|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,230.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$1,253.66 |
| Max. Negotiated Rate |
$2,319.27 |
| Rate for Payer: Aetna Commercial |
$1,679.90
|
| Rate for Payer: Aetna Medicare |
$1,303.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.90
|
| Rate for Payer: BCBS Complete |
$1,292.00
|
| Rate for Payer: BCBS MAPPO |
$1,253.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.66
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cofinity Commercial |
$1,805.27
|
| Rate for Payer: Cofinity Commercial |
$1,679.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.66
|
| Rate for Payer: Healthscope Commercial |
$2,319.27
|
| Rate for Payer: Healthscope Commercial |
$2,005.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,316.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.50
|
| Rate for Payer: Nomi Health Commercial |
$1,504.39
|
| Rate for Payer: PACE SWMI |
$1,253.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,099.50
|
| Rate for Payer: Priority Health Medicare |
$1,253.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,253.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.66
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$848.50 |
| Max. Negotiated Rate |
$1,636.05 |
| Rate for Payer: Aetna Commercial |
$1,136.99
|
| Rate for Payer: Aetna Medicare |
$882.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.99
|
| Rate for Payer: BCBS Complete |
$1,006.80
|
| Rate for Payer: BCBS MAPPO |
$848.50
|
| Rate for Payer: BCN Medicare Advantage |
$848.50
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,221.84
|
| Rate for Payer: Cofinity Commercial |
$1,136.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.50
|
| Rate for Payer: Healthscope Commercial |
$1,357.60
|
| Rate for Payer: Healthscope Commercial |
$1,569.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.05
|
| Rate for Payer: Nomi Health Commercial |
$1,018.20
|
| Rate for Payer: PACE SWMI |
$848.50
|
| Rate for Payer: PHP Medicare Advantage |
$848.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.05
|
| Rate for Payer: Priority Health Medicare |
$848.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$848.50
|
| Rate for Payer: UHC Medicare Advantage |
$848.50
|
|
|
PR LAPS W/REVISION INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 49325
|
| Min. Negotiated Rate |
$382.80 |
| Max. Negotiated Rate |
$741.85 |
| Rate for Payer: Aetna Commercial |
$537.34
|
| Rate for Payer: Aetna Medicare |
$417.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.34
|
| Rate for Payer: BCBS Complete |
$382.80
|
| Rate for Payer: BCBS MAPPO |
$401.00
|
| Rate for Payer: BCN Medicare Advantage |
$401.00
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$577.44
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.00
|
| Rate for Payer: Healthscope Commercial |
$741.85
|
| Rate for Payer: Healthscope Commercial |
$641.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$622.05
|
| Rate for Payer: Nomi Health Commercial |
$481.20
|
| Rate for Payer: PACE SWMI |
$401.00
|
| Rate for Payer: PHP Medicare Advantage |
$401.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health Medicare |
$401.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.00
|
| Rate for Payer: UHC Medicare Advantage |
$401.00
|
|
|
PR LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 58552
|
| Min. Negotiated Rate |
$943.77 |
| Max. Negotiated Rate |
$1,745.97 |
| Rate for Payer: Aetna Commercial |
$1,264.65
|
| Rate for Payer: Aetna Medicare |
$981.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.65
|
| Rate for Payer: BCBS Complete |
$1,003.60
|
| Rate for Payer: BCBS MAPPO |
$943.77
|
| Rate for Payer: BCN Medicare Advantage |
$943.77
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,359.03
|
| Rate for Payer: Cofinity Commercial |
$1,264.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.77
|
| Rate for Payer: Healthscope Commercial |
$1,510.03
|
| Rate for Payer: Healthscope Commercial |
$1,745.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,630.85
|
| Rate for Payer: Nomi Health Commercial |
$1,132.52
|
| Rate for Payer: PACE SWMI |
$943.77
|
| Rate for Payer: PHP Medicare Advantage |
$943.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health Medicare |
$943.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.77
|
| Rate for Payer: UHC Medicare Advantage |
$943.77
|
|
|
PR LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS
|
Professional
|
Both
|
$3,016.00
|
|
|
Service Code
|
HCPCS 58553
|
| Min. Negotiated Rate |
$1,077.81 |
| Max. Negotiated Rate |
$1,993.95 |
| Rate for Payer: Aetna Commercial |
$1,444.27
|
| Rate for Payer: Aetna Medicare |
$1,120.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.27
|
| Rate for Payer: BCBS Complete |
$1,206.40
|
| Rate for Payer: BCBS MAPPO |
$1,077.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.81
|
| Rate for Payer: Cash Price |
$2,412.80
|
| Rate for Payer: Cash Price |
$2,412.80
|
| Rate for Payer: Cofinity Commercial |
$1,552.05
|
| Rate for Payer: Cofinity Commercial |
$1,444.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.81
|
| Rate for Payer: Healthscope Commercial |
$1,993.95
|
| Rate for Payer: Healthscope Commercial |
$1,724.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,960.40
|
| Rate for Payer: Nomi Health Commercial |
$1,293.37
|
| Rate for Payer: PACE SWMI |
$1,077.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,960.40
|
| Rate for Payer: Priority Health Medicare |
$1,077.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.81
|
|
|
PR LAPT RPR PARAESOPH HIATAL HERNIA W/MESH
|
Professional
|
Both
|
$2,625.00
|
|
|
Service Code
|
HCPCS 43333
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$2,262.27 |
| Rate for Payer: Aetna Commercial |
$1,638.62
|
| Rate for Payer: Aetna Medicare |
$1,271.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,760.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,638.62
|
| Rate for Payer: BCBS Complete |
$1,050.00
|
| Rate for Payer: BCBS MAPPO |
$1,222.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.85
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cofinity Commercial |
$1,760.90
|
| Rate for Payer: Cofinity Commercial |
$1,638.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.85
|
| Rate for Payer: Healthscope Commercial |
$1,956.56
|
| Rate for Payer: Healthscope Commercial |
$2,262.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,706.25
|
| Rate for Payer: Nomi Health Commercial |
$1,467.42
|
| Rate for Payer: PACE SWMI |
$1,222.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,706.25
|
| Rate for Payer: Priority Health Medicare |
$1,222.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.85
|
|
|
PR LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 58960
|
| Min. Negotiated Rate |
$860.00 |
| Max. Negotiated Rate |
$1,769.28 |
| Rate for Payer: Aetna Commercial |
$1,281.54
|
| Rate for Payer: Aetna Medicare |
$994.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.54
|
| Rate for Payer: BCBS Complete |
$860.00
|
| Rate for Payer: BCBS MAPPO |
$956.37
|
| Rate for Payer: BCN Medicare Advantage |
$956.37
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,377.17
|
| Rate for Payer: Cofinity Commercial |
$1,281.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.37
|
| Rate for Payer: Healthscope Commercial |
$1,769.28
|
| Rate for Payer: Healthscope Commercial |
$1,530.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,397.50
|
| Rate for Payer: Nomi Health Commercial |
$1,147.64
|
| Rate for Payer: PACE SWMI |
$956.37
|
| Rate for Payer: PHP Medicare Advantage |
$956.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health Medicare |
$956.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.37
|
| Rate for Payer: UHC Medicare Advantage |
$956.37
|
|
|
PR LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS
|
Professional
|
Both
|
$2,415.00
|
|
|
Service Code
|
HCPCS 47015
|
| Min. Negotiated Rate |
$966.00 |
| Max. Negotiated Rate |
$2,091.78 |
| Rate for Payer: Aetna Commercial |
$1,515.12
|
| Rate for Payer: Aetna Medicare |
$1,175.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.12
|
| Rate for Payer: BCBS Complete |
$966.00
|
| Rate for Payer: BCBS MAPPO |
$1,130.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,130.69
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cofinity Commercial |
$1,628.19
|
| Rate for Payer: Cofinity Commercial |
$1,515.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,130.69
|
| Rate for Payer: Healthscope Commercial |
$1,809.10
|
| Rate for Payer: Healthscope Commercial |
$2,091.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.75
|
| Rate for Payer: Nomi Health Commercial |
$1,356.83
|
| Rate for Payer: PACE SWMI |
$1,130.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,130.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.75
|
| Rate for Payer: Priority Health Medicare |
$1,130.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,130.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,130.69
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,BIOPSY
|
Professional
|
Both
|
$2,159.00
|
|
|
Service Code
|
HCPCS 47561
|
| Min. Negotiated Rate |
$863.60 |
| Max. Negotiated Rate |
$1,403.35 |
| Rate for Payer: Aetna Medicare |
$1,079.50
|
| Rate for Payer: BCBS Complete |
$863.60
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,403.35
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,W/O BX
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 47560
|
| Min. Negotiated Rate |
$194.80 |
| Max. Negotiated Rate |
$316.55 |
| Rate for Payer: Aetna Medicare |
$243.50
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.55
|
|
|
PR LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 31561
|
| Min. Negotiated Rate |
$317.20 |
| Max. Negotiated Rate |
$599.81 |
| Rate for Payer: Aetna Commercial |
$434.45
|
| Rate for Payer: Aetna Medicare |
$337.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.45
|
| Rate for Payer: BCBS Complete |
$317.20
|
| Rate for Payer: BCBS MAPPO |
$324.22
|
| Rate for Payer: BCN Medicare Advantage |
$324.22
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$434.45
|
| Rate for Payer: Cofinity Commercial |
$466.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.22
|
| Rate for Payer: Healthscope Commercial |
$599.81
|
| Rate for Payer: Healthscope Commercial |
$518.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.45
|
| Rate for Payer: Nomi Health Commercial |
$389.06
|
| Rate for Payer: PACE SWMI |
$324.22
|
| Rate for Payer: PHP Medicare Advantage |
$324.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health Medicare |
$324.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.22
|
| Rate for Payer: UHC Medicare Advantage |
$324.22
|
|
|
PR LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 31541
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$786.50 |
| Rate for Payer: Aetna Commercial |
$335.19
|
| Rate for Payer: Aetna Medicare |
$260.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.19
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$250.14
|
| Rate for Payer: BCN Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$360.20
|
| Rate for Payer: Cofinity Commercial |
$335.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.14
|
| Rate for Payer: Healthscope Commercial |
$462.76
|
| Rate for Payer: Healthscope Commercial |
$400.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$786.50
|
| Rate for Payer: Nomi Health Commercial |
$300.17
|
| Rate for Payer: PACE SWMI |
$250.14
|
| Rate for Payer: PHP Medicare Advantage |
$250.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.50
|
| Rate for Payer: Priority Health Medicare |
$250.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.14
|
| Rate for Payer: UHC Medicare Advantage |
$250.14
|
|
|
PR LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP
|
Professional
|
Both
|
$1,331.00
|
|
|
Service Code
|
HCPCS 31545
|
| Min. Negotiated Rate |
$343.43 |
| Max. Negotiated Rate |
$865.15 |
| Rate for Payer: Aetna Commercial |
$460.20
|
| Rate for Payer: Aetna Medicare |
$357.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.20
|
| Rate for Payer: BCBS Complete |
$532.40
|
| Rate for Payer: BCBS MAPPO |
$343.43
|
| Rate for Payer: BCN Medicare Advantage |
$343.43
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cofinity Commercial |
$494.54
|
| Rate for Payer: Cofinity Commercial |
$460.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.43
|
| Rate for Payer: Healthscope Commercial |
$549.49
|
| Rate for Payer: Healthscope Commercial |
$635.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.15
|
| Rate for Payer: Nomi Health Commercial |
$412.12
|
| Rate for Payer: PACE SWMI |
$343.43
|
| Rate for Payer: PHP Medicare Advantage |
$343.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.15
|
| Rate for Payer: Priority Health Medicare |
$343.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.43
|
| Rate for Payer: UHC Medicare Advantage |
$343.43
|
|
|
PR LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Professional
|
Both
|
$1,108.00
|
|
|
Service Code
|
HCPCS 31571
|
| Min. Negotiated Rate |
$237.14 |
| Max. Negotiated Rate |
$720.20 |
| Rate for Payer: Aetna Commercial |
$317.77
|
| Rate for Payer: Aetna Medicare |
$246.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.77
|
| Rate for Payer: BCBS Complete |
$443.20
|
| Rate for Payer: BCBS MAPPO |
$237.14
|
| Rate for Payer: BCN Medicare Advantage |
$237.14
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cofinity Commercial |
$341.48
|
| Rate for Payer: Cofinity Commercial |
$317.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.14
|
| Rate for Payer: Healthscope Commercial |
$438.71
|
| Rate for Payer: Healthscope Commercial |
$379.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$720.20
|
| Rate for Payer: Nomi Health Commercial |
$284.57
|
| Rate for Payer: PACE SWMI |
$237.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$720.20
|
| Rate for Payer: Priority Health Medicare |
$237.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.14
|
| Rate for Payer: UHC Medicare Advantage |
$237.14
|
|
|
PR LARYNGOPLASTY MEDIALIZATION UNLIATERAL
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 31591
|
| Min. Negotiated Rate |
$882.40 |
| Max. Negotiated Rate |
$1,917.91 |
| Rate for Payer: Aetna Commercial |
$1,389.19
|
| Rate for Payer: Aetna Medicare |
$1,078.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,492.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.19
|
| Rate for Payer: BCBS Complete |
$882.40
|
| Rate for Payer: BCBS MAPPO |
$1,036.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.71
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$1,492.86
|
| Rate for Payer: Cofinity Commercial |
$1,389.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.71
|
| Rate for Payer: Healthscope Commercial |
$1,658.74
|
| Rate for Payer: Healthscope Commercial |
$1,917.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,088.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.90
|
| Rate for Payer: Nomi Health Commercial |
$1,244.05
|
| Rate for Payer: PACE SWMI |
$1,036.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.90
|
| Rate for Payer: Priority Health Medicare |
$1,036.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.71
|
|
|
PR LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 31570
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$404.63 |
| Rate for Payer: Aetna Commercial |
$293.08
|
| Rate for Payer: Aetna Medicare |
$227.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.08
|
| Rate for Payer: BCBS Complete |
$236.80
|
| Rate for Payer: BCBS MAPPO |
$218.72
|
| Rate for Payer: BCN Medicare Advantage |
$218.72
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$314.96
|
| Rate for Payer: Cofinity Commercial |
$293.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.72
|
| Rate for Payer: Healthscope Commercial |
$404.63
|
| Rate for Payer: Healthscope Commercial |
$349.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Nomi Health Commercial |
$262.46
|
| Rate for Payer: PACE SWMI |
$218.72
|
| Rate for Payer: PHP Medicare Advantage |
$218.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
| Rate for Payer: Priority Health Medicare |
$218.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.72
|
| Rate for Payer: UHC Medicare Advantage |
$218.72
|
|
|
PR LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 31535
|
| Min. Negotiated Rate |
$155.60 |
| Max. Negotiated Rate |
$334.55 |
| Rate for Payer: Aetna Commercial |
$242.33
|
| Rate for Payer: Aetna Medicare |
$188.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.33
|
| Rate for Payer: BCBS Complete |
$155.60
|
| Rate for Payer: BCBS MAPPO |
$180.84
|
| Rate for Payer: BCN Medicare Advantage |
$180.84
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cofinity Commercial |
$260.41
|
| Rate for Payer: Cofinity Commercial |
$242.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.84
|
| Rate for Payer: Healthscope Commercial |
$289.34
|
| Rate for Payer: Healthscope Commercial |
$334.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.85
|
| Rate for Payer: Nomi Health Commercial |
$217.01
|
| Rate for Payer: PACE SWMI |
$180.84
|
| Rate for Payer: PHP Medicare Advantage |
$180.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.85
|
| Rate for Payer: Priority Health Medicare |
$180.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.84
|
| Rate for Payer: UHC Medicare Advantage |
$180.84
|
|
|
PR LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 31540
|
| Min. Negotiated Rate |
$178.40 |
| Max. Negotiated Rate |
$424.94 |
| Rate for Payer: Aetna Commercial |
$307.80
|
| Rate for Payer: Aetna Medicare |
$238.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.80
|
| Rate for Payer: BCBS Complete |
$178.40
|
| Rate for Payer: BCBS MAPPO |
$229.70
|
| Rate for Payer: BCN Medicare Advantage |
$229.70
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$330.77
|
| Rate for Payer: Cofinity Commercial |
$307.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.70
|
| Rate for Payer: Healthscope Commercial |
$424.94
|
| Rate for Payer: Healthscope Commercial |
$367.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.90
|
| Rate for Payer: Nomi Health Commercial |
$275.64
|
| Rate for Payer: PACE SWMI |
$229.70
|
| Rate for Payer: PHP Medicare Advantage |
$229.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: Priority Health Medicare |
$229.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.70
|
| Rate for Payer: UHC Medicare Advantage |
$229.70
|
|
|
PR LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 31572
|
| Min. Negotiated Rate |
$172.40 |
| Max. Negotiated Rate |
$490.75 |
| Rate for Payer: Aetna Commercial |
$231.02
|
| Rate for Payer: Aetna Medicare |
$179.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.02
|
| Rate for Payer: BCBS Complete |
$302.00
|
| Rate for Payer: BCBS MAPPO |
$172.40
|
| Rate for Payer: BCN Medicare Advantage |
$172.40
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$248.26
|
| Rate for Payer: Cofinity Commercial |
$231.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.40
|
| Rate for Payer: Healthscope Commercial |
$275.84
|
| Rate for Payer: Healthscope Commercial |
$318.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.75
|
| Rate for Payer: Nomi Health Commercial |
$206.88
|
| Rate for Payer: PACE SWMI |
$172.40
|
| Rate for Payer: PHP Medicare Advantage |
$172.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.75
|
| Rate for Payer: Priority Health Medicare |
$172.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$172.40
|
|
|
PR LARYNGOSCOPY FLEXIBLE DIAGNOSTIC
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 31575
|
| Min. Negotiated Rate |
$65.56 |
| Max. Negotiated Rate |
$191.75 |
| Rate for Payer: Aetna Commercial |
$87.85
|
| Rate for Payer: Aetna Medicare |
$68.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.85
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$65.56
|
| Rate for Payer: BCN Medicare Advantage |
$65.56
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$94.41
|
| Rate for Payer: Cofinity Commercial |
$87.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.56
|
| Rate for Payer: Healthscope Commercial |
$121.29
|
| Rate for Payer: Healthscope Commercial |
$104.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.75
|
| Rate for Payer: Nomi Health Commercial |
$78.67
|
| Rate for Payer: PACE SWMI |
$65.56
|
| Rate for Payer: PHP Medicare Advantage |
$65.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health Medicare |
$65.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.56
|
| Rate for Payer: UHC Medicare Advantage |
$65.56
|
|
|
PR LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 31573
|
| Min. Negotiated Rate |
$141.68 |
| Max. Negotiated Rate |
$367.25 |
| Rate for Payer: Aetna Commercial |
$189.85
|
| Rate for Payer: Aetna Medicare |
$147.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.85
|
| Rate for Payer: BCBS Complete |
$226.00
|
| Rate for Payer: BCBS MAPPO |
$141.68
|
| Rate for Payer: BCN Medicare Advantage |
$141.68
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$204.02
|
| Rate for Payer: Cofinity Commercial |
$189.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.68
|
| Rate for Payer: Healthscope Commercial |
$226.69
|
| Rate for Payer: Healthscope Commercial |
$262.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.25
|
| Rate for Payer: Nomi Health Commercial |
$170.02
|
| Rate for Payer: PACE SWMI |
$141.68
|
| Rate for Payer: PHP Medicare Advantage |
$141.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$141.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.68
|
| Rate for Payer: UHC Medicare Advantage |
$141.68
|
|
|
PR LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 31576
|
| Min. Negotiated Rate |
$114.19 |
| Max. Negotiated Rate |
$261.95 |
| Rate for Payer: Aetna Commercial |
$153.01
|
| Rate for Payer: Aetna Medicare |
$118.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.01
|
| Rate for Payer: BCBS Complete |
$161.20
|
| Rate for Payer: BCBS MAPPO |
$114.19
|
| Rate for Payer: BCN Medicare Advantage |
$114.19
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$164.43
|
| Rate for Payer: Cofinity Commercial |
$153.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.19
|
| Rate for Payer: Healthscope Commercial |
$211.25
|
| Rate for Payer: Healthscope Commercial |
$182.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.95
|
| Rate for Payer: Nomi Health Commercial |
$137.03
|
| Rate for Payer: PACE SWMI |
$114.19
|
| Rate for Payer: PHP Medicare Advantage |
$114.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health Medicare |
$114.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.19
|
| Rate for Payer: UHC Medicare Advantage |
$114.19
|
|
|
PR LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 31579
|
| Min. Negotiated Rate |
$113.91 |
| Max. Negotiated Rate |
$249.60 |
| Rate for Payer: Aetna Commercial |
$152.64
|
| Rate for Payer: Aetna Medicare |
$118.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.64
|
| Rate for Payer: BCBS Complete |
$153.60
|
| Rate for Payer: BCBS MAPPO |
$113.91
|
| Rate for Payer: BCN Medicare Advantage |
$113.91
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$164.03
|
| Rate for Payer: Cofinity Commercial |
$152.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.91
|
| Rate for Payer: Healthscope Commercial |
$182.26
|
| Rate for Payer: Healthscope Commercial |
$210.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.60
|
| Rate for Payer: Nomi Health Commercial |
$136.69
|
| Rate for Payer: PACE SWMI |
$113.91
|
| Rate for Payer: PHP Medicare Advantage |
$113.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.60
|
| Rate for Payer: Priority Health Medicare |
$113.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.91
|
| Rate for Payer: UHC Medicare Advantage |
$113.91
|
|
|
PR LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 31577
|
| Min. Negotiated Rate |
$127.56 |
| Max. Negotiated Rate |
$267.15 |
| Rate for Payer: Aetna Commercial |
$170.93
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.93
|
| Rate for Payer: BCBS Complete |
$164.40
|
| Rate for Payer: BCBS MAPPO |
$127.56
|
| Rate for Payer: BCN Medicare Advantage |
$127.56
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cofinity Commercial |
$183.69
|
| Rate for Payer: Cofinity Commercial |
$170.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.56
|
| Rate for Payer: Healthscope Commercial |
$235.99
|
| Rate for Payer: Healthscope Commercial |
$204.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.15
|
| Rate for Payer: Nomi Health Commercial |
$153.07
|
| Rate for Payer: PACE SWMI |
$127.56
|
| Rate for Payer: PHP Medicare Advantage |
$127.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.15
|
| Rate for Payer: Priority Health Medicare |
$127.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.56
|
| Rate for Payer: UHC Medicare Advantage |
$127.56
|
|
|
PR LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 31531
|
| Min. Negotiated Rate |
$185.60 |
| Max. Negotiated Rate |
$371.20 |
| Rate for Payer: Aetna Commercial |
$268.87
|
| Rate for Payer: Aetna Medicare |
$208.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.87
|
| Rate for Payer: BCBS Complete |
$185.60
|
| Rate for Payer: BCBS MAPPO |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$200.65
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$288.94
|
| Rate for Payer: Cofinity Commercial |
$268.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.65
|
| Rate for Payer: Healthscope Commercial |
$321.04
|
| Rate for Payer: Healthscope Commercial |
$371.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.60
|
| Rate for Payer: Nomi Health Commercial |
$240.78
|
| Rate for Payer: PACE SWMI |
$200.65
|
| Rate for Payer: PHP Medicare Advantage |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.60
|
| Rate for Payer: Priority Health Medicare |
$200.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.65
|
| Rate for Payer: UHC Medicare Advantage |
$200.65
|
|
