|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$4,664.00
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$899.50 |
| Max. Negotiated Rate |
$255,811.00 |
| Rate for Payer: Aetna Commercial |
$1,852.03
|
| Rate for Payer: Aetna Medicare |
$1,437.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,852.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.24
|
| Rate for Payer: BCBS Complete |
$944.48
|
| Rate for Payer: BCBS MAPPO |
$1,382.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.35
|
| Rate for Payer: BCN Commercial |
$2,057.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.11
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,990.24
|
| Rate for Payer: Cofinity Commercial |
$1,852.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.11
|
| Rate for Payer: Healthscope Commercial |
$2,556.90
|
| Rate for Payer: Healthscope Commercial |
$2,211.38
|
| Rate for Payer: Mclaren Medicaid |
$899.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,451.22
|
| Rate for Payer: Meridian Medicaid |
$944.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255,811.00
|
| Rate for Payer: Nomi Health Commercial |
$1,658.53
|
| Rate for Payer: PACE SWMI |
$1,382.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$899.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,031.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.24
|
| Rate for Payer: Priority Health Medicare |
$1,382.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,243.24
|
| Rate for Payer: Priority Health SBD |
$2,243.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,382.11
|
| Rate for Payer: UHC Exchange |
$2,053.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,382.11
|
| Rate for Payer: UHCCP Medicaid |
$899.50
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$2,851.00
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$833.68 |
| Max. Negotiated Rate |
$241,787.00 |
| Rate for Payer: Aetna Commercial |
$1,719.98
|
| Rate for Payer: Aetna Medicare |
$1,334.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,848.34
|
| Rate for Payer: BCBS Complete |
$875.36
|
| Rate for Payer: BCBS MAPPO |
$1,283.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$1,945.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.57
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cofinity Commercial |
$1,848.34
|
| Rate for Payer: Cofinity Commercial |
$1,719.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.57
|
| Rate for Payer: Healthscope Commercial |
$2,374.60
|
| Rate for Payer: Healthscope Commercial |
$2,053.71
|
| Rate for Payer: Mclaren Medicaid |
$833.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.75
|
| Rate for Payer: Meridian Medicaid |
$875.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241,787.00
|
| Rate for Payer: Nomi Health Commercial |
$1,540.28
|
| Rate for Payer: PACE SWMI |
$1,283.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,853.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,076.78
|
| Rate for Payer: Priority Health Medicare |
$1,283.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.78
|
| Rate for Payer: Priority Health SBD |
$2,076.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,915.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.57
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.57
|
| Rate for Payer: UHCCP Medicaid |
$833.68
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$234.73 |
| Max. Negotiated Rate |
$65,601.00 |
| Rate for Payer: Aetna Commercial |
$471.13
|
| Rate for Payer: Aetna Medicare |
$365.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.29
|
| Rate for Payer: BCBS Complete |
$246.47
|
| Rate for Payer: BCBS MAPPO |
$351.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,885.50
|
| Rate for Payer: BCN Commercial |
$539.01
|
| Rate for Payer: BCN Medicare Advantage |
$351.59
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$506.29
|
| Rate for Payer: Cofinity Commercial |
$471.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.59
|
| Rate for Payer: Healthscope Commercial |
$650.44
|
| Rate for Payer: Healthscope Commercial |
$562.54
|
| Rate for Payer: Mclaren Medicaid |
$234.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.17
|
| Rate for Payer: Meridian Medicaid |
$246.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,601.00
|
| Rate for Payer: Nomi Health Commercial |
$421.91
|
| Rate for Payer: PACE SWMI |
$351.59
|
| Rate for Payer: PHP Medicare Advantage |
$351.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.95
|
| Rate for Payer: Priority Health Medicare |
$351.59
|
| Rate for Payer: Priority Health Narrow Network |
$583.95
|
| Rate for Payer: Priority Health SBD |
$583.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.59
|
| Rate for Payer: UHC Exchange |
$449.34
|
| Rate for Payer: UHC Medicare Advantage |
$351.59
|
| Rate for Payer: UHCCP Medicaid |
$234.73
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$64,964.00 |
| Rate for Payer: Aetna Commercial |
$468.76
|
| Rate for Payer: Aetna Medicare |
$363.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.74
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS MAPPO |
$349.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,400.52
|
| Rate for Payer: BCN Commercial |
$533.63
|
| Rate for Payer: BCN Medicare Advantage |
$349.82
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$503.74
|
| Rate for Payer: Cofinity Commercial |
$468.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.82
|
| Rate for Payer: Healthscope Commercial |
$647.17
|
| Rate for Payer: Healthscope Commercial |
$559.71
|
| Rate for Payer: Mclaren Medicaid |
$233.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.31
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,964.00
|
| Rate for Payer: Nomi Health Commercial |
$419.78
|
| Rate for Payer: PACE SWMI |
$349.82
|
| Rate for Payer: PHP Medicare Advantage |
$349.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$579.68
|
| Rate for Payer: Priority Health Medicare |
$349.82
|
| Rate for Payer: Priority Health Narrow Network |
$579.68
|
| Rate for Payer: Priority Health SBD |
$579.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.82
|
| Rate for Payer: UHC Exchange |
$464.51
|
| Rate for Payer: UHC Medicare Advantage |
$349.82
|
| Rate for Payer: UHCCP Medicaid |
$233.45
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$46,301.00 |
| Rate for Payer: Aetna Commercial |
$337.24
|
| Rate for Payer: Aetna Medicare |
$261.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.40
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$251.67
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$375.30
|
| Rate for Payer: BCN Medicare Advantage |
$251.67
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$362.40
|
| Rate for Payer: Cofinity Commercial |
$337.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.67
|
| Rate for Payer: Healthscope Commercial |
$402.67
|
| Rate for Payer: Healthscope Commercial |
$465.59
|
| Rate for Payer: Mclaren Medicaid |
$164.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.25
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,301.00
|
| Rate for Payer: Nomi Health Commercial |
$302.00
|
| Rate for Payer: PACE SWMI |
$251.67
|
| Rate for Payer: PHP Medicare Advantage |
$251.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.82
|
| Rate for Payer: Priority Health Medicare |
$251.67
|
| Rate for Payer: Priority Health Narrow Network |
$391.82
|
| Rate for Payer: Priority Health SBD |
$391.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.67
|
| Rate for Payer: UHC Medicare Advantage |
$251.67
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$59,735.00 |
| Rate for Payer: Aetna Commercial |
$439.29
|
| Rate for Payer: Aetna Medicare |
$340.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.08
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS MAPPO |
$327.83
|
| Rate for Payer: BCBS Trust/PPO |
$133.29
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: BCN Medicare Advantage |
$327.83
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$472.08
|
| Rate for Payer: Cofinity Commercial |
$439.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.83
|
| Rate for Payer: Healthscope Commercial |
$524.53
|
| Rate for Payer: Healthscope Commercial |
$606.49
|
| Rate for Payer: Mclaren Medicaid |
$214.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.22
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,735.00
|
| Rate for Payer: Nomi Health Commercial |
$393.40
|
| Rate for Payer: PACE SWMI |
$327.83
|
| Rate for Payer: PHP Medicare Advantage |
$327.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.82
|
| Rate for Payer: Priority Health Medicare |
$327.83
|
| Rate for Payer: Priority Health Narrow Network |
$506.82
|
| Rate for Payer: Priority Health SBD |
$506.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.83
|
| Rate for Payer: UHC Medicare Advantage |
$327.83
|
| Rate for Payer: UHCCP Medicaid |
$214.49
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$60,280.00 |
| Rate for Payer: Aetna Commercial |
$439.80
|
| Rate for Payer: Aetna Medicare |
$341.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.62
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS MAPPO |
$328.21
|
| Rate for Payer: BCBS Trust/PPO |
$69.19
|
| Rate for Payer: BCN Commercial |
$488.19
|
| Rate for Payer: BCN Medicare Advantage |
$328.21
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$472.62
|
| Rate for Payer: Cofinity Commercial |
$439.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.21
|
| Rate for Payer: Healthscope Commercial |
$525.14
|
| Rate for Payer: Healthscope Commercial |
$607.19
|
| Rate for Payer: Mclaren Medicaid |
$214.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.62
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,280.00
|
| Rate for Payer: Nomi Health Commercial |
$393.85
|
| Rate for Payer: PACE SWMI |
$328.21
|
| Rate for Payer: PHP Medicare Advantage |
$328.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.38
|
| Rate for Payer: Priority Health Medicare |
$328.21
|
| Rate for Payer: Priority Health Narrow Network |
$510.38
|
| Rate for Payer: Priority Health SBD |
$510.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.21
|
| Rate for Payer: UHC Medicare Advantage |
$328.21
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$121.62 |
| Max. Negotiated Rate |
$36,839.00 |
| Rate for Payer: Aetna Commercial |
$244.04
|
| Rate for Payer: Aetna Medicare |
$189.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.25
|
| Rate for Payer: BCBS Complete |
$127.70
|
| Rate for Payer: BCBS MAPPO |
$182.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.69
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: BCN Medicare Advantage |
$182.12
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$262.25
|
| Rate for Payer: Cofinity Commercial |
$244.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.12
|
| Rate for Payer: Healthscope Commercial |
$336.92
|
| Rate for Payer: Healthscope Commercial |
$291.39
|
| Rate for Payer: Mclaren Medicaid |
$121.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.23
|
| Rate for Payer: Meridian Medicaid |
$127.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,839.00
|
| Rate for Payer: Nomi Health Commercial |
$218.54
|
| Rate for Payer: PACE SWMI |
$182.12
|
| Rate for Payer: PHP Medicare Advantage |
$182.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.20
|
| Rate for Payer: Priority Health Medicare |
$182.12
|
| Rate for Payer: Priority Health Narrow Network |
$329.20
|
| Rate for Payer: Priority Health SBD |
$329.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.12
|
| Rate for Payer: UHC Exchange |
$369.02
|
| Rate for Payer: UHC Medicare Advantage |
$182.12
|
| Rate for Payer: UHCCP Medicaid |
$121.62
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$21,337.00 |
| Rate for Payer: Aetna Commercial |
$153.12
|
| Rate for Payer: Aetna Medicare |
$118.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.55
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$114.27
|
| Rate for Payer: BCBS Trust/PPO |
$720.07
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: BCN Medicare Advantage |
$114.27
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$164.55
|
| Rate for Payer: Cofinity Commercial |
$153.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.27
|
| Rate for Payer: Healthscope Commercial |
$211.40
|
| Rate for Payer: Healthscope Commercial |
$182.83
|
| Rate for Payer: Mclaren Medicaid |
$75.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.98
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,337.00
|
| Rate for Payer: Nomi Health Commercial |
$137.12
|
| Rate for Payer: PACE SWMI |
$114.27
|
| Rate for Payer: PHP Medicare Advantage |
$114.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.32
|
| Rate for Payer: Priority Health Medicare |
$114.27
|
| Rate for Payer: Priority Health Narrow Network |
$189.32
|
| Rate for Payer: Priority Health SBD |
$189.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.27
|
| Rate for Payer: UHC Exchange |
$206.90
|
| Rate for Payer: UHC Medicare Advantage |
$114.27
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$1,619.00
|
|
|
Service Code
|
HCPCS 33224
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$90,895.00 |
| Rate for Payer: Aetna Commercial |
$651.70
|
| Rate for Payer: Aetna Medicare |
$505.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.33
|
| Rate for Payer: BCBS Complete |
$336.37
|
| Rate for Payer: BCBS MAPPO |
$486.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.07
|
| Rate for Payer: BCN Commercial |
$738.39
|
| Rate for Payer: BCN Medicare Advantage |
$486.34
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Cofinity Commercial |
$700.33
|
| Rate for Payer: Cofinity Commercial |
$651.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.34
|
| Rate for Payer: Healthscope Commercial |
$899.73
|
| Rate for Payer: Healthscope Commercial |
$778.14
|
| Rate for Payer: Mclaren Medicaid |
$320.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.66
|
| Rate for Payer: Meridian Medicaid |
$336.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90,895.00
|
| Rate for Payer: Nomi Health Commercial |
$583.61
|
| Rate for Payer: PACE SWMI |
$486.34
|
| Rate for Payer: PHP Medicare Advantage |
$486.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.21
|
| Rate for Payer: Priority Health Medicare |
$486.34
|
| Rate for Payer: Priority Health Narrow Network |
$797.21
|
| Rate for Payer: Priority Health SBD |
$797.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$533.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.34
|
| Rate for Payer: UHC Exchange |
$533.90
|
| Rate for Payer: UHC Medicare Advantage |
$486.34
|
| Rate for Payer: UHCCP Medicaid |
$320.35
|
|
|
PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 33225
|
| Min. Negotiated Rate |
$288.83 |
| Max. Negotiated Rate |
$82,300.00 |
| Rate for Payer: Aetna Commercial |
$589.04
|
| Rate for Payer: Aetna Medicare |
$457.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.00
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$439.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.50
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$439.58
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$633.00
|
| Rate for Payer: Cofinity Commercial |
$589.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.58
|
| Rate for Payer: Healthscope Commercial |
$813.22
|
| Rate for Payer: Healthscope Commercial |
$703.33
|
| Rate for Payer: Mclaren Medicaid |
$288.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.56
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,300.00
|
| Rate for Payer: Nomi Health Commercial |
$527.50
|
| Rate for Payer: PACE SWMI |
$439.58
|
| Rate for Payer: PHP Medicare Advantage |
$439.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$718.49
|
| Rate for Payer: Priority Health Medicare |
$439.58
|
| Rate for Payer: Priority Health Narrow Network |
$718.49
|
| Rate for Payer: Priority Health SBD |
$718.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.58
|
| Rate for Payer: UHC Exchange |
$474.54
|
| Rate for Payer: UHC Medicare Advantage |
$439.58
|
| Rate for Payer: UHCCP Medicaid |
$288.83
|
|
|
PR INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$8,205.00
|
|
|
Service Code
|
HCPCS 33335
|
| Min. Negotiated Rate |
$818.87 |
| Max. Negotiated Rate |
$330,057.00 |
| Rate for Payer: Aetna Commercial |
$2,392.29
|
| Rate for Payer: Aetna Medicare |
$1,856.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,392.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,570.82
|
| Rate for Payer: BCBS Complete |
$1,230.97
|
| Rate for Payer: BCBS MAPPO |
$1,785.29
|
| Rate for Payer: BCBS Trust/PPO |
$818.87
|
| Rate for Payer: BCN Commercial |
$2,673.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,785.29
|
| Rate for Payer: Cash Price |
$6,564.00
|
| Rate for Payer: Cash Price |
$6,564.00
|
| Rate for Payer: Cofinity Commercial |
$2,570.82
|
| Rate for Payer: Cofinity Commercial |
$2,392.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,785.29
|
| Rate for Payer: Healthscope Commercial |
$3,302.79
|
| Rate for Payer: Healthscope Commercial |
$2,856.46
|
| Rate for Payer: Mclaren Medicaid |
$1,172.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,874.55
|
| Rate for Payer: Meridian Medicaid |
$1,230.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330,057.00
|
| Rate for Payer: Nomi Health Commercial |
$2,142.35
|
| Rate for Payer: PACE SWMI |
$1,785.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,785.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,172.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,333.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,912.81
|
| Rate for Payer: Priority Health Medicare |
$1,785.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,912.81
|
| Rate for Payer: Priority Health SBD |
$2,912.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,166.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,785.29
|
| Rate for Payer: UHC Exchange |
$2,166.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,785.29
|
| Rate for Payer: UHCCP Medicaid |
$1,172.35
|
|
|
PR INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 53445
|
| Min. Negotiated Rate |
$485.85 |
| Max. Negotiated Rate |
$132,869.00 |
| Rate for Payer: Aetna Commercial |
$968.67
|
| Rate for Payer: Aetna Medicare |
$751.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.67
|
| Rate for Payer: BCBS Complete |
$510.14
|
| Rate for Payer: BCBS MAPPO |
$722.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,567.61
|
| Rate for Payer: BCN Commercial |
$1,092.68
|
| Rate for Payer: BCN Medicare Advantage |
$722.89
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$968.67
|
| Rate for Payer: Cofinity Commercial |
$1,040.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.89
|
| Rate for Payer: Healthscope Commercial |
$1,337.35
|
| Rate for Payer: Healthscope Commercial |
$1,156.62
|
| Rate for Payer: Mclaren Medicaid |
$485.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.03
|
| Rate for Payer: Meridian Medicaid |
$510.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,869.00
|
| Rate for Payer: Nomi Health Commercial |
$867.47
|
| Rate for Payer: PACE SWMI |
$722.89
|
| Rate for Payer: PHP Medicare Advantage |
$722.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.86
|
| Rate for Payer: Priority Health Medicare |
$722.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.86
|
| Rate for Payer: Priority Health SBD |
$1,206.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$956.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.89
|
| Rate for Payer: UHC Exchange |
$956.75
|
| Rate for Payer: UHC Medicare Advantage |
$722.89
|
| Rate for Payer: UHCCP Medicaid |
$485.85
|
|
|
PR INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN
|
Professional
|
Both
|
$1,358.00
|
|
|
Service Code
|
HCPCS 33970
|
| Min. Negotiated Rate |
$220.46 |
| Max. Negotiated Rate |
$62,647.00 |
| Rate for Payer: Aetna Commercial |
$452.40
|
| Rate for Payer: Aetna Medicare |
$351.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.16
|
| Rate for Payer: BCBS Complete |
$231.48
|
| Rate for Payer: BCBS MAPPO |
$337.61
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$505.29
|
| Rate for Payer: BCN Medicare Advantage |
$337.61
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cofinity Commercial |
$486.16
|
| Rate for Payer: Cofinity Commercial |
$452.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.61
|
| Rate for Payer: Healthscope Commercial |
$624.58
|
| Rate for Payer: Healthscope Commercial |
$540.18
|
| Rate for Payer: Mclaren Medicaid |
$220.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.49
|
| Rate for Payer: Meridian Medicaid |
$231.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,647.00
|
| Rate for Payer: Nomi Health Commercial |
$405.13
|
| Rate for Payer: PACE SWMI |
$337.61
|
| Rate for Payer: PHP Medicare Advantage |
$337.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.85
|
| Rate for Payer: Priority Health Medicare |
$337.61
|
| Rate for Payer: Priority Health Narrow Network |
$548.85
|
| Rate for Payer: Priority Health SBD |
$548.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.61
|
| Rate for Payer: UHC Exchange |
$495.49
|
| Rate for Payer: UHC Medicare Advantage |
$337.61
|
| Rate for Payer: UHCCP Medicaid |
$220.46
|
|
|
PR INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 57267
|
| Min. Negotiated Rate |
$159.11 |
| Max. Negotiated Rate |
$44,737.00 |
| Rate for Payer: Aetna Commercial |
$322.19
|
| Rate for Payer: Aetna Medicare |
$250.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.23
|
| Rate for Payer: BCBS Complete |
$167.07
|
| Rate for Payer: BCBS MAPPO |
$240.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,692.14
|
| Rate for Payer: BCN Commercial |
$363.58
|
| Rate for Payer: BCN Medicare Advantage |
$240.44
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cofinity Commercial |
$346.23
|
| Rate for Payer: Cofinity Commercial |
$322.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.44
|
| Rate for Payer: Healthscope Commercial |
$444.81
|
| Rate for Payer: Healthscope Commercial |
$384.70
|
| Rate for Payer: Mclaren Medicaid |
$159.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.46
|
| Rate for Payer: Meridian Medicaid |
$167.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,737.00
|
| Rate for Payer: Nomi Health Commercial |
$288.53
|
| Rate for Payer: PACE SWMI |
$240.44
|
| Rate for Payer: PHP Medicare Advantage |
$240.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.04
|
| Rate for Payer: Priority Health Medicare |
$240.44
|
| Rate for Payer: Priority Health Narrow Network |
$370.04
|
| Rate for Payer: Priority Health SBD |
$370.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.44
|
| Rate for Payer: UHC Exchange |
$378.46
|
| Rate for Payer: UHC Medicare Advantage |
$240.44
|
| Rate for Payer: UHCCP Medicaid |
$159.11
|
|
|
PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 54405
|
| Min. Negotiated Rate |
$156.83 |
| Max. Negotiated Rate |
$142,153.00 |
| Rate for Payer: Aetna Commercial |
$1,035.65
|
| Rate for Payer: Aetna Medicare |
$803.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.93
|
| Rate for Payer: BCBS Complete |
$543.47
|
| Rate for Payer: BCBS MAPPO |
$772.87
|
| Rate for Payer: BCBS Trust/PPO |
$156.83
|
| Rate for Payer: BCN Commercial |
$1,165.50
|
| Rate for Payer: BCN Medicare Advantage |
$772.87
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cofinity Commercial |
$1,112.93
|
| Rate for Payer: Cofinity Commercial |
$1,035.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.87
|
| Rate for Payer: Healthscope Commercial |
$1,429.81
|
| Rate for Payer: Healthscope Commercial |
$1,236.59
|
| Rate for Payer: Mclaren Medicaid |
$517.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.51
|
| Rate for Payer: Meridian Medicaid |
$543.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,153.00
|
| Rate for Payer: Nomi Health Commercial |
$927.44
|
| Rate for Payer: PACE SWMI |
$772.87
|
| Rate for Payer: PHP Medicare Advantage |
$772.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.62
|
| Rate for Payer: Priority Health Medicare |
$772.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,284.62
|
| Rate for Payer: Priority Health SBD |
$1,284.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,197.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.87
|
| Rate for Payer: UHC Exchange |
$1,197.90
|
| Rate for Payer: UHC Medicare Advantage |
$772.87
|
| Rate for Payer: UHCCP Medicaid |
$517.59
|
|
|
PR INSJ NON-NDWELLG BLADDER CATHETER
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 51701
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$4,509.00 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare |
$25.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$24.05
|
| Rate for Payer: BCBS Trust/PPO |
$661.43
|
| Rate for Payer: BCN Commercial |
$52.23
|
| Rate for Payer: BCN Medicare Advantage |
$24.05
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$34.63
|
| Rate for Payer: Cofinity Commercial |
$32.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.05
|
| Rate for Payer: Healthscope Commercial |
$44.49
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.25
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,509.00
|
| Rate for Payer: Nomi Health Commercial |
$28.86
|
| Rate for Payer: PACE SWMI |
$24.05
|
| Rate for Payer: PHP Medicare Advantage |
$24.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.48
|
| Rate for Payer: Priority Health Medicare |
$24.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.48
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.05
|
| Rate for Payer: UHC Exchange |
$86.28
|
| Rate for Payer: UHC Medicare Advantage |
$24.05
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 36555
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$15,055.00 |
| Rate for Payer: Aetna Commercial |
$107.59
|
| Rate for Payer: Aetna Medicare |
$83.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.62
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.29
|
| Rate for Payer: BCBS Trust/PPO |
$898.64
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: BCN Medicare Advantage |
$80.29
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$115.62
|
| Rate for Payer: Cofinity Commercial |
$107.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.29
|
| Rate for Payer: Healthscope Commercial |
$148.54
|
| Rate for Payer: Healthscope Commercial |
$128.46
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.30
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,055.00
|
| Rate for Payer: Nomi Health Commercial |
$96.35
|
| Rate for Payer: PACE SWMI |
$80.29
|
| Rate for Payer: PHP Medicare Advantage |
$80.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.89
|
| Rate for Payer: Priority Health Medicare |
$80.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.89
|
| Rate for Payer: Priority Health SBD |
$131.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.29
|
| Rate for Payer: UHC Exchange |
$360.99
|
| Rate for Payer: UHC Medicare Advantage |
$80.29
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 36556
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$14,953.00 |
| Rate for Payer: Aetna Commercial |
$107.58
|
| Rate for Payer: Aetna Medicare |
$83.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.60
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.28
|
| Rate for Payer: BCBS Trust/PPO |
$253.58
|
| Rate for Payer: BCN Commercial |
$313.24
|
| Rate for Payer: BCN Medicare Advantage |
$80.28
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Cofinity Commercial |
$107.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.28
|
| Rate for Payer: Healthscope Commercial |
$148.52
|
| Rate for Payer: Healthscope Commercial |
$128.45
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.29
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,953.00
|
| Rate for Payer: Nomi Health Commercial |
$96.34
|
| Rate for Payer: PACE SWMI |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$80.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.43
|
| Rate for Payer: Priority Health Medicare |
$80.28
|
| Rate for Payer: Priority Health Narrow Network |
$132.43
|
| Rate for Payer: Priority Health SBD |
$132.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.28
|
| Rate for Payer: UHC Exchange |
$340.47
|
| Rate for Payer: UHC Medicare Advantage |
$80.28
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 54400
|
| Min. Negotiated Rate |
$199.17 |
| Max. Negotiated Rate |
$93,550.00 |
| Rate for Payer: Aetna Commercial |
$682.25
|
| Rate for Payer: Aetna Medicare |
$529.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.16
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$509.14
|
| Rate for Payer: BCBS Trust/PPO |
$199.17
|
| Rate for Payer: BCN Commercial |
$769.17
|
| Rate for Payer: BCN Medicare Advantage |
$509.14
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cofinity Commercial |
$733.16
|
| Rate for Payer: Cofinity Commercial |
$682.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.14
|
| Rate for Payer: Healthscope Commercial |
$941.91
|
| Rate for Payer: Healthscope Commercial |
$814.62
|
| Rate for Payer: Mclaren Medicaid |
$342.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.60
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,550.00
|
| Rate for Payer: Nomi Health Commercial |
$610.97
|
| Rate for Payer: PACE SWMI |
$509.14
|
| Rate for Payer: PHP Medicare Advantage |
$509.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,037.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.03
|
| Rate for Payer: Priority Health Medicare |
$509.14
|
| Rate for Payer: Priority Health Narrow Network |
$850.03
|
| Rate for Payer: Priority Health SBD |
$850.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$723.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.14
|
| Rate for Payer: UHC Exchange |
$723.23
|
| Rate for Payer: UHC Medicare Advantage |
$509.14
|
| Rate for Payer: UHCCP Medicaid |
$342.08
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 33990
|
| Min. Negotiated Rate |
$224.93 |
| Max. Negotiated Rate |
$63,752.00 |
| Rate for Payer: Aetna Commercial |
$460.40
|
| Rate for Payer: Aetna Medicare |
$357.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.76
|
| Rate for Payer: BCBS Complete |
$236.18
|
| Rate for Payer: BCBS MAPPO |
$343.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.41
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$343.58
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cofinity Commercial |
$494.76
|
| Rate for Payer: Cofinity Commercial |
$460.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.58
|
| Rate for Payer: Healthscope Commercial |
$549.73
|
| Rate for Payer: Healthscope Commercial |
$635.62
|
| Rate for Payer: Mclaren Medicaid |
$224.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.76
|
| Rate for Payer: Meridian Medicaid |
$236.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,752.00
|
| Rate for Payer: Nomi Health Commercial |
$412.30
|
| Rate for Payer: PACE SWMI |
$343.58
|
| Rate for Payer: PHP Medicare Advantage |
$343.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.07
|
| Rate for Payer: Priority Health Medicare |
$343.58
|
| Rate for Payer: Priority Health Narrow Network |
$561.07
|
| Rate for Payer: Priority Health SBD |
$561.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.58
|
| Rate for Payer: UHC Medicare Advantage |
$343.58
|
| Rate for Payer: UHCCP Medicaid |
$224.93
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS
|
Professional
|
Both
|
$3,380.00
|
|
|
Service Code
|
HCPCS 33991
|
| Min. Negotiated Rate |
$282.86 |
| Max. Negotiated Rate |
$80,552.00 |
| Rate for Payer: Aetna Commercial |
$581.43
|
| Rate for Payer: Aetna Medicare |
$451.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.82
|
| Rate for Payer: BCBS Complete |
$297.00
|
| Rate for Payer: BCBS MAPPO |
$433.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$433.90
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Cofinity Commercial |
$581.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.90
|
| Rate for Payer: Healthscope Commercial |
$694.24
|
| Rate for Payer: Healthscope Commercial |
$802.72
|
| Rate for Payer: Mclaren Medicaid |
$282.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.60
|
| Rate for Payer: Meridian Medicaid |
$297.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,552.00
|
| Rate for Payer: Nomi Health Commercial |
$520.68
|
| Rate for Payer: PACE SWMI |
$433.90
|
| Rate for Payer: PHP Medicare Advantage |
$433.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,197.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.14
|
| Rate for Payer: Priority Health Medicare |
$433.90
|
| Rate for Payer: Priority Health Narrow Network |
$704.14
|
| Rate for Payer: Priority Health SBD |
$704.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.90
|
| Rate for Payer: UHC Medicare Advantage |
$433.90
|
| Rate for Payer: UHCCP Medicaid |
$282.86
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$1,733.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,091.79 |
| Max. Negotiated Rate |
$1,559.70 |
| Rate for Payer: Aetna Commercial |
$1,473.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.45
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,213.10
|
| Rate for Payer: Cofinity Commercial |
$1,490.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,386.40
|
| Rate for Payer: Healthscope Commercial |
$1,559.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.05
|
| Rate for Payer: PHP Commercial |
$1,473.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health SBD |
$1,091.79
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
36571
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$55,134.00 |
| Rate for Payer: Aetna Commercial |
$399.47
|
| Rate for Payer: Aetna Medicare |
$310.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.28
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$298.11
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$298.11
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$429.28
|
| Rate for Payer: Cofinity Commercial |
$399.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.11
|
| Rate for Payer: Healthscope Commercial |
$551.50
|
| Rate for Payer: Healthscope Commercial |
$476.98
|
| Rate for Payer: Mclaren Medicaid |
$198.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.02
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,134.00
|
| Rate for Payer: Nomi Health Commercial |
$357.73
|
| Rate for Payer: PACE SWMI |
$298.11
|
| Rate for Payer: PHP Medicare Advantage |
$298.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.06
|
| Rate for Payer: Priority Health Medicare |
$298.11
|
| Rate for Payer: Priority Health Narrow Network |
$494.06
|
| Rate for Payer: Priority Health SBD |
$494.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,657.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.11
|
| Rate for Payer: UHC Exchange |
$1,657.32
|
| Rate for Payer: UHC Medicare Advantage |
$298.11
|
| Rate for Payer: UHCCP Medicaid |
$198.52
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 36571
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$55,134.00 |
| Rate for Payer: Aetna Commercial |
$399.47
|
| Rate for Payer: Aetna Medicare |
$310.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.28
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$298.11
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$298.11
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$429.28
|
| Rate for Payer: Cofinity Commercial |
$399.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.11
|
| Rate for Payer: Healthscope Commercial |
$551.50
|
| Rate for Payer: Healthscope Commercial |
$476.98
|
| Rate for Payer: Mclaren Medicaid |
$198.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.02
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,134.00
|
| Rate for Payer: Nomi Health Commercial |
$357.73
|
| Rate for Payer: PACE SWMI |
$298.11
|
| Rate for Payer: PHP Medicare Advantage |
$298.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.06
|
| Rate for Payer: Priority Health Medicare |
$298.11
|
| Rate for Payer: Priority Health Narrow Network |
$494.06
|
| Rate for Payer: Priority Health SBD |
$494.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,657.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.11
|
| Rate for Payer: UHC Exchange |
$1,657.32
|
| Rate for Payer: UHC Medicare Advantage |
$298.11
|
| Rate for Payer: UHCCP Medicaid |
$198.52
|
|
