|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$192.08 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$257.39
|
| Rate for Payer: Aetna Medicare |
$199.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.39
|
| Rate for Payer: BCBS Complete |
$448.00
|
| Rate for Payer: BCBS MAPPO |
$192.08
|
| Rate for Payer: BCN Medicare Advantage |
$192.08
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$276.60
|
| Rate for Payer: Cofinity Commercial |
$257.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.08
|
| Rate for Payer: Healthscope Commercial |
$355.35
|
| Rate for Payer: Healthscope Commercial |
$307.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.00
|
| Rate for Payer: Nomi Health Commercial |
$230.50
|
| Rate for Payer: PACE SWMI |
$192.08
|
| Rate for Payer: PHP Medicare Advantage |
$192.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health Medicare |
$192.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.08
|
| Rate for Payer: UHC Medicare Advantage |
$192.08
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$947.33 |
| Max. Negotiated Rate |
$1,796.60 |
| Rate for Payer: Aetna Commercial |
$1,269.42
|
| Rate for Payer: Aetna Medicare |
$985.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.42
|
| Rate for Payer: BCBS Complete |
$1,105.60
|
| Rate for Payer: BCBS MAPPO |
$947.33
|
| Rate for Payer: BCN Medicare Advantage |
$947.33
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cofinity Commercial |
$1,364.16
|
| Rate for Payer: Cofinity Commercial |
$1,269.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.33
|
| Rate for Payer: Healthscope Commercial |
$1,515.73
|
| Rate for Payer: Healthscope Commercial |
$1,752.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$994.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,796.60
|
| Rate for Payer: Nomi Health Commercial |
$1,136.80
|
| Rate for Payer: PACE SWMI |
$947.33
|
| Rate for Payer: PHP Medicare Advantage |
$947.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.60
|
| Rate for Payer: Priority Health Medicare |
$947.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.33
|
| Rate for Payer: UHC Medicare Advantage |
$947.33
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$947.95 |
| Max. Negotiated Rate |
$1,914.90 |
| Rate for Payer: Aetna Commercial |
$1,270.25
|
| Rate for Payer: Aetna Medicare |
$985.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.25
|
| Rate for Payer: BCBS Complete |
$1,178.40
|
| Rate for Payer: BCBS MAPPO |
$947.95
|
| Rate for Payer: BCN Medicare Advantage |
$947.95
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,365.05
|
| Rate for Payer: Cofinity Commercial |
$1,270.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.95
|
| Rate for Payer: Healthscope Commercial |
$1,753.71
|
| Rate for Payer: Healthscope Commercial |
$1,516.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$995.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.90
|
| Rate for Payer: Nomi Health Commercial |
$1,137.54
|
| Rate for Payer: PACE SWMI |
$947.95
|
| Rate for Payer: PHP Medicare Advantage |
$947.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,914.90
|
| Rate for Payer: Priority Health Medicare |
$947.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.95
|
| Rate for Payer: UHC Medicare Advantage |
$947.95
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,992.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$236.17 |
| Max. Negotiated Rate |
$1,294.80 |
| Rate for Payer: Aetna Commercial |
$316.47
|
| Rate for Payer: Aetna Medicare |
$245.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.47
|
| Rate for Payer: BCBS Complete |
$796.80
|
| Rate for Payer: BCBS MAPPO |
$236.17
|
| Rate for Payer: BCN Medicare Advantage |
$236.17
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Cofinity Commercial |
$316.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.17
|
| Rate for Payer: Healthscope Commercial |
$377.87
|
| Rate for Payer: Healthscope Commercial |
$436.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,294.80
|
| Rate for Payer: Nomi Health Commercial |
$283.40
|
| Rate for Payer: PACE SWMI |
$236.17
|
| Rate for Payer: PHP Medicare Advantage |
$236.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.80
|
| Rate for Payer: Priority Health Medicare |
$236.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.17
|
| Rate for Payer: UHC Medicare Advantage |
$236.17
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,027.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$2,010.80 |
| Max. Negotiated Rate |
$5,128.16 |
| Rate for Payer: Aetna Commercial |
$3,714.45
|
| Rate for Payer: Aetna Medicare |
$2,882.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.45
|
| Rate for Payer: BCBS Complete |
$2,010.80
|
| Rate for Payer: BCBS MAPPO |
$2,771.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,771.98
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Cofinity Commercial |
$3,991.65
|
| Rate for Payer: Cofinity Commercial |
$3,714.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,771.98
|
| Rate for Payer: Healthscope Commercial |
$5,128.16
|
| Rate for Payer: Healthscope Commercial |
$4,435.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,910.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,267.55
|
| Rate for Payer: Nomi Health Commercial |
$3,326.38
|
| Rate for Payer: PACE SWMI |
$2,771.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,771.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,267.55
|
| Rate for Payer: Priority Health Medicare |
$2,771.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,771.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,771.98
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,332.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,732.80 |
| Max. Negotiated Rate |
$4,441.52 |
| Rate for Payer: Aetna Commercial |
$3,217.10
|
| Rate for Payer: Aetna Medicare |
$2,496.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,457.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.10
|
| Rate for Payer: BCBS Complete |
$1,732.80
|
| Rate for Payer: BCBS MAPPO |
$2,400.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,400.82
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Cofinity Commercial |
$3,457.18
|
| Rate for Payer: Cofinity Commercial |
$3,217.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,400.82
|
| Rate for Payer: Healthscope Commercial |
$3,841.31
|
| Rate for Payer: Healthscope Commercial |
$4,441.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,520.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,815.80
|
| Rate for Payer: Nomi Health Commercial |
$2,880.98
|
| Rate for Payer: PACE SWMI |
$2,400.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,400.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,815.80
|
| Rate for Payer: Priority Health Medicare |
$2,400.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,400.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,400.82
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,316.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$1,186.81 |
| Max. Negotiated Rate |
$2,195.60 |
| Rate for Payer: Aetna Commercial |
$1,590.33
|
| Rate for Payer: Aetna Medicare |
$1,234.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,590.33
|
| Rate for Payer: BCBS Complete |
$1,326.40
|
| Rate for Payer: BCBS MAPPO |
$1,186.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,186.81
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,709.01
|
| Rate for Payer: Cofinity Commercial |
$1,590.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,186.81
|
| Rate for Payer: Healthscope Commercial |
$2,195.60
|
| Rate for Payer: Healthscope Commercial |
$1,898.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,246.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,155.40
|
| Rate for Payer: Nomi Health Commercial |
$1,424.17
|
| Rate for Payer: PACE SWMI |
$1,186.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,186.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,155.40
|
| Rate for Payer: Priority Health Medicare |
$1,186.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,186.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,186.81
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$585.78 |
| Rate for Payer: Aetna Commercial |
$424.30
|
| Rate for Payer: Aetna Medicare |
$329.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.30
|
| Rate for Payer: BCBS Complete |
$108.00
|
| Rate for Payer: BCBS MAPPO |
$316.64
|
| Rate for Payer: BCN Medicare Advantage |
$316.64
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cofinity Commercial |
$455.96
|
| Rate for Payer: Cofinity Commercial |
$424.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.64
|
| Rate for Payer: Healthscope Commercial |
$506.62
|
| Rate for Payer: Healthscope Commercial |
$585.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.50
|
| Rate for Payer: Nomi Health Commercial |
$379.97
|
| Rate for Payer: PACE SWMI |
$316.64
|
| Rate for Payer: PHP Medicare Advantage |
$316.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
| Rate for Payer: Priority Health Medicare |
$316.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.64
|
| Rate for Payer: UHC Medicare Advantage |
$316.64
|
|
|
PR EPDRM AGRFT T/A/L EA ADD 100 SQCM/EA 1%INFT/CHLD
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$98.85 |
| Max. Negotiated Rate |
$182.87 |
| Rate for Payer: Aetna Commercial |
$132.46
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.46
|
| Rate for Payer: BCBS Complete |
$101.60
|
| Rate for Payer: BCBS MAPPO |
$98.85
|
| Rate for Payer: BCN Medicare Advantage |
$98.85
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$142.34
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.85
|
| Rate for Payer: Healthscope Commercial |
$158.16
|
| Rate for Payer: Healthscope Commercial |
$182.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.10
|
| Rate for Payer: Nomi Health Commercial |
$118.62
|
| Rate for Payer: PACE SWMI |
$98.85
|
| Rate for Payer: PHP Medicare Advantage |
$98.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health Medicare |
$98.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.85
|
| Rate for Payer: UHC Medicare Advantage |
$98.85
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$349.05 |
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: BCBS Complete |
$214.80
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$309.44 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$414.65
|
| Rate for Payer: Aetna Medicare |
$321.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.59
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$309.44
|
| Rate for Payer: BCN Medicare Advantage |
$309.44
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$414.65
|
| Rate for Payer: Cofinity Commercial |
$445.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.44
|
| Rate for Payer: Healthscope Commercial |
$495.10
|
| Rate for Payer: Healthscope Commercial |
$572.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$371.33
|
| Rate for Payer: PACE SWMI |
$309.44
|
| Rate for Payer: PHP Medicare Advantage |
$309.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$309.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.44
|
| Rate for Payer: UHC Medicare Advantage |
$309.44
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT 1ST 100 SQCM/<
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$587.20 |
| Max. Negotiated Rate |
$1,241.29 |
| Rate for Payer: Aetna Commercial |
$899.10
|
| Rate for Payer: Aetna Medicare |
$697.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.10
|
| Rate for Payer: BCBS Complete |
$587.20
|
| Rate for Payer: BCBS MAPPO |
$670.97
|
| Rate for Payer: BCN Medicare Advantage |
$670.97
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$966.20
|
| Rate for Payer: Cofinity Commercial |
$899.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.97
|
| Rate for Payer: Healthscope Commercial |
$1,241.29
|
| Rate for Payer: Healthscope Commercial |
$1,073.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.20
|
| Rate for Payer: Nomi Health Commercial |
$805.16
|
| Rate for Payer: PACE SWMI |
$670.97
|
| Rate for Payer: PHP Medicare Advantage |
$670.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.20
|
| Rate for Payer: Priority Health Medicare |
$670.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.97
|
| Rate for Payer: UHC Medicare Advantage |
$670.97
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT EA 100 SQCM
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$247.23 |
| Rate for Payer: Aetna Commercial |
$179.08
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.08
|
| Rate for Payer: BCBS Complete |
$133.60
|
| Rate for Payer: BCBS MAPPO |
$133.64
|
| Rate for Payer: BCN Medicare Advantage |
$133.64
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$192.44
|
| Rate for Payer: Cofinity Commercial |
$179.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.64
|
| Rate for Payer: Healthscope Commercial |
$213.82
|
| Rate for Payer: Healthscope Commercial |
$247.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.10
|
| Rate for Payer: Nomi Health Commercial |
$160.37
|
| Rate for Payer: PACE SWMI |
$133.64
|
| Rate for Payer: PHP Medicare Advantage |
$133.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Medicare |
$133.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.64
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,072.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$428.80 |
| Max. Negotiated Rate |
$1,004.79 |
| Rate for Payer: Aetna Commercial |
$727.79
|
| Rate for Payer: Aetna Medicare |
$564.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.79
|
| Rate for Payer: BCBS Complete |
$428.80
|
| Rate for Payer: BCBS MAPPO |
$543.13
|
| Rate for Payer: BCN Medicare Advantage |
$543.13
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Cofinity Commercial |
$782.11
|
| Rate for Payer: Cofinity Commercial |
$727.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.13
|
| Rate for Payer: Healthscope Commercial |
$869.01
|
| Rate for Payer: Healthscope Commercial |
$1,004.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.80
|
| Rate for Payer: Nomi Health Commercial |
$651.76
|
| Rate for Payer: PACE SWMI |
$543.13
|
| Rate for Payer: PHP Medicare Advantage |
$543.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.80
|
| Rate for Payer: Priority Health Medicare |
$543.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.13
|
| Rate for Payer: UHC Medicare Advantage |
$543.13
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$741.83 |
| Rate for Payer: Aetna Commercial |
$537.33
|
| Rate for Payer: Aetna Medicare |
$417.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.33
|
| Rate for Payer: BCBS Complete |
$302.40
|
| Rate for Payer: BCBS MAPPO |
$400.99
|
| Rate for Payer: BCN Medicare Advantage |
$400.99
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$577.43
|
| Rate for Payer: Cofinity Commercial |
$537.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.99
|
| Rate for Payer: Healthscope Commercial |
$641.58
|
| Rate for Payer: Healthscope Commercial |
$741.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$491.40
|
| Rate for Payer: Nomi Health Commercial |
$481.19
|
| Rate for Payer: PACE SWMI |
$400.99
|
| Rate for Payer: PHP Medicare Advantage |
$400.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health Medicare |
$400.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.99
|
| Rate for Payer: UHC Medicare Advantage |
$400.99
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$688.80 |
| Max. Negotiated Rate |
$1,415.86 |
| Rate for Payer: Aetna Commercial |
$1,025.54
|
| Rate for Payer: Aetna Medicare |
$795.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.54
|
| Rate for Payer: BCBS Complete |
$688.80
|
| Rate for Payer: BCBS MAPPO |
$765.33
|
| Rate for Payer: BCN Medicare Advantage |
$765.33
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cofinity Commercial |
$1,102.08
|
| Rate for Payer: Cofinity Commercial |
$1,025.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.33
|
| Rate for Payer: Healthscope Commercial |
$1,415.86
|
| Rate for Payer: Healthscope Commercial |
$1,224.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,119.30
|
| Rate for Payer: Nomi Health Commercial |
$918.40
|
| Rate for Payer: PACE SWMI |
$765.33
|
| Rate for Payer: PHP Medicare Advantage |
$765.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health Medicare |
$765.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.33
|
| Rate for Payer: UHC Medicare Advantage |
$765.33
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 SQCM/</1% INFT/CHLD
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$643.20 |
| Max. Negotiated Rate |
$1,268.25 |
| Rate for Payer: Aetna Commercial |
$918.62
|
| Rate for Payer: Aetna Medicare |
$712.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.62
|
| Rate for Payer: BCBS Complete |
$643.20
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCN Medicare Advantage |
$685.54
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$987.18
|
| Rate for Payer: Cofinity Commercial |
$918.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.54
|
| Rate for Payer: Healthscope Commercial |
$1,096.86
|
| Rate for Payer: Healthscope Commercial |
$1,268.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,045.20
|
| Rate for Payer: Nomi Health Commercial |
$822.65
|
| Rate for Payer: PACE SWMI |
$685.54
|
| Rate for Payer: PHP Medicare Advantage |
$685.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.20
|
| Rate for Payer: Priority Health Medicare |
$685.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.54
|
| Rate for Payer: UHC Medicare Advantage |
$685.54
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/ULNA
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$504.00 |
| Max. Negotiated Rate |
$1,108.41 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$623.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.85
|
| Rate for Payer: BCBS Complete |
$504.00
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCN Medicare Advantage |
$599.14
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$862.76
|
| Rate for Payer: Cofinity Commercial |
$802.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.14
|
| Rate for Payer: Healthscope Commercial |
$958.62
|
| Rate for Payer: Healthscope Commercial |
$1,108.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.00
|
| Rate for Payer: Nomi Health Commercial |
$718.97
|
| Rate for Payer: PACE SWMI |
$599.14
|
| Rate for Payer: PHP Medicare Advantage |
$599.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.14
|
| Rate for Payer: UHC Medicare Advantage |
$599.14
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$470.00 |
| Max. Negotiated Rate |
$1,286.10 |
| Rate for Payer: Aetna Commercial |
$931.55
|
| Rate for Payer: Aetna Medicare |
$723.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.07
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: BCBS MAPPO |
$695.19
|
| Rate for Payer: BCN Medicare Advantage |
$695.19
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$931.55
|
| Rate for Payer: Cofinity Commercial |
$1,001.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.19
|
| Rate for Payer: Healthscope Commercial |
$1,112.30
|
| Rate for Payer: Healthscope Commercial |
$1,286.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$763.75
|
| Rate for Payer: Nomi Health Commercial |
$834.23
|
| Rate for Payer: PACE SWMI |
$695.19
|
| Rate for Payer: PHP Medicare Advantage |
$695.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health Medicare |
$695.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.19
|
| Rate for Payer: UHC Medicare Advantage |
$695.19
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$143.88 |
| Max. Negotiated Rate |
$266.18 |
| Rate for Payer: Aetna Commercial |
$192.80
|
| Rate for Payer: Aetna Medicare |
$149.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.80
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$143.88
|
| Rate for Payer: BCN Medicare Advantage |
$143.88
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.88
|
| Rate for Payer: Healthscope Commercial |
$266.18
|
| Rate for Payer: Healthscope Commercial |
$230.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.65
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: PACE SWMI |
$143.88
|
| Rate for Payer: PHP Medicare Advantage |
$143.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Medicare |
$143.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.88
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$11.44
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.44
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Cofinity Commercial |
$11.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$13.66
|
| Rate for Payer: Healthscope Commercial |
$15.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$10.25
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$662.00 |
| Max. Negotiated Rate |
$1,075.75 |
| Rate for Payer: Aetna Medicare |
$827.50
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$355.29 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$476.09
|
| Rate for Payer: Aetna Medicare |
$369.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.09
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$355.29
|
| Rate for Payer: BCN Medicare Advantage |
$355.29
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$476.09
|
| Rate for Payer: Cofinity Commercial |
$511.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$657.29
|
| Rate for Payer: Healthscope Commercial |
$568.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.25
|
| Rate for Payer: Nomi Health Commercial |
$426.35
|
| Rate for Payer: PACE SWMI |
$355.29
|
| Rate for Payer: PHP Medicare Advantage |
$355.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$355.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.29
|
| Rate for Payer: UHC Medicare Advantage |
$355.29
|
|
|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$1,086.80 |
| Rate for Payer: Aetna Medicare |
$836.00
|
| Rate for Payer: BCBS Complete |
$668.80
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,086.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.80
|
|
|
PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
HCPCS 43276
|
| Min. Negotiated Rate |
$451.73 |
| Max. Negotiated Rate |
$966.55 |
| Rate for Payer: Aetna Commercial |
$605.32
|
| Rate for Payer: Aetna Medicare |
$469.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.32
|
| Rate for Payer: BCBS Complete |
$594.80
|
| Rate for Payer: BCBS MAPPO |
$451.73
|
| Rate for Payer: BCN Medicare Advantage |
$451.73
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cofinity Commercial |
$650.49
|
| Rate for Payer: Cofinity Commercial |
$605.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.73
|
| Rate for Payer: Healthscope Commercial |
$835.70
|
| Rate for Payer: Healthscope Commercial |
$722.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.55
|
| Rate for Payer: Nomi Health Commercial |
$542.08
|
| Rate for Payer: PACE SWMI |
$451.73
|
| Rate for Payer: PHP Medicare Advantage |
$451.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.55
|
| Rate for Payer: Priority Health Medicare |
$451.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$451.73
|
| Rate for Payer: UHC Medicare Advantage |
$451.73
|
|
