|
PR EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 44800
|
| Min. Negotiated Rate |
$332.30 |
| Max. Negotiated Rate |
$138,233.00 |
| Rate for Payer: Aetna Commercial |
$1,006.11
|
| Rate for Payer: Aetna Medicare |
$780.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.20
|
| Rate for Payer: BCBS Complete |
$525.13
|
| Rate for Payer: BCBS MAPPO |
$750.83
|
| Rate for Payer: BCBS Trust/PPO |
$332.30
|
| Rate for Payer: BCN Commercial |
$1,133.25
|
| Rate for Payer: BCN Medicare Advantage |
$750.83
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cofinity Commercial |
$1,081.20
|
| Rate for Payer: Cofinity Commercial |
$1,006.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.83
|
| Rate for Payer: Healthscope Commercial |
$1,389.04
|
| Rate for Payer: Healthscope Commercial |
$1,201.33
|
| Rate for Payer: Mclaren Medicaid |
$500.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.37
|
| Rate for Payer: Meridian Medicaid |
$525.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,233.00
|
| Rate for Payer: Nomi Health Commercial |
$901.00
|
| Rate for Payer: PACE SWMI |
$750.83
|
| Rate for Payer: PHP Medicare Advantage |
$750.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,397.22
|
| Rate for Payer: Priority Health Medicare |
$750.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,397.22
|
| Rate for Payer: Priority Health SBD |
$1,397.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$750.83
|
| Rate for Payer: UHC Exchange |
$795.05
|
| Rate for Payer: UHC Medicare Advantage |
$750.83
|
| Rate for Payer: UHCCP Medicaid |
$500.12
|
|
|
PR EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT
|
Facility
|
IP
|
$2,114.00
|
|
|
Service Code
|
CPT 44800
|
| Hospital Charge Code |
44800
|
| Min. Negotiated Rate |
$1,331.82 |
| Max. Negotiated Rate |
$1,902.60 |
| Rate for Payer: Aetna Commercial |
$1,796.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.10
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cofinity Commercial |
$1,479.80
|
| Rate for Payer: Cofinity Commercial |
$1,818.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,479.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.20
|
| Rate for Payer: Healthscope Commercial |
$1,902.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,796.90
|
| Rate for Payer: PHP Commercial |
$1,796.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.10
|
| Rate for Payer: Priority Health SBD |
$1,331.82
|
|
|
PR EXC MUCOSA VESTIBULE MOUTH AS DON GRF
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 40818
|
| Min. Negotiated Rate |
$170.40 |
| Max. Negotiated Rate |
$46,278.00 |
| Rate for Payer: Aetna Commercial |
$330.67
|
| Rate for Payer: Aetna Medicare |
$256.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.35
|
| Rate for Payer: BCBS Complete |
$178.92
|
| Rate for Payer: BCBS MAPPO |
$246.77
|
| Rate for Payer: BCBS Trust/PPO |
$762.87
|
| Rate for Payer: BCN Commercial |
$539.99
|
| Rate for Payer: BCN Medicare Advantage |
$246.77
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$355.35
|
| Rate for Payer: Cofinity Commercial |
$330.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.77
|
| Rate for Payer: Healthscope Commercial |
$456.52
|
| Rate for Payer: Healthscope Commercial |
$394.83
|
| Rate for Payer: Mclaren Medicaid |
$170.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.11
|
| Rate for Payer: Meridian Medicaid |
$178.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,278.00
|
| Rate for Payer: Nomi Health Commercial |
$296.12
|
| Rate for Payer: PACE SWMI |
$246.77
|
| Rate for Payer: PHP Medicare Advantage |
$246.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.68
|
| Rate for Payer: Priority Health Medicare |
$246.77
|
| Rate for Payer: Priority Health Narrow Network |
$476.68
|
| Rate for Payer: Priority Health SBD |
$476.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.77
|
| Rate for Payer: UHC Exchange |
$306.33
|
| Rate for Payer: UHC Medicare Advantage |
$246.77
|
| Rate for Payer: UHCCP Medicaid |
$170.40
|
|
|
PR EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV
|
Professional
|
Both
|
$1,905.00
|
|
|
Service Code
|
HCPCS 64788
|
| Min. Negotiated Rate |
$161.13 |
| Max. Negotiated Rate |
$71,593.00 |
| Rate for Payer: Aetna Commercial |
$525.72
|
| Rate for Payer: Aetna Medicare |
$408.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.96
|
| Rate for Payer: BCBS Complete |
$279.56
|
| Rate for Payer: BCBS MAPPO |
$392.33
|
| Rate for Payer: BCBS Trust/PPO |
$161.13
|
| Rate for Payer: BCN Commercial |
$595.21
|
| Rate for Payer: BCN Medicare Advantage |
$392.33
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cofinity Commercial |
$564.96
|
| Rate for Payer: Cofinity Commercial |
$525.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.33
|
| Rate for Payer: Healthscope Commercial |
$725.81
|
| Rate for Payer: Healthscope Commercial |
$627.73
|
| Rate for Payer: Mclaren Medicaid |
$266.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.95
|
| Rate for Payer: Meridian Medicaid |
$279.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,593.00
|
| Rate for Payer: Nomi Health Commercial |
$470.80
|
| Rate for Payer: PACE SWMI |
$392.33
|
| Rate for Payer: PHP Medicare Advantage |
$392.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,238.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.49
|
| Rate for Payer: Priority Health Medicare |
$392.33
|
| Rate for Payer: Priority Health Narrow Network |
$707.49
|
| Rate for Payer: Priority Health SBD |
$707.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.33
|
| Rate for Payer: UHC Exchange |
$404.09
|
| Rate for Payer: UHC Medicare Advantage |
$392.33
|
| Rate for Payer: UHCCP Medicaid |
$266.25
|
|
|
PR EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 64792
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$189,823.00 |
| Rate for Payer: Aetna Commercial |
$1,399.96
|
| Rate for Payer: Aetna Medicare |
$1,086.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,504.44
|
| Rate for Payer: BCBS Complete |
$732.68
|
| Rate for Payer: BCBS MAPPO |
$1,044.75
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: BCN Commercial |
$1,559.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,044.75
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$1,504.44
|
| Rate for Payer: Cofinity Commercial |
$1,399.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,044.75
|
| Rate for Payer: Healthscope Commercial |
$1,932.79
|
| Rate for Payer: Healthscope Commercial |
$1,671.60
|
| Rate for Payer: Mclaren Medicaid |
$697.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.99
|
| Rate for Payer: Meridian Medicaid |
$732.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189,823.00
|
| Rate for Payer: Nomi Health Commercial |
$1,253.70
|
| Rate for Payer: PACE SWMI |
$1,044.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,044.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$697.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,850.03
|
| Rate for Payer: Priority Health Medicare |
$1,044.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,850.03
|
| Rate for Payer: Priority Health SBD |
$1,850.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,209.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,044.75
|
| Rate for Payer: UHC Exchange |
$1,209.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,044.75
|
| Rate for Payer: UHCCP Medicaid |
$697.79
|
|
|
PR EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV
|
Professional
|
Both
|
$2,381.00
|
|
|
Service Code
|
HCPCS 64790
|
| Min. Negotiated Rate |
$160.07 |
| Max. Negotiated Rate |
$151,110.00 |
| Rate for Payer: Aetna Commercial |
$1,112.94
|
| Rate for Payer: Aetna Medicare |
$863.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,195.99
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS MAPPO |
$830.55
|
| Rate for Payer: BCBS Trust/PPO |
$160.07
|
| Rate for Payer: BCN Commercial |
$1,243.68
|
| Rate for Payer: BCN Medicare Advantage |
$830.55
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cofinity Commercial |
$1,195.99
|
| Rate for Payer: Cofinity Commercial |
$1,112.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.55
|
| Rate for Payer: Healthscope Commercial |
$1,536.52
|
| Rate for Payer: Healthscope Commercial |
$1,328.88
|
| Rate for Payer: Mclaren Medicaid |
$555.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.08
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,110.00
|
| Rate for Payer: Nomi Health Commercial |
$996.66
|
| Rate for Payer: PACE SWMI |
$830.55
|
| Rate for Payer: PHP Medicare Advantage |
$830.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,465.02
|
| Rate for Payer: Priority Health Medicare |
$830.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,465.02
|
| Rate for Payer: Priority Health SBD |
$1,465.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$900.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.55
|
| Rate for Payer: UHC Exchange |
$900.00
|
| Rate for Payer: UHC Medicare Advantage |
$830.55
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
|
|
PR EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 64774
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$75,616.00 |
| Rate for Payer: Aetna Commercial |
$554.29
|
| Rate for Payer: Aetna Medicare |
$430.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.66
|
| Rate for Payer: BCBS Complete |
$293.87
|
| Rate for Payer: BCBS MAPPO |
$413.65
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$627.46
|
| Rate for Payer: BCN Medicare Advantage |
$413.65
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$595.66
|
| Rate for Payer: Cofinity Commercial |
$554.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.65
|
| Rate for Payer: Healthscope Commercial |
$765.25
|
| Rate for Payer: Healthscope Commercial |
$661.84
|
| Rate for Payer: Mclaren Medicaid |
$279.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.33
|
| Rate for Payer: Meridian Medicaid |
$293.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,616.00
|
| Rate for Payer: Nomi Health Commercial |
$496.38
|
| Rate for Payer: PACE SWMI |
$413.65
|
| Rate for Payer: PHP Medicare Advantage |
$413.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.90
|
| Rate for Payer: Priority Health Medicare |
$413.65
|
| Rate for Payer: Priority Health Narrow Network |
$739.90
|
| Rate for Payer: Priority Health SBD |
$739.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.65
|
| Rate for Payer: UHC Exchange |
$407.92
|
| Rate for Payer: UHC Medicare Advantage |
$413.65
|
| Rate for Payer: UHCCP Medicaid |
$279.88
|
|
|
PR EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 64776
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$70,441.00 |
| Rate for Payer: Aetna Commercial |
$518.42
|
| Rate for Payer: Aetna Medicare |
$402.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.11
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$386.88
|
| Rate for Payer: BCBS Trust/PPO |
$302.19
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: BCN Medicare Advantage |
$386.88
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$557.11
|
| Rate for Payer: Cofinity Commercial |
$518.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.88
|
| Rate for Payer: Healthscope Commercial |
$715.73
|
| Rate for Payer: Healthscope Commercial |
$619.01
|
| Rate for Payer: Mclaren Medicaid |
$262.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.22
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70,441.00
|
| Rate for Payer: Nomi Health Commercial |
$464.26
|
| Rate for Payer: PACE SWMI |
$386.88
|
| Rate for Payer: PHP Medicare Advantage |
$386.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.09
|
| Rate for Payer: Priority Health Medicare |
$386.88
|
| Rate for Payer: Priority Health Narrow Network |
$700.09
|
| Rate for Payer: Priority Health SBD |
$700.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.88
|
| Rate for Payer: UHC Exchange |
$410.18
|
| Rate for Payer: UHC Medicare Advantage |
$386.88
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 64783
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$38,221.00 |
| Rate for Payer: Aetna Commercial |
$276.84
|
| Rate for Payer: Aetna Medicare |
$214.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.50
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$206.60
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$206.60
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$297.50
|
| Rate for Payer: Cofinity Commercial |
$276.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.60
|
| Rate for Payer: Healthscope Commercial |
$382.21
|
| Rate for Payer: Healthscope Commercial |
$330.56
|
| Rate for Payer: Mclaren Medicaid |
$136.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.93
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,221.00
|
| Rate for Payer: Nomi Health Commercial |
$247.92
|
| Rate for Payer: PACE SWMI |
$206.60
|
| Rate for Payer: PHP Medicare Advantage |
$206.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.83
|
| Rate for Payer: Priority Health Medicare |
$206.60
|
| Rate for Payer: Priority Health Narrow Network |
$362.83
|
| Rate for Payer: Priority Health SBD |
$362.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.60
|
| Rate for Payer: UHC Exchange |
$263.80
|
| Rate for Payer: UHC Medicare Advantage |
$206.60
|
| Rate for Payer: UHCCP Medicaid |
$136.96
|
|
|
PR EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 64782
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$80,465.00 |
| Rate for Payer: Aetna Commercial |
$591.70
|
| Rate for Payer: Aetna Medicare |
$459.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$591.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$635.86
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$441.57
|
| Rate for Payer: BCBS Trust/PPO |
$306.94
|
| Rate for Payer: BCN Commercial |
$666.56
|
| Rate for Payer: BCN Medicare Advantage |
$441.57
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cofinity Commercial |
$635.86
|
| Rate for Payer: Cofinity Commercial |
$591.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.57
|
| Rate for Payer: Healthscope Commercial |
$816.90
|
| Rate for Payer: Healthscope Commercial |
$706.51
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.65
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,465.00
|
| Rate for Payer: Nomi Health Commercial |
$529.88
|
| Rate for Payer: PACE SWMI |
$441.57
|
| Rate for Payer: PHP Medicare Advantage |
$441.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$784.25
|
| Rate for Payer: Priority Health Medicare |
$441.57
|
| Rate for Payer: Priority Health Narrow Network |
$784.25
|
| Rate for Payer: Priority Health SBD |
$784.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.57
|
| Rate for Payer: UHC Exchange |
$462.88
|
| Rate for Payer: UHC Medicare Advantage |
$441.57
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC
|
Professional
|
Both
|
$2,489.00
|
|
|
Service Code
|
HCPCS 64784
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$128,705.00 |
| Rate for Payer: Aetna Commercial |
$940.63
|
| Rate for Payer: Aetna Medicare |
$730.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.63
|
| Rate for Payer: BCBS Complete |
$496.05
|
| Rate for Payer: BCBS MAPPO |
$701.96
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$1,063.36
|
| Rate for Payer: BCN Medicare Advantage |
$701.96
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cofinity Commercial |
$940.63
|
| Rate for Payer: Cofinity Commercial |
$1,010.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.96
|
| Rate for Payer: Healthscope Commercial |
$1,298.63
|
| Rate for Payer: Healthscope Commercial |
$1,123.14
|
| Rate for Payer: Mclaren Medicaid |
$472.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.06
|
| Rate for Payer: Meridian Medicaid |
$496.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,705.00
|
| Rate for Payer: Nomi Health Commercial |
$842.35
|
| Rate for Payer: PACE SWMI |
$701.96
|
| Rate for Payer: PHP Medicare Advantage |
$701.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,244.91
|
| Rate for Payer: Priority Health Medicare |
$701.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,244.91
|
| Rate for Payer: Priority Health SBD |
$1,244.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.96
|
| Rate for Payer: UHC Exchange |
$773.10
|
| Rate for Payer: UHC Medicare Advantage |
$701.96
|
| Rate for Payer: UHCCP Medicaid |
$472.43
|
|
|
PR EXC PRESAC/SACROCOCCYGEAL TUMOR
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 49215
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$391,581.00 |
| Rate for Payer: Aetna Commercial |
$2,857.43
|
| Rate for Payer: Aetna Medicare |
$2,217.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,857.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,070.67
|
| Rate for Payer: BCBS Complete |
$1,484.82
|
| Rate for Payer: BCBS MAPPO |
$2,132.41
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$3,195.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.41
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.67
|
| Rate for Payer: Cofinity Commercial |
$2,857.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.41
|
| Rate for Payer: Healthscope Commercial |
$3,944.96
|
| Rate for Payer: Healthscope Commercial |
$3,411.86
|
| Rate for Payer: Mclaren Medicaid |
$1,414.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.03
|
| Rate for Payer: Meridian Medicaid |
$1,484.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391,581.00
|
| Rate for Payer: Nomi Health Commercial |
$2,558.89
|
| Rate for Payer: PACE SWMI |
$2,132.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,414.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,600.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,963.18
|
| Rate for Payer: Priority Health Medicare |
$2,132.41
|
| Rate for Payer: Priority Health Narrow Network |
$3,963.18
|
| Rate for Payer: Priority Health SBD |
$3,963.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,162.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,132.41
|
| Rate for Payer: UHC Exchange |
$2,162.62
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.41
|
| Rate for Payer: UHCCP Medicaid |
$1,414.11
|
|
|
PR EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 42415
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$188,206.00 |
| Rate for Payer: Aetna Commercial |
$1,358.10
|
| Rate for Payer: Aetna Medicare |
$1,054.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,459.45
|
| Rate for Payer: BCBS Complete |
$715.46
|
| Rate for Payer: BCBS MAPPO |
$1,013.51
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$1,551.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,013.51
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,459.45
|
| Rate for Payer: Cofinity Commercial |
$1,358.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,013.51
|
| Rate for Payer: Healthscope Commercial |
$1,874.99
|
| Rate for Payer: Healthscope Commercial |
$1,621.62
|
| Rate for Payer: Mclaren Medicaid |
$681.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.19
|
| Rate for Payer: Meridian Medicaid |
$715.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188,206.00
|
| Rate for Payer: Nomi Health Commercial |
$1,216.21
|
| Rate for Payer: PACE SWMI |
$1,013.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,013.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,161.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.13
|
| Rate for Payer: Priority Health Medicare |
$1,013.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,903.13
|
| Rate for Payer: Priority Health SBD |
$1,903.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,290.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,013.51
|
| Rate for Payer: UHC Exchange |
$1,290.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,013.51
|
| Rate for Payer: UHCCP Medicaid |
$681.39
|
|
|
PR EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ
|
Professional
|
Both
|
$1,184.00
|
|
|
Service Code
|
HCPCS 42410
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$112,007.00 |
| Rate for Payer: Aetna Commercial |
$806.63
|
| Rate for Payer: Aetna Medicare |
$626.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.82
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$601.96
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$926.05
|
| Rate for Payer: BCN Medicare Advantage |
$601.96
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cofinity Commercial |
$866.82
|
| Rate for Payer: Cofinity Commercial |
$806.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.96
|
| Rate for Payer: Healthscope Commercial |
$963.14
|
| Rate for Payer: Healthscope Commercial |
$1,113.63
|
| Rate for Payer: Mclaren Medicaid |
$406.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.06
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,007.00
|
| Rate for Payer: Nomi Health Commercial |
$722.35
|
| Rate for Payer: PACE SWMI |
$601.96
|
| Rate for Payer: PHP Medicare Advantage |
$601.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$769.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.52
|
| Rate for Payer: Priority Health Medicare |
$601.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.52
|
| Rate for Payer: Priority Health SBD |
$1,136.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$601.96
|
| Rate for Payer: UHC Exchange |
$757.39
|
| Rate for Payer: UHC Medicare Advantage |
$601.96
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
|
|
PR EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 42420
|
| Min. Negotiated Rate |
$279.47 |
| Max. Negotiated Rate |
$211,005.00 |
| Rate for Payer: Aetna Commercial |
$1,521.56
|
| Rate for Payer: Aetna Medicare |
$1,180.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,521.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,635.11
|
| Rate for Payer: BCBS Complete |
$800.67
|
| Rate for Payer: BCBS MAPPO |
$1,135.49
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$1,737.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.49
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,635.11
|
| Rate for Payer: Cofinity Commercial |
$1,521.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.49
|
| Rate for Payer: Healthscope Commercial |
$2,100.66
|
| Rate for Payer: Healthscope Commercial |
$1,816.78
|
| Rate for Payer: Mclaren Medicaid |
$762.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,192.26
|
| Rate for Payer: Meridian Medicaid |
$800.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211,005.00
|
| Rate for Payer: Nomi Health Commercial |
$1,362.59
|
| Rate for Payer: PACE SWMI |
$1,135.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$762.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,128.06
|
| Rate for Payer: Priority Health Medicare |
$1,135.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,128.06
|
| Rate for Payer: Priority Health SBD |
$2,128.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,479.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,135.49
|
| Rate for Payer: UHC Exchange |
$1,479.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.49
|
| Rate for Payer: UHCCP Medicaid |
$762.54
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 45135
|
| Min. Negotiated Rate |
$826.87 |
| Max. Negotiated Rate |
$228,722.00 |
| Rate for Payer: Aetna Commercial |
$1,653.20
|
| Rate for Payer: Aetna Medicare |
$1,283.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,776.57
|
| Rate for Payer: BCBS Complete |
$868.21
|
| Rate for Payer: BCBS MAPPO |
$1,233.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.90
|
| Rate for Payer: BCN Commercial |
$1,878.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,233.73
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,776.57
|
| Rate for Payer: Cofinity Commercial |
$1,653.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,233.73
|
| Rate for Payer: Healthscope Commercial |
$2,282.40
|
| Rate for Payer: Healthscope Commercial |
$1,973.97
|
| Rate for Payer: Mclaren Medicaid |
$826.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,295.42
|
| Rate for Payer: Meridian Medicaid |
$868.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228,722.00
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PACE SWMI |
$1,233.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,233.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,305.83
|
| Rate for Payer: Priority Health Medicare |
$1,233.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,305.83
|
| Rate for Payer: Priority Health SBD |
$2,305.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,307.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,233.73
|
| Rate for Payer: UHC Exchange |
$1,307.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.73
|
| Rate for Payer: UHCCP Medicaid |
$826.87
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH
|
Professional
|
Both
|
$2,827.00
|
|
|
Service Code
|
HCPCS 45130
|
| Min. Negotiated Rate |
$692.46 |
| Max. Negotiated Rate |
$192,139.00 |
| Rate for Payer: Aetna Commercial |
$1,390.73
|
| Rate for Payer: Aetna Medicare |
$1,079.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.52
|
| Rate for Payer: BCBS Complete |
$727.08
|
| Rate for Payer: BCBS MAPPO |
$1,037.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.50
|
| Rate for Payer: BCN Commercial |
$1,574.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.86
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.52
|
| Rate for Payer: Cofinity Commercial |
$1,390.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.86
|
| Rate for Payer: Healthscope Commercial |
$1,920.04
|
| Rate for Payer: Healthscope Commercial |
$1,660.58
|
| Rate for Payer: Mclaren Medicaid |
$692.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.75
|
| Rate for Payer: Meridian Medicaid |
$727.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192,139.00
|
| Rate for Payer: Nomi Health Commercial |
$1,245.43
|
| Rate for Payer: PACE SWMI |
$1,037.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,930.57
|
| Rate for Payer: Priority Health Medicare |
$1,037.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,930.57
|
| Rate for Payer: Priority Health SBD |
$1,930.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.86
|
| Rate for Payer: UHC Exchange |
$1,064.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.86
|
| Rate for Payer: UHCCP Medicaid |
$692.46
|
|
|
PR EXC RCT TUM INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 45172
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$145,487.00 |
| Rate for Payer: Aetna Commercial |
$1,053.01
|
| Rate for Payer: Aetna Medicare |
$817.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,053.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.60
|
| Rate for Payer: BCBS Complete |
$556.22
|
| Rate for Payer: BCBS MAPPO |
$785.83
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$785.83
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,131.60
|
| Rate for Payer: Cofinity Commercial |
$1,053.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.83
|
| Rate for Payer: Healthscope Commercial |
$1,257.33
|
| Rate for Payer: Healthscope Commercial |
$1,453.79
|
| Rate for Payer: Mclaren Medicaid |
$529.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$825.12
|
| Rate for Payer: Meridian Medicaid |
$556.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145,487.00
|
| Rate for Payer: Nomi Health Commercial |
$943.00
|
| Rate for Payer: PACE SWMI |
$785.83
|
| Rate for Payer: PHP Medicare Advantage |
$785.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,476.58
|
| Rate for Payer: Priority Health Medicare |
$785.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,476.58
|
| Rate for Payer: Priority Health SBD |
$1,476.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.83
|
| Rate for Payer: UHC Medicare Advantage |
$785.83
|
| Rate for Payer: UHCCP Medicaid |
$529.73
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$863.10 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.50
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Cofinity Commercial |
$959.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health SBD |
$863.10
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$108,866.00 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.43
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Healthscope Commercial |
$1,087.43
|
| Rate for Payer: Healthscope Commercial |
$940.48
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,866.00
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$587.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.06
|
| Rate for Payer: Priority Health SBD |
$1,109.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$650.68 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.59
|
| Rate for Payer: BCN Commercial |
$1,640.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$959.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$863.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.68
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,512.75
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$108,866.00 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.43
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Healthscope Commercial |
$1,087.43
|
| Rate for Payer: Healthscope Commercial |
$940.48
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,866.00
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$587.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.06
|
| Rate for Payer: Priority Health SBD |
$1,109.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 45160
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$183,632.00 |
| Rate for Payer: Aetna Commercial |
$1,338.27
|
| Rate for Payer: Aetna Medicare |
$1,038.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,338.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,438.14
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$998.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.43
|
| Rate for Payer: BCN Commercial |
$1,500.73
|
| Rate for Payer: BCN Medicare Advantage |
$998.71
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,438.14
|
| Rate for Payer: Cofinity Commercial |
$1,338.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.71
|
| Rate for Payer: Healthscope Commercial |
$1,847.61
|
| Rate for Payer: Healthscope Commercial |
$1,597.94
|
| Rate for Payer: Mclaren Medicaid |
$662.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,048.65
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,632.00
|
| Rate for Payer: Nomi Health Commercial |
$1,198.45
|
| Rate for Payer: PACE SWMI |
$998.71
|
| Rate for Payer: PHP Medicare Advantage |
$998.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,843.47
|
| Rate for Payer: Priority Health Medicare |
$998.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,843.47
|
| Rate for Payer: Priority Health SBD |
$1,843.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.71
|
| Rate for Payer: UHC Exchange |
$1,035.25
|
| Rate for Payer: UHC Medicare Advantage |
$998.71
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 15936
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$160,002.00 |
| Rate for Payer: Aetna Commercial |
$1,145.43
|
| Rate for Payer: Aetna Medicare |
$888.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,230.91
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$854.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,625.00
|
| Rate for Payer: BCN Commercial |
$1,319.92
|
| Rate for Payer: BCN Medicare Advantage |
$854.80
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,230.91
|
| Rate for Payer: Cofinity Commercial |
$1,145.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.80
|
| Rate for Payer: Healthscope Commercial |
$1,581.38
|
| Rate for Payer: Healthscope Commercial |
$1,367.68
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.54
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160,002.00
|
| Rate for Payer: Nomi Health Commercial |
$1,025.76
|
| Rate for Payer: PACE SWMI |
$854.80
|
| Rate for Payer: PHP Medicare Advantage |
$854.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,219.55
|
| Rate for Payer: Priority Health Medicare |
$854.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,219.55
|
| Rate for Payer: Priority Health SBD |
$1,219.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.80
|
| Rate for Payer: UHC Exchange |
$1,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$854.80
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC
|
Professional
|
Both
|
$2,107.00
|
|
|
Service Code
|
HCPCS 15937
|
| Min. Negotiated Rate |
$632.82 |
| Max. Negotiated Rate |
$184,905.00 |
| Rate for Payer: Aetna Commercial |
$1,260.74
|
| Rate for Payer: Aetna Medicare |
$978.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.82
|
| Rate for Payer: BCBS Complete |
$664.46
|
| Rate for Payer: BCBS MAPPO |
$940.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.07
|
| Rate for Payer: BCN Commercial |
$1,527.61
|
| Rate for Payer: BCN Medicare Advantage |
$940.85
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,354.82
|
| Rate for Payer: Cofinity Commercial |
$1,260.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.85
|
| Rate for Payer: Healthscope Commercial |
$1,740.57
|
| Rate for Payer: Healthscope Commercial |
$1,505.36
|
| Rate for Payer: Mclaren Medicaid |
$632.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.89
|
| Rate for Payer: Meridian Medicaid |
$664.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184,905.00
|
| Rate for Payer: Nomi Health Commercial |
$1,129.02
|
| Rate for Payer: PACE SWMI |
$940.85
|
| Rate for Payer: PHP Medicare Advantage |
$940.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.48
|
| Rate for Payer: Priority Health Medicare |
$940.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.48
|
| Rate for Payer: Priority Health SBD |
$1,406.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,250.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.85
|
| Rate for Payer: UHC Exchange |
$1,250.72
|
| Rate for Payer: UHC Medicare Advantage |
$940.85
|
| Rate for Payer: UHCCP Medicaid |
$632.82
|
|
