|
PR DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 45910
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Aetna Commercial |
$245.53
|
| Rate for Payer: Aetna Medicare |
$190.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.85
|
| Rate for Payer: BCBS Complete |
$125.92
|
| Rate for Payer: BCBS MAPPO |
$183.23
|
| Rate for Payer: BCN Commercial |
$292.32
|
| Rate for Payer: BCN Medicare Advantage |
$183.23
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cofinity Commercial |
$263.85
|
| Rate for Payer: Cofinity Commercial |
$245.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.23
|
| Rate for Payer: Healthscope Commercial |
$338.98
|
| Rate for Payer: Healthscope Commercial |
$293.17
|
| Rate for Payer: Mclaren Medicaid |
$119.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.39
|
| Rate for Payer: Meridian Medicaid |
$125.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.03
|
| Rate for Payer: Nomi Health Commercial |
$219.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,020.00
|
| Rate for Payer: PACE SWMI |
$183.23
|
| Rate for Payer: PHP Medicare Advantage |
$183.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$356.16
|
| Rate for Payer: Priority Health Medicare |
$183.23
|
| Rate for Payer: Priority Health SBD |
$356.16
|
| Rate for Payer: Priority Health Tiered Network |
$356.16
|
| Rate for Payer: Railroad Medicare Medicare |
$183.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.96
|
| Rate for Payer: UHC Core |
$335.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$183.23
|
| Rate for Payer: UHC Exchange |
$335.96
|
| Rate for Payer: UHC Medicaid |
$119.92
|
| Rate for Payer: UHCCP Medicaid |
$119.92
|
|
|
PR DILAT URETHRAL STRIX DILATOR MALE 1ST
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 53600
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$132.75 |
| Rate for Payer: Aetna Commercial |
$74.69
|
| Rate for Payer: Aetna Medicare |
$57.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.27
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.74
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$55.74
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$80.27
|
| Rate for Payer: Cofinity Commercial |
$74.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.74
|
| Rate for Payer: Healthscope Commercial |
$89.18
|
| Rate for Payer: Healthscope Commercial |
$103.12
|
| Rate for Payer: Mclaren Medicaid |
$35.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.53
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.31
|
| Rate for Payer: Nomi Health Commercial |
$66.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
| Rate for Payer: PACE SWMI |
$55.74
|
| Rate for Payer: PHP Medicare Advantage |
$55.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.61
|
| Rate for Payer: Priority Health Medicare |
$55.74
|
| Rate for Payer: Priority Health SBD |
$103.61
|
| Rate for Payer: Priority Health Tiered Network |
$103.61
|
| Rate for Payer: Railroad Medicare Medicare |
$55.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.30
|
| Rate for Payer: UHC Core |
$112.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.74
|
| Rate for Payer: UHC Exchange |
$112.30
|
| Rate for Payer: UHC Medicaid |
$35.78
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
|
|
PR DILAT URETHRAL STRIX DILATOR MALE SBSQ
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 53601
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Medicare |
$49.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.05
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.26
|
| Rate for Payer: BCN Commercial |
$79.68
|
| Rate for Payer: BCN Medicare Advantage |
$47.26
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$68.05
|
| Rate for Payer: Cofinity Commercial |
$63.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.26
|
| Rate for Payer: Healthscope Commercial |
$87.43
|
| Rate for Payer: Healthscope Commercial |
$75.62
|
| Rate for Payer: Mclaren Medicaid |
$30.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.62
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.76
|
| Rate for Payer: Nomi Health Commercial |
$56.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: PACE SWMI |
$47.26
|
| Rate for Payer: PHP Medicare Advantage |
$47.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$86.79
|
| Rate for Payer: Priority Health Medicare |
$47.26
|
| Rate for Payer: Priority Health SBD |
$86.79
|
| Rate for Payer: Priority Health Tiered Network |
$86.79
|
| Rate for Payer: Railroad Medicare Medicare |
$47.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.29
|
| Rate for Payer: UHC Core |
$94.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.26
|
| Rate for Payer: UHC Exchange |
$94.29
|
| Rate for Payer: UHC Medicaid |
$30.46
|
| Rate for Payer: UHCCP Medicaid |
$30.46
|
|
|
PR DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 53620
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna Medicare |
$79.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.13
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$76.48
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$76.48
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$110.13
|
| Rate for Payer: Cofinity Commercial |
$102.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.48
|
| Rate for Payer: Healthscope Commercial |
$141.49
|
| Rate for Payer: Healthscope Commercial |
$122.37
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.30
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.41
|
| Rate for Payer: Nomi Health Commercial |
$91.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.75
|
| Rate for Payer: PACE SWMI |
$76.48
|
| Rate for Payer: PHP Medicare Advantage |
$76.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.04
|
| Rate for Payer: Priority Health Medicare |
$76.48
|
| Rate for Payer: Priority Health SBD |
$141.04
|
| Rate for Payer: Priority Health Tiered Network |
$141.04
|
| Rate for Payer: Railroad Medicare Medicare |
$76.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$153.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.48
|
| Rate for Payer: UHC Exchange |
$153.82
|
| Rate for Payer: UHC Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 53621
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: Aetna Commercial |
$84.84
|
| Rate for Payer: Aetna Medicare |
$65.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.17
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$63.31
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: BCN Medicare Advantage |
$63.31
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$91.17
|
| Rate for Payer: Cofinity Commercial |
$84.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.31
|
| Rate for Payer: Healthscope Commercial |
$117.12
|
| Rate for Payer: Healthscope Commercial |
$101.30
|
| Rate for Payer: Mclaren Medicaid |
$40.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.48
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.29
|
| Rate for Payer: Nomi Health Commercial |
$75.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.75
|
| Rate for Payer: PACE SWMI |
$63.31
|
| Rate for Payer: PHP Medicare Advantage |
$63.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$116.08
|
| Rate for Payer: Priority Health Medicare |
$63.31
|
| Rate for Payer: Priority Health SBD |
$116.08
|
| Rate for Payer: Priority Health Tiered Network |
$116.08
|
| Rate for Payer: Railroad Medicare Medicare |
$63.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.93
|
| Rate for Payer: UHC Core |
$126.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.31
|
| Rate for Payer: UHC Exchange |
$126.93
|
| Rate for Payer: UHC Medicaid |
$40.68
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
|
|
PR DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 53605
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$115.07 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Medicare |
$57.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.22
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$55.71
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: BCN Medicare Advantage |
$55.71
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$80.22
|
| Rate for Payer: Cofinity Commercial |
$74.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.71
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$103.06
|
| Rate for Payer: Mclaren Medicaid |
$35.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.50
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.69
|
| Rate for Payer: Nomi Health Commercial |
$66.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$55.71
|
| Rate for Payer: PHP Medicare Advantage |
$55.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.07
|
| Rate for Payer: Priority Health Medicare |
$55.71
|
| Rate for Payer: Priority Health SBD |
$103.07
|
| Rate for Payer: Priority Health Tiered Network |
$103.07
|
| Rate for Payer: Railroad Medicare Medicare |
$55.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.07
|
| Rate for Payer: UHC Core |
$115.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.71
|
| Rate for Payer: UHC Exchange |
$115.07
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
|
|
PR DIPHENHYDRAMINE HCL INJECTIO
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS J1200
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: Aetna Medicare |
$0.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.99
|
| Rate for Payer: BCBS MAPPO |
$0.69
|
| Rate for Payer: BCBS Trust/PPO |
$0.27
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Medicare Advantage |
$0.69
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$0.92
|
| Rate for Payer: Cofinity Commercial |
$0.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.69
|
| Rate for Payer: Healthscope Commercial |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$1.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.85
|
| Rate for Payer: Nomi Health Commercial |
$0.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$0.69
|
| Rate for Payer: PHP Medicare Advantage |
$0.69
|
| Rate for Payer: Priority Health Medicare |
$0.69
|
| Rate for Payer: Railroad Medicare Medicare |
$0.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.71
|
| Rate for Payer: UHC Core |
$0.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.69
|
| Rate for Payer: UHC Exchange |
$0.71
|
|
|
PR DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 90700
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$29.53
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.53
|
| Rate for Payer: BCBS Trust/PPO |
$29.59
|
| Rate for Payer: BCN Commercial |
$29.53
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.56
|
| Rate for Payer: UHC Core |
$30.56
|
| Rate for Payer: UHC Exchange |
$30.56
|
|
|
PR DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG
|
Professional
|
Both
|
$7,857.00
|
|
|
Service Code
|
HCPCS 33645
|
| Min. Negotiated Rate |
$1,031.99 |
| Max. Negotiated Rate |
$5,892.75 |
| Rate for Payer: Aetna Commercial |
$2,173.01
|
| Rate for Payer: Aetna Medicare |
$1,686.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,173.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,335.18
|
| Rate for Payer: BCBS Complete |
$1,083.59
|
| Rate for Payer: BCBS MAPPO |
$1,621.65
|
| Rate for Payer: BCN Commercial |
$2,547.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,621.65
|
| Rate for Payer: Cash Price |
$6,285.60
|
| Rate for Payer: Cash Price |
$6,285.60
|
| Rate for Payer: Cofinity Commercial |
$2,335.18
|
| Rate for Payer: Cofinity Commercial |
$2,173.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,621.65
|
| Rate for Payer: Healthscope Commercial |
$3,000.05
|
| Rate for Payer: Healthscope Commercial |
$2,594.64
|
| Rate for Payer: Mclaren Medicaid |
$1,031.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,702.73
|
| Rate for Payer: Meridian Medicaid |
$1,083.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,783.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,068.68
|
| Rate for Payer: Nomi Health Commercial |
$1,945.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,892.75
|
| Rate for Payer: PACE SWMI |
$1,621.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,621.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,031.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,739.16
|
| Rate for Payer: Priority Health Medicare |
$1,621.65
|
| Rate for Payer: Priority Health SBD |
$2,739.16
|
| Rate for Payer: Priority Health Tiered Network |
$2,739.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,621.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,085.11
|
| Rate for Payer: UHC Core |
$3,085.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,621.65
|
| Rate for Payer: UHC Exchange |
$3,085.11
|
| Rate for Payer: UHC Medicaid |
$1,031.99
|
| Rate for Payer: UHCCP Medicaid |
$1,031.99
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS
|
Professional
|
Both
|
$3,833.00
|
|
|
Service Code
|
HCPCS 35102
|
| Min. Negotiated Rate |
$1,084.60 |
| Max. Negotiated Rate |
$3,380.40 |
| Rate for Payer: Aetna Commercial |
$2,307.14
|
| Rate for Payer: Aetna Medicare |
$1,790.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,307.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,479.32
|
| Rate for Payer: BCBS Complete |
$1,138.83
|
| Rate for Payer: BCBS MAPPO |
$1,721.75
|
| Rate for Payer: BCN Commercial |
$2,741.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,721.75
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cash Price |
$3,066.40
|
| Rate for Payer: Cofinity Commercial |
$2,479.32
|
| Rate for Payer: Cofinity Commercial |
$2,307.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,721.75
|
| Rate for Payer: Healthscope Commercial |
$3,185.24
|
| Rate for Payer: Healthscope Commercial |
$2,754.80
|
| Rate for Payer: Mclaren Medicaid |
$1,084.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,807.84
|
| Rate for Payer: Meridian Medicaid |
$1,138.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,893.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,328.07
|
| Rate for Payer: Nomi Health Commercial |
$2,066.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,874.75
|
| Rate for Payer: PACE SWMI |
$1,721.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,721.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,948.00
|
| Rate for Payer: Priority Health Medicare |
$1,721.75
|
| Rate for Payer: Priority Health SBD |
$2,948.00
|
| Rate for Payer: Priority Health Tiered Network |
$2,948.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,721.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,380.40
|
| Rate for Payer: UHC Core |
$3,380.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,721.75
|
| Rate for Payer: UHC Exchange |
$3,380.40
|
| Rate for Payer: UHC Medicaid |
$1,084.60
|
| Rate for Payer: UHCCP Medicaid |
$1,084.60
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS
|
Professional
|
Both
|
$3,680.00
|
|
|
Service Code
|
HCPCS 35091
|
| Min. Negotiated Rate |
$1,022.83 |
| Max. Negotiated Rate |
$3,222.08 |
| Rate for Payer: Aetna Commercial |
$2,181.06
|
| Rate for Payer: Aetna Medicare |
$1,692.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,181.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,343.83
|
| Rate for Payer: BCBS Complete |
$1,073.97
|
| Rate for Payer: BCBS MAPPO |
$1,627.66
|
| Rate for Payer: BCN Commercial |
$2,597.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,627.66
|
| Rate for Payer: Cash Price |
$2,944.00
|
| Rate for Payer: Cash Price |
$2,944.00
|
| Rate for Payer: Cofinity Commercial |
$2,343.83
|
| Rate for Payer: Cofinity Commercial |
$2,181.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,627.66
|
| Rate for Payer: Healthscope Commercial |
$3,011.17
|
| Rate for Payer: Healthscope Commercial |
$2,604.26
|
| Rate for Payer: Mclaren Medicaid |
$1,022.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,709.04
|
| Rate for Payer: Meridian Medicaid |
$1,073.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,790.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,162.29
|
| Rate for Payer: Nomi Health Commercial |
$1,953.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,760.00
|
| Rate for Payer: PACE SWMI |
$1,627.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,627.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,022.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,793.79
|
| Rate for Payer: Priority Health Medicare |
$1,627.66
|
| Rate for Payer: Priority Health SBD |
$2,793.79
|
| Rate for Payer: Priority Health Tiered Network |
$2,793.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,627.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,222.08
|
| Rate for Payer: UHC Core |
$3,222.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,627.66
|
| Rate for Payer: UHC Exchange |
$3,222.08
|
| Rate for Payer: UHC Medicaid |
$1,022.83
|
| Rate for Payer: UHCCP Medicaid |
$1,022.83
|
|
|
PR DIR RPR ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$5,852.00
|
|
|
Service Code
|
HCPCS 35081
|
| Min. Negotiated Rate |
$1,003.66 |
| Max. Negotiated Rate |
$4,389.00 |
| Rate for Payer: Aetna Commercial |
$2,133.31
|
| Rate for Payer: Aetna Medicare |
$1,655.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,133.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.51
|
| Rate for Payer: BCBS Complete |
$1,053.84
|
| Rate for Payer: BCBS MAPPO |
$1,592.02
|
| Rate for Payer: BCN Commercial |
$2,523.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,592.02
|
| Rate for Payer: Cash Price |
$4,681.60
|
| Rate for Payer: Cash Price |
$4,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,292.51
|
| Rate for Payer: Cofinity Commercial |
$2,133.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,592.02
|
| Rate for Payer: Healthscope Commercial |
$2,945.24
|
| Rate for Payer: Healthscope Commercial |
$2,547.23
|
| Rate for Payer: Mclaren Medicaid |
$1,003.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,671.62
|
| Rate for Payer: Meridian Medicaid |
$1,053.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,751.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,069.09
|
| Rate for Payer: Nomi Health Commercial |
$1,910.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,389.00
|
| Rate for Payer: PACE SWMI |
$1,592.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,592.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,713.46
|
| Rate for Payer: Priority Health Medicare |
$1,592.02
|
| Rate for Payer: Priority Health SBD |
$2,713.46
|
| Rate for Payer: Priority Health Tiered Network |
$2,713.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,592.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,112.77
|
| Rate for Payer: UHC Core |
$3,112.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,592.02
|
| Rate for Payer: UHC Exchange |
$3,112.77
|
| Rate for Payer: UHC Medicaid |
$1,003.66
|
| Rate for Payer: UHCCP Medicaid |
$1,003.66
|
|
|
PR DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION
|
Professional
|
Both
|
$3,832.00
|
|
|
Service Code
|
HCPCS 35011
|
| Min. Negotiated Rate |
$582.98 |
| Max. Negotiated Rate |
$2,874.00 |
| Rate for Payer: Aetna Commercial |
$1,234.33
|
| Rate for Payer: Aetna Medicare |
$957.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.44
|
| Rate for Payer: BCBS Complete |
$612.13
|
| Rate for Payer: BCBS MAPPO |
$921.14
|
| Rate for Payer: BCN Commercial |
$1,476.51
|
| Rate for Payer: BCN Medicare Advantage |
$921.14
|
| Rate for Payer: Cash Price |
$3,065.60
|
| Rate for Payer: Cash Price |
$3,065.60
|
| Rate for Payer: Cofinity Commercial |
$1,326.44
|
| Rate for Payer: Cofinity Commercial |
$1,234.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.14
|
| Rate for Payer: Healthscope Commercial |
$1,704.11
|
| Rate for Payer: Healthscope Commercial |
$1,473.82
|
| Rate for Payer: Mclaren Medicaid |
$582.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.20
|
| Rate for Payer: Meridian Medicaid |
$612.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,013.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.70
|
| Rate for Payer: Nomi Health Commercial |
$1,105.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,874.00
|
| Rate for Payer: PACE SWMI |
$921.14
|
| Rate for Payer: PHP Medicare Advantage |
$921.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,587.80
|
| Rate for Payer: Priority Health Medicare |
$921.14
|
| Rate for Payer: Priority Health SBD |
$1,587.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,587.80
|
| Rate for Payer: Railroad Medicare Medicare |
$921.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.83
|
| Rate for Payer: UHC Core |
$1,796.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$921.14
|
| Rate for Payer: UHC Exchange |
$1,796.83
|
| Rate for Payer: UHC Medicaid |
$582.98
|
| Rate for Payer: UHCCP Medicaid |
$582.98
|
|
|
PR DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,279.00
|
|
|
Service Code
|
HCPCS 35001
|
| Min. Negotiated Rate |
$641.98 |
| Max. Negotiated Rate |
$2,010.33 |
| Rate for Payer: Aetna Commercial |
$1,360.22
|
| Rate for Payer: Aetna Medicare |
$1,055.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,360.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.73
|
| Rate for Payer: BCBS Complete |
$674.08
|
| Rate for Payer: BCBS MAPPO |
$1,015.09
|
| Rate for Payer: BCN Commercial |
$1,622.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.09
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cofinity Commercial |
$1,461.73
|
| Rate for Payer: Cofinity Commercial |
$1,360.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.09
|
| Rate for Payer: Healthscope Commercial |
$1,877.92
|
| Rate for Payer: Healthscope Commercial |
$1,624.14
|
| Rate for Payer: Mclaren Medicaid |
$641.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.84
|
| Rate for Payer: Meridian Medicaid |
$674.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,116.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,991.90
|
| Rate for Payer: Nomi Health Commercial |
$1,218.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,709.25
|
| Rate for Payer: PACE SWMI |
$1,015.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,745.24
|
| Rate for Payer: Priority Health Medicare |
$1,015.09
|
| Rate for Payer: Priority Health SBD |
$1,745.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,745.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,015.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,010.33
|
| Rate for Payer: UHC Core |
$2,010.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,015.09
|
| Rate for Payer: UHC Exchange |
$2,010.33
|
| Rate for Payer: UHC Medicaid |
$641.98
|
| Rate for Payer: UHCCP Medicaid |
$641.98
|
|
|
PR DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY
|
Professional
|
Both
|
$2,241.00
|
|
|
Service Code
|
HCPCS 35141
|
| Min. Negotiated Rate |
$631.76 |
| Max. Negotiated Rate |
$1,978.62 |
| Rate for Payer: Priority Health SBD |
$1,715.79
|
| Rate for Payer: Aetna Commercial |
$1,341.38
|
| Rate for Payer: Aetna Medicare |
$1,041.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,441.48
|
| Rate for Payer: BCBS Complete |
$663.35
|
| Rate for Payer: BCBS MAPPO |
$1,001.03
|
| Rate for Payer: BCN Commercial |
$1,595.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.03
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,441.48
|
| Rate for Payer: Cofinity Commercial |
$1,341.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.03
|
| Rate for Payer: Healthscope Commercial |
$1,851.91
|
| Rate for Payer: Healthscope Commercial |
$1,601.65
|
| Rate for Payer: Mclaren Medicaid |
$631.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.08
|
| Rate for Payer: Meridian Medicaid |
$663.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,101.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,938.53
|
| Rate for Payer: Nomi Health Commercial |
$1,201.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,680.75
|
| Rate for Payer: PACE SWMI |
$1,001.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$631.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,715.79
|
| Rate for Payer: Priority Health Medicare |
$1,001.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,715.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,001.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.62
|
| Rate for Payer: UHC Core |
$1,978.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,001.03
|
| Rate for Payer: UHC Exchange |
$1,978.62
|
| Rate for Payer: UHC Medicaid |
$631.76
|
| Rate for Payer: UHCCP Medicaid |
$631.76
|
|
|
PR DIR RPR ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$5,104.00
|
|
|
Service Code
|
HCPCS 35131
|
| Min. Negotiated Rate |
$803.01 |
| Max. Negotiated Rate |
$3,828.00 |
| Rate for Payer: Aetna Commercial |
$1,704.20
|
| Rate for Payer: Aetna Medicare |
$1,322.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,704.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,831.38
|
| Rate for Payer: BCBS Complete |
$843.16
|
| Rate for Payer: BCBS MAPPO |
$1,271.79
|
| Rate for Payer: BCN Commercial |
$2,025.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,271.79
|
| Rate for Payer: Cash Price |
$4,083.20
|
| Rate for Payer: Cash Price |
$4,083.20
|
| Rate for Payer: Cofinity Commercial |
$1,831.38
|
| Rate for Payer: Cofinity Commercial |
$1,704.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,271.79
|
| Rate for Payer: Healthscope Commercial |
$2,352.81
|
| Rate for Payer: Healthscope Commercial |
$2,034.86
|
| Rate for Payer: Mclaren Medicaid |
$803.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.38
|
| Rate for Payer: Meridian Medicaid |
$843.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,398.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,443.14
|
| Rate for Payer: Nomi Health Commercial |
$1,526.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,828.00
|
| Rate for Payer: PACE SWMI |
$1,271.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,271.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,177.94
|
| Rate for Payer: Priority Health Medicare |
$1,271.79
|
| Rate for Payer: Priority Health SBD |
$2,177.94
|
| Rate for Payer: Priority Health Tiered Network |
$2,177.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,271.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,474.19
|
| Rate for Payer: UHC Core |
$2,474.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,271.79
|
| Rate for Payer: UHC Exchange |
$2,474.19
|
| Rate for Payer: UHC Medicaid |
$803.01
|
| Rate for Payer: UHCCP Medicaid |
$803.01
|
|
|
PR DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY
|
Professional
|
Both
|
$2,531.00
|
|
|
Service Code
|
HCPCS 35151
|
| Min. Negotiated Rate |
$716.11 |
| Max. Negotiated Rate |
$2,223.13 |
| Rate for Payer: Aetna Commercial |
$1,520.93
|
| Rate for Payer: Aetna Medicare |
$1,180.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,520.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.43
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,135.02
|
| Rate for Payer: BCN Commercial |
$1,808.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.02
|
| Rate for Payer: Cash Price |
$2,024.80
|
| Rate for Payer: Cash Price |
$2,024.80
|
| Rate for Payer: Cofinity Commercial |
$1,634.43
|
| Rate for Payer: Cofinity Commercial |
$1,520.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.02
|
| Rate for Payer: Healthscope Commercial |
$2,099.79
|
| Rate for Payer: Healthscope Commercial |
$1,816.03
|
| Rate for Payer: Mclaren Medicaid |
$716.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,191.77
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,248.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.54
|
| Rate for Payer: Nomi Health Commercial |
$1,362.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,898.25
|
| Rate for Payer: PACE SWMI |
$1,135.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,944.45
|
| Rate for Payer: Priority Health Medicare |
$1,135.02
|
| Rate for Payer: Priority Health SBD |
$1,944.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,944.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,135.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,223.13
|
| Rate for Payer: UHC Core |
$2,223.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,135.02
|
| Rate for Payer: UHC Exchange |
$2,223.13
|
| Rate for Payer: UHC Medicaid |
$716.11
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
|
|
PR DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC
|
Professional
|
Both
|
$3,292.00
|
|
|
Service Code
|
HCPCS 35121
|
| Min. Negotiated Rate |
$916.33 |
| Max. Negotiated Rate |
$2,847.86 |
| Rate for Payer: Aetna Commercial |
$1,953.68
|
| Rate for Payer: Aetna Medicare |
$1,516.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,953.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.48
|
| Rate for Payer: BCBS Complete |
$962.15
|
| Rate for Payer: BCBS MAPPO |
$1,457.97
|
| Rate for Payer: BCN Commercial |
$2,310.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,457.97
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cofinity Commercial |
$2,099.48
|
| Rate for Payer: Cofinity Commercial |
$1,953.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,457.97
|
| Rate for Payer: Healthscope Commercial |
$2,697.24
|
| Rate for Payer: Healthscope Commercial |
$2,332.75
|
| Rate for Payer: Mclaren Medicaid |
$916.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,530.87
|
| Rate for Payer: Meridian Medicaid |
$962.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,603.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,808.59
|
| Rate for Payer: Nomi Health Commercial |
$1,749.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,469.00
|
| Rate for Payer: PACE SWMI |
$1,457.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,457.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,484.80
|
| Rate for Payer: Priority Health Medicare |
$1,457.97
|
| Rate for Payer: Priority Health SBD |
$2,484.80
|
| Rate for Payer: Priority Health Tiered Network |
$2,484.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,457.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.86
|
| Rate for Payer: UHC Core |
$2,847.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,457.97
|
| Rate for Payer: UHC Exchange |
$2,847.86
|
| Rate for Payer: UHC Medicaid |
$916.33
|
| Rate for Payer: UHCCP Medicaid |
$916.33
|
|
|
PR DIR RPR ANEURYSM SPLENIC ARTERY
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 35111
|
| Min. Negotiated Rate |
$770.63 |
| Max. Negotiated Rate |
$2,390.97 |
| Rate for Payer: Aetna Commercial |
$1,641.51
|
| Rate for Payer: Aetna Medicare |
$1,274.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.01
|
| Rate for Payer: BCBS Complete |
$809.16
|
| Rate for Payer: BCBS MAPPO |
$1,225.01
|
| Rate for Payer: BCN Commercial |
$1,944.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,225.01
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cofinity Commercial |
$1,764.01
|
| Rate for Payer: Cofinity Commercial |
$1,641.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,225.01
|
| Rate for Payer: Healthscope Commercial |
$2,266.27
|
| Rate for Payer: Healthscope Commercial |
$1,960.02
|
| Rate for Payer: Mclaren Medicaid |
$770.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,286.26
|
| Rate for Payer: Meridian Medicaid |
$809.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,347.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,362.01
|
| Rate for Payer: Nomi Health Commercial |
$1,470.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.75
|
| Rate for Payer: PACE SWMI |
$1,225.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,225.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,090.66
|
| Rate for Payer: Priority Health Medicare |
$1,225.01
|
| Rate for Payer: Priority Health SBD |
$2,090.66
|
| Rate for Payer: Priority Health Tiered Network |
$2,090.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,225.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,390.97
|
| Rate for Payer: UHC Core |
$2,390.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,225.01
|
| Rate for Payer: UHC Exchange |
$2,390.97
|
| Rate for Payer: UHC Medicaid |
$770.63
|
| Rate for Payer: UHCCP Medicaid |
$770.63
|
|
|
PR DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS
|
Professional
|
Both
|
$5,663.00
|
|
|
Service Code
|
HCPCS 35092
|
| Min. Negotiated Rate |
$1,461.18 |
| Max. Negotiated Rate |
$4,689.30 |
| Rate for Payer: Aetna Commercial |
$3,119.63
|
| Rate for Payer: Aetna Medicare |
$2,421.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,119.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,352.44
|
| Rate for Payer: BCBS Complete |
$1,534.24
|
| Rate for Payer: BCBS MAPPO |
$2,328.08
|
| Rate for Payer: BCN Commercial |
$3,786.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,328.08
|
| Rate for Payer: Cash Price |
$4,530.40
|
| Rate for Payer: Cash Price |
$4,530.40
|
| Rate for Payer: Cofinity Commercial |
$3,352.44
|
| Rate for Payer: Cofinity Commercial |
$3,119.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,328.08
|
| Rate for Payer: Healthscope Commercial |
$4,306.95
|
| Rate for Payer: Healthscope Commercial |
$3,724.93
|
| Rate for Payer: Mclaren Medicaid |
$1,461.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,444.48
|
| Rate for Payer: Meridian Medicaid |
$1,534.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,560.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,586.90
|
| Rate for Payer: Nomi Health Commercial |
$2,793.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,247.25
|
| Rate for Payer: PACE SWMI |
$2,328.08
|
| Rate for Payer: PHP Medicare Advantage |
$2,328.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,461.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,071.52
|
| Rate for Payer: Priority Health Medicare |
$2,328.08
|
| Rate for Payer: Priority Health SBD |
$4,071.52
|
| Rate for Payer: Priority Health Tiered Network |
$4,071.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,328.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,689.30
|
| Rate for Payer: UHC Core |
$4,689.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,328.08
|
| Rate for Payer: UHC Exchange |
$4,689.30
|
| Rate for Payer: UHC Medicaid |
$1,461.18
|
| Rate for Payer: UHCCP Medicaid |
$1,461.18
|
|
|
PR DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN
|
Professional
|
Both
|
$3,975.00
|
|
|
Service Code
|
HCPCS 35122
|
| Min. Negotiated Rate |
$1,094.61 |
| Max. Negotiated Rate |
$3,407.63 |
| Rate for Payer: Aetna Commercial |
$2,335.07
|
| Rate for Payer: Aetna Medicare |
$1,812.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,335.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,509.33
|
| Rate for Payer: BCBS Complete |
$1,149.34
|
| Rate for Payer: BCBS MAPPO |
$1,742.59
|
| Rate for Payer: BCN Commercial |
$2,760.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,742.59
|
| Rate for Payer: Cash Price |
$3,180.00
|
| Rate for Payer: Cash Price |
$3,180.00
|
| Rate for Payer: Cofinity Commercial |
$2,509.33
|
| Rate for Payer: Cofinity Commercial |
$2,335.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,742.59
|
| Rate for Payer: Healthscope Commercial |
$3,223.79
|
| Rate for Payer: Healthscope Commercial |
$2,788.14
|
| Rate for Payer: Mclaren Medicaid |
$1,094.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,829.72
|
| Rate for Payer: Meridian Medicaid |
$1,149.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,916.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,358.69
|
| Rate for Payer: Nomi Health Commercial |
$2,091.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,981.25
|
| Rate for Payer: PACE SWMI |
$1,742.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,742.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,094.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,968.90
|
| Rate for Payer: Priority Health Medicare |
$1,742.59
|
| Rate for Payer: Priority Health SBD |
$2,968.90
|
| Rate for Payer: Priority Health Tiered Network |
$2,968.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,742.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,407.63
|
| Rate for Payer: UHC Core |
$3,407.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,742.59
|
| Rate for Payer: UHC Exchange |
$3,407.63
|
| Rate for Payer: UHC Medicaid |
$1,094.61
|
| Rate for Payer: UHCCP Medicaid |
$1,094.61
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS
|
Professional
|
Both
|
$3,667.00
|
|
|
Service Code
|
HCPCS 35103
|
| Min. Negotiated Rate |
$1,253.93 |
| Max. Negotiated Rate |
$4,025.04 |
| Rate for Payer: Priority Health SBD |
$3,401.07
|
| Rate for Payer: Aetna Commercial |
$2,676.52
|
| Rate for Payer: Aetna Medicare |
$2,077.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,676.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,876.26
|
| Rate for Payer: BCBS Complete |
$1,316.63
|
| Rate for Payer: BCBS MAPPO |
$1,997.40
|
| Rate for Payer: BCN Commercial |
$3,162.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.40
|
| Rate for Payer: Cash Price |
$2,933.60
|
| Rate for Payer: Cash Price |
$2,933.60
|
| Rate for Payer: Cofinity Commercial |
$2,876.26
|
| Rate for Payer: Cofinity Commercial |
$2,676.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.40
|
| Rate for Payer: Healthscope Commercial |
$3,695.19
|
| Rate for Payer: Healthscope Commercial |
$3,195.84
|
| Rate for Payer: Mclaren Medicaid |
$1,253.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.27
|
| Rate for Payer: Meridian Medicaid |
$1,316.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,197.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,943.24
|
| Rate for Payer: Nomi Health Commercial |
$2,396.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,750.25
|
| Rate for Payer: PACE SWMI |
$1,997.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,253.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,401.07
|
| Rate for Payer: Priority Health Medicare |
$1,997.40
|
| Rate for Payer: Priority Health Tiered Network |
$3,401.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,025.04
|
| Rate for Payer: UHC Core |
$4,025.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,997.40
|
| Rate for Payer: UHC Exchange |
$4,025.04
|
| Rate for Payer: UHC Medicaid |
$1,253.93
|
| Rate for Payer: UHCCP Medicaid |
$1,253.93
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$4,415.00
|
|
|
Service Code
|
HCPCS 35082
|
| Min. Negotiated Rate |
$1,246.90 |
| Max. Negotiated Rate |
$3,925.23 |
| Rate for Payer: Aetna Commercial |
$2,652.58
|
| Rate for Payer: Aetna Medicare |
$2,058.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,850.54
|
| Rate for Payer: BCBS Complete |
$1,309.24
|
| Rate for Payer: BCBS MAPPO |
$1,979.54
|
| Rate for Payer: BCN Commercial |
$3,161.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,979.54
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cash Price |
$3,532.00
|
| Rate for Payer: Cofinity Commercial |
$2,850.54
|
| Rate for Payer: Cofinity Commercial |
$2,652.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,979.54
|
| Rate for Payer: Healthscope Commercial |
$3,662.15
|
| Rate for Payer: Healthscope Commercial |
$3,167.26
|
| Rate for Payer: Mclaren Medicaid |
$1,246.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,078.52
|
| Rate for Payer: Meridian Medicaid |
$1,309.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,177.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,836.56
|
| Rate for Payer: Nomi Health Commercial |
$2,375.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,311.25
|
| Rate for Payer: PACE SWMI |
$1,979.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,979.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,246.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,399.99
|
| Rate for Payer: Priority Health Medicare |
$1,979.54
|
| Rate for Payer: Priority Health SBD |
$3,399.99
|
| Rate for Payer: Priority Health Tiered Network |
$3,399.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,979.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,925.23
|
| Rate for Payer: UHC Core |
$3,925.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,979.54
|
| Rate for Payer: UHC Exchange |
$3,925.23
|
| Rate for Payer: UHC Medicaid |
$1,246.90
|
| Rate for Payer: UHCCP Medicaid |
$1,246.90
|
|
|
PR DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS
|
Professional
|
Both
|
$4,045.00
|
|
|
Service Code
|
HCPCS 35013
|
| Min. Negotiated Rate |
$688.20 |
| Max. Negotiated Rate |
$3,033.75 |
| Rate for Payer: Aetna Commercial |
$1,464.37
|
| Rate for Payer: Aetna Medicare |
$1,136.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,573.65
|
| Rate for Payer: BCBS Complete |
$722.61
|
| Rate for Payer: BCBS MAPPO |
$1,092.81
|
| Rate for Payer: BCN Commercial |
$1,734.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,092.81
|
| Rate for Payer: Cash Price |
$3,236.00
|
| Rate for Payer: Cash Price |
$3,236.00
|
| Rate for Payer: Cofinity Commercial |
$1,573.65
|
| Rate for Payer: Cofinity Commercial |
$1,464.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,092.81
|
| Rate for Payer: Healthscope Commercial |
$2,021.70
|
| Rate for Payer: Healthscope Commercial |
$1,748.50
|
| Rate for Payer: Mclaren Medicaid |
$688.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,147.45
|
| Rate for Payer: Meridian Medicaid |
$722.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,247.70
|
| Rate for Payer: Nomi Health Commercial |
$1,311.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,033.75
|
| Rate for Payer: PACE SWMI |
$1,092.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,092.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,865.20
|
| Rate for Payer: Priority Health Medicare |
$1,092.81
|
| Rate for Payer: Priority Health SBD |
$1,865.20
|
| Rate for Payer: Priority Health Tiered Network |
$1,865.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,092.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,259.63
|
| Rate for Payer: UHC Core |
$2,259.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,092.81
|
| Rate for Payer: UHC Exchange |
$2,259.63
|
| Rate for Payer: UHC Medicaid |
$688.20
|
| Rate for Payer: UHCCP Medicaid |
$688.20
|
|
|
PR DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,618.00
|
|
|
Service Code
|
HCPCS 35002
|
| Min. Negotiated Rate |
$661.15 |
| Max. Negotiated Rate |
$2,042.90 |
| Rate for Payer: Aetna Commercial |
$1,406.33
|
| Rate for Payer: Aetna Medicare |
$1,091.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,406.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.28
|
| Rate for Payer: BCBS Complete |
$694.21
|
| Rate for Payer: BCBS MAPPO |
$1,049.50
|
| Rate for Payer: BCN Commercial |
$1,666.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.50
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cash Price |
$2,094.40
|
| Rate for Payer: Cofinity Commercial |
$1,511.28
|
| Rate for Payer: Cofinity Commercial |
$1,406.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.50
|
| Rate for Payer: Healthscope Commercial |
$1,941.58
|
| Rate for Payer: Healthscope Commercial |
$1,679.20
|
| Rate for Payer: Mclaren Medicaid |
$661.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,101.97
|
| Rate for Payer: Meridian Medicaid |
$694.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,154.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,020.81
|
| Rate for Payer: Nomi Health Commercial |
$1,259.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,963.50
|
| Rate for Payer: PACE SWMI |
$1,049.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$661.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,792.37
|
| Rate for Payer: Priority Health Medicare |
$1,049.50
|
| Rate for Payer: Priority Health SBD |
$1,792.37
|
| Rate for Payer: Priority Health Tiered Network |
$1,792.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,049.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,042.90
|
| Rate for Payer: UHC Core |
$2,042.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,049.50
|
| Rate for Payer: UHC Exchange |
$2,042.90
|
| Rate for Payer: UHC Medicaid |
$661.15
|
| Rate for Payer: UHCCP Medicaid |
$661.15
|
|
