|
PR DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 53621
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$12,629.00 |
| Rate for Payer: Aetna Commercial |
$91.52
|
| Rate for Payer: Aetna Medicare |
$71.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.35
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$68.30
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$237.98
|
| Rate for Payer: BCN Medicare Advantage |
$68.30
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$98.35
|
| Rate for Payer: Cofinity Commercial |
$91.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.30
|
| Rate for Payer: Healthscope Commercial |
$126.36
|
| Rate for Payer: Healthscope Commercial |
$109.28
|
| Rate for Payer: Mclaren Medicaid |
$45.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.72
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,629.00
|
| Rate for Payer: Nomi Health Commercial |
$81.96
|
| Rate for Payer: PACE SWMI |
$68.30
|
| Rate for Payer: PHP Medicare Advantage |
$68.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.44
|
| Rate for Payer: Priority Health Medicare |
$68.30
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Priority Health SBD |
$113.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.30
|
| Rate for Payer: UHC Exchange |
$141.69
|
| Rate for Payer: UHC Medicare Advantage |
$68.30
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
PR DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 53605
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$11,369.00 |
| Rate for Payer: Aetna Commercial |
$81.78
|
| Rate for Payer: Aetna Medicare |
$63.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.88
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$61.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,411.09
|
| Rate for Payer: BCN Commercial |
$92.36
|
| Rate for Payer: BCN Medicare Advantage |
$61.03
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$87.88
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.03
|
| Rate for Payer: Healthscope Commercial |
$97.65
|
| Rate for Payer: Healthscope Commercial |
$112.91
|
| Rate for Payer: Mclaren Medicaid |
$40.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.08
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,369.00
|
| Rate for Payer: Nomi Health Commercial |
$73.24
|
| Rate for Payer: PACE SWMI |
$61.03
|
| Rate for Payer: PHP Medicare Advantage |
$61.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.66
|
| Rate for Payer: Priority Health Medicare |
$61.03
|
| Rate for Payer: Priority Health Narrow Network |
$100.66
|
| Rate for Payer: Priority Health SBD |
$100.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.03
|
| Rate for Payer: UHC Exchange |
$85.19
|
| Rate for Payer: UHC Medicare Advantage |
$61.03
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
|
|
PR DIPHENHYDRAMINE HCL INJECTIO
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J1200
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$1.21
|
| Rate for Payer: Aetna Medicare |
$0.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$0.90
|
| Rate for Payer: BCBS Trust/PPO |
$0.39
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.90
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$1.30
|
| Rate for Payer: Cofinity Commercial |
$1.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.90
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Healthscope Commercial |
$1.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$1.08
|
| Rate for Payer: PACE SWMI |
$0.90
|
| Rate for Payer: PHP Medicare Advantage |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$0.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.90
|
| Rate for Payer: UHC Exchange |
$0.77
|
| Rate for Payer: UHC Medicare Advantage |
$0.90
|
|
|
PR DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 90700
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$2,820.00 |
| Rate for Payer: Aetna Commercial |
$29.53
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.53
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,820.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Exchange |
$31.75
|
|
|
PR DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG
|
Professional
|
Both
|
$7,628.00
|
|
|
Service Code
|
HCPCS 33645
|
| Min. Negotiated Rate |
$1,089.50 |
| Max. Negotiated Rate |
$306,868.00 |
| Rate for Payer: Aetna Commercial |
$2,227.48
|
| Rate for Payer: Aetna Medicare |
$1,728.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,227.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,393.71
|
| Rate for Payer: BCBS Complete |
$1,143.98
|
| Rate for Payer: BCBS MAPPO |
$1,662.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.01
|
| Rate for Payer: BCN Commercial |
$2,482.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,662.30
|
| Rate for Payer: Cash Price |
$6,102.40
|
| Rate for Payer: Cash Price |
$6,102.40
|
| Rate for Payer: Cofinity Commercial |
$2,393.71
|
| Rate for Payer: Cofinity Commercial |
$2,227.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,662.30
|
| Rate for Payer: Healthscope Commercial |
$3,075.26
|
| Rate for Payer: Healthscope Commercial |
$2,659.68
|
| Rate for Payer: Mclaren Medicaid |
$1,089.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,745.42
|
| Rate for Payer: Meridian Medicaid |
$1,143.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306,868.00
|
| Rate for Payer: Nomi Health Commercial |
$1,994.76
|
| Rate for Payer: PACE SWMI |
$1,662.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,662.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,712.30
|
| Rate for Payer: Priority Health Medicare |
$1,662.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,712.30
|
| Rate for Payer: Priority Health SBD |
$2,712.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,678.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,662.30
|
| Rate for Payer: UHC Exchange |
$2,678.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,662.30
|
| Rate for Payer: UHCCP Medicaid |
$1,089.50
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS
|
Professional
|
Both
|
$3,721.00
|
|
|
Service Code
|
HCPCS 35102
|
| Min. Negotiated Rate |
$1,172.57 |
| Max. Negotiated Rate |
$332,807.00 |
| Rate for Payer: Aetna Commercial |
$2,416.64
|
| Rate for Payer: Aetna Medicare |
$1,875.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,416.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,596.98
|
| Rate for Payer: BCBS Complete |
$1,231.20
|
| Rate for Payer: BCBS MAPPO |
$1,803.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.33
|
| Rate for Payer: BCN Commercial |
$2,674.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,803.46
|
| Rate for Payer: Cash Price |
$2,976.80
|
| Rate for Payer: Cash Price |
$2,976.80
|
| Rate for Payer: Cofinity Commercial |
$2,596.98
|
| Rate for Payer: Cofinity Commercial |
$2,416.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,803.46
|
| Rate for Payer: Healthscope Commercial |
$3,336.40
|
| Rate for Payer: Healthscope Commercial |
$2,885.54
|
| Rate for Payer: Mclaren Medicaid |
$1,172.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,893.63
|
| Rate for Payer: Meridian Medicaid |
$1,231.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332,807.00
|
| Rate for Payer: Nomi Health Commercial |
$2,164.15
|
| Rate for Payer: PACE SWMI |
$1,803.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,803.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,172.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,418.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,929.82
|
| Rate for Payer: Priority Health Medicare |
$1,803.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,929.82
|
| Rate for Payer: Priority Health SBD |
$2,929.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,540.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,803.46
|
| Rate for Payer: UHC Exchange |
$2,540.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,803.46
|
| Rate for Payer: UHCCP Medicaid |
$1,172.57
|
|
|
PR DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS
|
Professional
|
Both
|
$3,573.00
|
|
|
Service Code
|
HCPCS 35091
|
| Min. Negotiated Rate |
$1,111.22 |
| Max. Negotiated Rate |
$316,229.00 |
| Rate for Payer: Aetna Commercial |
$2,294.84
|
| Rate for Payer: Aetna Medicare |
$1,781.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,294.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,466.10
|
| Rate for Payer: BCBS Complete |
$1,166.78
|
| Rate for Payer: BCBS MAPPO |
$1,712.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.81
|
| Rate for Payer: BCN Commercial |
$2,536.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,712.57
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cofinity Commercial |
$2,466.10
|
| Rate for Payer: Cofinity Commercial |
$2,294.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,712.57
|
| Rate for Payer: Healthscope Commercial |
$3,168.25
|
| Rate for Payer: Healthscope Commercial |
$2,740.11
|
| Rate for Payer: Mclaren Medicaid |
$1,111.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,798.20
|
| Rate for Payer: Meridian Medicaid |
$1,166.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316,229.00
|
| Rate for Payer: Nomi Health Commercial |
$2,055.08
|
| Rate for Payer: PACE SWMI |
$1,712.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,712.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,111.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,322.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,767.61
|
| Rate for Payer: Priority Health Medicare |
$1,712.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,767.61
|
| Rate for Payer: Priority Health SBD |
$2,767.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,663.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,712.57
|
| Rate for Payer: UHC Exchange |
$2,663.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,712.57
|
| Rate for Payer: UHCCP Medicaid |
$1,111.22
|
|
|
PR DIR RPR ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$5,682.00
|
|
|
Service Code
|
HCPCS 35081
|
| Min. Negotiated Rate |
$1,079.27 |
| Max. Negotiated Rate |
$306,909.00 |
| Rate for Payer: Aetna Commercial |
$2,223.14
|
| Rate for Payer: Aetna Medicare |
$1,725.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,223.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,389.05
|
| Rate for Payer: BCBS Complete |
$1,133.23
|
| Rate for Payer: BCBS MAPPO |
$1,659.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.67
|
| Rate for Payer: BCN Commercial |
$2,467.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,659.06
|
| Rate for Payer: Cash Price |
$4,545.60
|
| Rate for Payer: Cash Price |
$4,545.60
|
| Rate for Payer: Cofinity Commercial |
$2,389.05
|
| Rate for Payer: Cofinity Commercial |
$2,223.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,659.06
|
| Rate for Payer: Healthscope Commercial |
$3,069.26
|
| Rate for Payer: Healthscope Commercial |
$2,654.50
|
| Rate for Payer: Mclaren Medicaid |
$1,079.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,742.01
|
| Rate for Payer: Meridian Medicaid |
$1,133.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306,909.00
|
| Rate for Payer: Nomi Health Commercial |
$1,990.87
|
| Rate for Payer: PACE SWMI |
$1,659.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,659.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,079.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,693.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,694.76
|
| Rate for Payer: Priority Health Medicare |
$1,659.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,694.76
|
| Rate for Payer: Priority Health SBD |
$2,694.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,421.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,659.06
|
| Rate for Payer: UHC Exchange |
$2,421.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,659.06
|
| Rate for Payer: UHCCP Medicaid |
$1,079.27
|
|
|
PR DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION
|
Professional
|
Both
|
$3,720.00
|
|
|
Service Code
|
HCPCS 35011
|
| Min. Negotiated Rate |
$631.55 |
| Max. Negotiated Rate |
$178,970.00 |
| Rate for Payer: Aetna Commercial |
$1,294.47
|
| Rate for Payer: Aetna Medicare |
$1,004.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,294.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,391.07
|
| Rate for Payer: BCBS Complete |
$663.13
|
| Rate for Payer: BCBS MAPPO |
$966.02
|
| Rate for Payer: BCBS Trust/PPO |
$767.09
|
| Rate for Payer: BCN Commercial |
$1,445.02
|
| Rate for Payer: BCN Medicare Advantage |
$966.02
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cofinity Commercial |
$1,391.07
|
| Rate for Payer: Cofinity Commercial |
$1,294.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.02
|
| Rate for Payer: Healthscope Commercial |
$1,787.14
|
| Rate for Payer: Healthscope Commercial |
$1,545.63
|
| Rate for Payer: Mclaren Medicaid |
$631.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,014.32
|
| Rate for Payer: Meridian Medicaid |
$663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178,970.00
|
| Rate for Payer: Nomi Health Commercial |
$1,159.22
|
| Rate for Payer: PACE SWMI |
$966.02
|
| Rate for Payer: PHP Medicare Advantage |
$966.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$631.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,418.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,578.45
|
| Rate for Payer: Priority Health Medicare |
$966.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,578.45
|
| Rate for Payer: Priority Health SBD |
$1,578.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$966.02
|
| Rate for Payer: UHC Exchange |
$1,296.52
|
| Rate for Payer: UHC Medicare Advantage |
$966.02
|
| Rate for Payer: UHCCP Medicaid |
$631.55
|
|
|
PR DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 35001
|
| Min. Negotiated Rate |
$694.17 |
| Max. Negotiated Rate |
$199,190.00 |
| Rate for Payer: Aetna Commercial |
$1,424.73
|
| Rate for Payer: Aetna Medicare |
$1,105.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,424.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,531.05
|
| Rate for Payer: BCBS Complete |
$728.88
|
| Rate for Payer: BCBS MAPPO |
$1,063.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.88
|
| Rate for Payer: BCN Commercial |
$1,607.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.23
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$1,531.05
|
| Rate for Payer: Cofinity Commercial |
$1,424.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.98
|
| Rate for Payer: Healthscope Commercial |
$1,701.17
|
| Rate for Payer: Mclaren Medicaid |
$694.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,116.39
|
| Rate for Payer: Meridian Medicaid |
$728.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199,190.00
|
| Rate for Payer: Nomi Health Commercial |
$1,275.88
|
| Rate for Payer: PACE SWMI |
$1,063.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$694.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,751.30
|
| Rate for Payer: Priority Health Medicare |
$1,063.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,751.30
|
| Rate for Payer: Priority Health SBD |
$1,751.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,611.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.23
|
| Rate for Payer: UHC Exchange |
$1,611.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,063.23
|
| Rate for Payer: UHCCP Medicaid |
$694.17
|
|
|
PR DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY
|
Professional
|
Both
|
$2,176.00
|
|
|
Service Code
|
HCPCS 35141
|
| Min. Negotiated Rate |
$381.43 |
| Max. Negotiated Rate |
$193,853.00 |
| Rate for Payer: Aetna Commercial |
$1,404.08
|
| Rate for Payer: Aetna Medicare |
$1,089.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,508.86
|
| Rate for Payer: BCBS Complete |
$716.57
|
| Rate for Payer: BCBS MAPPO |
$1,047.82
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$1,560.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.82
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Cofinity Commercial |
$1,508.86
|
| Rate for Payer: Cofinity Commercial |
$1,404.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.82
|
| Rate for Payer: Healthscope Commercial |
$1,938.47
|
| Rate for Payer: Healthscope Commercial |
$1,676.51
|
| Rate for Payer: Mclaren Medicaid |
$682.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.21
|
| Rate for Payer: Meridian Medicaid |
$716.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,853.00
|
| Rate for Payer: Nomi Health Commercial |
$1,257.38
|
| Rate for Payer: PACE SWMI |
$1,047.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,701.84
|
| Rate for Payer: Priority Health Medicare |
$1,047.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,701.84
|
| Rate for Payer: Priority Health SBD |
$1,701.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,571.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.82
|
| Rate for Payer: UHC Exchange |
$1,571.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.82
|
| Rate for Payer: UHCCP Medicaid |
$682.45
|
|
|
PR DIR RPR ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$4,955.00
|
|
|
Service Code
|
HCPCS 35131
|
| Min. Negotiated Rate |
$866.27 |
| Max. Negotiated Rate |
$244,314.00 |
| Rate for Payer: Aetna Commercial |
$1,780.90
|
| Rate for Payer: Aetna Medicare |
$1,382.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,780.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,913.80
|
| Rate for Payer: BCBS Complete |
$909.58
|
| Rate for Payer: BCBS MAPPO |
$1,329.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,490.86
|
| Rate for Payer: BCN Commercial |
$1,965.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,329.03
|
| Rate for Payer: Cash Price |
$3,964.00
|
| Rate for Payer: Cash Price |
$3,964.00
|
| Rate for Payer: Cofinity Commercial |
$1,913.80
|
| Rate for Payer: Cofinity Commercial |
$1,780.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,329.03
|
| Rate for Payer: Healthscope Commercial |
$2,458.71
|
| Rate for Payer: Healthscope Commercial |
$2,126.45
|
| Rate for Payer: Mclaren Medicaid |
$866.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,395.48
|
| Rate for Payer: Meridian Medicaid |
$909.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244,314.00
|
| Rate for Payer: Nomi Health Commercial |
$1,594.84
|
| Rate for Payer: PACE SWMI |
$1,329.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,329.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,220.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,152.83
|
| Rate for Payer: Priority Health Medicare |
$1,329.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,152.83
|
| Rate for Payer: Priority Health SBD |
$2,152.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,515.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,329.03
|
| Rate for Payer: UHC Exchange |
$1,515.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,329.03
|
| Rate for Payer: UHCCP Medicaid |
$866.27
|
|
|
PR DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 35151
|
| Min. Negotiated Rate |
$773.40 |
| Max. Negotiated Rate |
$219,654.00 |
| Rate for Payer: Aetna Commercial |
$1,591.46
|
| Rate for Payer: Aetna Medicare |
$1,235.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,710.23
|
| Rate for Payer: BCBS Complete |
$812.07
|
| Rate for Payer: BCBS MAPPO |
$1,187.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,760.30
|
| Rate for Payer: BCN Commercial |
$1,767.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,187.66
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cofinity Commercial |
$1,710.23
|
| Rate for Payer: Cofinity Commercial |
$1,591.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.66
|
| Rate for Payer: Healthscope Commercial |
$2,197.17
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Mclaren Medicaid |
$773.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.04
|
| Rate for Payer: Meridian Medicaid |
$812.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219,654.00
|
| Rate for Payer: Nomi Health Commercial |
$1,425.19
|
| Rate for Payer: PACE SWMI |
$1,187.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,187.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$773.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,597.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,934.78
|
| Rate for Payer: Priority Health Medicare |
$1,187.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,934.78
|
| Rate for Payer: Priority Health SBD |
$1,934.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,652.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,187.66
|
| Rate for Payer: UHC Exchange |
$1,652.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,187.66
|
| Rate for Payer: UHCCP Medicaid |
$773.40
|
|
|
PR DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC
|
Professional
|
Both
|
$3,196.00
|
|
|
Service Code
|
HCPCS 35121
|
| Min. Negotiated Rate |
$283.70 |
| Max. Negotiated Rate |
$280,859.00 |
| Rate for Payer: Aetna Commercial |
$2,042.01
|
| Rate for Payer: Aetna Medicare |
$1,584.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,042.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,194.40
|
| Rate for Payer: BCBS Complete |
$1,037.74
|
| Rate for Payer: BCBS MAPPO |
$1,523.89
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$2,251.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,523.89
|
| Rate for Payer: Cash Price |
$2,556.80
|
| Rate for Payer: Cash Price |
$2,556.80
|
| Rate for Payer: Cofinity Commercial |
$2,194.40
|
| Rate for Payer: Cofinity Commercial |
$2,042.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,523.89
|
| Rate for Payer: Healthscope Commercial |
$2,819.20
|
| Rate for Payer: Healthscope Commercial |
$2,438.22
|
| Rate for Payer: Mclaren Medicaid |
$988.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,600.08
|
| Rate for Payer: Meridian Medicaid |
$1,037.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280,859.00
|
| Rate for Payer: Nomi Health Commercial |
$1,828.67
|
| Rate for Payer: PACE SWMI |
$1,523.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,523.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$988.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,077.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,461.29
|
| Rate for Payer: Priority Health Medicare |
$1,523.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,461.29
|
| Rate for Payer: Priority Health SBD |
$2,461.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,140.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,523.89
|
| Rate for Payer: UHC Exchange |
$2,140.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,523.89
|
| Rate for Payer: UHCCP Medicaid |
$988.32
|
|
|
PR DIR RPR ANEURYSM SPLENIC ARTERY
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 35111
|
| Min. Negotiated Rate |
$831.55 |
| Max. Negotiated Rate |
$236,201.00 |
| Rate for Payer: Aetna Commercial |
$1,716.63
|
| Rate for Payer: Aetna Medicare |
$1,332.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,716.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.74
|
| Rate for Payer: BCBS Complete |
$873.13
|
| Rate for Payer: BCBS MAPPO |
$1,281.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.86
|
| Rate for Payer: BCN Commercial |
$1,895.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,281.07
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,844.74
|
| Rate for Payer: Cofinity Commercial |
$1,716.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,281.07
|
| Rate for Payer: Healthscope Commercial |
$2,369.98
|
| Rate for Payer: Healthscope Commercial |
$2,049.71
|
| Rate for Payer: Mclaren Medicaid |
$831.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,345.12
|
| Rate for Payer: Meridian Medicaid |
$873.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236,201.00
|
| Rate for Payer: Nomi Health Commercial |
$1,537.28
|
| Rate for Payer: PACE SWMI |
$1,281.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,281.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$831.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,070.93
|
| Rate for Payer: Priority Health Medicare |
$1,281.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,070.93
|
| Rate for Payer: Priority Health SBD |
$2,070.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,281.07
|
| Rate for Payer: UHC Exchange |
$1,606.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,281.07
|
| Rate for Payer: UHCCP Medicaid |
$831.55
|
|
|
PR DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS
|
Professional
|
Both
|
$5,498.00
|
|
|
Service Code
|
HCPCS 35092
|
| Min. Negotiated Rate |
$1,619.44 |
| Max. Negotiated Rate |
$458,690.00 |
| Rate for Payer: Aetna Commercial |
$3,339.84
|
| Rate for Payer: Aetna Medicare |
$2,592.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,339.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,589.08
|
| Rate for Payer: BCBS Complete |
$1,700.41
|
| Rate for Payer: BCBS MAPPO |
$2,492.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,136.58
|
| Rate for Payer: BCN Commercial |
$3,681.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,492.42
|
| Rate for Payer: Cash Price |
$4,398.40
|
| Rate for Payer: Cash Price |
$4,398.40
|
| Rate for Payer: Cofinity Commercial |
$3,589.08
|
| Rate for Payer: Cofinity Commercial |
$3,339.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,492.42
|
| Rate for Payer: Healthscope Commercial |
$4,610.98
|
| Rate for Payer: Healthscope Commercial |
$3,987.87
|
| Rate for Payer: Mclaren Medicaid |
$1,619.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,617.04
|
| Rate for Payer: Meridian Medicaid |
$1,700.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$458,690.00
|
| Rate for Payer: Nomi Health Commercial |
$2,990.90
|
| Rate for Payer: PACE SWMI |
$2,492.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,492.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,619.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,573.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,038.14
|
| Rate for Payer: Priority Health Medicare |
$2,492.42
|
| Rate for Payer: Priority Health Narrow Network |
$4,038.14
|
| Rate for Payer: Priority Health SBD |
$4,038.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,170.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,492.42
|
| Rate for Payer: UHC Exchange |
$3,170.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,492.42
|
| Rate for Payer: UHCCP Medicaid |
$1,619.44
|
|
|
PR DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN
|
Professional
|
Both
|
$3,859.00
|
|
|
Service Code
|
HCPCS 35122
|
| Min. Negotiated Rate |
$1,180.87 |
| Max. Negotiated Rate |
$335,869.00 |
| Rate for Payer: Aetna Commercial |
$2,441.14
|
| Rate for Payer: Aetna Medicare |
$1,894.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,623.32
|
| Rate for Payer: BCBS Complete |
$1,239.91
|
| Rate for Payer: BCBS MAPPO |
$1,821.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.66
|
| Rate for Payer: BCN Commercial |
$2,691.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,821.75
|
| Rate for Payer: Cash Price |
$3,087.20
|
| Rate for Payer: Cash Price |
$3,087.20
|
| Rate for Payer: Cofinity Commercial |
$2,623.32
|
| Rate for Payer: Cofinity Commercial |
$2,441.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,821.75
|
| Rate for Payer: Healthscope Commercial |
$3,370.24
|
| Rate for Payer: Healthscope Commercial |
$2,914.80
|
| Rate for Payer: Mclaren Medicaid |
$1,180.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,912.84
|
| Rate for Payer: Meridian Medicaid |
$1,239.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335,869.00
|
| Rate for Payer: Nomi Health Commercial |
$2,186.10
|
| Rate for Payer: PACE SWMI |
$1,821.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,821.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,180.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,508.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,943.64
|
| Rate for Payer: Priority Health Medicare |
$1,821.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,943.64
|
| Rate for Payer: Priority Health SBD |
$2,943.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,821.75
|
| Rate for Payer: UHC Exchange |
$2,245.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,821.75
|
| Rate for Payer: UHCCP Medicaid |
$1,180.87
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS
|
Professional
|
Both
|
$3,560.00
|
|
|
Service Code
|
HCPCS 35103
|
| Min. Negotiated Rate |
$621.81 |
| Max. Negotiated Rate |
$394,324.00 |
| Rate for Payer: Aetna Commercial |
$2,798.04
|
| Rate for Payer: Aetna Medicare |
$2,171.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,798.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,006.85
|
| Rate for Payer: BCBS Complete |
$1,420.40
|
| Rate for Payer: BCBS MAPPO |
$2,088.09
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$3,166.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,088.09
|
| Rate for Payer: Cash Price |
$2,848.00
|
| Rate for Payer: Cash Price |
$2,848.00
|
| Rate for Payer: Cofinity Commercial |
$3,006.85
|
| Rate for Payer: Cofinity Commercial |
$2,798.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,088.09
|
| Rate for Payer: Healthscope Commercial |
$3,862.97
|
| Rate for Payer: Healthscope Commercial |
$3,340.94
|
| Rate for Payer: Mclaren Medicaid |
$1,352.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,192.49
|
| Rate for Payer: Meridian Medicaid |
$1,420.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394,324.00
|
| Rate for Payer: Nomi Health Commercial |
$2,505.71
|
| Rate for Payer: PACE SWMI |
$2,088.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,088.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,352.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,448.88
|
| Rate for Payer: Priority Health Medicare |
$2,088.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,448.88
|
| Rate for Payer: Priority Health SBD |
$3,448.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,794.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,088.09
|
| Rate for Payer: UHC Exchange |
$2,794.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,088.09
|
| Rate for Payer: UHCCP Medicaid |
$1,352.76
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$4,286.00
|
|
|
Service Code
|
HCPCS 35082
|
| Min. Negotiated Rate |
$750.19 |
| Max. Negotiated Rate |
$383,656.00 |
| Rate for Payer: Aetna Commercial |
$2,786.46
|
| Rate for Payer: Aetna Medicare |
$2,162.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,786.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,994.41
|
| Rate for Payer: BCBS Complete |
$1,419.96
|
| Rate for Payer: BCBS MAPPO |
$2,079.45
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$3,083.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,079.45
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cash Price |
$3,428.80
|
| Rate for Payer: Cofinity Commercial |
$2,994.41
|
| Rate for Payer: Cofinity Commercial |
$2,786.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,079.45
|
| Rate for Payer: Healthscope Commercial |
$3,846.98
|
| Rate for Payer: Healthscope Commercial |
$3,327.12
|
| Rate for Payer: Mclaren Medicaid |
$1,352.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,183.42
|
| Rate for Payer: Meridian Medicaid |
$1,419.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383,656.00
|
| Rate for Payer: Nomi Health Commercial |
$2,495.34
|
| Rate for Payer: PACE SWMI |
$2,079.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,079.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,352.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,785.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,363.78
|
| Rate for Payer: Priority Health Medicare |
$2,079.45
|
| Rate for Payer: Priority Health Narrow Network |
$3,363.78
|
| Rate for Payer: Priority Health SBD |
$3,363.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,733.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,079.45
|
| Rate for Payer: UHC Exchange |
$2,733.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,079.45
|
| Rate for Payer: UHCCP Medicaid |
$1,352.34
|
|
|
PR DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS
|
Professional
|
Both
|
$3,927.00
|
|
|
Service Code
|
HCPCS 35013
|
| Min. Negotiated Rate |
$741.88 |
| Max. Negotiated Rate |
$224,770.00 |
| Rate for Payer: Aetna Commercial |
$1,530.00
|
| Rate for Payer: Aetna Medicare |
$1,187.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.18
|
| Rate for Payer: BCBS Complete |
$778.97
|
| Rate for Payer: BCBS MAPPO |
$1,141.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,152.22
|
| Rate for Payer: BCN Commercial |
$1,815.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.79
|
| Rate for Payer: Cash Price |
$3,141.60
|
| Rate for Payer: Cash Price |
$3,141.60
|
| Rate for Payer: Cofinity Commercial |
$1,644.18
|
| Rate for Payer: Cofinity Commercial |
$1,530.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.79
|
| Rate for Payer: Healthscope Commercial |
$2,112.31
|
| Rate for Payer: Healthscope Commercial |
$1,826.86
|
| Rate for Payer: Mclaren Medicaid |
$741.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,198.88
|
| Rate for Payer: Meridian Medicaid |
$778.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224,770.00
|
| Rate for Payer: Nomi Health Commercial |
$1,370.15
|
| Rate for Payer: PACE SWMI |
$1,141.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,552.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,981.05
|
| Rate for Payer: Priority Health Medicare |
$1,141.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,981.05
|
| Rate for Payer: Priority Health SBD |
$1,981.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,639.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.79
|
| Rate for Payer: UHC Exchange |
$1,639.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,141.79
|
| Rate for Payer: UHCCP Medicaid |
$741.88
|
|
|
PR DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 35002
|
| Min. Negotiated Rate |
$712.91 |
| Max. Negotiated Rate |
$202,081.00 |
| Rate for Payer: Aetna Commercial |
$1,469.60
|
| Rate for Payer: Aetna Medicare |
$1,140.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,579.28
|
| Rate for Payer: BCBS Complete |
$748.56
|
| Rate for Payer: BCBS MAPPO |
$1,096.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,959.01
|
| Rate for Payer: BCN Commercial |
$1,623.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.72
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cofinity Commercial |
$1,579.28
|
| Rate for Payer: Cofinity Commercial |
$1,469.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.72
|
| Rate for Payer: Healthscope Commercial |
$2,028.93
|
| Rate for Payer: Healthscope Commercial |
$1,754.75
|
| Rate for Payer: Mclaren Medicaid |
$712.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,151.56
|
| Rate for Payer: Meridian Medicaid |
$748.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202,081.00
|
| Rate for Payer: Nomi Health Commercial |
$1,316.06
|
| Rate for Payer: PACE SWMI |
$1,096.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,775.76
|
| Rate for Payer: Priority Health Medicare |
$1,096.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,775.76
|
| Rate for Payer: Priority Health SBD |
$1,775.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,667.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.72
|
| Rate for Payer: UHC Exchange |
$1,667.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.72
|
| Rate for Payer: UHCCP Medicaid |
$712.91
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$3,452.00
|
|
|
Service Code
|
HCPCS 35132
|
| Min. Negotiated Rate |
$1,021.55 |
| Max. Negotiated Rate |
$290,416.00 |
| Rate for Payer: Aetna Commercial |
$2,110.50
|
| Rate for Payer: Aetna Medicare |
$1,638.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,268.00
|
| Rate for Payer: BCBS Complete |
$1,072.63
|
| Rate for Payer: BCBS MAPPO |
$1,575.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,010.18
|
| Rate for Payer: BCN Commercial |
$2,328.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,575.00
|
| Rate for Payer: Cash Price |
$2,761.60
|
| Rate for Payer: Cash Price |
$2,761.60
|
| Rate for Payer: Cofinity Commercial |
$2,268.00
|
| Rate for Payer: Cofinity Commercial |
$2,110.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,575.00
|
| Rate for Payer: Healthscope Commercial |
$2,913.75
|
| Rate for Payer: Healthscope Commercial |
$2,520.00
|
| Rate for Payer: Mclaren Medicaid |
$1,021.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,653.75
|
| Rate for Payer: Meridian Medicaid |
$1,072.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290,416.00
|
| Rate for Payer: Nomi Health Commercial |
$1,890.00
|
| Rate for Payer: PACE SWMI |
$1,575.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,575.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,243.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,544.79
|
| Rate for Payer: Priority Health Medicare |
$1,575.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,544.79
|
| Rate for Payer: Priority Health SBD |
$2,544.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,575.00
|
| Rate for Payer: UHC Exchange |
$1,899.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,575.00
|
| Rate for Payer: UHCCP Medicaid |
$1,021.55
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART
|
Professional
|
Both
|
$2,610.00
|
|
|
Service Code
|
HCPCS 35142
|
| Min. Negotiated Rate |
$571.62 |
| Max. Negotiated Rate |
$234,018.00 |
| Rate for Payer: Aetna Commercial |
$1,695.26
|
| Rate for Payer: Aetna Medicare |
$1,315.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,695.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,821.77
|
| Rate for Payer: BCBS Complete |
$865.53
|
| Rate for Payer: BCBS MAPPO |
$1,265.12
|
| Rate for Payer: BCBS Trust/PPO |
$571.62
|
| Rate for Payer: BCN Commercial |
$1,884.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,265.12
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cofinity Commercial |
$1,821.77
|
| Rate for Payer: Cofinity Commercial |
$1,695.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,265.12
|
| Rate for Payer: Healthscope Commercial |
$2,340.47
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Mclaren Medicaid |
$824.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,328.38
|
| Rate for Payer: Meridian Medicaid |
$865.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234,018.00
|
| Rate for Payer: Nomi Health Commercial |
$1,518.14
|
| Rate for Payer: PACE SWMI |
$1,265.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,265.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,696.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,055.50
|
| Rate for Payer: Priority Health Medicare |
$1,265.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,055.50
|
| Rate for Payer: Priority Health SBD |
$2,055.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,654.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,265.12
|
| Rate for Payer: UHC Exchange |
$1,654.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,265.12
|
| Rate for Payer: UHCCP Medicaid |
$824.31
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 35152
|
| Min. Negotiated Rate |
$874.58 |
| Max. Negotiated Rate |
$248,321.00 |
| Rate for Payer: Aetna Commercial |
$1,805.48
|
| Rate for Payer: Aetna Medicare |
$1,401.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,940.21
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCBS MAPPO |
$1,347.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.46
|
| Rate for Payer: BCN Commercial |
$1,992.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,347.37
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$1,940.21
|
| Rate for Payer: Cofinity Commercial |
$1,805.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,347.37
|
| Rate for Payer: Healthscope Commercial |
$2,492.63
|
| Rate for Payer: Healthscope Commercial |
$2,155.79
|
| Rate for Payer: Mclaren Medicaid |
$874.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,414.74
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248,321.00
|
| Rate for Payer: Nomi Health Commercial |
$1,616.84
|
| Rate for Payer: PACE SWMI |
$1,347.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,347.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,779.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,177.29
|
| Rate for Payer: Priority Health Medicare |
$1,347.37
|
| Rate for Payer: Priority Health Narrow Network |
$2,177.29
|
| Rate for Payer: Priority Health SBD |
$2,177.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,791.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,347.37
|
| Rate for Payer: UHC Exchange |
$1,791.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,347.37
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
|
|
PR DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN
|
Professional
|
Both
|
$2,934.00
|
|
|
Service Code
|
HCPCS 35022
|
| Min. Negotiated Rate |
$906.74 |
| Max. Negotiated Rate |
$254,657.00 |
| Rate for Payer: Aetna Commercial |
$1,846.87
|
| Rate for Payer: Aetna Medicare |
$1,433.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,846.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.69
|
| Rate for Payer: BCBS Complete |
$952.08
|
| Rate for Payer: BCBS MAPPO |
$1,378.26
|
| Rate for Payer: BCN Commercial |
$2,065.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.26
|
| Rate for Payer: Cash Price |
$2,347.20
|
| Rate for Payer: Cash Price |
$2,347.20
|
| Rate for Payer: Cofinity Commercial |
$1,984.69
|
| Rate for Payer: Cofinity Commercial |
$1,846.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.26
|
| Rate for Payer: Healthscope Commercial |
$2,549.78
|
| Rate for Payer: Healthscope Commercial |
$2,205.22
|
| Rate for Payer: Mclaren Medicaid |
$906.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.17
|
| Rate for Payer: Meridian Medicaid |
$952.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254,657.00
|
| Rate for Payer: Nomi Health Commercial |
$1,653.91
|
| Rate for Payer: PACE SWMI |
$1,378.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$906.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,907.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,253.34
|
| Rate for Payer: Priority Health Medicare |
$1,378.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,253.34
|
| Rate for Payer: Priority Health SBD |
$2,253.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,742.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,378.26
|
| Rate for Payer: UHC Exchange |
$1,742.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,378.26
|
| Rate for Payer: UHCCP Medicaid |
$906.74
|
|
