|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$243.02
|
| Rate for Payer: Aetna Medicare |
$188.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.16
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$181.36
|
| Rate for Payer: BCN Commercial |
$305.26
|
| Rate for Payer: BCN Medicare Advantage |
$181.36
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Cofinity Commercial |
$243.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.36
|
| Rate for Payer: Healthscope Commercial |
$335.52
|
| Rate for Payer: Healthscope Commercial |
$290.18
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.43
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.46
|
| Rate for Payer: Nomi Health Commercial |
$217.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: PACE SWMI |
$181.36
|
| Rate for Payer: PHP Medicare Advantage |
$181.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.93
|
| Rate for Payer: Priority Health Medicare |
$181.36
|
| Rate for Payer: Priority Health SBD |
$371.93
|
| Rate for Payer: Priority Health Tiered Network |
$371.93
|
| Rate for Payer: Railroad Medicare Medicare |
$181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.33
|
| Rate for Payer: UHC Core |
$363.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.36
|
| Rate for Payer: UHC Exchange |
$363.33
|
| Rate for Payer: UHC Medicaid |
$120.35
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$333.94 |
| Rate for Payer: Aetna Commercial |
$224.88
|
| Rate for Payer: Aetna Medicare |
$174.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.66
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$167.82
|
| Rate for Payer: BCN Commercial |
$285.34
|
| Rate for Payer: BCN Medicare Advantage |
$167.82
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$224.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.82
|
| Rate for Payer: Healthscope Commercial |
$310.47
|
| Rate for Payer: Healthscope Commercial |
$268.51
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.21
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.94
|
| Rate for Payer: Nomi Health Commercial |
$201.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$167.82
|
| Rate for Payer: PHP Medicare Advantage |
$167.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$310.84
|
| Rate for Payer: Priority Health Medicare |
$167.82
|
| Rate for Payer: Priority Health SBD |
$310.84
|
| Rate for Payer: Priority Health Tiered Network |
$310.84
|
| Rate for Payer: Railroad Medicare Medicare |
$167.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Core |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.82
|
| Rate for Payer: UHC Exchange |
$330.51
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$320.09 |
| Rate for Payer: Aetna Commercial |
$218.33
|
| Rate for Payer: Aetna Medicare |
$169.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.62
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$162.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$162.93
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$234.62
|
| Rate for Payer: Cofinity Commercial |
$218.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.93
|
| Rate for Payer: Healthscope Commercial |
$301.42
|
| Rate for Payer: Healthscope Commercial |
$260.69
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.08
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.09
|
| Rate for Payer: Nomi Health Commercial |
$195.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.25
|
| Rate for Payer: PACE SWMI |
$162.93
|
| Rate for Payer: PHP Medicare Advantage |
$162.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$297.81
|
| Rate for Payer: Priority Health Medicare |
$162.93
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$297.81
|
| Rate for Payer: Railroad Medicare Medicare |
$162.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.16
|
| Rate for Payer: UHC Core |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.93
|
| Rate for Payer: UHC Exchange |
$318.16
|
| Rate for Payer: UHC Medicaid |
$105.65
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$116.30
|
| Rate for Payer: Aetna Medicare |
$90.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.98
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$86.79
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: BCN Medicare Advantage |
$86.79
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$124.98
|
| Rate for Payer: Cofinity Commercial |
$116.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.79
|
| Rate for Payer: Healthscope Commercial |
$160.56
|
| Rate for Payer: Healthscope Commercial |
$138.86
|
| Rate for Payer: Mclaren Medicaid |
$56.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.13
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.06
|
| Rate for Payer: Nomi Health Commercial |
$104.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$86.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.49
|
| Rate for Payer: Priority Health Medicare |
$86.79
|
| Rate for Payer: Priority Health SBD |
$159.49
|
| Rate for Payer: Priority Health Tiered Network |
$159.49
|
| Rate for Payer: Railroad Medicare Medicare |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.98
|
| Rate for Payer: UHC Core |
$175.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.79
|
| Rate for Payer: UHC Exchange |
$175.98
|
| Rate for Payer: UHC Medicaid |
$56.02
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$81.45
|
| Rate for Payer: Aetna Medicare |
$63.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.52
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$60.78
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$60.78
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$87.52
|
| Rate for Payer: Cofinity Commercial |
$81.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.78
|
| Rate for Payer: Healthscope Commercial |
$97.25
|
| Rate for Payer: Healthscope Commercial |
$112.44
|
| Rate for Payer: Mclaren Medicaid |
$38.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.82
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.23
|
| Rate for Payer: Nomi Health Commercial |
$72.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$60.78
|
| Rate for Payer: PHP Medicare Advantage |
$60.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$125.60
|
| Rate for Payer: Priority Health Medicare |
$60.78
|
| Rate for Payer: Priority Health SBD |
$125.60
|
| Rate for Payer: Priority Health Tiered Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$60.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.22
|
| Rate for Payer: UHC Core |
$126.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.78
|
| Rate for Payer: UHC Exchange |
$126.22
|
| Rate for Payer: UHC Medicaid |
$38.77
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$691.96 |
| Rate for Payer: Aetna Commercial |
$482.49
|
| Rate for Payer: Aetna Medicare |
$374.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.50
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$360.07
|
| Rate for Payer: BCN Commercial |
$591.11
|
| Rate for Payer: BCN Medicare Advantage |
$360.07
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$518.50
|
| Rate for Payer: Cofinity Commercial |
$482.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.07
|
| Rate for Payer: Healthscope Commercial |
$666.13
|
| Rate for Payer: Healthscope Commercial |
$576.11
|
| Rate for Payer: Mclaren Medicaid |
$234.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.07
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.96
|
| Rate for Payer: Nomi Health Commercial |
$432.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$560.25
|
| Rate for Payer: PACE SWMI |
$360.07
|
| Rate for Payer: PHP Medicare Advantage |
$360.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$643.90
|
| Rate for Payer: Priority Health Medicare |
$360.07
|
| Rate for Payer: Priority Health SBD |
$643.90
|
| Rate for Payer: Priority Health Tiered Network |
$643.90
|
| Rate for Payer: Railroad Medicare Medicare |
$360.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$690.10
|
| Rate for Payer: UHC Core |
$690.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.07
|
| Rate for Payer: UHC Exchange |
$690.10
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$3,224.30 |
| Rate for Payer: Aetna Commercial |
$2,159.03
|
| Rate for Payer: Aetna Medicare |
$1,675.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,159.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.16
|
| Rate for Payer: BCBS Complete |
$1,094.77
|
| Rate for Payer: BCBS MAPPO |
$1,611.22
|
| Rate for Payer: BCN Commercial |
$2,646.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,611.22
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,320.16
|
| Rate for Payer: Cofinity Commercial |
$2,159.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,611.22
|
| Rate for Payer: Healthscope Commercial |
$2,980.76
|
| Rate for Payer: Healthscope Commercial |
$2,577.95
|
| Rate for Payer: Mclaren Medicaid |
$1,042.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,691.78
|
| Rate for Payer: Meridian Medicaid |
$1,094.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,772.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,144.51
|
| Rate for Payer: Nomi Health Commercial |
$1,933.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,514.00
|
| Rate for Payer: PACE SWMI |
$1,611.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,611.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,042.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,224.30
|
| Rate for Payer: Priority Health Medicare |
$1,611.22
|
| Rate for Payer: Priority Health SBD |
$3,224.30
|
| Rate for Payer: Priority Health Tiered Network |
$3,224.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,611.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,162.57
|
| Rate for Payer: UHC Core |
$3,162.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,611.22
|
| Rate for Payer: UHC Exchange |
$3,162.57
|
| Rate for Payer: UHC Medicaid |
$1,042.64
|
| Rate for Payer: UHCCP Medicaid |
$1,042.64
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,524.00
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,244.56 |
| Max. Negotiated Rate |
$3,737.69 |
| Rate for Payer: Aetna Commercial |
$2,622.96
|
| Rate for Payer: Aetna Medicare |
$2,035.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,622.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,818.70
|
| Rate for Payer: BCBS Complete |
$1,306.79
|
| Rate for Payer: BCBS MAPPO |
$1,957.43
|
| Rate for Payer: BCN Commercial |
$3,072.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,957.43
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cofinity Commercial |
$2,818.70
|
| Rate for Payer: Cofinity Commercial |
$2,622.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,957.43
|
| Rate for Payer: Healthscope Commercial |
$3,621.25
|
| Rate for Payer: Healthscope Commercial |
$3,131.89
|
| Rate for Payer: Mclaren Medicaid |
$1,244.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,055.30
|
| Rate for Payer: Meridian Medicaid |
$1,306.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,700.40
|
| Rate for Payer: Nomi Health Commercial |
$2,348.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: PACE SWMI |
$1,957.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,957.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,244.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,303.60
|
| Rate for Payer: Priority Health Medicare |
$1,957.43
|
| Rate for Payer: Priority Health SBD |
$3,303.60
|
| Rate for Payer: Priority Health Tiered Network |
$3,303.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,957.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,737.69
|
| Rate for Payer: UHC Core |
$3,737.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,957.43
|
| Rate for Payer: UHC Exchange |
$3,737.69
|
| Rate for Payer: UHC Medicaid |
$1,244.56
|
| Rate for Payer: UHCCP Medicaid |
$1,244.56
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,749.75 |
| Rate for Payer: Aetna Medicare |
$1,166.50
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,516.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.75
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,258.49 |
| Rate for Payer: Aetna Commercial |
$873.47
|
| Rate for Payer: Aetna Medicare |
$677.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.65
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$651.84
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: BCN Medicare Advantage |
$651.84
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$938.65
|
| Rate for Payer: Cofinity Commercial |
$873.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.84
|
| Rate for Payer: Healthscope Commercial |
$1,042.94
|
| Rate for Payer: Healthscope Commercial |
$1,205.90
|
| Rate for Payer: Mclaren Medicaid |
$423.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.43
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,258.49
|
| Rate for Payer: Nomi Health Commercial |
$782.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.75
|
| Rate for Payer: PACE SWMI |
$651.84
|
| Rate for Payer: PHP Medicare Advantage |
$651.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$983.58
|
| Rate for Payer: Priority Health Medicare |
$651.84
|
| Rate for Payer: Priority Health SBD |
$983.58
|
| Rate for Payer: Priority Health Tiered Network |
$983.58
|
| Rate for Payer: Railroad Medicare Medicare |
$651.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,231.66
|
| Rate for Payer: UHC Core |
$1,231.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.84
|
| Rate for Payer: UHC Exchange |
$1,231.66
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$542.72 |
| Max. Negotiated Rate |
$1,647.20 |
| Rate for Payer: Aetna Commercial |
$1,110.18
|
| Rate for Payer: Aetna Medicare |
$861.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.03
|
| Rate for Payer: BCBS Complete |
$569.86
|
| Rate for Payer: BCBS MAPPO |
$828.49
|
| Rate for Payer: BCN Commercial |
$1,412.78
|
| Rate for Payer: BCN Medicare Advantage |
$828.49
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$1,193.03
|
| Rate for Payer: Cofinity Commercial |
$1,110.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.49
|
| Rate for Payer: Healthscope Commercial |
$1,532.71
|
| Rate for Payer: Healthscope Commercial |
$1,325.58
|
| Rate for Payer: Mclaren Medicaid |
$542.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$869.91
|
| Rate for Payer: Meridian Medicaid |
$569.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$911.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.20
|
| Rate for Payer: Nomi Health Commercial |
$994.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,249.50
|
| Rate for Payer: PACE SWMI |
$828.49
|
| Rate for Payer: PHP Medicare Advantage |
$828.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,293.05
|
| Rate for Payer: Priority Health Medicare |
$828.49
|
| Rate for Payer: Priority Health SBD |
$1,293.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,293.05
|
| Rate for Payer: Railroad Medicare Medicare |
$828.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.22
|
| Rate for Payer: UHC Core |
$1,588.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$828.49
|
| Rate for Payer: UHC Exchange |
$1,588.22
|
| Rate for Payer: UHC Medicaid |
$542.72
|
| Rate for Payer: UHCCP Medicaid |
$542.72
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,453.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$931.45 |
| Max. Negotiated Rate |
$2,865.22 |
| Rate for Payer: Aetna Commercial |
$1,925.71
|
| Rate for Payer: Aetna Medicare |
$1,494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,925.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.42
|
| Rate for Payer: BCBS Complete |
$978.02
|
| Rate for Payer: BCBS MAPPO |
$1,437.10
|
| Rate for Payer: BCN Commercial |
$2,410.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,437.10
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cofinity Commercial |
$2,069.42
|
| Rate for Payer: Cofinity Commercial |
$1,925.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,437.10
|
| Rate for Payer: Healthscope Commercial |
$2,658.64
|
| Rate for Payer: Healthscope Commercial |
$2,299.36
|
| Rate for Payer: Mclaren Medicaid |
$931.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,508.95
|
| Rate for Payer: Meridian Medicaid |
$978.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,580.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,865.22
|
| Rate for Payer: Nomi Health Commercial |
$1,724.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,589.75
|
| Rate for Payer: PACE SWMI |
$1,437.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,437.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,205.98
|
| Rate for Payer: Priority Health Medicare |
$1,437.10
|
| Rate for Payer: Priority Health SBD |
$2,205.98
|
| Rate for Payer: Priority Health Tiered Network |
$2,205.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,437.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,858.61
|
| Rate for Payer: UHC Core |
$2,858.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,437.10
|
| Rate for Payer: UHC Exchange |
$2,858.61
|
| Rate for Payer: UHC Medicaid |
$931.45
|
| Rate for Payer: UHCCP Medicaid |
$931.45
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$552.31 |
| Max. Negotiated Rate |
$1,653.14 |
| Rate for Payer: Aetna Commercial |
$1,128.45
|
| Rate for Payer: Aetna Medicare |
$875.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,128.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.67
|
| Rate for Payer: BCBS Complete |
$579.93
|
| Rate for Payer: BCBS MAPPO |
$842.13
|
| Rate for Payer: BCN Commercial |
$1,432.20
|
| Rate for Payer: BCN Medicare Advantage |
$842.13
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,212.67
|
| Rate for Payer: Cofinity Commercial |
$1,128.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.13
|
| Rate for Payer: Healthscope Commercial |
$1,557.94
|
| Rate for Payer: Healthscope Commercial |
$1,347.41
|
| Rate for Payer: Mclaren Medicaid |
$552.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.24
|
| Rate for Payer: Meridian Medicaid |
$579.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$926.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,653.14
|
| Rate for Payer: Nomi Health Commercial |
$1,010.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,248.00
|
| Rate for Payer: PACE SWMI |
$842.13
|
| Rate for Payer: PHP Medicare Advantage |
$842.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,310.83
|
| Rate for Payer: Priority Health Medicare |
$842.13
|
| Rate for Payer: Priority Health SBD |
$1,310.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,310.83
|
| Rate for Payer: Railroad Medicare Medicare |
$842.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,597.58
|
| Rate for Payer: UHC Core |
$1,597.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$842.13
|
| Rate for Payer: UHC Exchange |
$1,597.58
|
| Rate for Payer: UHC Medicaid |
$552.31
|
| Rate for Payer: UHCCP Medicaid |
$552.31
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$371.47 |
| Max. Negotiated Rate |
$1,110.26 |
| Rate for Payer: Aetna Commercial |
$776.89
|
| Rate for Payer: Aetna Medicare |
$602.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.87
|
| Rate for Payer: BCBS Complete |
$390.04
|
| Rate for Payer: BCBS MAPPO |
$579.77
|
| Rate for Payer: BCN Commercial |
$935.71
|
| Rate for Payer: BCN Medicare Advantage |
$579.77
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$834.87
|
| Rate for Payer: Cofinity Commercial |
$776.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.77
|
| Rate for Payer: Healthscope Commercial |
$927.63
|
| Rate for Payer: Healthscope Commercial |
$1,072.57
|
| Rate for Payer: Mclaren Medicaid |
$371.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.76
|
| Rate for Payer: Meridian Medicaid |
$390.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,110.26
|
| Rate for Payer: Nomi Health Commercial |
$695.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.50
|
| Rate for Payer: PACE SWMI |
$579.77
|
| Rate for Payer: PHP Medicare Advantage |
$579.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,000.24
|
| Rate for Payer: Priority Health Medicare |
$579.77
|
| Rate for Payer: Priority Health SBD |
$1,000.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,000.24
|
| Rate for Payer: Railroad Medicare Medicare |
$579.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.54
|
| Rate for Payer: UHC Core |
$1,095.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.77
|
| Rate for Payer: UHC Exchange |
$1,095.54
|
| Rate for Payer: UHC Medicaid |
$371.47
|
| Rate for Payer: UHCCP Medicaid |
$371.47
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$751.25 |
| Max. Negotiated Rate |
$2,291.11 |
| Rate for Payer: Aetna Commercial |
$1,569.90
|
| Rate for Payer: Aetna Medicare |
$1,218.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,569.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.06
|
| Rate for Payer: BCBS Complete |
$788.81
|
| Rate for Payer: BCBS MAPPO |
$1,171.57
|
| Rate for Payer: BCN Commercial |
$1,880.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.57
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,687.06
|
| Rate for Payer: Cofinity Commercial |
$1,569.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.57
|
| Rate for Payer: Healthscope Commercial |
$2,167.40
|
| Rate for Payer: Healthscope Commercial |
$1,874.51
|
| Rate for Payer: Mclaren Medicaid |
$751.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.15
|
| Rate for Payer: Meridian Medicaid |
$788.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,241.04
|
| Rate for Payer: Nomi Health Commercial |
$1,405.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,426.50
|
| Rate for Payer: PACE SWMI |
$1,171.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,291.11
|
| Rate for Payer: Priority Health Medicare |
$1,171.57
|
| Rate for Payer: Priority Health SBD |
$2,291.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,291.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.83
|
| Rate for Payer: UHC Core |
$2,229.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,171.57
|
| Rate for Payer: UHC Exchange |
$2,229.83
|
| Rate for Payer: UHC Medicaid |
$751.25
|
| Rate for Payer: UHCCP Medicaid |
$751.25
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$153.60
|
| Rate for Payer: Aetna Medicare |
$119.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.07
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$114.63
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$114.63
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cofinity Commercial |
$165.07
|
| Rate for Payer: Cofinity Commercial |
$153.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.63
|
| Rate for Payer: Healthscope Commercial |
$212.07
|
| Rate for Payer: Healthscope Commercial |
$183.41
|
| Rate for Payer: Mclaren Medicaid |
$76.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.36
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.63
|
| Rate for Payer: Nomi Health Commercial |
$137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: PACE SWMI |
$114.63
|
| Rate for Payer: PHP Medicare Advantage |
$114.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.39
|
| Rate for Payer: Priority Health Medicare |
$114.63
|
| Rate for Payer: Priority Health SBD |
$192.39
|
| Rate for Payer: Priority Health Tiered Network |
$192.39
|
| Rate for Payer: Railroad Medicare Medicare |
$114.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.32
|
| Rate for Payer: UHC Core |
$213.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.63
|
| Rate for Payer: UHC Exchange |
$213.32
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$717.75 |
| Rate for Payer: Aetna Commercial |
$373.06
|
| Rate for Payer: Aetna Medicare |
$289.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.90
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$278.40
|
| Rate for Payer: BCN Commercial |
$471.59
|
| Rate for Payer: BCN Medicare Advantage |
$278.40
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$400.90
|
| Rate for Payer: Cofinity Commercial |
$373.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.40
|
| Rate for Payer: Healthscope Commercial |
$515.04
|
| Rate for Payer: Healthscope Commercial |
$445.44
|
| Rate for Payer: Mclaren Medicaid |
$180.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.32
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$561.53
|
| Rate for Payer: Nomi Health Commercial |
$334.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.75
|
| Rate for Payer: PACE SWMI |
$278.40
|
| Rate for Payer: PHP Medicare Advantage |
$278.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$477.61
|
| Rate for Payer: Priority Health Medicare |
$278.40
|
| Rate for Payer: Priority Health SBD |
$477.61
|
| Rate for Payer: Priority Health Tiered Network |
$477.61
|
| Rate for Payer: Railroad Medicare Medicare |
$278.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.74
|
| Rate for Payer: UHC Core |
$542.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.40
|
| Rate for Payer: UHC Exchange |
$542.74
|
| Rate for Payer: UHC Medicaid |
$180.41
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$1,005.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$753.75 |
| Rate for Payer: Aetna Commercial |
$437.48
|
| Rate for Payer: Aetna Medicare |
$339.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.13
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$326.48
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$326.48
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cofinity Commercial |
$470.13
|
| Rate for Payer: Cofinity Commercial |
$437.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.48
|
| Rate for Payer: Healthscope Commercial |
$603.99
|
| Rate for Payer: Healthscope Commercial |
$522.37
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.80
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$635.06
|
| Rate for Payer: Nomi Health Commercial |
$391.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.75
|
| Rate for Payer: PACE SWMI |
$326.48
|
| Rate for Payer: PHP Medicare Advantage |
$326.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$326.48
|
| Rate for Payer: Priority Health SBD |
$588.75
|
| Rate for Payer: Priority Health Tiered Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$326.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.29
|
| Rate for Payer: UHC Core |
$669.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.48
|
| Rate for Payer: UHC Exchange |
$669.29
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$1,456.94 |
| Rate for Payer: Aetna Commercial |
$992.38
|
| Rate for Payer: Aetna Medicare |
$770.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.38
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$740.58
|
| Rate for Payer: BCN Commercial |
$1,248.94
|
| Rate for Payer: BCN Medicare Advantage |
$740.58
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$992.38
|
| Rate for Payer: Cofinity Commercial |
$1,066.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.58
|
| Rate for Payer: Healthscope Commercial |
$1,370.07
|
| Rate for Payer: Healthscope Commercial |
$1,184.93
|
| Rate for Payer: Mclaren Medicaid |
$483.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.61
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,456.94
|
| Rate for Payer: Nomi Health Commercial |
$888.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,156.50
|
| Rate for Payer: PACE SWMI |
$740.58
|
| Rate for Payer: PHP Medicare Advantage |
$740.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,335.08
|
| Rate for Payer: Priority Health Medicare |
$740.58
|
| Rate for Payer: Priority Health SBD |
$1,335.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,335.08
|
| Rate for Payer: Railroad Medicare Medicare |
$740.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,415.18
|
| Rate for Payer: UHC Core |
$1,415.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.58
|
| Rate for Payer: UHC Exchange |
$1,415.18
|
| Rate for Payer: UHC Medicaid |
$483.72
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$932.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$936.47 |
| Rate for Payer: Aetna Commercial |
$659.87
|
| Rate for Payer: Aetna Medicare |
$512.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.11
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$492.44
|
| Rate for Payer: BCN Commercial |
$804.24
|
| Rate for Payer: BCN Medicare Advantage |
$492.44
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cofinity Commercial |
$709.11
|
| Rate for Payer: Cofinity Commercial |
$659.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.44
|
| Rate for Payer: Healthscope Commercial |
$911.01
|
| Rate for Payer: Healthscope Commercial |
$787.90
|
| Rate for Payer: Mclaren Medicaid |
$324.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.06
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$936.47
|
| Rate for Payer: Nomi Health Commercial |
$590.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$699.00
|
| Rate for Payer: PACE SWMI |
$492.44
|
| Rate for Payer: PHP Medicare Advantage |
$492.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$859.72
|
| Rate for Payer: Priority Health Medicare |
$492.44
|
| Rate for Payer: Priority Health SBD |
$859.72
|
| Rate for Payer: Priority Health Tiered Network |
$859.72
|
| Rate for Payer: Railroad Medicare Medicare |
$492.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.58
|
| Rate for Payer: UHC Core |
$903.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.44
|
| Rate for Payer: UHC Exchange |
$903.58
|
| Rate for Payer: UHC Medicaid |
$324.19
|
| Rate for Payer: UHCCP Medicaid |
$324.19
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$391.28 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$801.40
|
| Rate for Payer: Aetna Medicare |
$621.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.21
|
| Rate for Payer: BCBS Complete |
$410.84
|
| Rate for Payer: BCBS MAPPO |
$598.06
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: BCN Medicare Advantage |
$598.06
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$861.21
|
| Rate for Payer: Cofinity Commercial |
$801.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.06
|
| Rate for Payer: Healthscope Commercial |
$956.90
|
| Rate for Payer: Healthscope Commercial |
$1,106.41
|
| Rate for Payer: Mclaren Medicaid |
$391.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.96
|
| Rate for Payer: Meridian Medicaid |
$410.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,158.95
|
| Rate for Payer: Nomi Health Commercial |
$717.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.00
|
| Rate for Payer: PACE SWMI |
$598.06
|
| Rate for Payer: PHP Medicare Advantage |
$598.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,079.57
|
| Rate for Payer: Priority Health Medicare |
$598.06
|
| Rate for Payer: Priority Health SBD |
$1,079.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,079.57
|
| Rate for Payer: Railroad Medicare Medicare |
$598.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.12
|
| Rate for Payer: UHC Core |
$1,203.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$598.06
|
| Rate for Payer: UHC Exchange |
$1,203.12
|
| Rate for Payer: UHC Medicaid |
$391.28
|
| Rate for Payer: UHCCP Medicaid |
$391.28
|
|
|
PR EXCISION CHALAZION MULTIPLE SAME LID
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 67801
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$228.66 |
| Rate for Payer: Aetna Commercial |
$143.54
|
| Rate for Payer: Aetna Medicare |
$111.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.25
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$107.12
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$107.12
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$154.25
|
| Rate for Payer: Cofinity Commercial |
$143.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.12
|
| Rate for Payer: Healthscope Commercial |
$198.17
|
| Rate for Payer: Healthscope Commercial |
$171.39
|
| Rate for Payer: Mclaren Medicaid |
$70.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.48
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.24
|
| Rate for Payer: Nomi Health Commercial |
$128.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PACE SWMI |
$107.12
|
| Rate for Payer: PHP Medicare Advantage |
$107.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$228.66
|
| Rate for Payer: Priority Health Medicare |
$107.12
|
| Rate for Payer: Priority Health SBD |
$228.66
|
| Rate for Payer: Priority Health Tiered Network |
$228.66
|
| Rate for Payer: Railroad Medicare Medicare |
$107.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.78
|
| Rate for Payer: UHC Core |
$225.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.12
|
| Rate for Payer: UHC Exchange |
$225.78
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
|
PR EXCISION CHALAZION SINGLE
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 67800
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$112.64
|
| Rate for Payer: Aetna Medicare |
$87.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.05
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$84.06
|
| Rate for Payer: BCN Commercial |
$120.17
|
| Rate for Payer: BCN Medicare Advantage |
$84.06
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$121.05
|
| Rate for Payer: Cofinity Commercial |
$112.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$155.51
|
| Rate for Payer: Healthscope Commercial |
$134.50
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.26
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.02
|
| Rate for Payer: Nomi Health Commercial |
$100.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE SWMI |
$84.06
|
| Rate for Payer: PHP Medicare Advantage |
$84.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.49
|
| Rate for Payer: Priority Health Medicare |
$84.06
|
| Rate for Payer: Priority Health SBD |
$178.49
|
| Rate for Payer: Priority Health Tiered Network |
$178.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.31
|
| Rate for Payer: UHC Core |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.06
|
| Rate for Payer: UHC Exchange |
$175.31
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR EXCISION CHEST WALL TUMOR INCLUDING RIBS
|
Professional
|
Both
|
$2,512.00
|
|
|
Service Code
|
HCPCS 21601
|
| Min. Negotiated Rate |
$708.86 |
| Max. Negotiated Rate |
$2,080.14 |
| Rate for Payer: Aetna Commercial |
$1,470.38
|
| Rate for Payer: Aetna Medicare |
$1,141.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,470.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,580.11
|
| Rate for Payer: BCBS Complete |
$744.30
|
| Rate for Payer: BCBS MAPPO |
$1,097.30
|
| Rate for Payer: BCN Commercial |
$1,716.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.30
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Cofinity Commercial |
$1,580.11
|
| Rate for Payer: Cofinity Commercial |
$1,470.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.30
|
| Rate for Payer: Healthscope Commercial |
$2,030.01
|
| Rate for Payer: Healthscope Commercial |
$1,755.68
|
| Rate for Payer: Mclaren Medicaid |
$708.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.16
|
| Rate for Payer: Meridian Medicaid |
$744.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,207.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.01
|
| Rate for Payer: Nomi Health Commercial |
$1,316.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,884.00
|
| Rate for Payer: PACE SWMI |
$1,097.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$708.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,834.93
|
| Rate for Payer: Priority Health Medicare |
$1,097.30
|
| Rate for Payer: Priority Health SBD |
$1,834.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,834.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.14
|
| Rate for Payer: UHC Core |
$2,080.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.30
|
| Rate for Payer: UHC Exchange |
$2,080.14
|
| Rate for Payer: UHC Medicaid |
$708.86
|
| Rate for Payer: UHCCP Medicaid |
$708.86
|
|
|
PR EXCISION CHOLEDOCHAL CYST
|
Professional
|
Both
|
$2,376.00
|
|
|
Service Code
|
HCPCS 47715
|
| Min. Negotiated Rate |
$799.60 |
| Max. Negotiated Rate |
$2,436.13 |
| Rate for Payer: Aetna Commercial |
$1,670.06
|
| Rate for Payer: Aetna Medicare |
$1,296.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,670.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,794.69
|
| Rate for Payer: BCBS Complete |
$839.58
|
| Rate for Payer: BCBS MAPPO |
$1,246.31
|
| Rate for Payer: BCN Commercial |
$1,999.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.31
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cofinity Commercial |
$1,794.69
|
| Rate for Payer: Cofinity Commercial |
$1,670.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.31
|
| Rate for Payer: Healthscope Commercial |
$2,305.67
|
| Rate for Payer: Healthscope Commercial |
$1,994.10
|
| Rate for Payer: Mclaren Medicaid |
$799.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,308.63
|
| Rate for Payer: Meridian Medicaid |
$839.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,370.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,382.30
|
| Rate for Payer: Nomi Health Commercial |
$1,495.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,782.00
|
| Rate for Payer: PACE SWMI |
$1,246.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$799.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,436.13
|
| Rate for Payer: Priority Health Medicare |
$1,246.31
|
| Rate for Payer: Priority Health SBD |
$2,436.13
|
| Rate for Payer: Priority Health Tiered Network |
$2,436.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,246.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,375.55
|
| Rate for Payer: UHC Core |
$2,375.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,246.31
|
| Rate for Payer: UHC Exchange |
$2,375.55
|
| Rate for Payer: UHC Medicaid |
$799.60
|
| Rate for Payer: UHCCP Medicaid |
$799.60
|
|
