|
PR ETONOGESTREL IMPLANT SYSTEM
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS J7307
|
| Min. Negotiated Rate |
$681.50 |
| Max. Negotiated Rate |
$111,433.00 |
| Rate for Payer: Aetna Commercial |
$1,092.48
|
| Rate for Payer: Aetna Medicare |
$681.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.48
|
| Rate for Payer: BCBS Complete |
$1,351.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.77
|
| Rate for Payer: BCN Commercial |
$1,107.77
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Mclaren Medicaid |
$1,287.51
|
| Rate for Payer: Meridian Medicaid |
$1,351.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,433.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,287.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,326.13
|
| Rate for Payer: UHC Exchange |
$1,326.13
|
| Rate for Payer: UHCCP Medicaid |
$1,287.51
|
|
|
PR EUFLEXXA INJ PER DOSE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS J7323
|
| Min. Negotiated Rate |
$114.48 |
| Max. Negotiated Rate |
$12,314.00 |
| Rate for Payer: Aetna Commercial |
$153.41
|
| Rate for Payer: Aetna Medicare |
$119.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.85
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$114.48
|
| Rate for Payer: BCBS Trust/PPO |
$129.70
|
| Rate for Payer: BCN Commercial |
$137.68
|
| Rate for Payer: BCN Medicare Advantage |
$114.48
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$164.85
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.48
|
| Rate for Payer: Healthscope Commercial |
$211.79
|
| Rate for Payer: Healthscope Commercial |
$183.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,314.00
|
| Rate for Payer: Nomi Health Commercial |
$137.38
|
| Rate for Payer: PACE SWMI |
$114.48
|
| Rate for Payer: PHP Medicare Advantage |
$114.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health Medicare |
$114.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.48
|
| Rate for Payer: UHC Exchange |
$127.92
|
| Rate for Payer: UHC Medicare Advantage |
$114.48
|
|
|
PR EVACUATION SUBUNGUAL HEMATOMA
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 11740
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$5,521.00 |
| Rate for Payer: Aetna Commercial |
$40.86
|
| Rate for Payer: Aetna Medicare |
$31.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.91
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$30.49
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$43.91
|
| Rate for Payer: Cofinity Commercial |
$40.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.49
|
| Rate for Payer: Healthscope Commercial |
$56.41
|
| Rate for Payer: Healthscope Commercial |
$48.78
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.01
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,521.00
|
| Rate for Payer: Nomi Health Commercial |
$36.59
|
| Rate for Payer: PACE SWMI |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$30.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.80
|
| Rate for Payer: Priority Health Medicare |
$30.49
|
| Rate for Payer: Priority Health Narrow Network |
$43.80
|
| Rate for Payer: Priority Health SBD |
$43.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.49
|
| Rate for Payer: UHC Exchange |
$49.87
|
| Rate for Payer: UHC Medicare Advantage |
$30.49
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 92626
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$10,901.00 |
| Rate for Payer: Aetna Commercial |
$93.52
|
| Rate for Payer: Aetna Medicare |
$72.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.52
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$69.79
|
| Rate for Payer: BCN Commercial |
$126.57
|
| Rate for Payer: BCN Medicare Advantage |
$69.79
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.79
|
| Rate for Payer: Healthscope Commercial |
$129.11
|
| Rate for Payer: Healthscope Commercial |
$111.66
|
| Rate for Payer: Mclaren Medicaid |
$47.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.28
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,901.00
|
| Rate for Payer: Nomi Health Commercial |
$83.75
|
| Rate for Payer: PACE SWMI |
$69.79
|
| Rate for Payer: PHP Medicare Advantage |
$69.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.51
|
| Rate for Payer: Priority Health Medicare |
$69.79
|
| Rate for Payer: Priority Health Narrow Network |
$99.51
|
| Rate for Payer: Priority Health SBD |
$99.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.79
|
| Rate for Payer: UHC Exchange |
$85.05
|
| Rate for Payer: UHC Medicare Advantage |
$69.79
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 92627
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$2,565.00 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Medicare |
$17.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.56
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$16.36
|
| Rate for Payer: BCN Commercial |
$29.81
|
| Rate for Payer: BCN Medicare Advantage |
$16.36
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.36
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Commercial |
$26.18
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.18
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,565.00
|
| Rate for Payer: Nomi Health Commercial |
$19.63
|
| Rate for Payer: PACE SWMI |
$16.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.52
|
| Rate for Payer: Priority Health Medicare |
$16.36
|
| Rate for Payer: Priority Health Narrow Network |
$23.52
|
| Rate for Payer: Priority Health SBD |
$23.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.36
|
| Rate for Payer: UHC Exchange |
$21.57
|
| Rate for Payer: UHC Medicare Advantage |
$16.36
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 92620
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$11,612.00 |
| Rate for Payer: Aetna Commercial |
$99.83
|
| Rate for Payer: Aetna Medicare |
$77.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.83
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$74.50
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$129.01
|
| Rate for Payer: BCN Medicare Advantage |
$74.50
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$99.83
|
| Rate for Payer: Cofinity Commercial |
$107.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.50
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$137.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,612.00
|
| Rate for Payer: Nomi Health Commercial |
$89.40
|
| Rate for Payer: PACE SWMI |
$74.50
|
| Rate for Payer: PHP Medicare Advantage |
$74.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.84
|
| Rate for Payer: Priority Health Medicare |
$74.50
|
| Rate for Payer: Priority Health Narrow Network |
$105.84
|
| Rate for Payer: Priority Health SBD |
$105.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.50
|
| Rate for Payer: UHC Exchange |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$74.50
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 92621
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$2,714.00 |
| Rate for Payer: Aetna Commercial |
$23.57
|
| Rate for Payer: Aetna Medicare |
$18.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.33
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$17.59
|
| Rate for Payer: BCBS Trust/PPO |
$281.58
|
| Rate for Payer: BCN Commercial |
$31.76
|
| Rate for Payer: BCN Medicare Advantage |
$17.59
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$25.33
|
| Rate for Payer: Cofinity Commercial |
$23.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.59
|
| Rate for Payer: Healthscope Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$32.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,714.00
|
| Rate for Payer: Nomi Health Commercial |
$21.11
|
| Rate for Payer: PACE SWMI |
$17.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.88
|
| Rate for Payer: Priority Health Medicare |
$17.59
|
| Rate for Payer: Priority Health Narrow Network |
$24.88
|
| Rate for Payer: Priority Health SBD |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.59
|
| Rate for Payer: UHC Exchange |
$13.72
|
| Rate for Payer: UHC Medicare Advantage |
$17.59
|
|
|
PR EVAL OF ORTHOTIC/PROSTH USE, EA 15 MIN
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 97762
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
|
|
PR EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 92523
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$33,264.00 |
| Rate for Payer: Aetna Commercial |
$288.80
|
| Rate for Payer: Aetna Medicare |
$224.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.35
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS MAPPO |
$215.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.15
|
| Rate for Payer: BCN Commercial |
$331.82
|
| Rate for Payer: BCN Medicare Advantage |
$215.52
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$310.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.52
|
| Rate for Payer: Healthscope Commercial |
$398.71
|
| Rate for Payer: Healthscope Commercial |
$344.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,264.00
|
| Rate for Payer: Nomi Health Commercial |
$258.62
|
| Rate for Payer: PACE SWMI |
$215.52
|
| Rate for Payer: PHP Medicare Advantage |
$215.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.39
|
| Rate for Payer: Priority Health Medicare |
$215.52
|
| Rate for Payer: Priority Health Narrow Network |
$309.39
|
| Rate for Payer: Priority Health SBD |
$309.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.52
|
| Rate for Payer: UHC Medicare Advantage |
$215.52
|
|
|
PR EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 92521
|
| Min. Negotiated Rate |
$84.40 |
| Max. Negotiated Rate |
$19,401.00 |
| Rate for Payer: Aetna Commercial |
$168.73
|
| Rate for Payer: Aetna Medicare |
$130.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.32
|
| Rate for Payer: BCBS Complete |
$84.40
|
| Rate for Payer: BCBS MAPPO |
$125.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.71
|
| Rate for Payer: BCN Commercial |
$193.52
|
| Rate for Payer: BCN Medicare Advantage |
$125.92
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$181.32
|
| Rate for Payer: Cofinity Commercial |
$168.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.92
|
| Rate for Payer: Healthscope Commercial |
$201.47
|
| Rate for Payer: Healthscope Commercial |
$232.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,401.00
|
| Rate for Payer: Nomi Health Commercial |
$151.10
|
| Rate for Payer: PACE SWMI |
$125.92
|
| Rate for Payer: PHP Medicare Advantage |
$125.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.48
|
| Rate for Payer: Priority Health Medicare |
$125.92
|
| Rate for Payer: Priority Health Narrow Network |
$180.48
|
| Rate for Payer: Priority Health SBD |
$180.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.92
|
| Rate for Payer: UHC Medicare Advantage |
$125.92
|
|
|
PR EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 92522
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$16,256.00 |
| Rate for Payer: Aetna Commercial |
$140.77
|
| Rate for Payer: Aetna Medicare |
$109.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.27
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS MAPPO |
$105.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.15
|
| Rate for Payer: BCN Commercial |
$161.75
|
| Rate for Payer: BCN Medicare Advantage |
$105.05
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$151.27
|
| Rate for Payer: Cofinity Commercial |
$140.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.05
|
| Rate for Payer: Healthscope Commercial |
$168.08
|
| Rate for Payer: Healthscope Commercial |
$194.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,256.00
|
| Rate for Payer: Nomi Health Commercial |
$126.06
|
| Rate for Payer: PACE SWMI |
$105.05
|
| Rate for Payer: PHP Medicare Advantage |
$105.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.07
|
| Rate for Payer: Priority Health Medicare |
$105.05
|
| Rate for Payer: Priority Health Narrow Network |
$151.07
|
| Rate for Payer: Priority Health SBD |
$151.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.05
|
| Rate for Payer: UHC Medicare Advantage |
$105.05
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 61650
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$103,010.00 |
| Rate for Payer: Aetna Commercial |
$770.85
|
| Rate for Payer: Aetna Medicare |
$598.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.37
|
| Rate for Payer: BCBS Complete |
$393.84
|
| Rate for Payer: BCBS MAPPO |
$575.26
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$832.21
|
| Rate for Payer: BCN Medicare Advantage |
$575.26
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$828.37
|
| Rate for Payer: Cofinity Commercial |
$770.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.26
|
| Rate for Payer: Healthscope Commercial |
$1,064.23
|
| Rate for Payer: Healthscope Commercial |
$920.42
|
| Rate for Payer: Mclaren Medicaid |
$375.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.02
|
| Rate for Payer: Meridian Medicaid |
$393.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103,010.00
|
| Rate for Payer: Nomi Health Commercial |
$690.31
|
| Rate for Payer: PACE SWMI |
$575.26
|
| Rate for Payer: PHP Medicare Advantage |
$575.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.71
|
| Rate for Payer: Priority Health Medicare |
$575.26
|
| Rate for Payer: Priority Health Narrow Network |
$990.71
|
| Rate for Payer: Priority Health SBD |
$990.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.26
|
| Rate for Payer: UHC Medicare Advantage |
$575.26
|
| Rate for Payer: UHCCP Medicaid |
$375.09
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 61651
|
| Min. Negotiated Rate |
$160.18 |
| Max. Negotiated Rate |
$44,366.00 |
| Rate for Payer: Aetna Commercial |
$329.12
|
| Rate for Payer: Aetna Medicare |
$255.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.68
|
| Rate for Payer: BCBS Complete |
$168.19
|
| Rate for Payer: BCBS MAPPO |
$245.61
|
| Rate for Payer: BCBS Trust/PPO |
$301.13
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$245.61
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$353.68
|
| Rate for Payer: Cofinity Commercial |
$329.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.61
|
| Rate for Payer: Healthscope Commercial |
$392.98
|
| Rate for Payer: Healthscope Commercial |
$454.38
|
| Rate for Payer: Mclaren Medicaid |
$160.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.89
|
| Rate for Payer: Meridian Medicaid |
$168.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,366.00
|
| Rate for Payer: Nomi Health Commercial |
$294.73
|
| Rate for Payer: PACE SWMI |
$245.61
|
| Rate for Payer: PHP Medicare Advantage |
$245.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.13
|
| Rate for Payer: Priority Health Medicare |
$245.61
|
| Rate for Payer: Priority Health Narrow Network |
$423.13
|
| Rate for Payer: Priority Health SBD |
$423.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.61
|
| Rate for Payer: UHC Medicare Advantage |
$245.61
|
| Rate for Payer: UHCCP Medicaid |
$160.18
|
|
|
PR EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 34808
|
| Min. Negotiated Rate |
$125.88 |
| Max. Negotiated Rate |
$35,953.00 |
| Rate for Payer: Aetna Commercial |
$260.72
|
| Rate for Payer: Aetna Medicare |
$202.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.18
|
| Rate for Payer: BCBS Complete |
$132.17
|
| Rate for Payer: BCBS MAPPO |
$194.57
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$194.57
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$280.18
|
| Rate for Payer: Cofinity Commercial |
$260.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.57
|
| Rate for Payer: Healthscope Commercial |
$359.95
|
| Rate for Payer: Healthscope Commercial |
$311.31
|
| Rate for Payer: Mclaren Medicaid |
$125.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.30
|
| Rate for Payer: Meridian Medicaid |
$132.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,953.00
|
| Rate for Payer: Nomi Health Commercial |
$233.48
|
| Rate for Payer: PACE SWMI |
$194.57
|
| Rate for Payer: PHP Medicare Advantage |
$194.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.31
|
| Rate for Payer: Priority Health Medicare |
$194.57
|
| Rate for Payer: Priority Health Narrow Network |
$314.31
|
| Rate for Payer: Priority Health SBD |
$314.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.57
|
| Rate for Payer: UHC Exchange |
$282.54
|
| Rate for Payer: UHC Medicare Advantage |
$194.57
|
| Rate for Payer: UHCCP Medicaid |
$125.88
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT
|
Professional
|
Both
|
$2,588.00
|
|
|
Service Code
|
HCPCS 34701
|
| Min. Negotiated Rate |
$772.13 |
| Max. Negotiated Rate |
$218,918.00 |
| Rate for Payer: Aetna Commercial |
$1,587.82
|
| Rate for Payer: Aetna Medicare |
$1,232.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,706.31
|
| Rate for Payer: BCBS Complete |
$810.74
|
| Rate for Payer: BCBS MAPPO |
$1,184.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
| Rate for Payer: BCN Commercial |
$1,763.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.94
|
| Rate for Payer: Cash Price |
$2,070.40
|
| Rate for Payer: Cash Price |
$2,070.40
|
| Rate for Payer: Cofinity Commercial |
$1,706.31
|
| Rate for Payer: Cofinity Commercial |
$1,587.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.94
|
| Rate for Payer: Healthscope Commercial |
$1,895.90
|
| Rate for Payer: Healthscope Commercial |
$2,192.14
|
| Rate for Payer: Mclaren Medicaid |
$772.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,244.19
|
| Rate for Payer: Meridian Medicaid |
$810.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,918.00
|
| Rate for Payer: Nomi Health Commercial |
$1,421.93
|
| Rate for Payer: PACE SWMI |
$1,184.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.42
|
| Rate for Payer: Priority Health Medicare |
$1,184.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.42
|
| Rate for Payer: Priority Health SBD |
$1,920.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.94
|
| Rate for Payer: UHCCP Medicaid |
$772.13
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT
|
Professional
|
Both
|
$3,913.00
|
|
|
Service Code
|
HCPCS 34702
|
| Min. Negotiated Rate |
$1,119.53 |
| Max. Negotiated Rate |
$327,233.00 |
| Rate for Payer: Aetna Commercial |
$2,315.02
|
| Rate for Payer: Aetna Medicare |
$1,796.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,315.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,487.79
|
| Rate for Payer: BCBS Complete |
$1,175.51
|
| Rate for Payer: BCBS MAPPO |
$1,727.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,005.96
|
| Rate for Payer: BCN Commercial |
$2,630.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,727.63
|
| Rate for Payer: Cash Price |
$3,130.40
|
| Rate for Payer: Cash Price |
$3,130.40
|
| Rate for Payer: Cofinity Commercial |
$2,487.79
|
| Rate for Payer: Cofinity Commercial |
$2,315.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,727.63
|
| Rate for Payer: Healthscope Commercial |
$2,764.21
|
| Rate for Payer: Healthscope Commercial |
$3,196.12
|
| Rate for Payer: Mclaren Medicaid |
$1,119.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,814.01
|
| Rate for Payer: Meridian Medicaid |
$1,175.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327,233.00
|
| Rate for Payer: Nomi Health Commercial |
$2,073.16
|
| Rate for Payer: PACE SWMI |
$1,727.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,727.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,119.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,543.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,868.12
|
| Rate for Payer: Priority Health Medicare |
$1,727.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,868.12
|
| Rate for Payer: Priority Health SBD |
$2,868.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,727.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,727.63
|
| Rate for Payer: UHCCP Medicaid |
$1,119.53
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT
|
Professional
|
Both
|
$3,166.00
|
|
|
Service Code
|
HCPCS 34705
|
| Min. Negotiated Rate |
$950.83 |
| Max. Negotiated Rate |
$270,331.00 |
| Rate for Payer: Aetna Commercial |
$1,957.42
|
| Rate for Payer: Aetna Medicare |
$1,519.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,957.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,103.49
|
| Rate for Payer: BCBS Complete |
$998.37
|
| Rate for Payer: BCBS MAPPO |
$1,460.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,747.37
|
| Rate for Payer: BCN Commercial |
$2,174.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,460.76
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cofinity Commercial |
$2,103.49
|
| Rate for Payer: Cofinity Commercial |
$1,957.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,460.76
|
| Rate for Payer: Healthscope Commercial |
$2,337.22
|
| Rate for Payer: Healthscope Commercial |
$2,702.41
|
| Rate for Payer: Mclaren Medicaid |
$950.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,533.80
|
| Rate for Payer: Meridian Medicaid |
$998.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270,331.00
|
| Rate for Payer: Nomi Health Commercial |
$1,752.91
|
| Rate for Payer: PACE SWMI |
$1,460.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,460.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$950.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,371.93
|
| Rate for Payer: Priority Health Medicare |
$1,460.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,371.93
|
| Rate for Payer: Priority Health SBD |
$2,371.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,460.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,460.76
|
| Rate for Payer: UHCCP Medicaid |
$950.83
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT
|
Professional
|
Both
|
$4,840.00
|
|
|
Service Code
|
HCPCS 34706
|
| Min. Negotiated Rate |
$1,419.65 |
| Max. Negotiated Rate |
$403,616.00 |
| Rate for Payer: Aetna Commercial |
$2,928.93
|
| Rate for Payer: Aetna Medicare |
$2,273.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,928.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,147.51
|
| Rate for Payer: BCBS Complete |
$1,490.63
|
| Rate for Payer: BCBS MAPPO |
$2,185.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,686.93
|
| Rate for Payer: BCN Commercial |
$3,239.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,185.77
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cofinity Commercial |
$3,147.51
|
| Rate for Payer: Cofinity Commercial |
$2,928.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,185.77
|
| Rate for Payer: Healthscope Commercial |
$3,497.23
|
| Rate for Payer: Healthscope Commercial |
$4,043.67
|
| Rate for Payer: Mclaren Medicaid |
$1,419.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,295.06
|
| Rate for Payer: Meridian Medicaid |
$1,490.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403,616.00
|
| Rate for Payer: Nomi Health Commercial |
$2,622.92
|
| Rate for Payer: PACE SWMI |
$2,185.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,185.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,419.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,146.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,535.04
|
| Rate for Payer: Priority Health Medicare |
$2,185.77
|
| Rate for Payer: Priority Health Narrow Network |
$3,535.04
|
| Rate for Payer: Priority Health SBD |
$3,535.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,185.77
|
| Rate for Payer: UHC Medicare Advantage |
$2,185.77
|
| Rate for Payer: UHCCP Medicaid |
$1,419.65
|
|
|
PR EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 34703
|
| Min. Negotiated Rate |
$855.62 |
| Max. Negotiated Rate |
$243,677.00 |
| Rate for Payer: Aetna Commercial |
$1,761.51
|
| Rate for Payer: Aetna Medicare |
$1,367.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,892.97
|
| Rate for Payer: BCBS Complete |
$898.40
|
| Rate for Payer: BCBS MAPPO |
$1,314.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.14
|
| Rate for Payer: BCN Commercial |
$1,960.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,314.56
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,892.97
|
| Rate for Payer: Cofinity Commercial |
$1,761.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,314.56
|
| Rate for Payer: Healthscope Commercial |
$2,103.30
|
| Rate for Payer: Healthscope Commercial |
$2,431.94
|
| Rate for Payer: Mclaren Medicaid |
$855.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,380.29
|
| Rate for Payer: Meridian Medicaid |
$898.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243,677.00
|
| Rate for Payer: Nomi Health Commercial |
$1,577.47
|
| Rate for Payer: PACE SWMI |
$1,314.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,314.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,133.15
|
| Rate for Payer: Priority Health Medicare |
$1,314.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,133.15
|
| Rate for Payer: Priority Health SBD |
$2,133.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,314.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,314.56
|
| Rate for Payer: UHCCP Medicaid |
$855.62
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT
|
Professional
|
Both
|
$2,414.00
|
|
|
Service Code
|
HCPCS 34707
|
| Min. Negotiated Rate |
$725.48 |
| Max. Negotiated Rate |
$206,383.00 |
| Rate for Payer: Aetna Commercial |
$1,491.27
|
| Rate for Payer: Aetna Medicare |
$1,157.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,491.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,602.56
|
| Rate for Payer: BCBS Complete |
$761.75
|
| Rate for Payer: BCBS MAPPO |
$1,112.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,209.35
|
| Rate for Payer: BCN Commercial |
$1,662.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.89
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,602.56
|
| Rate for Payer: Cofinity Commercial |
$1,491.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.89
|
| Rate for Payer: Healthscope Commercial |
$1,780.62
|
| Rate for Payer: Healthscope Commercial |
$2,058.85
|
| Rate for Payer: Mclaren Medicaid |
$725.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,168.53
|
| Rate for Payer: Meridian Medicaid |
$761.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206,383.00
|
| Rate for Payer: Nomi Health Commercial |
$1,335.47
|
| Rate for Payer: PACE SWMI |
$1,112.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,803.95
|
| Rate for Payer: Priority Health Medicare |
$1,112.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,803.95
|
| Rate for Payer: Priority Health SBD |
$1,803.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,112.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,112.89
|
| Rate for Payer: UHCCP Medicaid |
$725.48
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT
|
Professional
|
Both
|
$3,899.00
|
|
|
Service Code
|
HCPCS 34708
|
| Min. Negotiated Rate |
$1,134.44 |
| Max. Negotiated Rate |
$322,965.00 |
| Rate for Payer: Aetna Commercial |
$2,345.95
|
| Rate for Payer: Aetna Medicare |
$1,820.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,345.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,521.02
|
| Rate for Payer: BCBS Complete |
$1,191.16
|
| Rate for Payer: BCBS MAPPO |
$1,750.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.88
|
| Rate for Payer: BCN Commercial |
$2,587.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,750.71
|
| Rate for Payer: Cash Price |
$3,119.20
|
| Rate for Payer: Cash Price |
$3,119.20
|
| Rate for Payer: Cofinity Commercial |
$2,521.02
|
| Rate for Payer: Cofinity Commercial |
$2,345.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,750.71
|
| Rate for Payer: Healthscope Commercial |
$2,801.14
|
| Rate for Payer: Healthscope Commercial |
$3,238.81
|
| Rate for Payer: Mclaren Medicaid |
$1,134.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,838.25
|
| Rate for Payer: Meridian Medicaid |
$1,191.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322,965.00
|
| Rate for Payer: Nomi Health Commercial |
$2,100.85
|
| Rate for Payer: PACE SWMI |
$1,750.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,750.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,134.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,827.72
|
| Rate for Payer: Priority Health Medicare |
$1,750.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,827.72
|
| Rate for Payer: Priority Health SBD |
$2,827.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,750.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,750.71
|
| Rate for Payer: UHCCP Medicaid |
$1,134.44
|
|
|
PR EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH
|
Professional
|
Both
|
$8,245.00
|
|
|
Service Code
|
HCPCS 33880
|
| Min. Negotiated Rate |
$649.81 |
| Max. Negotiated Rate |
$317,234.00 |
| Rate for Payer: Aetna Commercial |
$2,291.68
|
| Rate for Payer: Aetna Medicare |
$1,778.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,291.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,462.70
|
| Rate for Payer: BCBS Complete |
$1,169.24
|
| Rate for Payer: BCBS MAPPO |
$1,710.21
|
| Rate for Payer: BCBS Trust/PPO |
$649.81
|
| Rate for Payer: BCN Commercial |
$2,552.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,710.21
|
| Rate for Payer: Cash Price |
$6,596.00
|
| Rate for Payer: Cash Price |
$6,596.00
|
| Rate for Payer: Cofinity Commercial |
$2,462.70
|
| Rate for Payer: Cofinity Commercial |
$2,291.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,710.21
|
| Rate for Payer: Healthscope Commercial |
$3,163.89
|
| Rate for Payer: Healthscope Commercial |
$2,736.34
|
| Rate for Payer: Mclaren Medicaid |
$1,113.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,795.72
|
| Rate for Payer: Meridian Medicaid |
$1,169.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317,234.00
|
| Rate for Payer: Nomi Health Commercial |
$2,052.25
|
| Rate for Payer: PACE SWMI |
$1,710.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,710.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,113.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,359.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,779.31
|
| Rate for Payer: Priority Health Medicare |
$1,710.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,779.31
|
| Rate for Payer: Priority Health SBD |
$2,779.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,992.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,710.21
|
| Rate for Payer: UHC Exchange |
$1,992.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.21
|
| Rate for Payer: UHCCP Medicaid |
$1,113.56
|
|
|
PR EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN
|
Professional
|
Both
|
$5,504.00
|
|
|
Service Code
|
HCPCS 33881
|
| Min. Negotiated Rate |
$924.53 |
| Max. Negotiated Rate |
$271,737.00 |
| Rate for Payer: Aetna Commercial |
$1,967.96
|
| Rate for Payer: Aetna Medicare |
$1,527.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,967.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,114.83
|
| Rate for Payer: BCBS Complete |
$1,004.41
|
| Rate for Payer: BCBS MAPPO |
$1,468.63
|
| Rate for Payer: BCBS Trust/PPO |
$924.53
|
| Rate for Payer: BCN Commercial |
$2,187.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,468.63
|
| Rate for Payer: Cash Price |
$4,403.20
|
| Rate for Payer: Cash Price |
$4,403.20
|
| Rate for Payer: Cofinity Commercial |
$2,114.83
|
| Rate for Payer: Cofinity Commercial |
$1,967.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,468.63
|
| Rate for Payer: Healthscope Commercial |
$2,716.97
|
| Rate for Payer: Healthscope Commercial |
$2,349.81
|
| Rate for Payer: Mclaren Medicaid |
$956.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,542.06
|
| Rate for Payer: Meridian Medicaid |
$1,004.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271,737.00
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: PACE SWMI |
$1,468.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,468.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,577.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.37
|
| Rate for Payer: Priority Health Medicare |
$1,468.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,387.37
|
| Rate for Payer: Priority Health SBD |
$2,387.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,468.63
|
| Rate for Payer: UHC Exchange |
$1,709.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,468.63
|
| Rate for Payer: UHCCP Medicaid |
$956.58
|
|
|
PR EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI
|
Professional
|
Both
|
$959.00
|
|
|
Service Code
|
HCPCS 0254T
|
| Min. Negotiated Rate |
$383.60 |
| Max. Negotiated Rate |
$623.35 |
| Rate for Payer: Aetna Medicare |
$479.50
|
| Rate for Payer: BCBS Complete |
$383.60
|
| Rate for Payer: Cash Price |
$767.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.35
|
|
|
PR EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$2,162.00
|
|
|
Service Code
|
HCPCS 34718
|
| Min. Negotiated Rate |
$770.63 |
| Max. Negotiated Rate |
$218,686.00 |
| Rate for Payer: Aetna Commercial |
$1,587.52
|
| Rate for Payer: Aetna Medicare |
$1,232.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,706.00
|
| Rate for Payer: BCBS Complete |
$809.16
|
| Rate for Payer: BCBS MAPPO |
$1,184.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.62
|
| Rate for Payer: BCN Commercial |
$1,758.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.72
|
| Rate for Payer: Cash Price |
$1,729.60
|
| Rate for Payer: Cash Price |
$1,729.60
|
| Rate for Payer: Cofinity Commercial |
$1,706.00
|
| Rate for Payer: Cofinity Commercial |
$1,587.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.72
|
| Rate for Payer: Healthscope Commercial |
$1,895.55
|
| Rate for Payer: Healthscope Commercial |
$2,191.73
|
| Rate for Payer: Mclaren Medicaid |
$770.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.96
|
| Rate for Payer: Meridian Medicaid |
$809.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,686.00
|
| Rate for Payer: Nomi Health Commercial |
$1,421.66
|
| Rate for Payer: PACE SWMI |
$1,184.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,405.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,924.14
|
| Rate for Payer: Priority Health Medicare |
$1,184.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,924.14
|
| Rate for Payer: Priority Health SBD |
$1,924.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.72
|
| Rate for Payer: UHCCP Medicaid |
$770.63
|
|
