|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,027.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$511,043.00 |
| Rate for Payer: Aetna Commercial |
$3,714.45
|
| Rate for Payer: Aetna Medicare |
$2,882.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.65
|
| Rate for Payer: BCBS Complete |
$1,915.34
|
| Rate for Payer: BCBS MAPPO |
$2,771.98
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$4,149.37
|
| 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: Mclaren Medicaid |
$1,824.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,910.58
|
| Rate for Payer: Meridian Medicaid |
$1,915.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511,043.00
|
| 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 Choice Medicaid |
$1,824.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,267.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,085.96
|
| Rate for Payer: Priority Health Medicare |
$2,771.98
|
| Rate for Payer: Priority Health Narrow Network |
$5,085.96
|
| Rate for Payer: Priority Health SBD |
$5,085.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,531.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,771.98
|
| Rate for Payer: UHC Exchange |
$2,531.31
|
| Rate for Payer: UHC Medicare Advantage |
$2,771.98
|
| Rate for Payer: UHCCP Medicaid |
$1,824.13
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,332.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,581.53 |
| Max. Negotiated Rate |
$442,289.00 |
| Rate for Payer: Aetna Commercial |
$3,217.10
|
| Rate for Payer: Aetna Medicare |
$2,496.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,457.18
|
| Rate for Payer: BCBS Complete |
$1,660.61
|
| Rate for Payer: BCBS MAPPO |
$2,400.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.09
|
| Rate for Payer: BCN Commercial |
$3,594.23
|
| 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 |
$4,441.52
|
| Rate for Payer: Healthscope Commercial |
$3,841.31
|
| Rate for Payer: Mclaren Medicaid |
$1,581.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,520.86
|
| Rate for Payer: Meridian Medicaid |
$1,660.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442,289.00
|
| 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 Choice Medicaid |
$1,581.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,815.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,406.43
|
| Rate for Payer: Priority Health Medicare |
$2,400.82
|
| Rate for Payer: Priority Health Narrow Network |
$4,406.43
|
| Rate for Payer: Priority Health SBD |
$4,406.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,200.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,400.82
|
| Rate for Payer: UHC Exchange |
$2,200.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,400.82
|
| Rate for Payer: UHCCP Medicaid |
$1,581.53
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,316.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$218,457.00 |
| Rate for Payer: Aetna Commercial |
$1,590.33
|
| Rate for Payer: Aetna Medicare |
$1,234.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,590.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.01
|
| Rate for Payer: BCBS Complete |
$823.03
|
| Rate for Payer: BCBS MAPPO |
$1,186.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.68
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| 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: Mclaren Medicaid |
$783.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,246.15
|
| Rate for Payer: Meridian Medicaid |
$823.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,457.00
|
| 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 Choice Medicaid |
$783.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,182.94
|
| Rate for Payer: Priority Health Medicare |
$1,186.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,182.94
|
| Rate for Payer: Priority Health SBD |
$2,182.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,350.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,186.81
|
| Rate for Payer: UHC Exchange |
$1,350.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,186.81
|
| Rate for Payer: UHCCP Medicaid |
$783.84
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$30,138.00 |
| Rate for Payer: BCBS Complete |
$108.00
|
| Rate for Payer: BCN Commercial |
$249.53
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,138.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
|
|
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 |
$64.97 |
| Max. Negotiated Rate |
$18,254.00 |
| Rate for Payer: Aetna Commercial |
$132.46
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.34
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$98.85
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$164.20
|
| 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 |
$132.46
|
| Rate for Payer: Cofinity Commercial |
$142.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.85
|
| Rate for Payer: Healthscope Commercial |
$182.87
|
| Rate for Payer: Healthscope Commercial |
$158.16
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.79
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,254.00
|
| 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 Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.36
|
| Rate for Payer: Priority Health Medicare |
$98.85
|
| Rate for Payer: Priority Health Narrow Network |
$136.36
|
| Rate for Payer: Priority Health SBD |
$136.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.85
|
| Rate for Payer: UHC Exchange |
$137.90
|
| Rate for Payer: UHC Medicare Advantage |
$98.85
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$190.64 |
| Max. Negotiated Rate |
$82,881.00 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.30
|
| Rate for Payer: BCBS Complete |
$200.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.73
|
| Rate for Payer: BCN Commercial |
$835.64
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Mclaren Medicaid |
$190.64
|
| Rate for Payer: Meridian Medicaid |
$200.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,881.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.65
|
| Rate for Payer: Priority Health Narrow Network |
$796.65
|
| Rate for Payer: Priority Health SBD |
$422.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.41
|
| Rate for Payer: UHC Exchange |
$864.41
|
| Rate for Payer: UHCCP Medicaid |
$190.64
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$48,453.00 |
| 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 |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$309.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.54
|
| Rate for Payer: BCN Commercial |
$481.35
|
| 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 |
$445.59
|
| Rate for Payer: Cofinity Commercial |
$414.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.44
|
| Rate for Payer: Healthscope Commercial |
$572.46
|
| Rate for Payer: Healthscope Commercial |
$495.10
|
| Rate for Payer: Mclaren Medicaid |
$156.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.91
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,453.00
|
| 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 Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.01
|
| Rate for Payer: Priority Health Medicare |
$309.44
|
| Rate for Payer: Priority Health Narrow Network |
$460.01
|
| Rate for Payer: Priority Health SBD |
$344.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,224.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.44
|
| Rate for Payer: UHC Exchange |
$1,224.74
|
| Rate for Payer: UHC Medicare Advantage |
$309.44
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
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 |
$138.90 |
| Max. Negotiated Rate |
$121,961.00 |
| Rate for Payer: Aetna Commercial |
$899.10
|
| Rate for Payer: Aetna Medicare |
$697.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.20
|
| Rate for Payer: BCBS Complete |
$473.47
|
| Rate for Payer: BCBS MAPPO |
$670.97
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| 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: Mclaren Medicaid |
$450.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.52
|
| Rate for Payer: Meridian Medicaid |
$473.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121,961.00
|
| 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 Choice Medicaid |
$450.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.67
|
| Rate for Payer: Priority Health Medicare |
$670.97
|
| Rate for Payer: Priority Health Narrow Network |
$943.67
|
| Rate for Payer: Priority Health SBD |
$943.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.97
|
| Rate for Payer: UHC Exchange |
$806.44
|
| Rate for Payer: UHC Medicare Advantage |
$670.97
|
| Rate for Payer: UHCCP Medicaid |
$450.92
|
|
|
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 |
$87.97 |
| Max. Negotiated Rate |
$24,916.00 |
| Rate for Payer: Aetna Commercial |
$179.08
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.44
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$133.64
|
| Rate for Payer: BCBS Trust/PPO |
$281.44
|
| Rate for Payer: BCN Commercial |
$225.28
|
| 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 |
$247.23
|
| Rate for Payer: Healthscope Commercial |
$213.82
|
| Rate for Payer: Mclaren Medicaid |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.32
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,916.00
|
| 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 Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.57
|
| Rate for Payer: Priority Health Medicare |
$133.64
|
| Rate for Payer: Priority Health Narrow Network |
$185.57
|
| Rate for Payer: Priority Health SBD |
$185.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.64
|
| Rate for Payer: UHC Exchange |
$179.01
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,072.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$365.30 |
| Max. Negotiated Rate |
$99,833.00 |
| Rate for Payer: Aetna Commercial |
$727.79
|
| Rate for Payer: Aetna Medicare |
$564.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.11
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$543.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.03
|
| Rate for Payer: BCN Commercial |
$821.46
|
| 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: Mclaren Medicaid |
$365.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.29
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99,833.00
|
| 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 Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.15
|
| Rate for Payer: Priority Health Medicare |
$543.13
|
| Rate for Payer: Priority Health Narrow Network |
$909.15
|
| Rate for Payer: Priority Health SBD |
$909.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.13
|
| Rate for Payer: UHC Exchange |
$697.36
|
| Rate for Payer: UHC Medicare Advantage |
$543.13
|
| Rate for Payer: UHCCP Medicaid |
$365.30
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$73,615.00 |
| Rate for Payer: Aetna Commercial |
$537.33
|
| Rate for Payer: Aetna Medicare |
$417.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.43
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS MAPPO |
$400.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.92
|
| Rate for Payer: BCN Commercial |
$606.94
|
| 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 |
$741.83
|
| Rate for Payer: Healthscope Commercial |
$641.58
|
| Rate for Payer: Mclaren Medicaid |
$270.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.04
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,615.00
|
| 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 Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.62
|
| Rate for Payer: Priority Health Medicare |
$400.99
|
| Rate for Payer: Priority Health Narrow Network |
$671.62
|
| Rate for Payer: Priority Health SBD |
$671.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.99
|
| Rate for Payer: UHC Exchange |
$500.33
|
| Rate for Payer: UHC Medicare Advantage |
$400.99
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$140,717.00 |
| Rate for Payer: Aetna Commercial |
$1,025.54
|
| Rate for Payer: Aetna Medicare |
$795.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.08
|
| Rate for Payer: BCBS Complete |
$538.78
|
| Rate for Payer: BCBS MAPPO |
$765.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.63
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| 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: Mclaren Medicaid |
$513.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.60
|
| Rate for Payer: Meridian Medicaid |
$538.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,717.00
|
| 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 Choice Medicaid |
$513.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.44
|
| Rate for Payer: Priority Health Medicare |
$765.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.44
|
| Rate for Payer: Priority Health SBD |
$1,273.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$892.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.33
|
| Rate for Payer: UHC Exchange |
$892.60
|
| Rate for Payer: UHC Medicare Advantage |
$765.33
|
| Rate for Payer: UHCCP Medicaid |
$513.12
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 SQCM/</1% INFT/CHLD
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$126,293.00 |
| Rate for Payer: Aetna Commercial |
$918.62
|
| Rate for Payer: Aetna Medicare |
$712.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.18
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,219.74
|
| 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 |
$1,268.25
|
| Rate for Payer: Healthscope Commercial |
$1,096.86
|
| Rate for Payer: Mclaren Medicaid |
$459.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.82
|
| Rate for Payer: Meridian Medicaid |
$482.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126,293.00
|
| 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 Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$969.86
|
| Rate for Payer: Priority Health Medicare |
$685.54
|
| Rate for Payer: Priority Health Narrow Network |
$969.86
|
| Rate for Payer: Priority Health SBD |
$969.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.54
|
| Rate for Payer: UHC Exchange |
$857.39
|
| Rate for Payer: UHC Medicare Advantage |
$685.54
|
| Rate for Payer: UHCCP Medicaid |
$459.65
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/ULNA
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$406.19 |
| Max. Negotiated Rate |
$109,919.00 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$623.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.76
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$913.83
|
| 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: Mclaren Medicaid |
$406.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.10
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109,919.00
|
| 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 Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: Priority Health SBD |
$961.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.14
|
| Rate for Payer: UHC Exchange |
$838.63
|
| Rate for Payer: UHC Medicare Advantage |
$599.14
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$469.88 |
| Max. Negotiated Rate |
$127,769.00 |
| Rate for Payer: Aetna Commercial |
$931.55
|
| Rate for Payer: Aetna Medicare |
$723.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.55
|
| Rate for Payer: BCBS Complete |
$493.37
|
| Rate for Payer: BCBS MAPPO |
$695.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.37
|
| Rate for Payer: BCN Commercial |
$1,059.45
|
| 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 |
$1,286.10
|
| Rate for Payer: Healthscope Commercial |
$1,112.30
|
| Rate for Payer: Mclaren Medicaid |
$469.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.95
|
| Rate for Payer: Meridian Medicaid |
$493.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127,769.00
|
| 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 Choice Medicaid |
$469.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,112.88
|
| Rate for Payer: Priority Health Medicare |
$695.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.88
|
| Rate for Payer: Priority Health SBD |
$1,112.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.19
|
| Rate for Payer: UHC Exchange |
$820.30
|
| Rate for Payer: UHC Medicare Advantage |
$695.19
|
| Rate for Payer: UHCCP Medicaid |
$469.88
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$26,539.00 |
| Rate for Payer: Aetna Commercial |
$192.80
|
| Rate for Payer: Aetna Medicare |
$149.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.19
|
| Rate for Payer: BCBS Complete |
$99.30
|
| Rate for Payer: BCBS MAPPO |
$143.88
|
| Rate for Payer: BCBS Trust/PPO |
$439.02
|
| Rate for Payer: BCN Commercial |
$340.61
|
| 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: Mclaren Medicaid |
$94.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.07
|
| Rate for Payer: Meridian Medicaid |
$99.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,539.00
|
| 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 Choice Medicaid |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.26
|
| Rate for Payer: Priority Health Medicare |
$143.88
|
| Rate for Payer: Priority Health Narrow Network |
$207.26
|
| Rate for Payer: Priority Health SBD |
$207.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.88
|
| Rate for Payer: UHC Exchange |
$212.76
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
| Rate for Payer: UHCCP Medicaid |
$94.57
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$709.00 |
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.05
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$7.68
|
| Rate for Payer: BCBS Trust/PPO |
$6.75
|
| Rate for Payer: BCN Commercial |
$6.02
|
| Rate for Payer: BCN Medicare Advantage |
$7.68
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$11.05
|
| Rate for Payer: Cofinity Commercial |
$10.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.68
|
| Rate for Payer: Healthscope Commercial |
$12.28
|
| Rate for Payer: Healthscope Commercial |
$14.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$709.00
|
| Rate for Payer: Nomi Health Commercial |
$9.21
|
| Rate for Payer: PACE SWMI |
$7.68
|
| Rate for Payer: PHP Medicare Advantage |
$7.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$7.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.68
|
| Rate for Payer: UHC Exchange |
$6.85
|
| Rate for Payer: UHC Medicare Advantage |
$7.68
|
|
|
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 |
$237.50 |
| Max. Negotiated Rate |
$66,055.00 |
| Rate for Payer: Aetna Commercial |
$476.09
|
| Rate for Payer: Aetna Medicare |
$369.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.62
|
| Rate for Payer: BCBS Complete |
$249.38
|
| Rate for Payer: BCBS MAPPO |
$355.29
|
| Rate for Payer: BCBS Trust/PPO |
$947.77
|
| Rate for Payer: BCN Commercial |
$540.97
|
| 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 |
$511.62
|
| Rate for Payer: Cofinity Commercial |
$476.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$568.46
|
| Rate for Payer: Healthscope Commercial |
$657.29
|
| Rate for Payer: Mclaren Medicaid |
$237.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.05
|
| Rate for Payer: Meridian Medicaid |
$249.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,055.00
|
| 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 Choice Medicaid |
$237.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$664.01
|
| Rate for Payer: Priority Health Medicare |
$355.29
|
| Rate for Payer: Priority Health Narrow Network |
$664.01
|
| Rate for Payer: Priority Health SBD |
$664.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.29
|
| Rate for Payer: UHC Medicare Advantage |
$355.29
|
| Rate for Payer: UHCCP Medicaid |
$237.50
|
|
|
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 |
$301.82 |
| Max. Negotiated Rate |
$84,121.00 |
| Rate for Payer: Aetna Commercial |
$605.32
|
| Rate for Payer: Aetna Medicare |
$469.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.49
|
| Rate for Payer: BCBS Complete |
$316.91
|
| Rate for Payer: BCBS MAPPO |
$451.73
|
| Rate for Payer: BCBS Trust/PPO |
$841.58
|
| Rate for Payer: BCN Commercial |
$688.54
|
| 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 |
$722.77
|
| Rate for Payer: Healthscope Commercial |
$835.70
|
| Rate for Payer: Mclaren Medicaid |
$301.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.32
|
| Rate for Payer: Meridian Medicaid |
$316.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84,121.00
|
| 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 Choice Medicaid |
$301.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.37
|
| Rate for Payer: Priority Health Medicare |
$451.73
|
| Rate for Payer: Priority Health Narrow Network |
$845.37
|
| Rate for Payer: Priority Health SBD |
$845.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$451.73
|
| Rate for Payer: UHC Medicare Advantage |
$451.73
|
| Rate for Payer: UHCCP Medicaid |
$301.82
|
|
|
PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD
|
Professional
|
Both
|
$1,905.00
|
|
|
Service Code
|
HCPCS 43265
|
| Min. Negotiated Rate |
$271.15 |
| Max. Negotiated Rate |
$75,569.00 |
| Rate for Payer: Aetna Commercial |
$543.58
|
| Rate for Payer: Aetna Medicare |
$421.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.15
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS MAPPO |
$405.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.20
|
| Rate for Payer: BCN Commercial |
$618.67
|
| Rate for Payer: BCN Medicare Advantage |
$405.66
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cofinity Commercial |
$584.15
|
| Rate for Payer: Cofinity Commercial |
$543.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.66
|
| Rate for Payer: Healthscope Commercial |
$750.47
|
| Rate for Payer: Healthscope Commercial |
$649.06
|
| Rate for Payer: Mclaren Medicaid |
$271.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.94
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,569.00
|
| Rate for Payer: Nomi Health Commercial |
$486.79
|
| Rate for Payer: PACE SWMI |
$405.66
|
| Rate for Payer: PHP Medicare Advantage |
$405.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,238.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.06
|
| Rate for Payer: Priority Health Medicare |
$405.66
|
| Rate for Payer: Priority Health Narrow Network |
$760.06
|
| Rate for Payer: Priority Health SBD |
$760.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$710.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.66
|
| Rate for Payer: UHC Exchange |
$710.07
|
| Rate for Payer: UHC Medicare Advantage |
$405.66
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
|
|
PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43260
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$56,252.00 |
| Rate for Payer: Aetna Commercial |
$405.93
|
| Rate for Payer: Aetna Medicare |
$315.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.22
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$302.93
|
| Rate for Payer: BCBS Trust/PPO |
$949.92
|
| Rate for Payer: BCN Commercial |
$460.83
|
| Rate for Payer: BCN Medicare Advantage |
$302.93
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$405.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.93
|
| Rate for Payer: Healthscope Commercial |
$560.42
|
| Rate for Payer: Healthscope Commercial |
$484.69
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.08
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,252.00
|
| Rate for Payer: Nomi Health Commercial |
$363.52
|
| Rate for Payer: PACE SWMI |
$302.93
|
| Rate for Payer: PHP Medicare Advantage |
$302.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.76
|
| Rate for Payer: Priority Health Medicare |
$302.93
|
| Rate for Payer: Priority Health Narrow Network |
$566.76
|
| Rate for Payer: Priority Health SBD |
$566.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.93
|
| Rate for Payer: UHC Exchange |
$429.81
|
| Rate for Payer: UHC Medicare Advantage |
$302.93
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR ERCP,INSERT STENT,BILIARY/PANC
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 43268
|
| Min. Negotiated Rate |
$682.00 |
| Max. Negotiated Rate |
$1,108.25 |
| Rate for Payer: Aetna Medicare |
$852.50
|
| Rate for Payer: BCBS Complete |
$682.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,108.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.25
|
|
|
PR ERCP,NASOBILIARY DRAIN TUBE
|
Professional
|
Both
|
$1,649.00
|
|
|
Service Code
|
HCPCS 43267
|
| Min. Negotiated Rate |
$659.60 |
| Max. Negotiated Rate |
$1,071.85 |
| Rate for Payer: Aetna Medicare |
$824.50
|
| Rate for Payer: BCBS Complete |
$659.60
|
| Rate for Payer: Cash Price |
$1,319.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,071.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.85
|
|
