|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,089.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$686.07 |
| Max. Negotiated Rate |
$980.10 |
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.85
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$762.30
|
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$762.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health SBD |
$686.07
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$58,786.00 |
| Rate for Payer: Aetna Commercial |
$431.57
|
| Rate for Payer: Aetna Medicare |
$334.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.78
|
| Rate for Payer: BCBS Complete |
$231.03
|
| Rate for Payer: BCBS MAPPO |
$322.07
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$322.07
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$431.57
|
| Rate for Payer: Cofinity Commercial |
$463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.07
|
| Rate for Payer: Healthscope Commercial |
$595.83
|
| Rate for Payer: Healthscope Commercial |
$515.31
|
| Rate for Payer: Mclaren Medicaid |
$220.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.17
|
| Rate for Payer: Meridian Medicaid |
$231.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,786.00
|
| Rate for Payer: Nomi Health Commercial |
$386.48
|
| Rate for Payer: PACE SWMI |
$322.07
|
| Rate for Payer: PHP Medicare Advantage |
$322.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$322.07
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.07
|
| Rate for Payer: UHC Exchange |
$706.88
|
| Rate for Payer: UHC Medicare Advantage |
$322.07
|
| Rate for Payer: UHCCP Medicaid |
$220.03
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,089.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$354.46 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$874.32
|
| Rate for Payer: BCN Commercial |
$874.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Cofinity Commercial |
$762.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$762.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$686.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.46
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$58,786.00 |
| Rate for Payer: Aetna Commercial |
$431.57
|
| Rate for Payer: Aetna Medicare |
$334.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.78
|
| Rate for Payer: BCBS Complete |
$231.03
|
| Rate for Payer: BCBS MAPPO |
$322.07
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$322.07
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$463.78
|
| Rate for Payer: Cofinity Commercial |
$431.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.07
|
| Rate for Payer: Healthscope Commercial |
$595.83
|
| Rate for Payer: Healthscope Commercial |
$515.31
|
| Rate for Payer: Mclaren Medicaid |
$220.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.17
|
| Rate for Payer: Meridian Medicaid |
$231.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,786.00
|
| Rate for Payer: Nomi Health Commercial |
$386.48
|
| Rate for Payer: PACE SWMI |
$322.07
|
| Rate for Payer: PHP Medicare Advantage |
$322.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$322.07
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.07
|
| Rate for Payer: UHC Exchange |
$706.88
|
| Rate for Payer: UHC Medicare Advantage |
$322.07
|
| Rate for Payer: UHCCP Medicaid |
$220.03
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$93,204.00 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: Aetna Medicare |
$529.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.86
|
| Rate for Payer: BCBS Complete |
$363.44
|
| Rate for Payer: BCBS MAPPO |
$508.93
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$508.93
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$732.86
|
| Rate for Payer: Cofinity Commercial |
$681.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.93
|
| Rate for Payer: Healthscope Commercial |
$941.52
|
| Rate for Payer: Healthscope Commercial |
$814.29
|
| Rate for Payer: Mclaren Medicaid |
$346.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.38
|
| Rate for Payer: Meridian Medicaid |
$363.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,204.00
|
| Rate for Payer: Nomi Health Commercial |
$610.72
|
| Rate for Payer: PACE SWMI |
$508.93
|
| Rate for Payer: PHP Medicare Advantage |
$508.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.71
|
| Rate for Payer: Priority Health Medicare |
$508.93
|
| Rate for Payer: Priority Health Narrow Network |
$816.71
|
| Rate for Payer: Priority Health SBD |
$816.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.93
|
| Rate for Payer: UHC Exchange |
$521.13
|
| Rate for Payer: UHC Medicare Advantage |
$508.93
|
| Rate for Payer: UHCCP Medicaid |
$346.13
|
|
|
PR EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR
|
Professional
|
Both
|
$5,537.00
|
|
|
Service Code
|
HCPCS 51500
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$112,009.00 |
| Rate for Payer: Aetna Commercial |
$817.68
|
| Rate for Payer: Aetna Medicare |
$634.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.70
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$610.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,025.57
|
| Rate for Payer: BCN Commercial |
$920.67
|
| Rate for Payer: BCN Medicare Advantage |
$610.21
|
| Rate for Payer: Cash Price |
$4,429.60
|
| Rate for Payer: Cash Price |
$4,429.60
|
| Rate for Payer: Cofinity Commercial |
$878.70
|
| Rate for Payer: Cofinity Commercial |
$817.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.21
|
| Rate for Payer: Healthscope Commercial |
$976.34
|
| Rate for Payer: Healthscope Commercial |
$1,128.89
|
| Rate for Payer: Mclaren Medicaid |
$409.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.72
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,009.00
|
| Rate for Payer: Nomi Health Commercial |
$732.25
|
| Rate for Payer: PACE SWMI |
$610.21
|
| Rate for Payer: PHP Medicare Advantage |
$610.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,599.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.74
|
| Rate for Payer: Priority Health Medicare |
$610.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.74
|
| Rate for Payer: Priority Health SBD |
$1,016.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.21
|
| Rate for Payer: UHC Exchange |
$849.92
|
| Rate for Payer: UHC Medicare Advantage |
$610.21
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
|
|
PR EXC URETHRAL DIVERTICULUM SPX FEMALE
|
Professional
|
Both
|
$1,149.00
|
|
|
Service Code
|
HCPCS 53230
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$107,338.00 |
| Rate for Payer: Aetna Commercial |
$782.95
|
| Rate for Payer: Aetna Medicare |
$607.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.38
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS MAPPO |
$584.29
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: BCN Commercial |
$882.06
|
| Rate for Payer: BCN Medicare Advantage |
$584.29
|
| Rate for Payer: Cash Price |
$919.20
|
| Rate for Payer: Cash Price |
$919.20
|
| Rate for Payer: Cofinity Commercial |
$841.38
|
| Rate for Payer: Cofinity Commercial |
$782.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$584.29
|
| Rate for Payer: Healthscope Commercial |
$934.86
|
| Rate for Payer: Healthscope Commercial |
$1,080.94
|
| Rate for Payer: Mclaren Medicaid |
$391.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$613.50
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107,338.00
|
| Rate for Payer: Nomi Health Commercial |
$701.15
|
| Rate for Payer: PACE SWMI |
$584.29
|
| Rate for Payer: PHP Medicare Advantage |
$584.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.66
|
| Rate for Payer: Priority Health Medicare |
$584.29
|
| Rate for Payer: Priority Health Narrow Network |
$974.66
|
| Rate for Payer: Priority Health SBD |
$974.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$584.29
|
| Rate for Payer: UHC Exchange |
$674.07
|
| Rate for Payer: UHC Medicare Advantage |
$584.29
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL
|
Professional
|
Both
|
$2,143.00
|
|
|
Service Code
|
HCPCS 55535
|
| Min. Negotiated Rate |
$277.54 |
| Max. Negotiated Rate |
$75,663.00 |
| Rate for Payer: Aetna Commercial |
$552.01
|
| Rate for Payer: Aetna Medicare |
$428.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.21
|
| Rate for Payer: BCBS Complete |
$291.42
|
| Rate for Payer: BCBS MAPPO |
$411.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,511.99
|
| Rate for Payer: BCN Commercial |
$623.55
|
| Rate for Payer: BCN Medicare Advantage |
$411.95
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cofinity Commercial |
$593.21
|
| Rate for Payer: Cofinity Commercial |
$552.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.95
|
| Rate for Payer: Healthscope Commercial |
$762.11
|
| Rate for Payer: Healthscope Commercial |
$659.12
|
| Rate for Payer: Mclaren Medicaid |
$277.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.55
|
| Rate for Payer: Meridian Medicaid |
$291.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,663.00
|
| Rate for Payer: Nomi Health Commercial |
$494.34
|
| Rate for Payer: PACE SWMI |
$411.95
|
| Rate for Payer: PHP Medicare Advantage |
$411.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.71
|
| Rate for Payer: Priority Health Medicare |
$411.95
|
| Rate for Payer: Priority Health Narrow Network |
$689.71
|
| Rate for Payer: Priority Health SBD |
$689.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.95
|
| Rate for Payer: UHC Exchange |
$569.66
|
| Rate for Payer: UHC Medicare Advantage |
$411.95
|
| Rate for Payer: UHCCP Medicaid |
$277.54
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX
|
Professional
|
Both
|
$655.00
|
|
|
Service Code
|
HCPCS 55530
|
| Min. Negotiated Rate |
$227.48 |
| Max. Negotiated Rate |
$61,906.00 |
| Rate for Payer: Aetna Commercial |
$451.97
|
| Rate for Payer: Aetna Medicare |
$350.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.70
|
| Rate for Payer: BCBS Complete |
$238.85
|
| Rate for Payer: BCBS MAPPO |
$337.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.50
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$337.29
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cofinity Commercial |
$485.70
|
| Rate for Payer: Cofinity Commercial |
$451.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.29
|
| Rate for Payer: Healthscope Commercial |
$623.99
|
| Rate for Payer: Healthscope Commercial |
$539.66
|
| Rate for Payer: Mclaren Medicaid |
$227.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.15
|
| Rate for Payer: Meridian Medicaid |
$238.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,906.00
|
| Rate for Payer: Nomi Health Commercial |
$404.75
|
| Rate for Payer: PACE SWMI |
$337.29
|
| Rate for Payer: PHP Medicare Advantage |
$337.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.09
|
| Rate for Payer: Priority Health Medicare |
$337.29
|
| Rate for Payer: Priority Health Narrow Network |
$565.09
|
| Rate for Payer: Priority Health SBD |
$565.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.29
|
| Rate for Payer: UHC Exchange |
$554.78
|
| Rate for Payer: UHC Medicare Advantage |
$337.29
|
| Rate for Payer: UHCCP Medicaid |
$227.48
|
|
|
PR EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 55540
|
| Min. Negotiated Rate |
$360.40 |
| Max. Negotiated Rate |
$99,176.00 |
| Rate for Payer: Aetna Commercial |
$724.32
|
| Rate for Payer: Aetna Medicare |
$562.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.38
|
| Rate for Payer: BCBS Complete |
$378.42
|
| Rate for Payer: BCBS MAPPO |
$540.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,332.37
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$540.54
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$778.38
|
| Rate for Payer: Cofinity Commercial |
$724.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.54
|
| Rate for Payer: Healthscope Commercial |
$864.86
|
| Rate for Payer: Healthscope Commercial |
$1,000.00
|
| Rate for Payer: Mclaren Medicaid |
$360.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.57
|
| Rate for Payer: Meridian Medicaid |
$378.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99,176.00
|
| Rate for Payer: Nomi Health Commercial |
$648.65
|
| Rate for Payer: PACE SWMI |
$540.54
|
| Rate for Payer: PHP Medicare Advantage |
$540.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.24
|
| Rate for Payer: Priority Health Medicare |
$540.54
|
| Rate for Payer: Priority Health Narrow Network |
$894.24
|
| Rate for Payer: Priority Health SBD |
$894.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$614.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.54
|
| Rate for Payer: UHC Exchange |
$614.83
|
| Rate for Payer: UHC Medicare Advantage |
$540.54
|
| Rate for Payer: UHCCP Medicaid |
$360.40
|
|
|
PR EXC XTRPARENCHYMAL LESION TESTIS
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 54512
|
| Min. Negotiated Rate |
$346.55 |
| Max. Negotiated Rate |
$94,500.00 |
| Rate for Payer: Aetna Commercial |
$691.49
|
| Rate for Payer: Aetna Medicare |
$536.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.10
|
| Rate for Payer: BCBS Complete |
$363.88
|
| Rate for Payer: BCBS MAPPO |
$516.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,954.18
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$516.04
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$743.10
|
| Rate for Payer: Cofinity Commercial |
$691.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.04
|
| Rate for Payer: Healthscope Commercial |
$954.67
|
| Rate for Payer: Healthscope Commercial |
$825.66
|
| Rate for Payer: Mclaren Medicaid |
$346.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.84
|
| Rate for Payer: Meridian Medicaid |
$363.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,500.00
|
| Rate for Payer: Nomi Health Commercial |
$619.25
|
| Rate for Payer: PACE SWMI |
$516.04
|
| Rate for Payer: PHP Medicare Advantage |
$516.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$859.09
|
| Rate for Payer: Priority Health Medicare |
$516.04
|
| Rate for Payer: Priority Health Narrow Network |
$859.09
|
| Rate for Payer: Priority Health SBD |
$859.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.04
|
| Rate for Payer: UHC Exchange |
$627.89
|
| Rate for Payer: UHC Medicare Advantage |
$516.04
|
| Rate for Payer: UHCCP Medicaid |
$346.55
|
|
|
PR EXERCISE EQUIPMENT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS A9300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 42450
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$64,337.00 |
| Rate for Payer: Aetna Commercial |
$464.42
|
| Rate for Payer: Aetna Medicare |
$360.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.08
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$346.58
|
| Rate for Payer: BCBS Trust/PPO |
$563.70
|
| Rate for Payer: BCN Commercial |
$696.86
|
| Rate for Payer: BCN Medicare Advantage |
$346.58
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$499.08
|
| Rate for Payer: Cofinity Commercial |
$464.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.58
|
| Rate for Payer: Healthscope Commercial |
$641.17
|
| Rate for Payer: Healthscope Commercial |
$554.53
|
| Rate for Payer: Mclaren Medicaid |
$236.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.91
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,337.00
|
| Rate for Payer: Nomi Health Commercial |
$415.90
|
| Rate for Payer: PACE SWMI |
$346.58
|
| Rate for Payer: PHP Medicare Advantage |
$346.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.24
|
| Rate for Payer: Priority Health Medicare |
$346.58
|
| Rate for Payer: Priority Health Narrow Network |
$659.24
|
| Rate for Payer: Priority Health SBD |
$659.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.58
|
| Rate for Payer: UHC Exchange |
$422.69
|
| Rate for Payer: UHC Medicare Advantage |
$346.58
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
|
PR EXPL CONGENITAL ATRESIA BILE DUCTS
|
Professional
|
Both
|
$2,902.00
|
|
|
Service Code
|
HCPCS 47700
|
| Min. Negotiated Rate |
$678.34 |
| Max. Negotiated Rate |
$189,432.00 |
| Rate for Payer: Aetna Commercial |
$1,375.31
|
| Rate for Payer: Aetna Medicare |
$1,067.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.94
|
| Rate for Payer: BCBS Complete |
$715.90
|
| Rate for Payer: BCBS MAPPO |
$1,026.35
|
| Rate for Payer: BCBS Trust/PPO |
$678.34
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,026.35
|
| Rate for Payer: Cash Price |
$2,321.60
|
| Rate for Payer: Cash Price |
$2,321.60
|
| Rate for Payer: Cofinity Commercial |
$1,477.94
|
| Rate for Payer: Cofinity Commercial |
$1,375.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.35
|
| Rate for Payer: Healthscope Commercial |
$1,898.75
|
| Rate for Payer: Healthscope Commercial |
$1,642.16
|
| Rate for Payer: Mclaren Medicaid |
$681.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,077.67
|
| Rate for Payer: Meridian Medicaid |
$715.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189,432.00
|
| Rate for Payer: Nomi Health Commercial |
$1,231.62
|
| Rate for Payer: PACE SWMI |
$1,026.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,026.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,886.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,901.95
|
| Rate for Payer: Priority Health Medicare |
$1,026.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,901.95
|
| Rate for Payer: Priority Health SBD |
$1,901.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,111.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,026.35
|
| Rate for Payer: UHC Exchange |
$1,111.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.35
|
| Rate for Payer: UHCCP Medicaid |
$681.81
|
|
|
PR EXPLORATION EPIDIDYMIS W/WO BIOPSY
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 54865
|
| Min. Negotiated Rate |
$233.24 |
| Max. Negotiated Rate |
$63,229.00 |
| Rate for Payer: Aetna Commercial |
$462.70
|
| Rate for Payer: Aetna Medicare |
$359.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.23
|
| Rate for Payer: BCBS Complete |
$244.90
|
| Rate for Payer: BCBS MAPPO |
$345.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.22
|
| Rate for Payer: BCN Commercial |
$522.39
|
| Rate for Payer: BCN Medicare Advantage |
$345.30
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$497.23
|
| Rate for Payer: Cofinity Commercial |
$462.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.30
|
| Rate for Payer: Healthscope Commercial |
$638.80
|
| Rate for Payer: Healthscope Commercial |
$552.48
|
| Rate for Payer: Mclaren Medicaid |
$233.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.56
|
| Rate for Payer: Meridian Medicaid |
$244.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,229.00
|
| Rate for Payer: Nomi Health Commercial |
$414.36
|
| Rate for Payer: PACE SWMI |
$345.30
|
| Rate for Payer: PHP Medicare Advantage |
$345.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.40
|
| Rate for Payer: Priority Health Medicare |
$345.30
|
| Rate for Payer: Priority Health Narrow Network |
$578.40
|
| Rate for Payer: Priority Health SBD |
$578.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.30
|
| Rate for Payer: UHC Exchange |
$413.60
|
| Rate for Payer: UHC Medicare Advantage |
$345.30
|
| Rate for Payer: UHCCP Medicaid |
$233.24
|
|
|
PR EXPLORATION, FEMORAL ARTERY
|
Professional
|
Both
|
$1,563.00
|
|
|
Service Code
|
HCPCS 35721
|
| Min. Negotiated Rate |
$625.20 |
| Max. Negotiated Rate |
$1,015.95 |
| Rate for Payer: Aetna Medicare |
$781.50
|
| Rate for Payer: BCBS Complete |
$625.20
|
| Rate for Payer: Cash Price |
$1,250.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,015.95
|
|
|
PR EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY
|
Professional
|
Both
|
$871.00
|
|
|
Service Code
|
HCPCS 35703
|
| Min. Negotiated Rate |
$263.27 |
| Max. Negotiated Rate |
$73,838.00 |
| Rate for Payer: Aetna Commercial |
$537.21
|
| Rate for Payer: Aetna Medicare |
$416.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.30
|
| Rate for Payer: BCBS Complete |
$276.43
|
| Rate for Payer: BCBS MAPPO |
$400.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.67
|
| Rate for Payer: BCN Commercial |
$598.14
|
| Rate for Payer: BCN Medicare Advantage |
$400.90
|
| Rate for Payer: Cash Price |
$696.80
|
| Rate for Payer: Cash Price |
$696.80
|
| Rate for Payer: Cofinity Commercial |
$577.30
|
| Rate for Payer: Cofinity Commercial |
$537.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.90
|
| Rate for Payer: Healthscope Commercial |
$641.44
|
| Rate for Payer: Healthscope Commercial |
$741.66
|
| Rate for Payer: Mclaren Medicaid |
$263.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.94
|
| Rate for Payer: Meridian Medicaid |
$276.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,838.00
|
| Rate for Payer: Nomi Health Commercial |
$481.08
|
| Rate for Payer: PACE SWMI |
$400.90
|
| Rate for Payer: PHP Medicare Advantage |
$400.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.95
|
| Rate for Payer: Priority Health Medicare |
$400.90
|
| Rate for Payer: Priority Health Narrow Network |
$650.95
|
| Rate for Payer: Priority Health SBD |
$650.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.90
|
| Rate for Payer: UHC Medicare Advantage |
$400.90
|
| Rate for Payer: UHCCP Medicaid |
$263.27
|
|
|
PR EXPLORATION N/FLWD SURG NECK ARTERY
|
Professional
|
Both
|
$908.00
|
|
|
Service Code
|
HCPCS 35701
|
| Min. Negotiated Rate |
$279.24 |
| Max. Negotiated Rate |
$77,933.00 |
| Rate for Payer: Aetna Commercial |
$561.82
|
| Rate for Payer: Aetna Medicare |
$436.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$561.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.75
|
| Rate for Payer: BCBS Complete |
$293.20
|
| Rate for Payer: BCBS MAPPO |
$419.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,119.54
|
| Rate for Payer: BCN Commercial |
$638.21
|
| Rate for Payer: BCN Medicare Advantage |
$419.27
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cofinity Commercial |
$603.75
|
| Rate for Payer: Cofinity Commercial |
$561.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.27
|
| Rate for Payer: Healthscope Commercial |
$775.65
|
| Rate for Payer: Healthscope Commercial |
$670.83
|
| Rate for Payer: Mclaren Medicaid |
$279.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.23
|
| Rate for Payer: Meridian Medicaid |
$293.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,933.00
|
| Rate for Payer: Nomi Health Commercial |
$503.12
|
| Rate for Payer: PACE SWMI |
$419.27
|
| Rate for Payer: PHP Medicare Advantage |
$419.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.90
|
| Rate for Payer: Priority Health Medicare |
$419.27
|
| Rate for Payer: Priority Health Narrow Network |
$691.90
|
| Rate for Payer: Priority Health SBD |
$691.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.27
|
| Rate for Payer: UHC Exchange |
$583.17
|
| Rate for Payer: UHC Medicare Advantage |
$419.27
|
| Rate for Payer: UHCCP Medicaid |
$279.24
|
|
|
PR EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY
|
Professional
|
Both
|
$905.00
|
|
|
Service Code
|
HCPCS 35702
|
| Min. Negotiated Rate |
$259.43 |
| Max. Negotiated Rate |
$72,824.00 |
| Rate for Payer: Aetna Commercial |
$527.38
|
| Rate for Payer: Aetna Medicare |
$409.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.74
|
| Rate for Payer: BCBS Complete |
$272.40
|
| Rate for Payer: BCBS MAPPO |
$393.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,869.13
|
| Rate for Payer: BCN Commercial |
$592.28
|
| Rate for Payer: BCN Medicare Advantage |
$393.57
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cofinity Commercial |
$566.74
|
| Rate for Payer: Cofinity Commercial |
$527.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.57
|
| Rate for Payer: Healthscope Commercial |
$629.71
|
| Rate for Payer: Healthscope Commercial |
$728.10
|
| Rate for Payer: Mclaren Medicaid |
$259.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.25
|
| Rate for Payer: Meridian Medicaid |
$272.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,824.00
|
| Rate for Payer: Nomi Health Commercial |
$472.28
|
| Rate for Payer: PACE SWMI |
$393.57
|
| Rate for Payer: PHP Medicare Advantage |
$393.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.51
|
| Rate for Payer: Priority Health Medicare |
$393.57
|
| Rate for Payer: Priority Health Narrow Network |
$643.51
|
| Rate for Payer: Priority Health SBD |
$643.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.57
|
| Rate for Payer: UHC Medicare Advantage |
$393.57
|
| Rate for Payer: UHCCP Medicaid |
$259.43
|
|
|
PR EXPLORATION OF ARTERY/VEIN
|
Professional
|
Both
|
$1,308.00
|
|
|
Service Code
|
HCPCS 35761
|
| Min. Negotiated Rate |
$523.20 |
| Max. Negotiated Rate |
$850.20 |
| Rate for Payer: Aetna Medicare |
$654.00
|
| Rate for Payer: BCBS Complete |
$523.20
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$850.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.20
|
|
|
PR EXPLORATION PENETRATING WOUND SPX CHEST
|
Professional
|
Both
|
$1,148.00
|
|
|
Service Code
|
HCPCS 20101
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$37,400.00 |
| Rate for Payer: Aetna Commercial |
$271.73
|
| Rate for Payer: Aetna Medicare |
$210.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.00
|
| Rate for Payer: BCBS Complete |
$141.57
|
| Rate for Payer: BCBS MAPPO |
$202.78
|
| Rate for Payer: BCBS Trust/PPO |
$5,215.40
|
| Rate for Payer: BCN Commercial |
$857.63
|
| Rate for Payer: BCN Medicare Advantage |
$202.78
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Cofinity Commercial |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$271.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$375.14
|
| Rate for Payer: Healthscope Commercial |
$324.45
|
| Rate for Payer: Mclaren Medicaid |
$134.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.92
|
| Rate for Payer: Meridian Medicaid |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,400.00
|
| Rate for Payer: Nomi Health Commercial |
$243.34
|
| Rate for Payer: PACE SWMI |
$202.78
|
| Rate for Payer: PHP Medicare Advantage |
$202.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.58
|
| Rate for Payer: Priority Health Medicare |
$202.78
|
| Rate for Payer: Priority Health Narrow Network |
$320.58
|
| Rate for Payer: Priority Health SBD |
$320.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.78
|
| Rate for Payer: UHC Exchange |
$256.06
|
| Rate for Payer: UHC Medicare Advantage |
$202.78
|
| Rate for Payer: UHCCP Medicaid |
$134.83
|
|
|
PR EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 20103
|
| Min. Negotiated Rate |
$221.95 |
| Max. Negotiated Rate |
$61,121.00 |
| Rate for Payer: Aetna Commercial |
$443.41
|
| Rate for Payer: Aetna Medicare |
$344.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.50
|
| Rate for Payer: BCBS Complete |
$233.05
|
| Rate for Payer: BCBS MAPPO |
$330.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,940.00
|
| Rate for Payer: BCN Commercial |
$828.31
|
| Rate for Payer: BCN Medicare Advantage |
$330.90
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$476.50
|
| Rate for Payer: Cofinity Commercial |
$443.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.90
|
| Rate for Payer: Healthscope Commercial |
$612.16
|
| Rate for Payer: Healthscope Commercial |
$529.44
|
| Rate for Payer: Mclaren Medicaid |
$221.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.44
|
| Rate for Payer: Meridian Medicaid |
$233.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,121.00
|
| Rate for Payer: Nomi Health Commercial |
$397.08
|
| Rate for Payer: PACE SWMI |
$330.90
|
| Rate for Payer: PHP Medicare Advantage |
$330.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.19
|
| Rate for Payer: Priority Health Medicare |
$330.90
|
| Rate for Payer: Priority Health Narrow Network |
$528.19
|
| Rate for Payer: Priority Health SBD |
$528.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.90
|
| Rate for Payer: UHC Exchange |
$404.86
|
| Rate for Payer: UHC Medicare Advantage |
$330.90
|
| Rate for Payer: UHCCP Medicaid |
$221.95
|
|
|
PR EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$1,939.00
|
|
|
Service Code
|
HCPCS 20100
|
| Min. Negotiated Rate |
$384.89 |
| Max. Negotiated Rate |
$106,994.00 |
| Rate for Payer: Aetna Commercial |
$777.98
|
| Rate for Payer: Aetna Medicare |
$603.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.04
|
| Rate for Payer: BCBS Complete |
$404.13
|
| Rate for Payer: BCBS MAPPO |
$580.58
|
| Rate for Payer: BCBS Trust/PPO |
$5,215.40
|
| Rate for Payer: BCN Commercial |
$872.77
|
| Rate for Payer: BCN Medicare Advantage |
$580.58
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Cofinity Commercial |
$836.04
|
| Rate for Payer: Cofinity Commercial |
$777.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.58
|
| Rate for Payer: Healthscope Commercial |
$928.93
|
| Rate for Payer: Healthscope Commercial |
$1,074.07
|
| Rate for Payer: Mclaren Medicaid |
$384.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.61
|
| Rate for Payer: Meridian Medicaid |
$404.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,994.00
|
| Rate for Payer: Nomi Health Commercial |
$696.70
|
| Rate for Payer: PACE SWMI |
$580.58
|
| Rate for Payer: PHP Medicare Advantage |
$580.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.44
|
| Rate for Payer: Priority Health Medicare |
$580.58
|
| Rate for Payer: Priority Health Narrow Network |
$915.44
|
| Rate for Payer: Priority Health SBD |
$915.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$580.58
|
| Rate for Payer: UHC Exchange |
$804.34
|
| Rate for Payer: UHC Medicare Advantage |
$580.58
|
| Rate for Payer: UHCCP Medicaid |
$384.89
|
|
|
PR EXPLORATION POPLITEAL ARTERY
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 35741
|
| Min. Negotiated Rate |
$431.60 |
| Max. Negotiated Rate |
$701.35 |
| Rate for Payer: Aetna Medicare |
$539.50
|
| Rate for Payer: BCBS Complete |
$431.60
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.35
|
|
|
PR EXPLORATION SPINAL FUSION
|
Professional
|
Both
|
$5,175.00
|
|
|
Service Code
|
HCPCS 22830
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$146,968.00 |
| Rate for Payer: Aetna Commercial |
$1,076.78
|
| Rate for Payer: Aetna Medicare |
$835.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,076.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.14
|
| Rate for Payer: BCBS Complete |
$563.82
|
| Rate for Payer: BCBS MAPPO |
$803.57
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$1,209.96
|
| Rate for Payer: BCN Medicare Advantage |
$803.57
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cofinity Commercial |
$1,157.14
|
| Rate for Payer: Cofinity Commercial |
$1,076.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.57
|
| Rate for Payer: Healthscope Commercial |
$1,486.60
|
| Rate for Payer: Healthscope Commercial |
$1,285.71
|
| Rate for Payer: Mclaren Medicaid |
$536.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.75
|
| Rate for Payer: Meridian Medicaid |
$563.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146,968.00
|
| Rate for Payer: Nomi Health Commercial |
$964.28
|
| Rate for Payer: PACE SWMI |
$803.57
|
| Rate for Payer: PHP Medicare Advantage |
$803.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,363.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.16
|
| Rate for Payer: Priority Health Medicare |
$803.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.16
|
| Rate for Payer: Priority Health SBD |
$1,273.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$803.57
|
| Rate for Payer: UHC Exchange |
$1,051.87
|
| Rate for Payer: UHC Medicare Advantage |
$803.57
|
| Rate for Payer: UHCCP Medicaid |
$536.97
|
|
