|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACIC
|
Professional
|
Both
|
$8,278.00
|
|
|
Service Code
|
HCPCS 63286
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$469,526.00 |
| Rate for Payer: Aetna Commercial |
$3,436.98
|
| Rate for Payer: Aetna Medicare |
$2,667.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,436.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,693.47
|
| Rate for Payer: BCBS Complete |
$1,765.49
|
| Rate for Payer: BCBS MAPPO |
$2,564.91
|
| Rate for Payer: BCBS Trust/PPO |
$172.75
|
| Rate for Payer: BCN Commercial |
$4,200.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,564.91
|
| Rate for Payer: Cash Price |
$6,622.40
|
| Rate for Payer: Cash Price |
$6,622.40
|
| Rate for Payer: Cofinity Commercial |
$3,693.47
|
| Rate for Payer: Cofinity Commercial |
$3,436.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,564.91
|
| Rate for Payer: Healthscope Commercial |
$4,745.08
|
| Rate for Payer: Healthscope Commercial |
$4,103.86
|
| Rate for Payer: Mclaren Medicaid |
$1,681.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,693.16
|
| Rate for Payer: Meridian Medicaid |
$1,765.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469,526.00
|
| Rate for Payer: Nomi Health Commercial |
$3,077.89
|
| Rate for Payer: PACE SWMI |
$2,564.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,564.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,380.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,447.93
|
| Rate for Payer: Priority Health Medicare |
$2,564.91
|
| Rate for Payer: Priority Health Narrow Network |
$4,447.93
|
| Rate for Payer: Priority Health SBD |
$4,447.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,099.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,564.91
|
| Rate for Payer: UHC Exchange |
$3,099.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,564.91
|
| Rate for Payer: UHCCP Medicaid |
$1,681.42
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR
|
Professional
|
Both
|
$8,749.00
|
|
|
Service Code
|
HCPCS 63287
|
| Min. Negotiated Rate |
$174.34 |
| Max. Negotiated Rate |
$497,466.00 |
| Rate for Payer: Aetna Commercial |
$3,646.41
|
| Rate for Payer: Aetna Medicare |
$2,830.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,646.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,918.53
|
| Rate for Payer: BCBS Complete |
$1,871.73
|
| Rate for Payer: BCBS MAPPO |
$2,721.20
|
| Rate for Payer: BCBS Trust/PPO |
$174.34
|
| Rate for Payer: BCN Commercial |
$4,448.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,721.20
|
| Rate for Payer: Cash Price |
$6,999.20
|
| Rate for Payer: Cash Price |
$6,999.20
|
| Rate for Payer: Cofinity Commercial |
$3,918.53
|
| Rate for Payer: Cofinity Commercial |
$3,646.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,721.20
|
| Rate for Payer: Healthscope Commercial |
$5,034.22
|
| Rate for Payer: Healthscope Commercial |
$4,353.92
|
| Rate for Payer: Mclaren Medicaid |
$1,782.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,857.26
|
| Rate for Payer: Meridian Medicaid |
$1,871.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497,466.00
|
| Rate for Payer: Nomi Health Commercial |
$3,265.44
|
| Rate for Payer: PACE SWMI |
$2,721.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,721.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,782.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,686.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,740.24
|
| Rate for Payer: Priority Health Medicare |
$2,721.20
|
| Rate for Payer: Priority Health Narrow Network |
$4,740.24
|
| Rate for Payer: Priority Health SBD |
$4,740.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,122.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,721.20
|
| Rate for Payer: UHC Exchange |
$3,122.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,721.20
|
| Rate for Payer: UHCCP Medicaid |
$1,782.60
|
|
|
PR LAM BX/EXC ISPI NEO IDRL SACRAL
|
Professional
|
Both
|
$6,285.00
|
|
|
Service Code
|
HCPCS 63283
|
| Min. Negotiated Rate |
$481.28 |
| Max. Negotiated Rate |
$345,298.00 |
| Rate for Payer: Aetna Commercial |
$2,533.10
|
| Rate for Payer: Aetna Medicare |
$1,965.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,533.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,722.13
|
| Rate for Payer: BCBS Complete |
$1,305.44
|
| Rate for Payer: BCBS MAPPO |
$1,890.37
|
| Rate for Payer: BCBS Trust/PPO |
$481.28
|
| Rate for Payer: BCN Commercial |
$2,812.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,890.37
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cofinity Commercial |
$2,722.13
|
| Rate for Payer: Cofinity Commercial |
$2,533.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,890.37
|
| Rate for Payer: Healthscope Commercial |
$3,497.18
|
| Rate for Payer: Healthscope Commercial |
$3,024.59
|
| Rate for Payer: Mclaren Medicaid |
$1,243.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,984.89
|
| Rate for Payer: Meridian Medicaid |
$1,305.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345,298.00
|
| Rate for Payer: Nomi Health Commercial |
$2,268.44
|
| Rate for Payer: PACE SWMI |
$1,890.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,890.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,243.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,085.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,304.23
|
| Rate for Payer: Priority Health Medicare |
$1,890.37
|
| Rate for Payer: Priority Health Narrow Network |
$3,304.23
|
| Rate for Payer: Priority Health SBD |
$3,304.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,214.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,890.37
|
| Rate for Payer: UHC Exchange |
$2,214.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,890.37
|
| Rate for Payer: UHCCP Medicaid |
$1,243.28
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED CERVICAL
|
Professional
|
Both
|
$7,589.00
|
|
|
Service Code
|
HCPCS 63280
|
| Min. Negotiated Rate |
$499.24 |
| Max. Negotiated Rate |
$384,158.00 |
| Rate for Payer: Aetna Commercial |
$2,808.65
|
| Rate for Payer: Aetna Medicare |
$2,179.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,808.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.25
|
| Rate for Payer: BCBS Complete |
$1,446.34
|
| Rate for Payer: BCBS MAPPO |
$2,096.01
|
| Rate for Payer: BCBS Trust/PPO |
$499.24
|
| Rate for Payer: BCN Commercial |
$3,442.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,096.01
|
| Rate for Payer: Cash Price |
$6,071.20
|
| Rate for Payer: Cash Price |
$6,071.20
|
| Rate for Payer: Cofinity Commercial |
$3,018.25
|
| Rate for Payer: Cofinity Commercial |
$2,808.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,096.01
|
| Rate for Payer: Healthscope Commercial |
$3,877.62
|
| Rate for Payer: Healthscope Commercial |
$3,353.62
|
| Rate for Payer: Mclaren Medicaid |
$1,377.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,200.81
|
| Rate for Payer: Meridian Medicaid |
$1,446.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384,158.00
|
| Rate for Payer: Nomi Health Commercial |
$2,515.21
|
| Rate for Payer: PACE SWMI |
$2,096.01
|
| Rate for Payer: PHP Medicare Advantage |
$2,096.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,932.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,672.19
|
| Rate for Payer: Priority Health Medicare |
$2,096.01
|
| Rate for Payer: Priority Health Narrow Network |
$3,672.19
|
| Rate for Payer: Priority Health SBD |
$3,672.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,540.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,096.01
|
| Rate for Payer: UHC Exchange |
$2,540.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,096.01
|
| Rate for Payer: UHCCP Medicaid |
$1,377.47
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED LUMBAR
|
Professional
|
Both
|
$8,001.00
|
|
|
Service Code
|
HCPCS 63282
|
| Min. Negotiated Rate |
$1,293.98 |
| Max. Negotiated Rate |
$359,100.00 |
| Rate for Payer: Aetna Commercial |
$2,637.21
|
| Rate for Payer: Aetna Medicare |
$2,046.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,834.02
|
| Rate for Payer: BCBS Complete |
$1,358.68
|
| Rate for Payer: BCBS MAPPO |
$1,968.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,220.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,968.07
|
| Rate for Payer: Cash Price |
$6,400.80
|
| Rate for Payer: Cash Price |
$6,400.80
|
| Rate for Payer: Cofinity Commercial |
$2,834.02
|
| Rate for Payer: Cofinity Commercial |
$2,637.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,968.07
|
| Rate for Payer: Healthscope Commercial |
$3,640.93
|
| Rate for Payer: Healthscope Commercial |
$3,148.91
|
| Rate for Payer: Mclaren Medicaid |
$1,293.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,066.47
|
| Rate for Payer: Meridian Medicaid |
$1,358.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359,100.00
|
| Rate for Payer: Nomi Health Commercial |
$2,361.68
|
| Rate for Payer: PACE SWMI |
$1,968.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,968.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,293.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,200.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,432.76
|
| Rate for Payer: Priority Health Medicare |
$1,968.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,432.76
|
| Rate for Payer: Priority Health SBD |
$3,432.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,329.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,968.07
|
| Rate for Payer: UHC Exchange |
$2,329.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,968.07
|
| Rate for Payer: UHCCP Medicaid |
$1,293.98
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED THORACIC
|
Professional
|
Both
|
$7,432.00
|
|
|
Service Code
|
HCPCS 63281
|
| Min. Negotiated Rate |
$1,367.46 |
| Max. Negotiated Rate |
$380,378.00 |
| Rate for Payer: Aetna Commercial |
$2,788.71
|
| Rate for Payer: Aetna Medicare |
$2,164.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,788.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,996.83
|
| Rate for Payer: BCBS Complete |
$1,435.83
|
| Rate for Payer: BCBS MAPPO |
$2,081.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,409.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,081.13
|
| Rate for Payer: Cash Price |
$5,945.60
|
| Rate for Payer: Cash Price |
$5,945.60
|
| Rate for Payer: Cofinity Commercial |
$2,996.83
|
| Rate for Payer: Cofinity Commercial |
$2,788.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,081.13
|
| Rate for Payer: Healthscope Commercial |
$3,850.09
|
| Rate for Payer: Healthscope Commercial |
$3,329.81
|
| Rate for Payer: Mclaren Medicaid |
$1,367.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,185.19
|
| Rate for Payer: Meridian Medicaid |
$1,435.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380,378.00
|
| Rate for Payer: Nomi Health Commercial |
$2,497.36
|
| Rate for Payer: PACE SWMI |
$2,081.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,081.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,367.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,642.05
|
| Rate for Payer: Priority Health Medicare |
$2,081.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,642.05
|
| Rate for Payer: Priority Health SBD |
$3,642.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,509.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,081.13
|
| Rate for Payer: UHC Exchange |
$2,509.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,081.13
|
| Rate for Payer: UHCCP Medicaid |
$1,367.46
|
|
|
PR LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL
|
Professional
|
Both
|
$9,383.00
|
|
|
Service Code
|
HCPCS 63290
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$505,949.00 |
| Rate for Payer: Aetna Commercial |
$3,708.45
|
| Rate for Payer: Aetna Medicare |
$2,878.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,708.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,985.20
|
| Rate for Payer: BCBS Complete |
$1,903.26
|
| Rate for Payer: BCBS MAPPO |
$2,767.50
|
| Rate for Payer: BCBS Trust/PPO |
$213.43
|
| Rate for Payer: BCN Commercial |
$4,523.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,767.50
|
| Rate for Payer: Cash Price |
$7,506.40
|
| Rate for Payer: Cash Price |
$7,506.40
|
| Rate for Payer: Cofinity Commercial |
$3,985.20
|
| Rate for Payer: Cofinity Commercial |
$3,708.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,767.50
|
| Rate for Payer: Healthscope Commercial |
$5,119.88
|
| Rate for Payer: Healthscope Commercial |
$4,428.00
|
| Rate for Payer: Mclaren Medicaid |
$1,812.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,905.88
|
| Rate for Payer: Meridian Medicaid |
$1,903.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505,949.00
|
| Rate for Payer: Nomi Health Commercial |
$3,321.00
|
| Rate for Payer: PACE SWMI |
$2,767.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,767.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,812.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,098.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,819.87
|
| Rate for Payer: Priority Health Medicare |
$2,767.50
|
| Rate for Payer: Priority Health Narrow Network |
$4,819.87
|
| Rate for Payer: Priority Health SBD |
$4,819.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,225.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,767.50
|
| Rate for Payer: UHC Exchange |
$3,225.11
|
| Rate for Payer: UHC Medicare Advantage |
$2,767.50
|
| Rate for Payer: UHCCP Medicaid |
$1,812.63
|
|
|
PR LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR
|
Professional
|
Both
|
$5,418.00
|
|
|
Service Code
|
HCPCS 63267
|
| Min. Negotiated Rate |
$244.07 |
| Max. Negotiated Rate |
$247,113.00 |
| Rate for Payer: Aetna Commercial |
$1,808.65
|
| Rate for Payer: Aetna Medicare |
$1,403.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,943.63
|
| Rate for Payer: BCBS Complete |
$938.88
|
| Rate for Payer: BCBS MAPPO |
$1,349.74
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: BCN Commercial |
$2,226.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.74
|
| Rate for Payer: Cash Price |
$4,334.40
|
| Rate for Payer: Cash Price |
$4,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.63
|
| Rate for Payer: Cofinity Commercial |
$1,808.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.74
|
| Rate for Payer: Healthscope Commercial |
$2,497.02
|
| Rate for Payer: Healthscope Commercial |
$2,159.58
|
| Rate for Payer: Mclaren Medicaid |
$894.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,417.23
|
| Rate for Payer: Meridian Medicaid |
$938.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247,113.00
|
| Rate for Payer: Nomi Health Commercial |
$1,619.69
|
| Rate for Payer: PACE SWMI |
$1,349.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,373.82
|
| Rate for Payer: Priority Health Medicare |
$1,349.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,373.82
|
| Rate for Payer: Priority Health SBD |
$2,373.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,635.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,349.74
|
| Rate for Payer: UHC Exchange |
$1,635.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,349.74
|
| Rate for Payer: UHCCP Medicaid |
$894.17
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL
|
Professional
|
Both
|
$5,819.00
|
|
|
Service Code
|
HCPCS 63265
|
| Min. Negotiated Rate |
$399.92 |
| Max. Negotiated Rate |
$301,968.00 |
| Rate for Payer: Aetna Commercial |
$2,202.60
|
| Rate for Payer: Aetna Medicare |
$1,709.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,202.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.97
|
| Rate for Payer: BCBS Complete |
$1,138.38
|
| Rate for Payer: BCBS MAPPO |
$1,643.73
|
| Rate for Payer: BCBS Trust/PPO |
$399.92
|
| Rate for Payer: BCN Commercial |
$2,712.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,643.73
|
| Rate for Payer: Cash Price |
$4,655.20
|
| Rate for Payer: Cash Price |
$4,655.20
|
| Rate for Payer: Cofinity Commercial |
$2,366.97
|
| Rate for Payer: Cofinity Commercial |
$2,202.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,643.73
|
| Rate for Payer: Healthscope Commercial |
$3,040.90
|
| Rate for Payer: Healthscope Commercial |
$2,629.97
|
| Rate for Payer: Mclaren Medicaid |
$1,084.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,725.92
|
| Rate for Payer: Meridian Medicaid |
$1,138.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301,968.00
|
| Rate for Payer: Nomi Health Commercial |
$1,972.48
|
| Rate for Payer: PACE SWMI |
$1,643.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,643.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,892.48
|
| Rate for Payer: Priority Health Medicare |
$1,643.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,892.48
|
| Rate for Payer: Priority Health SBD |
$2,892.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,946.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,643.73
|
| Rate for Payer: UHC Exchange |
$1,946.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,643.73
|
| Rate for Payer: UHCCP Medicaid |
$1,084.17
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL
|
Professional
|
Both
|
$4,597.00
|
|
|
Service Code
|
HCPCS 63268
|
| Min. Negotiated Rate |
$312.75 |
| Max. Negotiated Rate |
$252,236.00 |
| Rate for Payer: Aetna Commercial |
$1,946.40
|
| Rate for Payer: Aetna Medicare |
$1,510.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,946.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,091.66
|
| Rate for Payer: BCBS Complete |
$1,005.75
|
| Rate for Payer: BCBS MAPPO |
$1,452.54
|
| Rate for Payer: BCBS Trust/PPO |
$312.75
|
| Rate for Payer: BCN Commercial |
$2,272.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,452.54
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cofinity Commercial |
$2,091.66
|
| Rate for Payer: Cofinity Commercial |
$1,946.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,452.54
|
| Rate for Payer: Healthscope Commercial |
$2,687.20
|
| Rate for Payer: Healthscope Commercial |
$2,324.06
|
| Rate for Payer: Mclaren Medicaid |
$957.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,525.17
|
| Rate for Payer: Meridian Medicaid |
$1,005.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252,236.00
|
| Rate for Payer: Nomi Health Commercial |
$1,743.05
|
| Rate for Payer: PACE SWMI |
$1,452.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,452.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$957.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,988.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,544.43
|
| Rate for Payer: Priority Health Medicare |
$1,452.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,544.43
|
| Rate for Payer: Priority Health SBD |
$2,544.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,452.54
|
| Rate for Payer: UHC Exchange |
$1,609.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,452.54
|
| Rate for Payer: UHCCP Medicaid |
$957.86
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC
|
Professional
|
Both
|
$5,916.00
|
|
|
Service Code
|
HCPCS 63266
|
| Min. Negotiated Rate |
$600.15 |
| Max. Negotiated Rate |
$310,527.00 |
| Rate for Payer: Aetna Commercial |
$2,271.55
|
| Rate for Payer: Aetna Medicare |
$1,763.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,271.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.07
|
| Rate for Payer: BCBS Complete |
$1,173.49
|
| Rate for Payer: BCBS MAPPO |
$1,695.19
|
| Rate for Payer: BCBS Trust/PPO |
$600.15
|
| Rate for Payer: BCN Commercial |
$2,788.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,695.19
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cofinity Commercial |
$2,441.07
|
| Rate for Payer: Cofinity Commercial |
$2,271.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,695.19
|
| Rate for Payer: Healthscope Commercial |
$3,136.10
|
| Rate for Payer: Healthscope Commercial |
$2,712.30
|
| Rate for Payer: Mclaren Medicaid |
$1,117.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.95
|
| Rate for Payer: Meridian Medicaid |
$1,173.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310,527.00
|
| Rate for Payer: Nomi Health Commercial |
$2,034.23
|
| Rate for Payer: PACE SWMI |
$1,695.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,695.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,845.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,968.70
|
| Rate for Payer: Priority Health Medicare |
$1,695.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,968.70
|
| Rate for Payer: Priority Health SBD |
$2,968.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,014.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,695.19
|
| Rate for Payer: UHC Exchange |
$2,014.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,695.19
|
| Rate for Payer: UHCCP Medicaid |
$1,117.61
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL
|
Professional
|
Both
|
$6,211.00
|
|
|
Service Code
|
HCPCS 63270
|
| Min. Negotiated Rate |
$440.60 |
| Max. Negotiated Rate |
$377,127.00 |
| Rate for Payer: Aetna Commercial |
$2,764.35
|
| Rate for Payer: Aetna Medicare |
$2,145.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,764.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,970.65
|
| Rate for Payer: BCBS Complete |
$1,421.74
|
| Rate for Payer: BCBS MAPPO |
$2,062.95
|
| Rate for Payer: BCBS Trust/PPO |
$440.60
|
| Rate for Payer: BCN Commercial |
$3,067.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,062.95
|
| Rate for Payer: Cash Price |
$4,968.80
|
| Rate for Payer: Cash Price |
$4,968.80
|
| Rate for Payer: Cofinity Commercial |
$2,970.65
|
| Rate for Payer: Cofinity Commercial |
$2,764.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,062.95
|
| Rate for Payer: Healthscope Commercial |
$3,816.46
|
| Rate for Payer: Healthscope Commercial |
$3,300.72
|
| Rate for Payer: Mclaren Medicaid |
$1,354.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,166.10
|
| Rate for Payer: Meridian Medicaid |
$1,421.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377,127.00
|
| Rate for Payer: Nomi Health Commercial |
$2,475.54
|
| Rate for Payer: PACE SWMI |
$2,062.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,062.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,037.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,599.97
|
| Rate for Payer: Priority Health Medicare |
$2,062.95
|
| Rate for Payer: Priority Health Narrow Network |
$3,599.97
|
| Rate for Payer: Priority Health SBD |
$3,599.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,062.95
|
| Rate for Payer: UHC Exchange |
$2,244.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,062.95
|
| Rate for Payer: UHCCP Medicaid |
$1,354.04
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR
|
Professional
|
Both
|
$6,546.00
|
|
|
Service Code
|
HCPCS 63272
|
| Min. Negotiated Rate |
$318.56 |
| Max. Negotiated Rate |
$337,178.00 |
| Rate for Payer: Aetna Commercial |
$2,495.60
|
| Rate for Payer: Aetna Medicare |
$1,936.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,495.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,681.84
|
| Rate for Payer: BCBS Complete |
$1,288.90
|
| Rate for Payer: BCBS MAPPO |
$1,862.39
|
| Rate for Payer: BCBS Trust/PPO |
$318.56
|
| Rate for Payer: BCN Commercial |
$3,028.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,862.39
|
| Rate for Payer: Cash Price |
$5,236.80
|
| Rate for Payer: Cash Price |
$5,236.80
|
| Rate for Payer: Cofinity Commercial |
$2,681.84
|
| Rate for Payer: Cofinity Commercial |
$2,495.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,862.39
|
| Rate for Payer: Healthscope Commercial |
$3,445.42
|
| Rate for Payer: Healthscope Commercial |
$2,979.82
|
| Rate for Payer: Mclaren Medicaid |
$1,227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,955.51
|
| Rate for Payer: Meridian Medicaid |
$1,288.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337,178.00
|
| Rate for Payer: Nomi Health Commercial |
$2,234.87
|
| Rate for Payer: PACE SWMI |
$1,862.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,862.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,227.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,254.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,236.56
|
| Rate for Payer: Priority Health Medicare |
$1,862.39
|
| Rate for Payer: Priority Health Narrow Network |
$3,236.56
|
| Rate for Payer: Priority Health SBD |
$3,236.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,862.39
|
| Rate for Payer: UHC Exchange |
$2,273.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,862.39
|
| Rate for Payer: UHCCP Medicaid |
$1,227.52
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL
|
Professional
|
Both
|
$5,744.00
|
|
|
Service Code
|
HCPCS 63273
|
| Min. Negotiated Rate |
$580.07 |
| Max. Negotiated Rate |
$339,073.00 |
| Rate for Payer: Aetna Commercial |
$2,485.89
|
| Rate for Payer: Aetna Medicare |
$1,929.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,485.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,671.40
|
| Rate for Payer: BCBS Complete |
$1,280.17
|
| Rate for Payer: BCBS MAPPO |
$1,855.14
|
| Rate for Payer: BCBS Trust/PPO |
$580.07
|
| Rate for Payer: BCN Commercial |
$3,039.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,855.14
|
| Rate for Payer: Cash Price |
$4,595.20
|
| Rate for Payer: Cash Price |
$4,595.20
|
| Rate for Payer: Cofinity Commercial |
$2,671.40
|
| Rate for Payer: Cofinity Commercial |
$2,485.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,855.14
|
| Rate for Payer: Healthscope Commercial |
$3,432.01
|
| Rate for Payer: Healthscope Commercial |
$2,968.22
|
| Rate for Payer: Mclaren Medicaid |
$1,219.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,947.90
|
| Rate for Payer: Meridian Medicaid |
$1,280.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339,073.00
|
| Rate for Payer: Nomi Health Commercial |
$2,226.17
|
| Rate for Payer: PACE SWMI |
$1,855.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,855.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,733.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,241.68
|
| Rate for Payer: Priority Health Medicare |
$1,855.14
|
| Rate for Payer: Priority Health Narrow Network |
$3,241.68
|
| Rate for Payer: Priority Health SBD |
$3,241.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,122.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,855.14
|
| Rate for Payer: UHC Exchange |
$2,122.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,855.14
|
| Rate for Payer: UHCCP Medicaid |
$1,219.21
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC
|
Professional
|
Both
|
$6,110.00
|
|
|
Service Code
|
HCPCS 63271
|
| Min. Negotiated Rate |
$1,352.34 |
| Max. Negotiated Rate |
$376,733.00 |
| Rate for Payer: Aetna Commercial |
$2,759.50
|
| Rate for Payer: Aetna Medicare |
$2,141.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,965.44
|
| Rate for Payer: BCBS Complete |
$1,419.96
|
| Rate for Payer: BCBS MAPPO |
$2,059.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,374.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,059.33
|
| Rate for Payer: Cash Price |
$4,888.00
|
| Rate for Payer: Cash Price |
$4,888.00
|
| Rate for Payer: Cofinity Commercial |
$2,965.44
|
| Rate for Payer: Cofinity Commercial |
$2,759.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,059.33
|
| Rate for Payer: Healthscope Commercial |
$3,809.76
|
| Rate for Payer: Healthscope Commercial |
$3,294.93
|
| Rate for Payer: Mclaren Medicaid |
$1,352.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,162.30
|
| Rate for Payer: Meridian Medicaid |
$1,419.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376,733.00
|
| Rate for Payer: Nomi Health Commercial |
$2,471.20
|
| Rate for Payer: PACE SWMI |
$2,059.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,059.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,352.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,971.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,589.16
|
| Rate for Payer: Priority Health Medicare |
$2,059.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,589.16
|
| Rate for Payer: Priority Health SBD |
$3,589.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,427.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,059.33
|
| Rate for Payer: UHC Exchange |
$2,427.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,059.33
|
| Rate for Payer: UHCCP Medicaid |
$1,352.34
|
|
|
PR LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR
|
Professional
|
Both
|
$6,468.00
|
|
|
Service Code
|
HCPCS 63252
|
| Min. Negotiated Rate |
$1,061.35 |
| Max. Negotiated Rate |
$549,520.00 |
| Rate for Payer: Aetna Commercial |
$4,027.14
|
| Rate for Payer: Aetna Medicare |
$3,125.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,027.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,327.68
|
| Rate for Payer: BCBS Complete |
$2,065.41
|
| Rate for Payer: BCBS MAPPO |
$3,005.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.35
|
| Rate for Payer: BCN Commercial |
$4,459.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,005.33
|
| Rate for Payer: Cash Price |
$5,174.40
|
| Rate for Payer: Cash Price |
$5,174.40
|
| Rate for Payer: Cofinity Commercial |
$4,327.68
|
| Rate for Payer: Cofinity Commercial |
$4,027.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,005.33
|
| Rate for Payer: Healthscope Commercial |
$5,559.86
|
| Rate for Payer: Healthscope Commercial |
$4,808.53
|
| Rate for Payer: Mclaren Medicaid |
$1,967.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,155.60
|
| Rate for Payer: Meridian Medicaid |
$2,065.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549,520.00
|
| Rate for Payer: Nomi Health Commercial |
$3,606.40
|
| Rate for Payer: PACE SWMI |
$3,005.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,005.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,967.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,204.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,230.47
|
| Rate for Payer: Priority Health Medicare |
$3,005.33
|
| Rate for Payer: Priority Health Narrow Network |
$5,230.47
|
| Rate for Payer: Priority Health SBD |
$5,230.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,517.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,005.33
|
| Rate for Payer: UHC Exchange |
$3,517.95
|
| Rate for Payer: UHC Medicare Advantage |
$3,005.33
|
| Rate for Payer: UHCCP Medicaid |
$1,967.06
|
|
|
PR LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL
|
Professional
|
Both
|
$4,877.00
|
|
|
Service Code
|
HCPCS 63250
|
| Min. Negotiated Rate |
$331.77 |
| Max. Negotiated Rate |
$537,788.00 |
| Rate for Payer: Aetna Commercial |
$3,941.01
|
| Rate for Payer: Aetna Medicare |
$3,058.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,941.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,235.11
|
| Rate for Payer: BCBS Complete |
$2,020.23
|
| Rate for Payer: BCBS MAPPO |
$2,941.05
|
| Rate for Payer: BCBS Trust/PPO |
$331.77
|
| Rate for Payer: BCN Commercial |
$4,362.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,941.05
|
| Rate for Payer: Cash Price |
$3,901.60
|
| Rate for Payer: Cash Price |
$3,901.60
|
| Rate for Payer: Cofinity Commercial |
$4,235.11
|
| Rate for Payer: Cofinity Commercial |
$3,941.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,941.05
|
| Rate for Payer: Healthscope Commercial |
$5,440.94
|
| Rate for Payer: Healthscope Commercial |
$4,705.68
|
| Rate for Payer: Mclaren Medicaid |
$1,924.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,088.10
|
| Rate for Payer: Meridian Medicaid |
$2,020.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537,788.00
|
| Rate for Payer: Nomi Health Commercial |
$3,529.26
|
| Rate for Payer: PACE SWMI |
$2,941.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,941.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,924.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,170.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,116.16
|
| Rate for Payer: Priority Health Medicare |
$2,941.05
|
| Rate for Payer: Priority Health Narrow Network |
$5,116.16
|
| Rate for Payer: Priority Health SBD |
$5,116.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,226.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,941.05
|
| Rate for Payer: UHC Exchange |
$3,226.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,941.05
|
| Rate for Payer: UHCCP Medicaid |
$1,924.03
|
|
|
PR LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC
|
Professional
|
Both
|
$5,857.00
|
|
|
Service Code
|
HCPCS 63251
|
| Min. Negotiated Rate |
$725.36 |
| Max. Negotiated Rate |
$549,713.00 |
| Rate for Payer: Aetna Commercial |
$4,027.58
|
| Rate for Payer: Aetna Medicare |
$3,125.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,027.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,328.15
|
| Rate for Payer: BCBS Complete |
$2,065.63
|
| Rate for Payer: BCBS MAPPO |
$3,005.66
|
| Rate for Payer: BCBS Trust/PPO |
$725.36
|
| Rate for Payer: BCN Commercial |
$4,461.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,005.66
|
| Rate for Payer: Cash Price |
$4,685.60
|
| Rate for Payer: Cash Price |
$4,685.60
|
| Rate for Payer: Cofinity Commercial |
$4,328.15
|
| Rate for Payer: Cofinity Commercial |
$4,027.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,005.66
|
| Rate for Payer: Healthscope Commercial |
$5,560.47
|
| Rate for Payer: Healthscope Commercial |
$4,809.06
|
| Rate for Payer: Mclaren Medicaid |
$1,967.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,155.94
|
| Rate for Payer: Meridian Medicaid |
$2,065.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549,713.00
|
| Rate for Payer: Nomi Health Commercial |
$3,606.79
|
| Rate for Payer: PACE SWMI |
$3,005.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,005.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,967.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,807.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,231.04
|
| Rate for Payer: Priority Health Medicare |
$3,005.66
|
| Rate for Payer: Priority Health Narrow Network |
$5,231.04
|
| Rate for Payer: Priority Health SBD |
$5,231.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,329.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,005.66
|
| Rate for Payer: UHC Exchange |
$3,329.72
|
| Rate for Payer: UHC Medicare Advantage |
$3,005.66
|
| Rate for Payer: UHCCP Medicaid |
$1,967.27
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 63053
|
| Min. Negotiated Rate |
$146.54 |
| Max. Negotiated Rate |
$41,051.00 |
| Rate for Payer: Aetna Commercial |
$299.65
|
| Rate for Payer: Aetna Medicare |
$232.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.01
|
| Rate for Payer: BCBS Complete |
$153.87
|
| Rate for Payer: BCBS MAPPO |
$223.62
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$223.62
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$322.01
|
| Rate for Payer: Cofinity Commercial |
$299.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.62
|
| Rate for Payer: Healthscope Commercial |
$357.79
|
| Rate for Payer: Healthscope Commercial |
$413.70
|
| Rate for Payer: Mclaren Medicaid |
$146.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.80
|
| Rate for Payer: Meridian Medicaid |
$153.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,051.00
|
| Rate for Payer: Nomi Health Commercial |
$268.34
|
| Rate for Payer: PACE SWMI |
$223.62
|
| Rate for Payer: PHP Medicare Advantage |
$223.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.13
|
| Rate for Payer: Priority Health Medicare |
$223.62
|
| Rate for Payer: Priority Health Narrow Network |
$390.13
|
| Rate for Payer: Priority Health SBD |
$390.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.62
|
| Rate for Payer: UHC Medicare Advantage |
$223.62
|
| Rate for Payer: UHCCP Medicaid |
$146.54
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM
|
Professional
|
Both
|
$653.00
|
|
|
Service Code
|
HCPCS 63052
|
| Min. Negotiated Rate |
$165.50 |
| Max. Negotiated Rate |
$46,368.00 |
| Rate for Payer: Aetna Commercial |
$338.77
|
| Rate for Payer: Aetna Medicare |
$262.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.05
|
| Rate for Payer: BCBS Complete |
$173.78
|
| Rate for Payer: BCBS MAPPO |
$252.81
|
| Rate for Payer: BCBS Trust/PPO |
$449.06
|
| Rate for Payer: BCN Commercial |
$375.79
|
| Rate for Payer: BCN Medicare Advantage |
$252.81
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cofinity Commercial |
$364.05
|
| Rate for Payer: Cofinity Commercial |
$338.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.81
|
| Rate for Payer: Healthscope Commercial |
$404.50
|
| Rate for Payer: Healthscope Commercial |
$467.70
|
| Rate for Payer: Mclaren Medicaid |
$165.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.45
|
| Rate for Payer: Meridian Medicaid |
$173.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,368.00
|
| Rate for Payer: Nomi Health Commercial |
$303.37
|
| Rate for Payer: PACE SWMI |
$252.81
|
| Rate for Payer: PHP Medicare Advantage |
$252.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$424.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$439.05
|
| Rate for Payer: Priority Health Medicare |
$252.81
|
| Rate for Payer: Priority Health Narrow Network |
$439.05
|
| Rate for Payer: Priority Health SBD |
$439.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.81
|
| Rate for Payer: UHC Medicare Advantage |
$252.81
|
| Rate for Payer: UHCCP Medicaid |
$165.50
|
|
|
PR LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM
|
Professional
|
Both
|
$2,308.00
|
|
|
Service Code
|
HCPCS 63048
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$37,737.00 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: Aetna Medicare |
$214.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.41
|
| Rate for Payer: BCBS Complete |
$141.57
|
| Rate for Payer: BCBS MAPPO |
$205.84
|
| Rate for Payer: BCBS Trust/PPO |
$347.09
|
| Rate for Payer: BCN Commercial |
$336.83
|
| Rate for Payer: BCN Medicare Advantage |
$205.84
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cofinity Commercial |
$296.41
|
| Rate for Payer: Cofinity Commercial |
$275.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.84
|
| Rate for Payer: Healthscope Commercial |
$380.80
|
| Rate for Payer: Healthscope Commercial |
$329.34
|
| Rate for Payer: Mclaren Medicaid |
$134.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.13
|
| Rate for Payer: Meridian Medicaid |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,737.00
|
| Rate for Payer: Nomi Health Commercial |
$247.01
|
| Rate for Payer: PACE SWMI |
$205.84
|
| Rate for Payer: PHP Medicare Advantage |
$205.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,500.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.29
|
| Rate for Payer: Priority Health Medicare |
$205.84
|
| Rate for Payer: Priority Health Narrow Network |
$358.29
|
| Rate for Payer: Priority Health SBD |
$358.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.84
|
| Rate for Payer: UHC Exchange |
$462.46
|
| Rate for Payer: UHC Medicare Advantage |
$205.84
|
| Rate for Payer: UHCCP Medicaid |
$134.83
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL
|
Professional
|
Both
|
$2,678.00
|
|
|
Service Code
|
HCPCS 63045
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$231,872.00 |
| Rate for Payer: Aetna Commercial |
$1,696.79
|
| Rate for Payer: Aetna Medicare |
$1,316.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,696.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,823.41
|
| Rate for Payer: BCBS Complete |
$881.18
|
| Rate for Payer: BCBS MAPPO |
$1,266.26
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$2,089.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,266.26
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cofinity Commercial |
$1,823.41
|
| Rate for Payer: Cofinity Commercial |
$1,696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,266.26
|
| Rate for Payer: Healthscope Commercial |
$2,342.58
|
| Rate for Payer: Healthscope Commercial |
$2,026.02
|
| Rate for Payer: Mclaren Medicaid |
$839.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,329.57
|
| Rate for Payer: Meridian Medicaid |
$881.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231,872.00
|
| Rate for Payer: Nomi Health Commercial |
$1,519.51
|
| Rate for Payer: PACE SWMI |
$1,266.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,266.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,740.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,229.36
|
| Rate for Payer: Priority Health Medicare |
$1,266.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,229.36
|
| Rate for Payer: Priority Health SBD |
$2,229.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,741.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,266.26
|
| Rate for Payer: UHC Exchange |
$1,741.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,266.26
|
| Rate for Payer: UHCCP Medicaid |
$839.22
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$2,286.00
|
|
|
Service Code
|
HCPCS 63047
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$198,338.00 |
| Rate for Payer: Aetna Commercial |
$1,451.22
|
| Rate for Payer: Aetna Medicare |
$1,126.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,559.52
|
| Rate for Payer: BCBS Complete |
$757.06
|
| Rate for Payer: BCBS MAPPO |
$1,083.00
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,792.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.00
|
| Rate for Payer: Cash Price |
$1,828.80
|
| Rate for Payer: Cash Price |
$1,828.80
|
| Rate for Payer: Cofinity Commercial |
$1,559.52
|
| Rate for Payer: Cofinity Commercial |
$1,451.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.00
|
| Rate for Payer: Healthscope Commercial |
$2,003.55
|
| Rate for Payer: Healthscope Commercial |
$1,732.80
|
| Rate for Payer: Mclaren Medicaid |
$721.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.15
|
| Rate for Payer: Meridian Medicaid |
$757.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198,338.00
|
| Rate for Payer: Nomi Health Commercial |
$1,299.60
|
| Rate for Payer: PACE SWMI |
$1,083.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,485.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.45
|
| Rate for Payer: Priority Health Medicare |
$1,083.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,911.45
|
| Rate for Payer: Priority Health SBD |
$1,911.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,266.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.00
|
| Rate for Payer: UHC Exchange |
$2,266.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.00
|
| Rate for Payer: UHCCP Medicaid |
$721.01
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC
|
Professional
|
Both
|
$2,551.00
|
|
|
Service Code
|
HCPCS 63046
|
| Min. Negotiated Rate |
$189.66 |
| Max. Negotiated Rate |
$220,801.00 |
| Rate for Payer: Aetna Commercial |
$1,617.50
|
| Rate for Payer: Aetna Medicare |
$1,255.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,617.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,738.21
|
| Rate for Payer: BCBS Complete |
$841.60
|
| Rate for Payer: BCBS MAPPO |
$1,207.09
|
| Rate for Payer: BCBS Trust/PPO |
$189.66
|
| Rate for Payer: BCN Commercial |
$1,992.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,207.09
|
| Rate for Payer: Cash Price |
$2,040.80
|
| Rate for Payer: Cash Price |
$2,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,738.21
|
| Rate for Payer: Cofinity Commercial |
$1,617.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,207.09
|
| Rate for Payer: Healthscope Commercial |
$2,233.12
|
| Rate for Payer: Healthscope Commercial |
$1,931.34
|
| Rate for Payer: Mclaren Medicaid |
$801.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,267.44
|
| Rate for Payer: Meridian Medicaid |
$841.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220,801.00
|
| Rate for Payer: Nomi Health Commercial |
$1,448.51
|
| Rate for Payer: PACE SWMI |
$1,207.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,207.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,126.99
|
| Rate for Payer: Priority Health Medicare |
$1,207.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,126.99
|
| Rate for Payer: Priority Health SBD |
$2,126.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,207.09
|
| Rate for Payer: UHC Exchange |
$1,665.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,207.09
|
| Rate for Payer: UHCCP Medicaid |
$801.52
|
|
|
PR LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL
|
Professional
|
Both
|
$1,720.00
|
|
|
Service Code
|
HCPCS 63655
|
| Min. Negotiated Rate |
$297.43 |
| Max. Negotiated Rate |
$150,381.00 |
| Rate for Payer: Aetna Commercial |
$1,104.43
|
| Rate for Payer: Aetna Medicare |
$857.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,104.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.85
|
| Rate for Payer: BCBS Complete |
$577.24
|
| Rate for Payer: BCBS MAPPO |
$824.20
|
| Rate for Payer: BCBS Trust/PPO |
$297.43
|
| Rate for Payer: BCN Commercial |
$1,362.40
|
| Rate for Payer: BCN Medicare Advantage |
$824.20
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cofinity Commercial |
$1,186.85
|
| Rate for Payer: Cofinity Commercial |
$1,104.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.20
|
| Rate for Payer: Healthscope Commercial |
$1,524.77
|
| Rate for Payer: Healthscope Commercial |
$1,318.72
|
| Rate for Payer: Mclaren Medicaid |
$549.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$865.41
|
| Rate for Payer: Meridian Medicaid |
$577.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150,381.00
|
| Rate for Payer: Nomi Health Commercial |
$989.04
|
| Rate for Payer: PACE SWMI |
$824.20
|
| Rate for Payer: PHP Medicare Advantage |
$824.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,455.91
|
| Rate for Payer: Priority Health Medicare |
$824.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,455.91
|
| Rate for Payer: Priority Health SBD |
$1,455.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$953.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$824.20
|
| Rate for Payer: UHC Exchange |
$953.90
|
| Rate for Payer: UHC Medicare Advantage |
$824.20
|
| Rate for Payer: UHCCP Medicaid |
$549.75
|
|
