179.64
|
| Rate for Payer: Aetna Medicare |
$139.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.05
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$134.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.65
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: BCN Medicare Advantage |
$134.06
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cofinity Commercial |
$193.05
|
| Rate for Payer: Cofinity Commercial |
$179.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.06
|
| Rate for Payer: Healthscope Commercial |
$248.01
|
| Rate for Payer: Healthscope Commercial |
$214.50
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.76
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,602.00
|
| Rate for Payer: Nomi Health Commercial |
$160.87
|
| Rate for Payer: PACE SWMI |
$134.06
|
| Rate for Payer: PHP Medicare Advantage |
$134.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.15
|
| Rate for Payer: Priority Health Medicare |
$134.06
|
| Rate for Payer: Priority Health Narrow Network |
$223.15
|
| Rate for Payer: Priority Health SBD |
$223.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.06
|
| Rate for Payer: UHC Exchange |
$345.11
|
| Rate for Payer: UHC Medicare Advantage |
$134.06
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
HCPCS 52320
|
| Min. Negotiated Rate |
$155.92 |
| Max. Negotiated Rate |
$42,998.00 |
| Rate for Payer: Aetna Commercial |
$313.72
|
| Rate for Payer: Aetna Medicare |
$243.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.13
|
| Rate for Payer: BCBS Complete |
$163.72
|
| Rate for Payer: BCBS MAPPO |
$234.12
|
| Rate for Payer: BCBS Trust/PPO |
$454.34
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: BCN Medicare Advantage |
$234.12
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Cofinity Commercial |
$337.13
|
| Rate for Payer: Cofinity Commercial |
$313.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.12
|
| Rate for Payer: Healthscope Commercial |
$433.12
|
| Rate for Payer: Healthscope Commercial |
$374.59
|
| Rate for Payer: Mclaren Medicaid |
$155.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.83
|
| Rate for Payer: Meridian Medicaid |
$163.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,998.00
|
| Rate for Payer: Nomi Health Commercial |
$280.94
|
| Rate for Payer: PACE SWMI |
$234.12
|
| Rate for Payer: PHP Medicare Advantage |
$234.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$926.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.13
|
| Rate for Payer: Priority Health Medicare |
$234.12
|
| Rate for Payer: Priority Health Narrow Network |
$386.13
|
| Rate for Payer: Priority Health SBD |
$386.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.12
|
| Rate for Payer: UHC Exchange |
$320.48
|
| Rate for Payer: UHC Medicare Advantage |
$234.12
|
| Rate for Payer: UHCCP Medicaid |
$155.92
|
|
|
PR CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 52283
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$35,141.00 |
| Rate for Payer: Aetna Commercial |
$257.55
|
| Rate for Payer: Aetna Medicare |
$199.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.77
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$192.20
|
| Rate for Payer: BCBS Trust/PPO |
$606.49
|
| Rate for Payer: BCN Commercial |
$517.51
|
| Rate for Payer: BCN Medicare Advantage |
$192.20
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Commercial |
$276.77
|
| Rate for Payer: Cofinity Commercial |
$257.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.20
|
| Rate for Payer: Healthscope Commercial |
$355.57
|
| Rate for Payer: Healthscope Commercial |
$307.52
|
| Rate for Payer: Mclaren Medicaid |
$128.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.81
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,141.00
|
| Rate for Payer: Nomi Health Commercial |
$230.64
|
| Rate for Payer: PACE SWMI |
$192.20
|
| Rate for Payer: PHP Medicare Advantage |
$192.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.90
|
| Rate for Payer: Priority Health Medicare |
$192.20
|
| Rate for Payer: Priority Health Narrow Network |
$316.90
|
| Rate for Payer: Priority Health SBD |
$316.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.20
|
| Rate for Payer: UHC Exchange |
$394.33
|
| Rate for Payer: UHC Medicare Advantage |
$192.20
|
| Rate for Payer: UHCCP Medicaid |
$128.23
|
|
|
PR CYSTOURETHROSCOPY W/URETERAL CATHETERIZATION
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 52005
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$23,063.00 |
| Rate for Payer: Aetna Commercial |
$169.59
|
| Rate for Payer: Aetna Medicare |
$131.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.25
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS MAPPO |
$126.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.80
|
| Rate for Payer: BCN Commercial |
$489.65
|
| Rate for Payer: BCN Medicare Advantage |
$126.56
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$182.25
|
| Rate for Payer: Cofinity Commercial |
$169.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.56
|
| Rate for Payer: Healthscope Commercial |
$234.14
|
| Rate for Payer: Healthscope Commercial |
$202.50
|
| Rate for Payer: Mclaren Medicaid |
$84.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.89
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,063.00
|
| Rate for Payer: Nomi Health Commercial |
$151.87
|
| Rate for Payer: PACE SWMI |
$126.56
|
| Rate for Payer: PHP Medicare Advantage |
$126.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.38
|
| Rate for Payer: Priority Health Medicare |
$126.56
|
| Rate for Payer: Priority Health Narrow Network |
$210.38
|
| Rate for Payer: Priority Health SBD |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.56
|
| Rate for Payer: UHC Exchange |
$353.62
|
| Rate for Payer: UHC Medicare Advantage |
$126.56
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
|
|
PR CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 52290
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$42,604.00 |
| Rate for Payer: Aetna Commercial |
$309.79
|
| Rate for Payer: Aetna Medicare |
$240.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.91
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$231.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.24
|
| Rate for Payer: BCN Commercial |
$347.94
|
| Rate for Payer: BCN Medicare Advantage |
$231.19
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$332.91
|
| Rate for Payer: Cofinity Commercial |
$309.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.19
|
| Rate for Payer: Healthscope Commercial |
$427.70
|
| Rate for Payer: Healthscope Commercial |
$369.90
|
| Rate for Payer: Mclaren Medicaid |
$154.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.75
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,604.00
|
| Rate for Payer: Nomi Health Commercial |
$277.43
|
| Rate for Payer: PACE SWMI |
$231.19
|
| Rate for Payer: PHP Medicare Advantage |
$231.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.40
|
| Rate for Payer: Priority Health Medicare |
$231.19
|
| Rate for Payer: Priority Health Narrow Network |
$382.40
|
| Rate for Payer: Priority Health SBD |
$382.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.19
|
| Rate for Payer: UHC Exchange |
$314.94
|
| Rate for Payer: UHC Medicare Advantage |
$231.19
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
|
|
PR CYSTO W/COMPLEX REMOVAL STONE & STENT
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 52315
|
| Min. Negotiated Rate |
$173.38 |
| Max. Negotiated Rate |
$48,089.00 |
| Rate for Payer: Aetna Commercial |
$348.64
|
| Rate for Payer: Aetna Medicare |
$270.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.66
|
| Rate for Payer: BCBS Complete |
$182.05
|
| Rate for Payer: BCBS MAPPO |
$260.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.68
|
| Rate for Payer: BCN Commercial |
$686.59
|
| Rate for Payer: BCN Medicare Advantage |
$260.18
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$374.66
|
| Rate for Payer: Cofinity Commercial |
$348.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.18
|
| Rate for Payer: Healthscope Commercial |
$481.33
|
| Rate for Payer: Healthscope Commercial |
$416.29
|
| Rate for Payer: Mclaren Medicaid |
$173.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.19
|
| Rate for Payer: Meridian Medicaid |
$182.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,089.00
|
| Rate for Payer: Nomi Health Commercial |
$312.22
|
| Rate for Payer: PACE SWMI |
$260.18
|
| Rate for Payer: PHP Medicare Advantage |
$260.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.88
|
| Rate for Payer: Priority Health Medicare |
$260.18
|
| Rate for Payer: Priority Health Narrow Network |
$430.88
|
| Rate for Payer: Priority Health SBD |
$430.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.18
|
| Rate for Payer: UHC Exchange |
$608.67
|
| Rate for Payer: UHC Medicare Advantage |
$260.18
|
| Rate for Payer: UHCCP Medicaid |
$173.38
|
|
|
PR CYSTO W/DESTRUCTION OF LESIONS
|
Professional
|
Both
|
$2,825.00
|
|
|
Service Code
|
HCPCS 52214
|
| Min. Negotiated Rate |
$110.76 |
| Max. Negotiated Rate |
$30,773.00 |
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna Medicare |
$173.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.41
|
| Rate for Payer: BCBS Complete |
$116.30
|
| Rate for Payer: BCBS MAPPO |
$166.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,177.12
|
| Rate for Payer: BCN Commercial |
$1,100.50
|
| Rate for Payer: BCN Medicare Advantage |
$166.95
|
| Rate for Payer: Cash Price |
$2,260.00
|
| Rate for Payer: Cash Price |
$2,260.00
|
| Rate for Payer: Cofinity Commercial |
$240.41
|
| Rate for Payer: Cofinity Commercial |
$223.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.95
|
| Rate for Payer: Healthscope Commercial |
$308.86
|
| Rate for Payer: Healthscope Commercial |
$267.12
|
| Rate for Payer: Mclaren Medicaid |
$110.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.30
|
| Rate for Payer: Meridian Medicaid |
$116.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,773.00
|
| Rate for Payer: Nomi Health Commercial |
$200.34
|
| Rate for Payer: PACE SWMI |
$166.95
|
| Rate for Payer: PHP Medicare Advantage |
$166.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,836.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.29
|
| Rate for Payer: Priority Health Medicare |
$166.95
|
| Rate for Payer: Priority Health Narrow Network |
$274.29
|
| Rate for Payer: Priority Health SBD |
$274.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.95
|
| Rate for Payer: UHC Exchange |
$435.36
|
| Rate for Payer: UHC Medicare Advantage |
$166.95
|
| Rate for Payer: UHCCP Medicaid |
$110.76
|
|
|
PR CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE
|
Professional
|
Both
|
$4,050.00
|
|
|
Service Code
|
HCPCS 52284
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$2,632.50 |
| Rate for Payer: Aetna Commercial |
$210.27
|
| Rate for Payer: Aetna Medicare |
$163.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.96
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS MAPPO |
$156.92
|
| Rate for Payer: BCN Medicare Advantage |
$156.92
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cofinity Commercial |
$225.96
|
| Rate for Payer: Cofinity Commercial |
$210.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.92
|
| Rate for Payer: Healthscope Commercial |
$290.30
|
| Rate for Payer: Healthscope Commercial |
$251.07
|
| Rate for Payer: Mclaren Medicaid |
$104.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.77
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,632.50
|
| Rate for Payer: Nomi Health Commercial |
$188.30
|
| Rate for Payer: PACE SWMI |
$156.92
|
| Rate for Payer: PHP Medicare Advantage |
$156.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,632.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.85
|
| Rate for Payer: Priority Health Medicare |
$156.92
|
| Rate for Payer: Priority Health Narrow Network |
$258.85
|
| Rate for Payer: Priority Health SBD |
$258.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.92
|
| Rate for Payer: UHC Medicare Advantage |
$156.92
|
| Rate for Payer: UHCCP Medicaid |
$104.58
|
|
|
PR CYSTO W/INSERT URETERAL STENT
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 52332
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$27,167.00 |
| Rate for Payer: Aetna Commercial |
$198.07
|
| Rate for Payer: Aetna Medicare |
$153.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.85
|
| Rate for Payer: BCBS Complete |
$103.77
|
| Rate for Payer: BCBS MAPPO |
$147.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,268.52
|
| Rate for Payer: BCN Commercial |
$588.86
|
| Rate for Payer: BCN Medicare Advantage |
$147.81
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$212.85
|
| Rate for Payer: Cofinity Commercial |
$198.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.81
|
| Rate for Payer: Healthscope Commercial |
$273.45
|
| Rate for Payer: Healthscope Commercial |
$236.50
|
| Rate for Payer: Mclaren Medicaid |
$98.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$103.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,167.00
|
| Rate for Payer: Nomi Health Commercial |
$177.37
|
| Rate for Payer: PACE SWMI |
$147.81
|
| Rate for Payer: PHP Medicare Advantage |
$147.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.99
|
| Rate for Payer: Priority Health Medicare |
$147.81
|
| Rate for Payer: Priority Health Narrow Network |
$244.99
|
| Rate for Payer: Priority Health SBD |
$244.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.81
|
| Rate for Payer: UHC Exchange |
$336.78
|
| Rate for Payer: UHC Medicare Advantage |
$147.81
|
| Rate for Payer: UHCCP Medicaid |
$98.83
|
|
|
PR CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
HCPCS 52001
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$50,173.00 |
| Rate for Payer: Aetna Commercial |
$364.40
|
| Rate for Payer: Aetna Medicare |
$282.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.59
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS MAPPO |
$271.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.41
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$271.94
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cofinity Commercial |
$391.59
|
| Rate for Payer: Cofinity Commercial |
$364.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.94
|
| Rate for Payer: Healthscope Commercial |
$503.09
|
| Rate for Payer: Healthscope Commercial |
$435.10
|
| Rate for Payer: Mclaren Medicaid |
$181.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.54
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,173.00
|
| Rate for Payer: Nomi Health Commercial |
$326.33
|
| Rate for Payer: PACE SWMI |
$271.94
|
| Rate for Payer: PHP Medicare Advantage |
$271.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.12
|
| Rate for Payer: Priority Health Medicare |
$271.94
|
| Rate for Payer: Priority Health Narrow Network |
$451.12
|
| Rate for Payer: Priority Health SBD |
$451.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.94
|
| Rate for Payer: UHC Exchange |
$549.49
|
| Rate for Payer: UHC Medicare Advantage |
$271.94
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
|
|
PR CYSTO W/REMOVAL OF LESIONS SMALL
|
Professional
|
Both
|
$2,326.00
|
|
|
Service Code
|
HCPCS 52224
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$35,644.00 |
| Rate for Payer: Aetna Commercial |
$258.62
|
| Rate for Payer: Aetna Medicare |
$200.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.92
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$193.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,846.48
|
| Rate for Payer: BCN Commercial |
$1,149.37
|
| Rate for Payer: BCN Medicare Advantage |
$193.00
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cofinity Commercial |
$277.92
|
| Rate for Payer: Cofinity Commercial |
$258.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.00
|
| Rate for Payer: Healthscope Commercial |
$357.05
|
| Rate for Payer: Healthscope Commercial |
$308.80
|
| Rate for Payer: Mclaren Medicaid |
$128.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.65
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,644.00
|
| Rate for Payer: Nomi Health Commercial |
$231.60
|
| Rate for Payer: PACE SWMI |
$193.00
|
| Rate for Payer: PHP Medicare Advantage |
$193.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.42
|
| Rate for Payer: Priority Health Medicare |
$193.00
|
| Rate for Payer: Priority Health Narrow Network |
$317.42
|
| Rate for Payer: Priority Health SBD |
$317.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.00
|
| Rate for Payer: UHC Exchange |
$370.46
|
| Rate for Payer: UHC Medicare Advantage |
$193.00
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
|
|
PR CYSTO W/REMOVAL OF TUMORS SMALL
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 52234
|
| Min. Negotiated Rate |
$155.49 |
| Max. Negotiated Rate |
$42,959.00 |
| Rate for Payer: Aetna Commercial |
$312.43
|
| Rate for Payer: Aetna Medicare |
$242.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.75
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$233.16
|
| Rate for Payer: BCBS Trust/PPO |
$5,244.96
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: BCN Medicare Advantage |
$233.16
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$335.75
|
| Rate for Payer: Cofinity Commercial |
$312.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.16
|
| Rate for Payer: Healthscope Commercial |
$431.35
|
| Rate for Payer: Healthscope Commercial |
$373.06
|
| Rate for Payer: Mclaren Medicaid |
$155.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.82
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,959.00
|
| Rate for Payer: Nomi Health Commercial |
$279.79
|
| Rate for Payer: PACE SWMI |
$233.16
|
| Rate for Payer: PHP Medicare Advantage |
$233.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.13
|
| Rate for Payer: Priority Health Medicare |
$233.16
|
| Rate for Payer: Priority Health Narrow Network |
$386.13
|
| Rate for Payer: Priority Health SBD |
$386.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.16
|
| Rate for Payer: UHC Exchange |
$425.30
|
| Rate for Payer: UHC Medicare Advantage |
$233.16
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS 52300
|
| Min. Negotiated Rate |
$176.79 |
| Max. Negotiated Rate |
$49,041.00 |
| Rate for Payer: Aetna Commercial |
$355.34
|
| Rate for Payer: Aetna Medicare |
$275.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.86
|
| Rate for Payer: BCBS Complete |
$185.63
|
| Rate for Payer: BCBS MAPPO |
$265.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,512.52
|
| Rate for Payer: BCN Commercial |
$400.23
|
| Rate for Payer: BCN Medicare Advantage |
$265.18
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cofinity Commercial |
$381.86
|
| Rate for Payer: Cofinity Commercial |
$355.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.18
|
| Rate for Payer: Healthscope Commercial |
$490.58
|
| Rate for Payer: Healthscope Commercial |
$424.29
|
| Rate for Payer: Mclaren Medicaid |
$176.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.44
|
| Rate for Payer: Meridian Medicaid |
$185.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,041.00
|
| Rate for Payer: Nomi Health Commercial |
$318.22
|
| Rate for Payer: PACE SWMI |
$265.18
|
| Rate for Payer: PHP Medicare Advantage |
$265.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$439.39
|
| Rate for Payer: Priority Health Medicare |
$265.18
|
| Rate for Payer: Priority Health Narrow Network |
$439.39
|
| Rate for Payer: Priority Health SBD |
$439.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.18
|
| Rate for Payer: UHC Exchange |
$364.68
|
| Rate for Payer: UHC Medicare Advantage |
$265.18
|
| Rate for Payer: UHCCP Medicaid |
$176.79
|
|
|
PR CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 52301
|
| Min. Negotiated Rate |
$183.18 |
| Max. Negotiated Rate |
$50,650.00 |
| Rate for Payer: Aetna Commercial |
$368.30
|
| Rate for Payer: Aetna Medicare |
$285.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.78
|
| Rate for Payer: BCBS Complete |
$192.34
|
| Rate for Payer: BCBS MAPPO |
$274.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.94
|
| Rate for Payer: BCN Commercial |
$413.42
|
| Rate for Payer: BCN Medicare Advantage |
$274.85
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$395.78
|
| Rate for Payer: Cofinity Commercial |
$368.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.85
|
| Rate for Payer: Healthscope Commercial |
$508.47
|
| Rate for Payer: Healthscope Commercial |
$439.76
|
| Rate for Payer: Mclaren Medicaid |
$183.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.59
|
| Rate for Payer: Meridian Medicaid |
$192.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,650.00
|
| Rate for Payer: Nomi Health Commercial |
$329.82
|
| Rate for Payer: PACE SWMI |
$274.85
|
| Rate for Payer: PHP Medicare Advantage |
$274.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.38
|
| Rate for Payer: Priority Health Medicare |
$274.85
|
| Rate for Payer: Priority Health Narrow Network |
$455.38
|
| Rate for Payer: Priority Health SBD |
$455.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.85
|
| Rate for Payer: UHC Exchange |
$382.95
|
| Rate for Payer: UHC Medicare Advantage |
$274.85
|
| Rate for Payer: UHCCP Medicaid |
$183.18
|
|
|
PR CYSTO W/SIMPLE REMOVAL STONE & STENT
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 52310
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$26,494.00 |
| Rate for Payer: Aetna Commercial |
$193.30
|
| Rate for Payer: Aetna Medicare |
$150.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.72
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS MAPPO |
$144.25
|
| Rate for Payer: BCBS Trust/PPO |
$904.45
|
| Rate for Payer: BCN Commercial |
$466.69
|
| Rate for Payer: BCN Medicare Advantage |
$144.25
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Cofinity Commercial |
$193.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.25
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Healthscope Commercial |
$230.80
|
| Rate for Payer: Mclaren Medicaid |
$96.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.46
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,494.00
|
| Rate for Payer: Nomi Health Commercial |
$173.10
|
| Rate for Payer: PACE SWMI |
$144.25
|
| Rate for Payer: PHP Medicare Advantage |
$144.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$383.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.61
|
| Rate for Payer: Priority Health Medicare |
$144.25
|
| Rate for Payer: Priority Health Narrow Network |
$238.61
|
| Rate for Payer: Priority Health SBD |
$238.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.25
|
| Rate for Payer: UHC Exchange |
$414.14
|
| Rate for Payer: UHC Medicare Advantage |
$144.25
|
| Rate for Payer: UHCCP Medicaid |
$96.28
|
|
|
PR CYSTO W/SUBURTRIC NJX IMPLT MATRL
|
Professional
|
Both
|
$1,313.00
|
|
|
Service Code
|
HCPCS 52327
|
| Min. Negotiated Rate |
$163.37 |
| Max. Negotiated Rate |
$45,425.00 |
| Rate for Payer: Aetna Commercial |
$330.00
|
| Rate for Payer: Aetna Medicare |
$256.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.63
|
| Rate for Payer: BCBS Complete |
$171.54
|
| Rate for Payer: BCBS MAPPO |
$246.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,129.58
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$246.27
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$354.63
|
| Rate for Payer: Cofinity Commercial |
$330.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.27
|
| Rate for Payer: Healthscope Commercial |
$455.60
|
| Rate for Payer: Healthscope Commercial |
$394.03
|
| Rate for Payer: Mclaren Medicaid |
$163.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.58
|
| Rate for Payer: Meridian Medicaid |
$171.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,425.00
|
| Rate for Payer: Nomi Health Commercial |
$295.52
|
| Rate for Payer: PACE SWMI |
$246.27
|
| Rate for Payer: PHP Medicare Advantage |
$246.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.84
|
| Rate for Payer: Priority Health Medicare |
$246.27
|
| Rate for Payer: Priority Health Narrow Network |
$405.84
|
| Rate for Payer: Priority Health SBD |
$405.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.27
|
| Rate for Payer: UHC Exchange |
$355.37
|
| Rate for Payer: UHC Medicare Advantage |
$246.27
|
| Rate for Payer: UHCCP Medicaid |
$163.37
|
|
|
PR CYSTO W/TX INTRA-RENAL STRICTURE
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 52343
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$60,131.00 |
| Rate for Payer: Aetna Commercial |
$437.51
|
| Rate for Payer: Aetna Medicare |
$339.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.16
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS MAPPO |
$326.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,659.46
|
| Rate for Payer: BCN Commercial |
$490.63
|
| Rate for Payer: BCN Medicare Advantage |
$326.50
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$470.16
|
| Rate for Payer: Cofinity Commercial |
$437.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.50
|
| Rate for Payer: Healthscope Commercial |
$604.02
|
| Rate for Payer: Healthscope Commercial |
$522.40
|
| Rate for Payer: Mclaren Medicaid |
$217.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.82
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,131.00
|
| Rate for Payer: Nomi Health Commercial |
$391.80
|
| Rate for Payer: PACE SWMI |
$326.50
|
| Rate for Payer: PHP Medicare Advantage |
$326.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.52
|
| Rate for Payer: Priority Health Medicare |
$326.50
|
| Rate for Payer: Priority Health Narrow Network |
$539.52
|
| Rate for Payer: Priority Health SBD |
$539.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.50
|
| Rate for Payer: UHC Exchange |
$484.46
|
| Rate for Payer: UHC Medicare Advantage |
$326.50
|
| Rate for Payer: UHCCP Medicaid |
$217.47
|
|
|
PR CYSTO W/TX URETERAL STRICTURE
|
Professional
|
Both
|
$1,537.00
|
|
|
Service Code
|
HCPCS 52341
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$49,680.00 |
| Rate for Payer: Aetna Commercial |
$360.38
|
| Rate for Payer: Aetna Medicare |
$279.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.27
|
| Rate for Payer: BCBS Complete |
$188.32
|
| Rate for Payer: BCBS MAPPO |
$268.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,160.75
|
| Rate for Payer: BCN Commercial |
$405.60
|
| Rate for Payer: BCN Medicare Advantage |
$268.94
|
| Rate for Payer: Cash Price |
$1,229.60
|
| Rate for Payer: Cash Price |
$1,229.60
|
| Rate for Payer: Cofinity Commercial |
$387.27
|
| Rate for Payer: Cofinity Commercial |
$360.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.94
|
| Rate for Payer: Healthscope Commercial |
$497.54
|
| Rate for Payer: Healthscope Commercial |
$430.30
|
| Rate for Payer: Mclaren Medicaid |
$179.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.39
|
| Rate for Payer: Meridian Medicaid |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,680.00
|
| Rate for Payer: Nomi Health Commercial |
$322.73
|
| Rate for Payer: PACE SWMI |
$268.94
|
| Rate for Payer: PHP Medicare Advantage |
$268.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.32
|
| Rate for Payer: Priority Health Medicare |
$268.94
|
| Rate for Payer: Priority Health Narrow Network |
$446.32
|
| Rate for Payer: Priority Health SBD |
$446.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.94
|
| Rate for Payer: UHC Exchange |
$404.24
|
| Rate for Payer: UHC Medicare Advantage |
$268.94
|
| Rate for Payer: UHCCP Medicaid |
$179.35
|
|
|
PR CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE
|
Professional
|
Both
|
$1,712.00
|
|
|
Service Code
|
HCPCS 52342
|
| Min. Negotiated Rate |
$195.32 |
| Max. Negotiated Rate |
$53,937.00 |
| Rate for Payer: Aetna Commercial |
$392.73
|
| Rate for Payer: Aetna Medicare |
$304.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.04
|
| Rate for Payer: BCBS Complete |
$205.09
|
| Rate for Payer: BCBS MAPPO |
$293.08
|
| Rate for Payer: BCBS Trust/PPO |
$440.60
|
| Rate for Payer: BCN Commercial |
$440.30
|
| Rate for Payer: BCN Medicare Advantage |
$293.08
|
| Rate for Payer: Cash Price |
$1,369.60
|
| Rate for Payer: Cash Price |
$1,369.60
|
| Rate for Payer: Cofinity Commercial |
$422.04
|
| Rate for Payer: Cofinity Commercial |
$392.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.08
|
| Rate for Payer: Healthscope Commercial |
$542.20
|
| Rate for Payer: Healthscope Commercial |
$468.93
|
| Rate for Payer: Mclaren Medicaid |
$195.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.73
|
| Rate for Payer: Meridian Medicaid |
$205.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,937.00
|
| Rate for Payer: Nomi Health Commercial |
$351.70
|
| Rate for Payer: PACE SWMI |
$293.08
|
| Rate for Payer: PHP Medicare Advantage |
$293.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,112.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.73
|
| Rate for Payer: Priority Health Medicare |
$293.08
|
| Rate for Payer: Priority Health Narrow Network |
$485.73
|
| Rate for Payer: Priority Health SBD |
$485.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.08
|
| Rate for Payer: UHC Exchange |
$437.28
|
| Rate for Payer: UHC Medicare Advantage |
$293.08
|
| Rate for Payer: UHCCP Medicaid |
$195.32
|
|
|
PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY
|
Professional
|
Both
|
$824.00
|
|
|
Service Code
|
HCPCS 52353
|
| 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 |
$7,607.52
|
| Rate for Payer: BCN Commercial |
$558.56
|
| Rate for Payer: BCN Medicare Advantage |
$370.96
|
| Rate for Payer: Cash Price |
$659.20
|
| Rate for Payer: Cash Price |
$659.20
|
| 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 |
$535.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.62
|
| Rate for Payer: Priority Health Medicare |
$370.96
|
| Rate for Payer: Priority Health Narrow Network |
$614.62
|
| Rate for Payer: Priority Health SBD |
$614.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.96
|
| Rate for Payer: UHC Exchange |
$587.40
|
| Rate for Payer: UHC Medicare Advantage |
$370.96
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 52352
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$61,871.00 |
| Rate for Payer: Aetna Commercial |
$450.36
|
| Rate for Payer: Aetna Medicare |
$349.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.97
|
| Rate for Payer: BCBS Complete |
$235.05
|
| Rate for Payer: BCBS MAPPO |
$336.09
|
| Rate for Payer: BCBS Trust/PPO |
$677.97
|
| Rate for Payer: BCN Commercial |
$504.80
|
| Rate for Payer: BCN Medicare Advantage |
$336.09
|
| Rate for Payer: Cash Price |
$2,400.00
|
| Rate for Payer: Cash Price |
$2,400.00
|
| Rate for Payer: Cofinity Commercial |
$483.97
|
| Rate for Payer: Cofinity Commercial |
$450.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.09
|
| Rate for Payer: Healthscope Commercial |
$621.77
|
| Rate for Payer: Healthscope Commercial |
$537.74
|
| Rate for Payer: Mclaren Medicaid |
$223.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.89
|
| Rate for Payer: Meridian Medicaid |
$235.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,871.00
|
| Rate for Payer: Nomi Health Commercial |
$403.31
|
| Rate for Payer: PACE SWMI |
$336.09
|
| Rate for Payer: PHP Medicare Advantage |
$336.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,950.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.50
|
| Rate for Payer: Priority Health Medicare |
$336.09
|
| Rate for Payer: Priority Health Narrow Network |
$555.50
|
| Rate for Payer: Priority Health SBD |
$555.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.09
|
| Rate for Payer: UHC Exchange |
$507.04
|
| Rate for Payer: UHC Medicare Advantage |
$336.09
|
| Rate for Payer: UHCCP Medicaid |
$223.86
|
|
|
PR CYSTO W/URTROSCOPY&/PYELOSCOPY DX
|
Professional
|
Both
|
$608.00
|
|
|
Service Code
|
HCPCS 52351
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$52,807.00 |
| Rate for Payer: Aetna Commercial |
$385.22
|
| Rate for Payer: Aetna Medicare |
$298.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.97
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS MAPPO |
$287.48
|
| Rate for Payer: BCBS Trust/PPO |
$393.43
|
| Rate for Payer: BCN Commercial |
$431.01
|
| Rate for Payer: BCN Medicare Advantage |
$287.48
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Cofinity Commercial |
$413.97
|
| Rate for Payer: Cofinity Commercial |
$385.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.48
|
| Rate for Payer: Healthscope Commercial |
$531.84
|
| Rate for Payer: Healthscope Commercial |
$459.97
|
| Rate for Payer: Mclaren Medicaid |
$191.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.85
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,807.00
|
| Rate for Payer: Nomi Health Commercial |
$344.98
|
| Rate for Payer: PACE SWMI |
$287.48
|
| Rate for Payer: PHP Medicare Advantage |
$287.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.62
|
| Rate for Payer: Priority Health Medicare |
$287.48
|
| Rate for Payer: Priority Health Narrow Network |
$475.62
|
| Rate for Payer: Priority Health SBD |
$475.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.48
|
| Rate for Payer: UHC Exchange |
$410.93
|
| Rate for Payer: UHC Medicare Advantage |
$287.48
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
|
|
PR CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 52346
|
| Min. Negotiated Rate |
$281.37 |
| Max. Negotiated Rate |
$77,924.00 |
| Rate for Payer: Aetna Commercial |
$566.42
|
| Rate for Payer: Aetna Medicare |
$439.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.69
|
| Rate for Payer: BCBS Complete |
$295.44
|
| Rate for Payer: BCBS MAPPO |
$422.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,753.98
|
| Rate for Payer: BCN Commercial |
$635.28
|
| Rate for Payer: BCN Medicare Advantage |
$422.70
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$608.69
|
| Rate for Payer: Cofinity Commercial |
$566.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.70
|
| Rate for Payer: Healthscope Commercial |
$782.00
|
| Rate for Payer: Healthscope Commercial |
$676.32
|
| Rate for Payer: Mclaren Medicaid |
$281.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.84
|
| Rate for Payer: Meridian Medicaid |
$295.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,924.00
|
| Rate for Payer: Nomi Health Commercial |
$507.24
|
| Rate for Payer: PACE SWMI |
$422.70
|
| Rate for Payer: PHP Medicare Advantage |
$422.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$699.84
|
| Rate for Payer: Priority Health Medicare |
$422.70
|
| Rate for Payer: Priority Health Narrow Network |
$699.84
|
| Rate for Payer: Priority Health SBD |
$699.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$422.70
|
| Rate for Payer: UHC Exchange |
$620.76
|
| Rate for Payer: UHC Medicare Advantage |
$422.70
|
| Rate for Payer: UHCCP Medicaid |
$281.37
|
|
|
PR CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE
|
Professional
|
Both
|
$799.00
|
|
|
Service Code
|
HCPCS 52344
|
| Min. Negotiated Rate |
$233.24 |
| Max. Negotiated Rate |
$64,399.00 |
| Rate for Payer: Aetna Commercial |
$469.23
|
| Rate for Payer: Aetna Medicare |
$364.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.24
|
| Rate for Payer: BCBS Complete |
$244.90
|
| Rate for Payer: BCBS MAPPO |
$350.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,736.67
|
| Rate for Payer: BCN Commercial |
$525.33
|
| Rate for Payer: BCN Medicare Advantage |
$350.17
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Cofinity Commercial |
$504.24
|
| Rate for Payer: Cofinity Commercial |
$469.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.17
|
| Rate for Payer: Healthscope Commercial |
$647.81
|
| Rate for Payer: Healthscope Commercial |
$560.27
|
| Rate for Payer: Mclaren Medicaid |
$233.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.68
|
| Rate for Payer: Meridian Medicaid |
$244.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,399.00
|
| Rate for Payer: Nomi Health Commercial |
$420.20
|
| Rate for Payer: PACE SWMI |
$350.17
|
| Rate for Payer: PHP Medicare Advantage |
$350.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.00
|
| Rate for Payer: Priority Health Medicare |
$350.17
|
| Rate for Payer: Priority Health Narrow Network |
$580.00
|
| Rate for Payer: Priority Health SBD |
$580.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.17
|
| Rate for Payer: UHC Exchange |
$517.50
|
| Rate for Payer: UHC Medicare Advantage |
$350.17
|
| Rate for Payer: UHCCP Medicaid |
$233.24
|
|
|
PR CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 52345
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$68,852.00 |
| Rate for Payer: Aetna Commercial |
$500.54
|
| Rate for Payer: Aetna Medicare |
$388.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.90
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$373.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$561.49
|
| Rate for Payer: BCN Medicare Advantage |
$373.54
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$537.90
|
| Rate for Payer: Cofinity Commercial |
$500.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.54
|
| Rate for Payer: Healthscope Commercial |
$691.05
|
| Rate for Payer: Healthscope Commercial |
$597.66
|
| Rate for Payer: Mclaren Medicaid |
$248.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.22
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,852.00
|
| Rate for Payer: Nomi Health Commercial |
$448.25
|
| Rate for Payer: PACE SWMI |
$373.54
|
| Rate for Payer: PHP Medicare Advantage |
$373.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.88
|
| Rate for Payer: Priority Health Medicare |
$373.54
|
| Rate for Payer: Priority Health Narrow Network |
$618.88
|
| Rate for Payer: Priority Health SBD |
$618.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.54
|
| Rate for Payer: UHC Exchange |
$552.11
|
| Rate for Payer: UHC Medicare Advantage |
$373.54
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
