|
PR LIGATION OF SPERM DUCT
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
HCPCS 55450
|
| Min. Negotiated Rate |
$268.40 |
| Max. Negotiated Rate |
$503.25 |
| Rate for Payer: Aetna Medicare |
$335.50
|
| Rate for Payer: BCBS Complete |
$268.40
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.25
|
|
|
PR LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 37607
|
| Min. Negotiated Rate |
$220.67 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$461.36
|
| Rate for Payer: Aetna Medicare |
$358.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.79
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$344.30
|
| Rate for Payer: BCN Commercial |
$552.76
|
| Rate for Payer: BCN Medicare Advantage |
$344.30
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$495.79
|
| Rate for Payer: Cofinity Commercial |
$461.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.30
|
| Rate for Payer: Healthscope Commercial |
$550.88
|
| Rate for Payer: Healthscope Commercial |
$636.96
|
| Rate for Payer: Mclaren Medicaid |
$220.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.51
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.33
|
| Rate for Payer: Nomi Health Commercial |
$413.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$344.30
|
| Rate for Payer: PHP Medicare Advantage |
$344.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$594.43
|
| Rate for Payer: Priority Health Medicare |
$344.30
|
| Rate for Payer: Priority Health SBD |
$594.43
|
| Rate for Payer: Priority Health Tiered Network |
$594.43
|
| Rate for Payer: Railroad Medicare Medicare |
$344.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.01
|
| Rate for Payer: UHC Core |
$665.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.30
|
| Rate for Payer: UHC Exchange |
$665.01
|
| Rate for Payer: UHC Medicaid |
$220.67
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 37735
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$1,040.12 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: Aetna Medicare |
$560.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.68
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$538.67
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: BCN Medicare Advantage |
$538.67
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$775.68
|
| Rate for Payer: Cofinity Commercial |
$721.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.67
|
| Rate for Payer: Healthscope Commercial |
$996.54
|
| Rate for Payer: Healthscope Commercial |
$861.87
|
| Rate for Payer: Mclaren Medicaid |
$341.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.60
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$592.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.39
|
| Rate for Payer: Nomi Health Commercial |
$646.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.75
|
| Rate for Payer: PACE SWMI |
$538.67
|
| Rate for Payer: PHP Medicare Advantage |
$538.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$921.62
|
| Rate for Payer: Priority Health Medicare |
$538.67
|
| Rate for Payer: Priority Health SBD |
$921.62
|
| Rate for Payer: Priority Health Tiered Network |
$921.62
|
| Rate for Payer: Railroad Medicare Medicare |
$538.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.12
|
| Rate for Payer: UHC Core |
$1,040.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$538.67
|
| Rate for Payer: UHC Exchange |
$1,040.12
|
| Rate for Payer: UHC Medicaid |
$341.01
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ
|
Professional
|
Both
|
$488.00
|
|
|
Service Code
|
HCPCS 37700
|
| Min. Negotiated Rate |
$145.27 |
| Max. Negotiated Rate |
$432.22 |
| Rate for Payer: Aetna Commercial |
$302.36
|
| Rate for Payer: Aetna Medicare |
$234.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.92
|
| Rate for Payer: BCBS Complete |
$152.53
|
| Rate for Payer: BCBS MAPPO |
$225.64
|
| Rate for Payer: BCN Commercial |
$363.53
|
| Rate for Payer: BCN Medicare Advantage |
$225.64
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cofinity Commercial |
$324.92
|
| Rate for Payer: Cofinity Commercial |
$302.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.64
|
| Rate for Payer: Healthscope Commercial |
$417.43
|
| Rate for Payer: Healthscope Commercial |
$361.02
|
| Rate for Payer: Mclaren Medicaid |
$145.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.92
|
| Rate for Payer: Meridian Medicaid |
$152.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.22
|
| Rate for Payer: Nomi Health Commercial |
$270.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.00
|
| Rate for Payer: PACE SWMI |
$225.64
|
| Rate for Payer: PHP Medicare Advantage |
$225.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$390.93
|
| Rate for Payer: Priority Health Medicare |
$225.64
|
| Rate for Payer: Priority Health SBD |
$390.93
|
| Rate for Payer: Priority Health Tiered Network |
$390.93
|
| Rate for Payer: Railroad Medicare Medicare |
$225.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.94
|
| Rate for Payer: UHC Core |
$431.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$225.64
|
| Rate for Payer: UHC Exchange |
$431.94
|
| Rate for Payer: UHC Medicaid |
$145.27
|
| Rate for Payer: UHCCP Medicaid |
$145.27
|
|
|
PR LIG DIV & STRIPPING SHORT SAPHENOUS VEIN
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 37718
|
| Min. Negotiated Rate |
$231.32 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Aetna Commercial |
$487.85
|
| Rate for Payer: Aetna Medicare |
$378.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.26
|
| Rate for Payer: BCBS Complete |
$242.89
|
| Rate for Payer: BCBS MAPPO |
$364.07
|
| Rate for Payer: BCN Commercial |
$581.64
|
| Rate for Payer: BCN Medicare Advantage |
$364.07
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cofinity Commercial |
$524.26
|
| Rate for Payer: Cofinity Commercial |
$487.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.07
|
| Rate for Payer: Healthscope Commercial |
$673.53
|
| Rate for Payer: Healthscope Commercial |
$582.51
|
| Rate for Payer: Mclaren Medicaid |
$231.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.27
|
| Rate for Payer: Meridian Medicaid |
$242.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$697.93
|
| Rate for Payer: Nomi Health Commercial |
$436.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$635.25
|
| Rate for Payer: PACE SWMI |
$364.07
|
| Rate for Payer: PHP Medicare Advantage |
$364.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$625.49
|
| Rate for Payer: Priority Health Medicare |
$364.07
|
| Rate for Payer: Priority Health SBD |
$625.49
|
| Rate for Payer: Priority Health Tiered Network |
$625.49
|
| Rate for Payer: Railroad Medicare Medicare |
$364.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.90
|
| Rate for Payer: UHC Core |
$747.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.07
|
| Rate for Payer: UHC Exchange |
$747.90
|
| Rate for Payer: UHC Medicaid |
$231.32
|
| Rate for Payer: UHCCP Medicaid |
$231.32
|
|
|
PR LIG DIV&STRPG LONG SAPH SAPHFEM JUNCT KNE/BELW
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 37722
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$840.39 |
| Rate for Payer: Aetna Commercial |
$569.69
|
| Rate for Payer: Aetna Medicare |
$442.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.20
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$425.14
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: BCN Medicare Advantage |
$425.14
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cofinity Commercial |
$612.20
|
| Rate for Payer: Cofinity Commercial |
$569.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.14
|
| Rate for Payer: Healthscope Commercial |
$786.51
|
| Rate for Payer: Healthscope Commercial |
$680.22
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.40
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.05
|
| Rate for Payer: Nomi Health Commercial |
$510.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.00
|
| Rate for Payer: PACE SWMI |
$425.14
|
| Rate for Payer: PHP Medicare Advantage |
$425.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$727.24
|
| Rate for Payer: Priority Health Medicare |
$425.14
|
| Rate for Payer: Priority Health SBD |
$727.24
|
| Rate for Payer: Priority Health Tiered Network |
$727.24
|
| Rate for Payer: Railroad Medicare Medicare |
$425.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.39
|
| Rate for Payer: UHC Core |
$840.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.14
|
| Rate for Payer: UHC Exchange |
$840.39
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 37785
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$748.50 |
| Rate for Payer: Aetna Commercial |
$310.65
|
| Rate for Payer: Aetna Medicare |
$241.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.84
|
| Rate for Payer: BCBS Complete |
$156.78
|
| Rate for Payer: BCBS MAPPO |
$231.83
|
| Rate for Payer: BCN Commercial |
$373.49
|
| Rate for Payer: BCN Medicare Advantage |
$231.83
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$333.84
|
| Rate for Payer: Cofinity Commercial |
$310.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.83
|
| Rate for Payer: Healthscope Commercial |
$428.89
|
| Rate for Payer: Healthscope Commercial |
$370.93
|
| Rate for Payer: Mclaren Medicaid |
$149.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.42
|
| Rate for Payer: Meridian Medicaid |
$156.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.47
|
| Rate for Payer: Nomi Health Commercial |
$278.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$231.83
|
| Rate for Payer: PHP Medicare Advantage |
$231.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$401.64
|
| Rate for Payer: Priority Health Medicare |
$231.83
|
| Rate for Payer: Priority Health SBD |
$401.64
|
| Rate for Payer: Priority Health Tiered Network |
$401.64
|
| Rate for Payer: Railroad Medicare Medicare |
$231.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.31
|
| Rate for Payer: UHC Core |
$454.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$231.83
|
| Rate for Payer: UHC Exchange |
$454.31
|
| Rate for Payer: UHC Medicaid |
$149.31
|
| Rate for Payer: UHCCP Medicaid |
$149.31
|
|
|
PR LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 37780
|
| Min. Negotiated Rate |
$140.79 |
| Max. Negotiated Rate |
$416.54 |
| Rate for Payer: Aetna Commercial |
$294.59
|
| Rate for Payer: Aetna Medicare |
$228.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.57
|
| Rate for Payer: BCBS Complete |
$147.83
|
| Rate for Payer: BCBS MAPPO |
$219.84
|
| Rate for Payer: BCN Commercial |
$350.58
|
| Rate for Payer: BCN Medicare Advantage |
$219.84
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$316.57
|
| Rate for Payer: Cofinity Commercial |
$294.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.84
|
| Rate for Payer: Healthscope Commercial |
$406.70
|
| Rate for Payer: Healthscope Commercial |
$351.74
|
| Rate for Payer: Mclaren Medicaid |
$140.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.83
|
| Rate for Payer: Meridian Medicaid |
$147.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$241.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.54
|
| Rate for Payer: Nomi Health Commercial |
$263.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.75
|
| Rate for Payer: PACE SWMI |
$219.84
|
| Rate for Payer: PHP Medicare Advantage |
$219.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$377.00
|
| Rate for Payer: Priority Health Medicare |
$219.84
|
| Rate for Payer: Priority Health SBD |
$377.00
|
| Rate for Payer: Priority Health Tiered Network |
$377.00
|
| Rate for Payer: Railroad Medicare Medicare |
$219.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.87
|
| Rate for Payer: UHC Core |
$414.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$219.84
|
| Rate for Payer: UHC Exchange |
$414.87
|
| Rate for Payer: UHC Medicaid |
$140.79
|
| Rate for Payer: UHCCP Medicaid |
$140.79
|
|
|
PR LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR
|
Professional
|
Both
|
$2,301.00
|
|
|
Service Code
|
HCPCS 27429
|
| Min. Negotiated Rate |
$747.42 |
| Max. Negotiated Rate |
$2,230.67 |
| Rate for Payer: Aetna Commercial |
$1,535.67
|
| Rate for Payer: Aetna Medicare |
$1,191.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,535.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,650.27
|
| Rate for Payer: BCBS Complete |
$784.79
|
| Rate for Payer: BCBS MAPPO |
$1,146.02
|
| Rate for Payer: BCN Commercial |
$1,916.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,146.02
|
| Rate for Payer: Cash Price |
$1,840.80
|
| Rate for Payer: Cash Price |
$1,840.80
|
| Rate for Payer: Cofinity Commercial |
$1,650.27
|
| Rate for Payer: Cofinity Commercial |
$1,535.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,146.02
|
| Rate for Payer: Healthscope Commercial |
$2,120.14
|
| Rate for Payer: Healthscope Commercial |
$1,833.63
|
| Rate for Payer: Mclaren Medicaid |
$747.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.32
|
| Rate for Payer: Meridian Medicaid |
$784.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,230.67
|
| Rate for Payer: Nomi Health Commercial |
$1,375.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,725.75
|
| Rate for Payer: PACE SWMI |
$1,146.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,146.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$747.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,048.93
|
| Rate for Payer: Priority Health Medicare |
$1,146.02
|
| Rate for Payer: Priority Health SBD |
$2,048.93
|
| Rate for Payer: Priority Health Tiered Network |
$2,048.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,146.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,193.11
|
| Rate for Payer: UHC Core |
$2,193.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,146.02
|
| Rate for Payer: UHC Exchange |
$2,193.11
|
| Rate for Payer: UHC Medicaid |
$747.42
|
| Rate for Payer: UHCCP Medicaid |
$747.42
|
|
|
PR LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG
|
Professional
|
Both
|
$1,160.00
|
|
|
Service Code
|
HCPCS 37761
|
| Min. Negotiated Rate |
$310.98 |
| Max. Negotiated Rate |
$962.59 |
| Rate for Payer: Aetna Commercial |
$652.73
|
| Rate for Payer: Aetna Medicare |
$506.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.44
|
| Rate for Payer: BCBS Complete |
$326.53
|
| Rate for Payer: BCBS MAPPO |
$487.11
|
| Rate for Payer: BCN Commercial |
$785.81
|
| Rate for Payer: BCN Medicare Advantage |
$487.11
|
| Rate for Payer: Cash Price |
$928.00
|
| Rate for Payer: Cash Price |
$928.00
|
| Rate for Payer: Cofinity Commercial |
$701.44
|
| Rate for Payer: Cofinity Commercial |
$652.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.11
|
| Rate for Payer: Healthscope Commercial |
$901.15
|
| Rate for Payer: Healthscope Commercial |
$779.38
|
| Rate for Payer: Mclaren Medicaid |
$310.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.47
|
| Rate for Payer: Meridian Medicaid |
$326.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$535.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.50
|
| Rate for Payer: Nomi Health Commercial |
$584.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.00
|
| Rate for Payer: PACE SWMI |
$487.11
|
| Rate for Payer: PHP Medicare Advantage |
$487.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$845.05
|
| Rate for Payer: Priority Health Medicare |
$487.11
|
| Rate for Payer: Priority Health SBD |
$845.05
|
| Rate for Payer: Priority Health Tiered Network |
$845.05
|
| Rate for Payer: Railroad Medicare Medicare |
$487.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$962.59
|
| Rate for Payer: UHC Core |
$962.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$487.11
|
| Rate for Payer: UHC Exchange |
$962.59
|
| Rate for Payer: UHC Medicaid |
$310.98
|
| Rate for Payer: UHCCP Medicaid |
$310.98
|
|
|
PR LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 58611
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$87.49
|
| Rate for Payer: Aetna Medicare |
$67.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.02
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$65.29
|
| Rate for Payer: BCN Commercial |
$112.05
|
| Rate for Payer: BCN Medicare Advantage |
$65.29
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$87.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.29
|
| Rate for Payer: Healthscope Commercial |
$120.79
|
| Rate for Payer: Healthscope Commercial |
$104.46
|
| Rate for Payer: Mclaren Medicaid |
$41.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.55
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.97
|
| Rate for Payer: Nomi Health Commercial |
$78.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE SWMI |
$65.29
|
| Rate for Payer: PHP Medicare Advantage |
$65.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$113.48
|
| Rate for Payer: Priority Health Medicare |
$65.29
|
| Rate for Payer: Priority Health SBD |
$113.48
|
| Rate for Payer: Priority Health Tiered Network |
$113.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.70
|
| Rate for Payer: UHC Core |
$137.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.29
|
| Rate for Payer: UHC Exchange |
$137.70
|
| Rate for Payer: UHC Medicaid |
$41.54
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI
|
Professional
|
Both
|
$1,324.00
|
|
|
Service Code
|
HCPCS 58600
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$993.00 |
| Rate for Payer: Aetna Commercial |
$438.88
|
| Rate for Payer: Aetna Medicare |
$340.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.63
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS MAPPO |
$327.52
|
| Rate for Payer: BCN Commercial |
$557.74
|
| Rate for Payer: BCN Medicare Advantage |
$327.52
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cofinity Commercial |
$471.63
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.52
|
| Rate for Payer: Healthscope Commercial |
$605.91
|
| Rate for Payer: Healthscope Commercial |
$524.03
|
| Rate for Payer: Mclaren Medicaid |
$211.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.90
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.99
|
| Rate for Payer: Nomi Health Commercial |
$393.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.00
|
| Rate for Payer: PACE SWMI |
$327.52
|
| Rate for Payer: PHP Medicare Advantage |
$327.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$564.87
|
| Rate for Payer: Priority Health Medicare |
$327.52
|
| Rate for Payer: Priority Health SBD |
$564.87
|
| Rate for Payer: Priority Health Tiered Network |
$564.87
|
| Rate for Payer: Railroad Medicare Medicare |
$327.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.90
|
| Rate for Payer: UHC Core |
$648.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$327.52
|
| Rate for Payer: UHC Exchange |
$648.90
|
| Rate for Payer: UHC Medicaid |
$211.94
|
| Rate for Payer: UHCCP Medicaid |
$211.94
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 58605
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$398.66
|
| Rate for Payer: Aetna Medicare |
$309.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.41
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$297.51
|
| Rate for Payer: BCN Commercial |
$506.44
|
| Rate for Payer: BCN Medicare Advantage |
$297.51
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$398.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.51
|
| Rate for Payer: Healthscope Commercial |
$550.39
|
| Rate for Payer: Healthscope Commercial |
$476.02
|
| Rate for Payer: Mclaren Medicaid |
$192.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.39
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$327.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.54
|
| Rate for Payer: Nomi Health Commercial |
$357.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$297.51
|
| Rate for Payer: PHP Medicare Advantage |
$297.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$512.91
|
| Rate for Payer: Priority Health Medicare |
$297.51
|
| Rate for Payer: Priority Health SBD |
$512.91
|
| Rate for Payer: Priority Health Tiered Network |
$512.91
|
| Rate for Payer: Railroad Medicare Medicare |
$297.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.99
|
| Rate for Payer: UHC Core |
$586.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.51
|
| Rate for Payer: UHC Exchange |
$586.99
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
|
|
PR LILETTA, 52 MG
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS J7297
|
| Min. Negotiated Rate |
$453.00 |
| Max. Negotiated Rate |
$1,037.01 |
| Rate for Payer: Aetna Commercial |
$845.10
|
| Rate for Payer: Aetna Medicare |
$453.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.10
|
| Rate for Payer: BCBS Complete |
$1,037.01
|
| Rate for Payer: BCBS Trust/PPO |
$939.18
|
| Rate for Payer: BCN Commercial |
$941.98
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Mclaren Medicaid |
$987.63
|
| Rate for Payer: Meridian Medicaid |
$1,037.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$862.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$679.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$978.32
|
| Rate for Payer: UHC Core |
$978.32
|
| Rate for Payer: UHC Exchange |
$978.32
|
| Rate for Payer: UHC Medicaid |
$987.63
|
| Rate for Payer: UHCCP Medicaid |
$987.63
|
|
|
PR LIMITED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 92081
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: Aetna Medicare |
$33.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.78
|
| Rate for Payer: BCBS MAPPO |
$31.79
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Medicare Advantage |
$31.79
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$42.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.79
|
| Rate for Payer: Healthscope Commercial |
$58.81
|
| Rate for Payer: Healthscope Commercial |
$50.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.37
|
| Rate for Payer: Nomi Health Commercial |
$38.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PACE SWMI |
$31.79
|
| Rate for Payer: PHP Medicare Advantage |
$31.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.61
|
| Rate for Payer: Priority Health Medicare |
$31.79
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Priority Health Tiered Network |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$31.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.94
|
| Rate for Payer: UHC Core |
$40.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.79
|
| Rate for Payer: UHC Exchange |
$40.94
|
|
|
PR LINCOMYCIN INJECTION
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS J2010
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.95
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Cofinity Commercial |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$8.73
|
| Rate for Payer: Healthscope Commercial |
$7.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Nomi Health Commercial |
$5.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Medicare |
$4.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.40
|
| Rate for Payer: UHC Core |
$5.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.72
|
| Rate for Payer: UHC Exchange |
$5.40
|
|
|
PR LITHOLAPAXY COMP/LG > 2.5 CM
|
Professional
|
Both
|
$964.00
|
|
|
Service Code
|
HCPCS 52318
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$839.41 |
| Rate for Payer: Aetna Commercial |
$552.76
|
| Rate for Payer: Aetna Medicare |
$429.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.01
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$412.51
|
| Rate for Payer: BCN Commercial |
$698.17
|
| Rate for Payer: BCN Medicare Advantage |
$412.51
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cofinity Commercial |
$594.01
|
| Rate for Payer: Cofinity Commercial |
$552.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.51
|
| Rate for Payer: Healthscope Commercial |
$763.14
|
| Rate for Payer: Healthscope Commercial |
$660.02
|
| Rate for Payer: Mclaren Medicaid |
$264.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.14
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$827.75
|
| Rate for Payer: Nomi Health Commercial |
$495.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.00
|
| Rate for Payer: PACE SWMI |
$412.51
|
| Rate for Payer: PHP Medicare Advantage |
$412.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$760.54
|
| Rate for Payer: Priority Health Medicare |
$412.51
|
| Rate for Payer: Priority Health SBD |
$760.54
|
| Rate for Payer: Priority Health Tiered Network |
$760.54
|
| Rate for Payer: Railroad Medicare Medicare |
$412.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.41
|
| Rate for Payer: UHC Core |
$839.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.51
|
| Rate for Payer: UHC Exchange |
$839.41
|
| Rate for Payer: UHC Medicaid |
$264.12
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
|
|
PR LITHOLAPAXY SMPL/SM <2.5 CM
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 52317
|
| Min. Negotiated Rate |
$194.04 |
| Max. Negotiated Rate |
$1,281.00 |
| Rate for Payer: Aetna Commercial |
$405.95
|
| Rate for Payer: Aetna Medicare |
$315.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.25
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$302.95
|
| Rate for Payer: BCN Commercial |
$511.92
|
| Rate for Payer: BCN Medicare Advantage |
$302.95
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cofinity Commercial |
$436.25
|
| Rate for Payer: Cofinity Commercial |
$405.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.95
|
| Rate for Payer: Healthscope Commercial |
$560.46
|
| Rate for Payer: Healthscope Commercial |
$484.72
|
| Rate for Payer: Mclaren Medicaid |
$194.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.10
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.17
|
| Rate for Payer: Nomi Health Commercial |
$363.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: PACE SWMI |
$302.95
|
| Rate for Payer: PHP Medicare Advantage |
$302.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$557.65
|
| Rate for Payer: Priority Health Medicare |
$302.95
|
| Rate for Payer: Priority Health SBD |
$557.65
|
| Rate for Payer: Priority Health Tiered Network |
$557.65
|
| Rate for Payer: Railroad Medicare Medicare |
$302.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.81
|
| Rate for Payer: UHC Core |
$616.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.95
|
| Rate for Payer: UHC Exchange |
$616.81
|
| Rate for Payer: UHC Medicaid |
$194.04
|
| Rate for Payer: UHCCP Medicaid |
$194.04
|
|
|
PR LITHOTRIPSY XTRCORP SHOCK WAVE
|
Professional
|
Both
|
$1,593.00
|
|
|
Service Code
|
HCPCS 50590
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$1,194.75 |
| Rate for Payer: Aetna Commercial |
$686.47
|
| Rate for Payer: Aetna Medicare |
$532.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$686.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.70
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$512.29
|
| Rate for Payer: BCN Commercial |
$943.70
|
| Rate for Payer: BCN Medicare Advantage |
$512.29
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cofinity Commercial |
$737.70
|
| Rate for Payer: Cofinity Commercial |
$686.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.29
|
| Rate for Payer: Healthscope Commercial |
$947.74
|
| Rate for Payer: Healthscope Commercial |
$819.66
|
| Rate for Payer: Mclaren Medicaid |
$332.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.90
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$563.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,002.04
|
| Rate for Payer: Nomi Health Commercial |
$614.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.75
|
| Rate for Payer: PACE SWMI |
$512.29
|
| Rate for Payer: PHP Medicare Advantage |
$512.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$935.75
|
| Rate for Payer: Priority Health Medicare |
$512.29
|
| Rate for Payer: Priority Health SBD |
$935.75
|
| Rate for Payer: Priority Health Tiered Network |
$935.75
|
| Rate for Payer: Railroad Medicare Medicare |
$512.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.58
|
| Rate for Payer: UHC Core |
$1,001.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$512.29
|
| Rate for Payer: UHC Exchange |
$1,001.58
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC
|
Professional
|
Both
|
$4,060.00
|
|
|
Service Code
|
HCPCS 38562
|
| Min. Negotiated Rate |
$427.07 |
| Max. Negotiated Rate |
$3,045.00 |
| Rate for Payer: Aetna Commercial |
$883.03
|
| Rate for Payer: Aetna Medicare |
$685.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.93
|
| Rate for Payer: BCBS Complete |
$448.42
|
| Rate for Payer: BCBS MAPPO |
$658.98
|
| Rate for Payer: BCN Commercial |
$1,068.17
|
| Rate for Payer: BCN Medicare Advantage |
$658.98
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cofinity Commercial |
$948.93
|
| Rate for Payer: Cofinity Commercial |
$883.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.98
|
| Rate for Payer: Healthscope Commercial |
$1,219.11
|
| Rate for Payer: Healthscope Commercial |
$1,054.37
|
| Rate for Payer: Mclaren Medicaid |
$427.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.93
|
| Rate for Payer: Meridian Medicaid |
$448.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$724.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.52
|
| Rate for Payer: Nomi Health Commercial |
$790.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,045.00
|
| Rate for Payer: PACE SWMI |
$658.98
|
| Rate for Payer: PHP Medicare Advantage |
$658.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,421.28
|
| Rate for Payer: Priority Health Medicare |
$658.98
|
| Rate for Payer: Priority Health SBD |
$1,421.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,421.28
|
| Rate for Payer: Railroad Medicare Medicare |
$658.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,242.10
|
| Rate for Payer: UHC Core |
$1,242.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$658.98
|
| Rate for Payer: UHC Exchange |
$1,242.10
|
| Rate for Payer: UHC Medicaid |
$427.07
|
| Rate for Payer: UHCCP Medicaid |
$427.07
|
|
|
PR LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC
|
Professional
|
Both
|
$2,916.00
|
|
|
Service Code
|
HCPCS 38564
|
| Min. Negotiated Rate |
$422.38 |
| Max. Negotiated Rate |
$2,187.00 |
| Rate for Payer: Aetna Commercial |
$877.42
|
| Rate for Payer: Aetna Medicare |
$680.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.90
|
| Rate for Payer: BCBS Complete |
$443.50
|
| Rate for Payer: BCBS MAPPO |
$654.79
|
| Rate for Payer: BCN Commercial |
$1,058.71
|
| Rate for Payer: BCN Medicare Advantage |
$654.79
|
| Rate for Payer: Cash Price |
$2,332.80
|
| Rate for Payer: Cash Price |
$2,332.80
|
| Rate for Payer: Cofinity Commercial |
$942.90
|
| Rate for Payer: Cofinity Commercial |
$877.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.79
|
| Rate for Payer: Healthscope Commercial |
$1,211.36
|
| Rate for Payer: Healthscope Commercial |
$1,047.66
|
| Rate for Payer: Mclaren Medicaid |
$422.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.53
|
| Rate for Payer: Meridian Medicaid |
$443.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,251.05
|
| Rate for Payer: Nomi Health Commercial |
$785.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,187.00
|
| Rate for Payer: PACE SWMI |
$654.79
|
| Rate for Payer: PHP Medicare Advantage |
$654.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$422.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,408.70
|
| Rate for Payer: Priority Health Medicare |
$654.79
|
| Rate for Payer: Priority Health SBD |
$1,408.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,408.70
|
| Rate for Payer: Railroad Medicare Medicare |
$654.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.01
|
| Rate for Payer: UHC Core |
$1,247.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$654.79
|
| Rate for Payer: UHC Exchange |
$1,247.01
|
| Rate for Payer: UHC Medicaid |
$422.38
|
| Rate for Payer: UHCCP Medicaid |
$422.38
|
|
|
PR LMTD OPH XM&EVAL GENERAL ANES W/WO MNPJ GLOBE
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 92019
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Aetna Commercial |
$77.48
|
| Rate for Payer: Aetna Medicare |
$60.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.26
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$57.82
|
| Rate for Payer: BCN Commercial |
$78.82
|
| Rate for Payer: BCN Medicare Advantage |
$57.82
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$83.26
|
| Rate for Payer: Cofinity Commercial |
$77.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.82
|
| Rate for Payer: Healthscope Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$106.97
|
| Rate for Payer: Mclaren Medicaid |
$37.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.97
|
| Rate for Payer: Nomi Health Commercial |
$69.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.25
|
| Rate for Payer: PACE SWMI |
$57.82
|
| Rate for Payer: PHP Medicare Advantage |
$57.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92.46
|
| Rate for Payer: Priority Health Medicare |
$57.82
|
| Rate for Payer: Priority Health SBD |
$92.46
|
| Rate for Payer: Priority Health Tiered Network |
$92.46
|
| Rate for Payer: Railroad Medicare Medicare |
$57.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.79
|
| Rate for Payer: UHC Core |
$91.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.82
|
| Rate for Payer: UHC Exchange |
$91.79
|
| Rate for Payer: UHC Medicaid |
$37.49
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
|
|
PR LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN
|
Professional
|
Both
|
$1,669.00
|
|
|
Service Code
|
HCPCS 25280
|
| Min. Negotiated Rate |
$339.52 |
| Max. Negotiated Rate |
$1,251.75 |
| Rate for Payer: Aetna Commercial |
$693.06
|
| Rate for Payer: Aetna Medicare |
$537.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.78
|
| Rate for Payer: BCBS Complete |
$356.50
|
| Rate for Payer: BCBS MAPPO |
$517.21
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$517.21
|
| Rate for Payer: Cash Price |
$1,335.20
|
| Rate for Payer: Cash Price |
$1,335.20
|
| Rate for Payer: Cofinity Commercial |
$744.78
|
| Rate for Payer: Cofinity Commercial |
$693.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.21
|
| Rate for Payer: Healthscope Commercial |
$956.84
|
| Rate for Payer: Healthscope Commercial |
$827.54
|
| Rate for Payer: Mclaren Medicaid |
$339.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.07
|
| Rate for Payer: Meridian Medicaid |
$356.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$568.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,005.48
|
| Rate for Payer: Nomi Health Commercial |
$620.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,251.75
|
| Rate for Payer: PACE SWMI |
$517.21
|
| Rate for Payer: PHP Medicare Advantage |
$517.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$931.04
|
| Rate for Payer: Priority Health Medicare |
$517.21
|
| Rate for Payer: Priority Health SBD |
$931.04
|
| Rate for Payer: Priority Health Tiered Network |
$931.04
|
| Rate for Payer: Railroad Medicare Medicare |
$517.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.93
|
| Rate for Payer: UHC Core |
$982.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$517.21
|
| Rate for Payer: UHC Exchange |
$982.93
|
| Rate for Payer: UHC Medicaid |
$339.52
|
| Rate for Payer: UHCCP Medicaid |
$339.52
|
|
|
PR LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA
|
Professional
|
Both
|
$1,403.00
|
|
|
Service Code
|
HCPCS 27686
|
| Min. Negotiated Rate |
$320.78 |
| Max. Negotiated Rate |
$1,052.25 |
| Rate for Payer: Aetna Commercial |
$656.64
|
| Rate for Payer: Aetna Medicare |
$509.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.64
|
| Rate for Payer: BCBS Complete |
$336.82
|
| Rate for Payer: BCBS MAPPO |
$490.03
|
| Rate for Payer: BCN Commercial |
$808.22
|
| Rate for Payer: BCN Medicare Advantage |
$490.03
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Cash Price |
$1,122.40
|
| Rate for Payer: Cofinity Commercial |
$705.64
|
| Rate for Payer: Cofinity Commercial |
$656.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.03
|
| Rate for Payer: Healthscope Commercial |
$906.56
|
| Rate for Payer: Healthscope Commercial |
$784.05
|
| Rate for Payer: Mclaren Medicaid |
$320.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.53
|
| Rate for Payer: Meridian Medicaid |
$336.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$539.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.63
|
| Rate for Payer: Nomi Health Commercial |
$588.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,052.25
|
| Rate for Payer: PACE SWMI |
$490.03
|
| Rate for Payer: PHP Medicare Advantage |
$490.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$863.96
|
| Rate for Payer: Priority Health Medicare |
$490.03
|
| Rate for Payer: Priority Health SBD |
$863.96
|
| Rate for Payer: Priority Health Tiered Network |
$863.96
|
| Rate for Payer: Railroad Medicare Medicare |
$490.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.84
|
| Rate for Payer: UHC Core |
$944.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$490.03
|
| Rate for Payer: UHC Exchange |
$944.84
|
| Rate for Payer: UHC Medicaid |
$320.78
|
| Rate for Payer: UHCCP Medicaid |
$320.78
|
|
|
PR LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX
|
Professional
|
Both
|
$1,876.00
|
|
|
Service Code
|
HCPCS 27685
|
| Min. Negotiated Rate |
$282.86 |
| Max. Negotiated Rate |
$1,407.00 |
| Rate for Payer: Aetna Commercial |
$576.95
|
| Rate for Payer: Aetna Medicare |
$447.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.01
|
| Rate for Payer: BCBS Complete |
$297.00
|
| Rate for Payer: BCBS MAPPO |
$430.56
|
| Rate for Payer: BCN Commercial |
$710.12
|
| Rate for Payer: BCN Medicare Advantage |
$430.56
|
| Rate for Payer: Cash Price |
$1,500.80
|
| Rate for Payer: Cash Price |
$1,500.80
|
| Rate for Payer: Cofinity Commercial |
$620.01
|
| Rate for Payer: Cofinity Commercial |
$576.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.56
|
| Rate for Payer: Healthscope Commercial |
$796.54
|
| Rate for Payer: Healthscope Commercial |
$688.90
|
| Rate for Payer: Mclaren Medicaid |
$282.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.09
|
| Rate for Payer: Meridian Medicaid |
$297.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$473.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.22
|
| Rate for Payer: Nomi Health Commercial |
$516.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,407.00
|
| Rate for Payer: PACE SWMI |
$430.56
|
| Rate for Payer: PHP Medicare Advantage |
$430.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$759.10
|
| Rate for Payer: Priority Health Medicare |
$430.56
|
| Rate for Payer: Priority Health SBD |
$759.10
|
| Rate for Payer: Priority Health Tiered Network |
$759.10
|
| Rate for Payer: Railroad Medicare Medicare |
$430.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.04
|
| Rate for Payer: UHC Core |
$808.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$430.56
|
| Rate for Payer: UHC Exchange |
$808.04
|
| Rate for Payer: UHC Medicaid |
$282.86
|
| Rate for Payer: UHCCP Medicaid |
$282.86
|
|
