|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$1,733.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$331.16 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$1,473.05
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.16
|
| Rate for Payer: BCN Commercial |
$1,694.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,490.38
|
| Rate for Payer: Cofinity Commercial |
$1,213.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,386.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,559.70
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.05
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$1,473.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,091.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.16
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,086.00
|
|
|
Service Code
|
HCPCS 36570
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$59,020.00 |
| Rate for Payer: Aetna Commercial |
$430.13
|
| Rate for Payer: Aetna Medicare |
$333.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.23
|
| Rate for Payer: BCBS Complete |
$224.10
|
| Rate for Payer: BCBS MAPPO |
$320.99
|
| Rate for Payer: BCN Commercial |
$2,152.62
|
| Rate for Payer: BCN Medicare Advantage |
$320.99
|
| Rate for Payer: Cash Price |
$2,468.80
|
| Rate for Payer: Cash Price |
$2,468.80
|
| Rate for Payer: Cofinity Commercial |
$462.23
|
| Rate for Payer: Cofinity Commercial |
$430.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.99
|
| Rate for Payer: Healthscope Commercial |
$593.83
|
| Rate for Payer: Healthscope Commercial |
$513.58
|
| Rate for Payer: Mclaren Medicaid |
$213.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.04
|
| Rate for Payer: Meridian Medicaid |
$224.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,020.00
|
| Rate for Payer: Nomi Health Commercial |
$385.19
|
| Rate for Payer: PACE SWMI |
$320.99
|
| Rate for Payer: PHP Medicare Advantage |
$320.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,005.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.69
|
| Rate for Payer: Priority Health Medicare |
$320.99
|
| Rate for Payer: Priority Health Narrow Network |
$529.69
|
| Rate for Payer: Priority Health SBD |
$529.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.99
|
| Rate for Payer: UHC Exchange |
$1,889.05
|
| Rate for Payer: UHC Medicare Advantage |
$320.99
|
| Rate for Payer: UHCCP Medicaid |
$213.43
|
|
|
PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 19342
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$134,363.00 |
| Rate for Payer: Aetna Commercial |
$976.35
|
| Rate for Payer: Aetna Medicare |
$757.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.35
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$728.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.65
|
| Rate for Payer: BCN Commercial |
$1,114.67
|
| Rate for Payer: BCN Medicare Advantage |
$728.62
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$976.35
|
| Rate for Payer: Cofinity Commercial |
$1,049.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.62
|
| Rate for Payer: Healthscope Commercial |
$1,347.95
|
| Rate for Payer: Healthscope Commercial |
$1,165.79
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.05
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,363.00
|
| Rate for Payer: Nomi Health Commercial |
$874.34
|
| Rate for Payer: PACE SWMI |
$728.62
|
| Rate for Payer: PHP Medicare Advantage |
$728.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,035.32
|
| Rate for Payer: Priority Health Medicare |
$728.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,035.32
|
| Rate for Payer: Priority Health SBD |
$1,035.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,013.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.62
|
| Rate for Payer: UHC Exchange |
$1,013.66
|
| Rate for Payer: UHC Medicare Advantage |
$728.62
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS
|
Professional
|
Both
|
$1,890.00
|
|
|
Service Code
|
HCPCS 61886
|
| Min. Negotiated Rate |
$579.36 |
| Max. Negotiated Rate |
$157,329.00 |
| Rate for Payer: Aetna Commercial |
$1,158.44
|
| Rate for Payer: Aetna Medicare |
$899.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.89
|
| Rate for Payer: BCBS Complete |
$608.33
|
| Rate for Payer: BCBS MAPPO |
$864.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.41
|
| Rate for Payer: BCN Commercial |
$1,804.66
|
| Rate for Payer: BCN Medicare Advantage |
$864.51
|
| Rate for Payer: Cash Price |
$1,512.00
|
| Rate for Payer: Cash Price |
$1,512.00
|
| Rate for Payer: Cofinity Commercial |
$1,244.89
|
| Rate for Payer: Cofinity Commercial |
$1,158.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.51
|
| Rate for Payer: Healthscope Commercial |
$1,599.34
|
| Rate for Payer: Healthscope Commercial |
$1,383.22
|
| Rate for Payer: Mclaren Medicaid |
$579.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.74
|
| Rate for Payer: Meridian Medicaid |
$608.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157,329.00
|
| Rate for Payer: Nomi Health Commercial |
$1,037.41
|
| Rate for Payer: PACE SWMI |
$864.51
|
| Rate for Payer: PHP Medicare Advantage |
$864.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,228.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.24
|
| Rate for Payer: Priority Health Medicare |
$864.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.24
|
| Rate for Payer: Priority Health SBD |
$1,537.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$690.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.51
|
| Rate for Payer: UHC Exchange |
$690.44
|
| Rate for Payer: UHC Medicare Advantage |
$864.51
|
| Rate for Payer: UHCCP Medicaid |
$579.36
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 61885
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$94,504.00 |
| Rate for Payer: Aetna Commercial |
$694.28
|
| Rate for Payer: Aetna Medicare |
$538.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.09
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$518.12
|
| Rate for Payer: BCBS Trust/PPO |
$810.94
|
| Rate for Payer: BCN Commercial |
$1,084.02
|
| Rate for Payer: BCN Medicare Advantage |
$518.12
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cofinity Commercial |
$746.09
|
| Rate for Payer: Cofinity Commercial |
$694.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.12
|
| Rate for Payer: Healthscope Commercial |
$958.52
|
| Rate for Payer: Healthscope Commercial |
$828.99
|
| Rate for Payer: Mclaren Medicaid |
$347.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.03
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,504.00
|
| Rate for Payer: Nomi Health Commercial |
$621.74
|
| Rate for Payer: PACE SWMI |
$518.12
|
| Rate for Payer: PHP Medicare Advantage |
$518.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.32
|
| Rate for Payer: Priority Health Medicare |
$518.12
|
| Rate for Payer: Priority Health Narrow Network |
$921.32
|
| Rate for Payer: Priority Health SBD |
$921.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.12
|
| Rate for Payer: UHC Exchange |
$529.78
|
| Rate for Payer: UHC Medicare Advantage |
$518.12
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,897.00
|
|
|
Service Code
|
HCPCS 33249
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$161,465.00 |
| Rate for Payer: Aetna Commercial |
$1,158.70
|
| Rate for Payer: Aetna Medicare |
$899.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,245.17
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$864.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$1,319.43
|
| Rate for Payer: BCN Medicare Advantage |
$864.70
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,245.17
|
| Rate for Payer: Cofinity Commercial |
$1,158.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.70
|
| Rate for Payer: Healthscope Commercial |
$1,599.70
|
| Rate for Payer: Healthscope Commercial |
$1,383.52
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.94
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161,465.00
|
| Rate for Payer: Nomi Health Commercial |
$1,037.64
|
| Rate for Payer: PACE SWMI |
$864.70
|
| Rate for Payer: PHP Medicare Advantage |
$864.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,427.95
|
| Rate for Payer: Priority Health Medicare |
$864.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,427.95
|
| Rate for Payer: Priority Health SBD |
$1,427.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,537.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.70
|
| Rate for Payer: UHC Exchange |
$1,537.98
|
| Rate for Payer: UHC Medicare Advantage |
$864.70
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 63685
|
| Min. Negotiated Rate |
$218.96 |
| Max. Negotiated Rate |
$64,170.00 |
| Rate for Payer: Aetna Commercial |
$437.87
|
| Rate for Payer: Aetna Medicare |
$339.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.55
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS MAPPO |
$326.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$529.73
|
| Rate for Payer: BCN Medicare Advantage |
$326.77
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$470.55
|
| Rate for Payer: Cofinity Commercial |
$437.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.77
|
| Rate for Payer: Healthscope Commercial |
$604.52
|
| Rate for Payer: Healthscope Commercial |
$522.83
|
| Rate for Payer: Mclaren Medicaid |
$218.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.11
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,170.00
|
| Rate for Payer: Nomi Health Commercial |
$392.12
|
| Rate for Payer: PACE SWMI |
$326.77
|
| Rate for Payer: PHP Medicare Advantage |
$326.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.65
|
| Rate for Payer: Priority Health Medicare |
$326.77
|
| Rate for Payer: Priority Health Narrow Network |
$584.65
|
| Rate for Payer: Priority Health SBD |
$584.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.77
|
| Rate for Payer: UHC Exchange |
$599.76
|
| Rate for Payer: UHC Medicare Advantage |
$326.77
|
| Rate for Payer: UHCCP Medicaid |
$218.96
|
|
|
PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 33210
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$28,640.00 |
| Rate for Payer: Aetna Commercial |
$206.09
|
| Rate for Payer: Aetna Medicare |
$159.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.47
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$153.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.69
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$221.47
|
| Rate for Payer: Cofinity Commercial |
$206.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.80
|
| Rate for Payer: Healthscope Commercial |
$284.53
|
| Rate for Payer: Healthscope Commercial |
$246.08
|
| Rate for Payer: Mclaren Medicaid |
$100.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.49
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,640.00
|
| Rate for Payer: Nomi Health Commercial |
$184.56
|
| Rate for Payer: PACE SWMI |
$153.80
|
| Rate for Payer: PHP Medicare Advantage |
$153.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.03
|
| Rate for Payer: Priority Health Medicare |
$153.80
|
| Rate for Payer: Priority Health Narrow Network |
$251.03
|
| Rate for Payer: Priority Health SBD |
$251.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.80
|
| Rate for Payer: UHC Exchange |
$369.09
|
| Rate for Payer: UHC Medicare Advantage |
$153.80
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
|
|
PR INSJ SUBQ RSVR PUMP/CONT INFUSION SYS VENTR CATH
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 61215
|
| Min. Negotiated Rate |
$341.44 |
| Max. Negotiated Rate |
$92,738.00 |
| Rate for Payer: Aetna Commercial |
$682.80
|
| Rate for Payer: Aetna Medicare |
$529.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.75
|
| Rate for Payer: BCBS Complete |
$358.51
|
| Rate for Payer: BCBS MAPPO |
$509.55
|
| Rate for Payer: BCBS Trust/PPO |
$682.56
|
| Rate for Payer: BCN Commercial |
$1,063.68
|
| Rate for Payer: BCN Medicare Advantage |
$509.55
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cofinity Commercial |
$733.75
|
| Rate for Payer: Cofinity Commercial |
$682.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.55
|
| Rate for Payer: Healthscope Commercial |
$942.67
|
| Rate for Payer: Healthscope Commercial |
$815.28
|
| Rate for Payer: Mclaren Medicaid |
$341.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.03
|
| Rate for Payer: Meridian Medicaid |
$358.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,738.00
|
| Rate for Payer: Nomi Health Commercial |
$611.46
|
| Rate for Payer: PACE SWMI |
$509.55
|
| Rate for Payer: PHP Medicare Advantage |
$509.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$904.26
|
| Rate for Payer: Priority Health Medicare |
$509.55
|
| Rate for Payer: Priority Health Narrow Network |
$904.26
|
| Rate for Payer: Priority Health SBD |
$904.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.55
|
| Rate for Payer: UHC Exchange |
$490.98
|
| Rate for Payer: UHC Medicare Advantage |
$509.55
|
| Rate for Payer: UHCCP Medicaid |
$341.44
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 51703
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$13,482.00 |
| Rate for Payer: Aetna Commercial |
$97.23
|
| Rate for Payer: Aetna Medicare |
$75.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.23
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$72.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,051.39
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: BCN Medicare Advantage |
$72.56
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$97.23
|
| Rate for Payer: Cofinity Commercial |
$104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.56
|
| Rate for Payer: Healthscope Commercial |
$134.24
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.19
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,482.00
|
| Rate for Payer: Nomi Health Commercial |
$87.07
|
| Rate for Payer: PACE SWMI |
$72.56
|
| Rate for Payer: PHP Medicare Advantage |
$72.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.37
|
| Rate for Payer: Priority Health Medicare |
$72.56
|
| Rate for Payer: Priority Health Narrow Network |
$120.37
|
| Rate for Payer: Priority Health SBD |
$120.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.56
|
| Rate for Payer: UHC Exchange |
$183.24
|
| Rate for Payer: UHC Medicare Advantage |
$72.56
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 51702
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$4,444.00 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.63
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Healthscope Commercial |
$43.79
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,444.00
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.95
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Narrow Network |
$39.95
|
| Rate for Payer: Priority Health SBD |
$39.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Exchange |
$113.98
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
|
|
PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 54660
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$62,860.00 |
| Rate for Payer: Aetna Commercial |
$461.00
|
| Rate for Payer: Aetna Medicare |
$357.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.40
|
| Rate for Payer: BCBS Complete |
$244.00
|
| Rate for Payer: BCBS MAPPO |
$344.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,434.41
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$344.03
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$495.40
|
| Rate for Payer: Cofinity Commercial |
$461.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.03
|
| Rate for Payer: Healthscope Commercial |
$636.46
|
| Rate for Payer: Healthscope Commercial |
$550.45
|
| Rate for Payer: Mclaren Medicaid |
$232.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.23
|
| Rate for Payer: Meridian Medicaid |
$244.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,860.00
|
| Rate for Payer: Nomi Health Commercial |
$412.84
|
| Rate for Payer: PACE SWMI |
$344.03
|
| Rate for Payer: PHP Medicare Advantage |
$344.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.74
|
| Rate for Payer: Priority Health Medicare |
$344.03
|
| Rate for Payer: Priority Health Narrow Network |
$575.74
|
| Rate for Payer: Priority Health SBD |
$575.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.03
|
| Rate for Payer: UHC Exchange |
$362.19
|
| Rate for Payer: UHC Medicare Advantage |
$344.03
|
| Rate for Payer: UHCCP Medicaid |
$232.38
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$3,446.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,170.98 |
| Max. Negotiated Rate |
$3,101.40 |
| Rate for Payer: Aetna Commercial |
$2,929.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.90
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$2,412.20
|
| Rate for Payer: Cofinity Commercial |
$2,963.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,412.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.80
|
| Rate for Payer: Healthscope Commercial |
$3,101.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,929.10
|
| Rate for Payer: PHP Commercial |
$2,929.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health SBD |
$2,170.98
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,446.00
|
|
|
Service Code
|
HCPCS 36561
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$58,603.00 |
| Rate for Payer: Aetna Commercial |
$421.34
|
| Rate for Payer: Aetna Medicare |
$327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.78
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$314.43
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$314.43
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$452.78
|
| Rate for Payer: Cofinity Commercial |
$421.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.43
|
| Rate for Payer: Healthscope Commercial |
$581.70
|
| Rate for Payer: Healthscope Commercial |
$503.09
|
| Rate for Payer: Mclaren Medicaid |
$209.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.15
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,603.00
|
| Rate for Payer: Nomi Health Commercial |
$377.32
|
| Rate for Payer: PACE SWMI |
$314.43
|
| Rate for Payer: PHP Medicare Advantage |
$314.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.72
|
| Rate for Payer: Priority Health Medicare |
$314.43
|
| Rate for Payer: Priority Health Narrow Network |
$521.72
|
| Rate for Payer: Priority Health SBD |
$521.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.43
|
| Rate for Payer: UHC Exchange |
$1,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$314.43
|
| Rate for Payer: UHCCP Medicaid |
$209.59
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,446.00
|
|
|
Service Code
|
HCPCS 36561
|
| Hospital Charge Code |
36561
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$58,603.00 |
| Rate for Payer: Aetna Commercial |
$421.34
|
| Rate for Payer: Aetna Medicare |
$327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.78
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$314.43
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$314.43
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$452.78
|
| Rate for Payer: Cofinity Commercial |
$421.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.43
|
| Rate for Payer: Healthscope Commercial |
$581.70
|
| Rate for Payer: Healthscope Commercial |
$503.09
|
| Rate for Payer: Mclaren Medicaid |
$209.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.15
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,603.00
|
| Rate for Payer: Nomi Health Commercial |
$377.32
|
| Rate for Payer: PACE SWMI |
$314.43
|
| Rate for Payer: PHP Medicare Advantage |
$314.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.72
|
| Rate for Payer: Priority Health Medicare |
$314.43
|
| Rate for Payer: Priority Health Narrow Network |
$521.72
|
| Rate for Payer: Priority Health SBD |
$521.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.43
|
| Rate for Payer: UHC Exchange |
$1,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$314.43
|
| Rate for Payer: UHCCP Medicaid |
$209.59
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$3,446.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$349.51 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$2,929.10
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,469.70
|
| Rate for Payer: BCN Commercial |
$1,469.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$2,963.56
|
| Rate for Payer: Cofinity Commercial |
$2,412.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,412.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,101.40
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,929.10
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,929.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,170.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.51
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,579.00
|
|
|
Service Code
|
HCPCS 36560
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$68,278.00 |
| Rate for Payer: Aetna Commercial |
$496.98
|
| Rate for Payer: Aetna Medicare |
$385.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.07
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$370.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,003.31
|
| Rate for Payer: BCN Commercial |
$1,825.70
|
| Rate for Payer: BCN Medicare Advantage |
$370.88
|
| Rate for Payer: Cash Price |
$2,863.20
|
| Rate for Payer: Cash Price |
$2,863.20
|
| Rate for Payer: Cofinity Commercial |
$534.07
|
| Rate for Payer: Cofinity Commercial |
$496.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.88
|
| Rate for Payer: Healthscope Commercial |
$686.13
|
| Rate for Payer: Healthscope Commercial |
$593.41
|
| Rate for Payer: Mclaren Medicaid |
$246.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.42
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,278.00
|
| Rate for Payer: Nomi Health Commercial |
$445.06
|
| Rate for Payer: PACE SWMI |
$370.88
|
| Rate for Payer: PHP Medicare Advantage |
$370.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,326.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.01
|
| Rate for Payer: Priority Health Medicare |
$370.88
|
| Rate for Payer: Priority Health Narrow Network |
$610.01
|
| Rate for Payer: Priority Health SBD |
$610.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.88
|
| Rate for Payer: UHC Exchange |
$1,425.58
|
| Rate for Payer: UHC Medicare Advantage |
$370.88
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
Both
|
$3,589.00
|
|
|
Service Code
|
HCPCS 36563
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$64,519.00 |
| Rate for Payer: Aetna Commercial |
$464.60
|
| Rate for Payer: Aetna Medicare |
$360.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.28
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS MAPPO |
$346.72
|
| Rate for Payer: BCBS Trust/PPO |
$742.79
|
| Rate for Payer: BCN Commercial |
$1,661.01
|
| Rate for Payer: BCN Medicare Advantage |
$346.72
|
| Rate for Payer: Cash Price |
$2,871.20
|
| Rate for Payer: Cash Price |
$2,871.20
|
| Rate for Payer: Cofinity Commercial |
$499.28
|
| Rate for Payer: Cofinity Commercial |
$464.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.72
|
| Rate for Payer: Healthscope Commercial |
$641.43
|
| Rate for Payer: Healthscope Commercial |
$554.75
|
| Rate for Payer: Mclaren Medicaid |
$230.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.06
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,519.00
|
| Rate for Payer: Nomi Health Commercial |
$416.06
|
| Rate for Payer: PACE SWMI |
$346.72
|
| Rate for Payer: PHP Medicare Advantage |
$346.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,332.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.11
|
| Rate for Payer: Priority Health Medicare |
$346.72
|
| Rate for Payer: Priority Health Narrow Network |
$570.11
|
| Rate for Payer: Priority Health SBD |
$570.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,779.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.72
|
| Rate for Payer: UHC Exchange |
$1,779.41
|
| Rate for Payer: UHC Medicare Advantage |
$346.72
|
| Rate for Payer: UHCCP Medicaid |
$230.25
|
|
|
PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>
|
Professional
|
Both
|
$1,982.00
|
|
|
Service Code
|
HCPCS 36558
|
| Min. Negotiated Rate |
$163.58 |
| Max. Negotiated Rate |
$45,655.00 |
| Rate for Payer: Aetna Commercial |
$328.11
|
| Rate for Payer: Aetna Medicare |
$254.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.60
|
| Rate for Payer: BCBS Complete |
$171.76
|
| Rate for Payer: BCBS MAPPO |
$244.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.82
|
| Rate for Payer: BCN Commercial |
$1,224.63
|
| Rate for Payer: BCN Medicare Advantage |
$244.86
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Cofinity Commercial |
$328.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.86
|
| Rate for Payer: Healthscope Commercial |
$452.99
|
| Rate for Payer: Healthscope Commercial |
$391.78
|
| Rate for Payer: Mclaren Medicaid |
$163.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.10
|
| Rate for Payer: Meridian Medicaid |
$171.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,655.00
|
| Rate for Payer: Nomi Health Commercial |
$293.83
|
| Rate for Payer: PACE SWMI |
$244.86
|
| Rate for Payer: PHP Medicare Advantage |
$244.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.78
|
| Rate for Payer: Priority Health Medicare |
$244.86
|
| Rate for Payer: Priority Health Narrow Network |
$405.78
|
| Rate for Payer: Priority Health SBD |
$405.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.86
|
| Rate for Payer: UHC Exchange |
$766.00
|
| Rate for Payer: UHC Medicare Advantage |
$244.86
|
| Rate for Payer: UHCCP Medicaid |
$163.58
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 36565
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$59,470.00 |
| Rate for Payer: Aetna Commercial |
$432.58
|
| Rate for Payer: Aetna Medicare |
$335.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.86
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$322.82
|
| Rate for Payer: BCBS Trust/PPO |
$705.81
|
| Rate for Payer: BCN Commercial |
$1,210.95
|
| Rate for Payer: BCN Medicare Advantage |
$322.82
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$464.86
|
| Rate for Payer: Cofinity Commercial |
$432.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.82
|
| Rate for Payer: Healthscope Commercial |
$597.22
|
| Rate for Payer: Healthscope Commercial |
$516.51
|
| Rate for Payer: Mclaren Medicaid |
$213.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.96
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,470.00
|
| Rate for Payer: Nomi Health Commercial |
$387.38
|
| Rate for Payer: PACE SWMI |
$322.82
|
| Rate for Payer: PHP Medicare Advantage |
$322.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.76
|
| Rate for Payer: Priority Health Medicare |
$322.82
|
| Rate for Payer: Priority Health Narrow Network |
$530.76
|
| Rate for Payer: Priority Health SBD |
$530.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,157.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.82
|
| Rate for Payer: UHC Exchange |
$1,157.44
|
| Rate for Payer: UHC Medicare Advantage |
$322.82
|
| Rate for Payer: UHCCP Medicaid |
$213.64
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT
|
Professional
|
Both
|
$2,907.00
|
|
|
Service Code
|
HCPCS 36566
|
| Min. Negotiated Rate |
$225.57 |
| Max. Negotiated Rate |
$63,112.00 |
| Rate for Payer: Aetna Commercial |
$455.04
|
| Rate for Payer: Aetna Medicare |
$353.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.00
|
| Rate for Payer: BCBS Complete |
$236.85
|
| Rate for Payer: BCBS MAPPO |
$339.58
|
| Rate for Payer: BCBS Trust/PPO |
$907.09
|
| Rate for Payer: BCN Commercial |
$6,274.62
|
| Rate for Payer: BCN Medicare Advantage |
$339.58
|
| Rate for Payer: Cash Price |
$2,325.60
|
| Rate for Payer: Cash Price |
$2,325.60
|
| Rate for Payer: Cofinity Commercial |
$489.00
|
| Rate for Payer: Cofinity Commercial |
$455.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.58
|
| Rate for Payer: Healthscope Commercial |
$628.22
|
| Rate for Payer: Healthscope Commercial |
$543.33
|
| Rate for Payer: Mclaren Medicaid |
$225.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.56
|
| Rate for Payer: Meridian Medicaid |
$236.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,112.00
|
| Rate for Payer: Nomi Health Commercial |
$407.50
|
| Rate for Payer: PACE SWMI |
$339.58
|
| Rate for Payer: PHP Medicare Advantage |
$339.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,889.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.07
|
| Rate for Payer: Priority Health Medicare |
$339.58
|
| Rate for Payer: Priority Health Narrow Network |
$561.07
|
| Rate for Payer: Priority Health SBD |
$561.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.58
|
| Rate for Payer: UHC Exchange |
$1,188.51
|
| Rate for Payer: UHC Medicare Advantage |
$339.58
|
| Rate for Payer: UHCCP Medicaid |
$225.57
|
|
|
PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL
|
Professional
|
Both
|
$1,514.00
|
|
|
Service Code
|
HCPCS 33206
|
| Min. Negotiated Rate |
$286.91 |
| Max. Negotiated Rate |
$80,307.00 |
| Rate for Payer: Aetna Commercial |
$577.59
|
| Rate for Payer: Aetna Medicare |
$448.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.70
|
| Rate for Payer: BCBS Complete |
$301.26
|
| Rate for Payer: BCBS MAPPO |
$431.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.41
|
| Rate for Payer: BCN Commercial |
$658.25
|
| Rate for Payer: BCN Medicare Advantage |
$431.04
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cofinity Commercial |
$620.70
|
| Rate for Payer: Cofinity Commercial |
$577.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.04
|
| Rate for Payer: Healthscope Commercial |
$797.42
|
| Rate for Payer: Healthscope Commercial |
$689.66
|
| Rate for Payer: Mclaren Medicaid |
$286.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.59
|
| Rate for Payer: Meridian Medicaid |
$301.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,307.00
|
| Rate for Payer: Nomi Health Commercial |
$517.25
|
| Rate for Payer: PACE SWMI |
$431.04
|
| Rate for Payer: PHP Medicare Advantage |
$431.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.18
|
| Rate for Payer: Priority Health Medicare |
$431.04
|
| Rate for Payer: Priority Health Narrow Network |
$713.18
|
| Rate for Payer: Priority Health SBD |
$713.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.04
|
| Rate for Payer: UHC Exchange |
$732.19
|
| Rate for Payer: UHC Medicare Advantage |
$431.04
|
| Rate for Payer: UHCCP Medicaid |
$286.91
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 33208
|
| Min. Negotiated Rate |
$325.89 |
| Max. Negotiated Rate |
$91,669.00 |
| Rate for Payer: Aetna Commercial |
$658.70
|
| Rate for Payer: Aetna Medicare |
$511.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.86
|
| Rate for Payer: BCBS Complete |
$342.18
|
| Rate for Payer: BCBS MAPPO |
$491.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.45
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$491.57
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$707.86
|
| Rate for Payer: Cofinity Commercial |
$658.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.57
|
| Rate for Payer: Healthscope Commercial |
$909.40
|
| Rate for Payer: Healthscope Commercial |
$786.51
|
| Rate for Payer: Mclaren Medicaid |
$325.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.15
|
| Rate for Payer: Meridian Medicaid |
$342.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,669.00
|
| Rate for Payer: Nomi Health Commercial |
$589.88
|
| Rate for Payer: PACE SWMI |
$491.57
|
| Rate for Payer: PHP Medicare Advantage |
$491.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.03
|
| Rate for Payer: Priority Health Medicare |
$491.57
|
| Rate for Payer: Priority Health Narrow Network |
$811.03
|
| Rate for Payer: Priority Health SBD |
$811.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.57
|
| Rate for Payer: UHC Exchange |
$1,098.61
|
| Rate for Payer: UHC Medicare Advantage |
$491.57
|
| Rate for Payer: UHCCP Medicaid |
$325.89
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$1,816.00
|
|
|
Service Code
|
HCPCS 33207
|
| Min. Negotiated Rate |
$301.82 |
| Max. Negotiated Rate |
$84,550.00 |
| Rate for Payer: Aetna Commercial |
$609.71
|
| Rate for Payer: Aetna Medicare |
$473.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.21
|
| Rate for Payer: BCBS Complete |
$316.91
|
| Rate for Payer: BCBS MAPPO |
$455.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,343.47
|
| Rate for Payer: BCN Commercial |
$690.99
|
| Rate for Payer: BCN Medicare Advantage |
$455.01
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Cash Price |
$1,452.80
|
| Rate for Payer: Cofinity Commercial |
$655.21
|
| Rate for Payer: Cofinity Commercial |
$609.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.01
|
| Rate for Payer: Healthscope Commercial |
$841.77
|
| Rate for Payer: Healthscope Commercial |
$728.02
|
| Rate for Payer: Mclaren Medicaid |
$301.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.76
|
| Rate for Payer: Meridian Medicaid |
$316.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84,550.00
|
| Rate for Payer: Nomi Health Commercial |
$546.01
|
| Rate for Payer: PACE SWMI |
$455.01
|
| Rate for Payer: PHP Medicare Advantage |
$455.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$749.34
|
| Rate for Payer: Priority Health Medicare |
$455.01
|
| Rate for Payer: Priority Health Narrow Network |
$749.34
|
| Rate for Payer: Priority Health SBD |
$749.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.01
|
| Rate for Payer: UHC Exchange |
$1,088.26
|
| Rate for Payer: UHC Medicare Advantage |
$455.01
|
| Rate for Payer: UHCCP Medicaid |
$301.82
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS
|
Professional
|
Both
|
$1,271.00
|
|
|
Service Code
|
HCPCS 33213
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$59,344.00 |
| Rate for Payer: Aetna Commercial |
$429.03
|
| Rate for Payer: Aetna Medicare |
$332.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.04
|
| Rate for Payer: BCBS Complete |
$223.87
|
| Rate for Payer: BCBS MAPPO |
$320.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$486.24
|
| Rate for Payer: BCN Medicare Advantage |
$320.17
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cofinity Commercial |
$461.04
|
| Rate for Payer: Cofinity Commercial |
$429.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.17
|
| Rate for Payer: Healthscope Commercial |
$592.31
|
| Rate for Payer: Healthscope Commercial |
$512.27
|
| Rate for Payer: Mclaren Medicaid |
$213.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.18
|
| Rate for Payer: Meridian Medicaid |
$223.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,344.00
|
| Rate for Payer: Nomi Health Commercial |
$384.20
|
| Rate for Payer: PACE SWMI |
$320.17
|
| Rate for Payer: PHP Medicare Advantage |
$320.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.83
|
| Rate for Payer: Priority Health Medicare |
$320.17
|
| Rate for Payer: Priority Health Narrow Network |
$531.83
|
| Rate for Payer: Priority Health SBD |
$531.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.17
|
| Rate for Payer: UHC Exchange |
$608.72
|
| Rate for Payer: UHC Medicare Advantage |
$320.17
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
|
