|
PR LESION SINGLE
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 00073
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR LEUPROLIDE ACETATE /3.75 MG
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS J1950
|
| Min. Negotiated Rate |
$441.20 |
| Max. Negotiated Rate |
$152,434.00 |
| Rate for Payer: Aetna Commercial |
$2,327.71
|
| Rate for Payer: Aetna Medicare |
$1,806.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,501.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,327.71
|
| Rate for Payer: BCBS Complete |
$441.20
|
| Rate for Payer: BCBS MAPPO |
$1,737.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.82
|
| Rate for Payer: BCN Commercial |
$1,126.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,737.10
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$2,501.42
|
| Rate for Payer: Cofinity Commercial |
$2,327.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,737.10
|
| Rate for Payer: Healthscope Commercial |
$2,779.36
|
| Rate for Payer: Healthscope Commercial |
$3,213.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,823.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,434.00
|
| Rate for Payer: Nomi Health Commercial |
$2,084.52
|
| Rate for Payer: PACE SWMI |
$1,737.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,737.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.95
|
| Rate for Payer: Priority Health Medicare |
$1,737.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,766.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,737.10
|
| Rate for Payer: UHC Exchange |
$1,766.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,737.10
|
|
|
PR LEUPROLIDE ACETATE INJECITON
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS J9218
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$788.00 |
| Rate for Payer: Aetna Commercial |
$14.16
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.16
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.04
|
| Rate for Payer: BCN Commercial |
$7.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.44
|
| Rate for Payer: UHC Exchange |
$9.44
|
|
|
PR LEUPROLIDE ACETATE SUSPNSION
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS J9217
|
| Min. Negotiated Rate |
$155.42 |
| Max. Negotiated Rate |
$16,669.00 |
| Rate for Payer: Aetna Commercial |
$208.26
|
| Rate for Payer: Aetna Medicare |
$161.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.80
|
| Rate for Payer: BCBS Complete |
$184.40
|
| Rate for Payer: BCBS MAPPO |
$155.42
|
| Rate for Payer: BCBS Trust/PPO |
$191.56
|
| Rate for Payer: BCN Commercial |
$182.32
|
| Rate for Payer: BCN Medicare Advantage |
$155.42
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$208.26
|
| Rate for Payer: Cofinity Commercial |
$223.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.42
|
| Rate for Payer: Healthscope Commercial |
$287.53
|
| Rate for Payer: Healthscope Commercial |
$248.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,669.00
|
| Rate for Payer: Nomi Health Commercial |
$186.50
|
| Rate for Payer: PACE SWMI |
$155.42
|
| Rate for Payer: PHP Medicare Advantage |
$155.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.65
|
| Rate for Payer: Priority Health Medicare |
$155.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.42
|
| Rate for Payer: UHC Exchange |
$191.64
|
| Rate for Payer: UHC Medicare Advantage |
$155.42
|
|
|
PR LEVALBUTEROL NON-COMP UNIT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J7614
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$5.00 |
| Rate for Payer: Aetna Commercial |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.13
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$0.09
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.09
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.09
|
| Rate for Payer: Healthscope Commercial |
$0.16
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.00
|
| Rate for Payer: Nomi Health Commercial |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.09
|
| Rate for Payer: PHP Medicare Advantage |
$0.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.09
|
| Rate for Payer: UHC Exchange |
$0.10
|
| Rate for Payer: UHC Medicare Advantage |
$0.09
|
|
|
PR LEVONORGESTREL IMPLANT SYS
|
Professional
|
Both
|
$561.00
|
|
|
Service Code
|
HCPCS J7306
|
| Min. Negotiated Rate |
$224.40 |
| Max. Negotiated Rate |
$53,808.00 |
| Rate for Payer: Aetna Commercial |
$406.00
|
| Rate for Payer: Aetna Medicare |
$280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.00
|
| Rate for Payer: BCBS Complete |
$224.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,147.54
|
| Rate for Payer: Cash Price |
$448.80
|
| Rate for Payer: Cash Price |
$448.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,808.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.95
|
| Rate for Payer: UHC Exchange |
$537.95
|
|
|
PR LEVONORGESTREL IU CONTRACEPT
|
Professional
|
Both
|
$839.00
|
|
|
Service Code
|
HCPCS J7302
|
| Min. Negotiated Rate |
$335.60 |
| Max. Negotiated Rate |
$545.35 |
| Rate for Payer: Aetna Medicare |
$419.50
|
| Rate for Payer: BCBS Complete |
$335.60
|
| Rate for Payer: Cash Price |
$671.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.35
|
|
|
PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 93452
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$127,769.00 |
| Rate for Payer: Aetna Commercial |
$1,040.47
|
| Rate for Payer: Aetna Medicare |
$807.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.12
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$776.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.09
|
| Rate for Payer: BCN Commercial |
$1,319.43
|
| Rate for Payer: BCN Medicare Advantage |
$776.47
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$1,118.12
|
| Rate for Payer: Cofinity Commercial |
$1,040.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$776.47
|
| Rate for Payer: Healthscope Commercial |
$1,242.35
|
| Rate for Payer: Healthscope Commercial |
$1,436.47
|
| Rate for Payer: Mclaren Medicaid |
$146.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$815.29
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127,769.00
|
| Rate for Payer: Nomi Health Commercial |
$931.76
|
| Rate for Payer: PACE SWMI |
$776.47
|
| Rate for Payer: PHP Medicare Advantage |
$776.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,248.65
|
| Rate for Payer: Priority Health Medicare |
$776.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.65
|
| Rate for Payer: Priority Health SBD |
$324.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$776.47
|
| Rate for Payer: UHC Medicare Advantage |
$776.47
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
|
|
PR LIDOCAINE INJECTION
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS J2001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.03
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
|
|
PR LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR
|
Professional
|
Both
|
$2,489.00
|
|
|
Service Code
|
HCPCS 27427
|
| Min. Negotiated Rate |
$462.42 |
| Max. Negotiated Rate |
$126,169.00 |
| Rate for Payer: Aetna Commercial |
$916.37
|
| Rate for Payer: Aetna Medicare |
$711.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.76
|
| Rate for Payer: BCBS Complete |
$485.54
|
| Rate for Payer: BCBS MAPPO |
$683.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.49
|
| Rate for Payer: BCN Commercial |
$1,046.26
|
| Rate for Payer: BCN Medicare Advantage |
$683.86
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cofinity Commercial |
$916.37
|
| Rate for Payer: Cofinity Commercial |
$984.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.86
|
| Rate for Payer: Healthscope Commercial |
$1,094.18
|
| Rate for Payer: Healthscope Commercial |
$1,265.14
|
| Rate for Payer: Mclaren Medicaid |
$462.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.05
|
| Rate for Payer: Meridian Medicaid |
$485.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126,169.00
|
| Rate for Payer: Nomi Health Commercial |
$820.63
|
| Rate for Payer: PACE SWMI |
$683.86
|
| Rate for Payer: PHP Medicare Advantage |
$683.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,096.60
|
| Rate for Payer: Priority Health Medicare |
$683.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,096.60
|
| Rate for Payer: Priority Health SBD |
$1,096.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$683.86
|
| Rate for Payer: UHC Exchange |
$1,088.24
|
| Rate for Payer: UHC Medicare Advantage |
$683.86
|
| Rate for Payer: UHCCP Medicaid |
$462.42
|
|
|
PR LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR
|
Professional
|
Both
|
$3,247.00
|
|
|
Service Code
|
HCPCS 27428
|
| Min. Negotiated Rate |
$727.18 |
| Max. Negotiated Rate |
$197,984.00 |
| Rate for Payer: Aetna Commercial |
$1,444.17
|
| Rate for Payer: Aetna Medicare |
$1,120.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.95
|
| Rate for Payer: BCBS Complete |
$763.54
|
| Rate for Payer: BCBS MAPPO |
$1,077.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.74
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Cofinity Commercial |
$1,551.95
|
| Rate for Payer: Cofinity Commercial |
$1,444.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.74
|
| Rate for Payer: Healthscope Commercial |
$1,993.82
|
| Rate for Payer: Healthscope Commercial |
$1,724.38
|
| Rate for Payer: Mclaren Medicaid |
$727.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.63
|
| Rate for Payer: Meridian Medicaid |
$763.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197,984.00
|
| Rate for Payer: Nomi Health Commercial |
$1,293.29
|
| Rate for Payer: PACE SWMI |
$1,077.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,110.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.99
|
| Rate for Payer: Priority Health Medicare |
$1,077.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,721.99
|
| Rate for Payer: Priority Health SBD |
$1,721.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.74
|
| Rate for Payer: UHC Exchange |
$1,283.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.74
|
| Rate for Payer: UHCCP Medicaid |
$727.18
|
|
|
PR LIGATION ARTERIES ETHMOIDAL
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 30915
|
| Min. Negotiated Rate |
$385.74 |
| Max. Negotiated Rate |
$106,628.00 |
| Rate for Payer: Aetna Commercial |
$755.96
|
| Rate for Payer: Aetna Medicare |
$586.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.38
|
| Rate for Payer: BCBS Complete |
$405.03
|
| Rate for Payer: BCBS MAPPO |
$564.15
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$892.81
|
| Rate for Payer: BCN Medicare Advantage |
$564.15
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$812.38
|
| Rate for Payer: Cofinity Commercial |
$755.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.15
|
| Rate for Payer: Healthscope Commercial |
$902.64
|
| Rate for Payer: Healthscope Commercial |
$1,043.68
|
| Rate for Payer: Mclaren Medicaid |
$385.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.36
|
| Rate for Payer: Meridian Medicaid |
$405.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,628.00
|
| Rate for Payer: Nomi Health Commercial |
$676.98
|
| Rate for Payer: PACE SWMI |
$564.15
|
| Rate for Payer: PHP Medicare Advantage |
$564.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.29
|
| Rate for Payer: Priority Health Medicare |
$564.15
|
| Rate for Payer: Priority Health Narrow Network |
$846.29
|
| Rate for Payer: Priority Health SBD |
$846.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.15
|
| Rate for Payer: UHC Exchange |
$599.79
|
| Rate for Payer: UHC Medicare Advantage |
$564.15
|
| Rate for Payer: UHCCP Medicaid |
$385.74
|
|
|
PR LIGATION ARTERIES INT MAXILLARY TRANSANTRAL
|
Professional
|
Both
|
$1,501.00
|
|
|
Service Code
|
HCPCS 30920
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$154,460.00 |
| Rate for Payer: Aetna Commercial |
$1,093.44
|
| Rate for Payer: Aetna Medicare |
$848.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,175.04
|
| Rate for Payer: BCBS Complete |
$584.62
|
| Rate for Payer: BCBS MAPPO |
$816.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.12
|
| Rate for Payer: BCN Commercial |
$1,291.09
|
| Rate for Payer: BCN Medicare Advantage |
$816.00
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Cofinity Commercial |
$1,175.04
|
| Rate for Payer: Cofinity Commercial |
$1,093.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$1,509.60
|
| Rate for Payer: Healthscope Commercial |
$1,305.60
|
| Rate for Payer: Mclaren Medicaid |
$556.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$856.80
|
| Rate for Payer: Meridian Medicaid |
$584.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,460.00
|
| Rate for Payer: Nomi Health Commercial |
$979.20
|
| Rate for Payer: PACE SWMI |
$816.00
|
| Rate for Payer: PHP Medicare Advantage |
$816.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$975.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,220.77
|
| Rate for Payer: Priority Health Medicare |
$816.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,220.77
|
| Rate for Payer: Priority Health SBD |
$1,220.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.00
|
| Rate for Payer: UHC Exchange |
$795.00
|
| Rate for Payer: UHC Medicare Advantage |
$816.00
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 37609
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$36,207.00 |
| Rate for Payer: Aetna Commercial |
$259.91
|
| Rate for Payer: Aetna Medicare |
$201.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.30
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$193.96
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: BCN Medicare Advantage |
$193.96
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$279.30
|
| Rate for Payer: Cofinity Commercial |
$259.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.96
|
| Rate for Payer: Healthscope Commercial |
$358.83
|
| Rate for Payer: Healthscope Commercial |
$310.34
|
| Rate for Payer: Mclaren Medicaid |
$129.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.66
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,207.00
|
| Rate for Payer: Nomi Health Commercial |
$232.75
|
| Rate for Payer: PACE SWMI |
$193.96
|
| Rate for Payer: PHP Medicare Advantage |
$193.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.95
|
| Rate for Payer: Priority Health Medicare |
$193.96
|
| Rate for Payer: Priority Health Narrow Network |
$324.95
|
| Rate for Payer: Priority Health SBD |
$324.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.96
|
| Rate for Payer: UHC Exchange |
$408.12
|
| Rate for Payer: UHC Medicare Advantage |
$193.96
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
37609
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$216.30 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.80
|
| Rate for Payer: BCN Commercial |
$1,625.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Cofinity Commercial |
$630.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$567.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.30
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
37609
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$567.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$630.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health SBD |
$567.00
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 37609
|
| Hospital Charge Code |
37609
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$36,207.00 |
| Rate for Payer: Aetna Commercial |
$259.91
|
| Rate for Payer: Aetna Medicare |
$201.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.30
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$193.96
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: BCN Medicare Advantage |
$193.96
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$259.91
|
| Rate for Payer: Cofinity Commercial |
$279.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.96
|
| Rate for Payer: Healthscope Commercial |
$358.83
|
| Rate for Payer: Healthscope Commercial |
$310.34
|
| Rate for Payer: Mclaren Medicaid |
$129.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.66
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,207.00
|
| Rate for Payer: Nomi Health Commercial |
$232.75
|
| Rate for Payer: PACE SWMI |
$193.96
|
| Rate for Payer: PHP Medicare Advantage |
$193.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.95
|
| Rate for Payer: Priority Health Medicare |
$193.96
|
| Rate for Payer: Priority Health Narrow Network |
$324.95
|
| Rate for Payer: Priority Health SBD |
$324.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.96
|
| Rate for Payer: UHC Exchange |
$408.12
|
| Rate for Payer: UHC Medicare Advantage |
$193.96
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR LIGATION DIRECT ESOPHAGEAL VARICES
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 43400
|
| Min. Negotiated Rate |
$977.46 |
| Max. Negotiated Rate |
$272,992.00 |
| Rate for Payer: Aetna Commercial |
$1,984.83
|
| Rate for Payer: Aetna Medicare |
$1,540.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.96
|
| Rate for Payer: BCBS Complete |
$1,026.33
|
| Rate for Payer: BCBS MAPPO |
$1,481.22
|
| Rate for Payer: BCBS Trust/PPO |
$986.56
|
| Rate for Payer: BCN Commercial |
$2,221.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,481.22
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cofinity Commercial |
$2,132.96
|
| Rate for Payer: Cofinity Commercial |
$1,984.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,481.22
|
| Rate for Payer: Healthscope Commercial |
$2,740.26
|
| Rate for Payer: Healthscope Commercial |
$2,369.95
|
| Rate for Payer: Mclaren Medicaid |
$977.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,555.28
|
| Rate for Payer: Meridian Medicaid |
$1,026.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272,992.00
|
| Rate for Payer: Nomi Health Commercial |
$1,777.46
|
| Rate for Payer: PACE SWMI |
$1,481.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,481.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,037.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,724.05
|
| Rate for Payer: Priority Health Medicare |
$1,481.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,724.05
|
| Rate for Payer: Priority Health SBD |
$2,724.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,344.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,481.22
|
| Rate for Payer: UHC Exchange |
$1,344.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,481.22
|
| Rate for Payer: UHCCP Medicaid |
$977.46
|
|
|
PR LIGATION HEMORRHOID BUNDLE W/US
|
Professional
|
Both
|
$2,091.00
|
|
|
Service Code
|
HCPCS 0249T
|
| Min. Negotiated Rate |
$836.40 |
| Max. Negotiated Rate |
$1,359.15 |
| Rate for Payer: Aetna Medicare |
$1,045.50
|
| Rate for Payer: BCBS Complete |
$836.40
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.15
|
|
|
PR LIGATION INTERNAL/COMMON CAROTID ARTERY
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 37605
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$131,216.00 |
| Rate for Payer: Aetna Commercial |
$954.17
|
| Rate for Payer: Aetna Medicare |
$740.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.17
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS MAPPO |
$712.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.94
|
| Rate for Payer: BCN Commercial |
$1,055.06
|
| Rate for Payer: BCN Medicare Advantage |
$712.07
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$954.17
|
| Rate for Payer: Cofinity Commercial |
$1,025.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.07
|
| Rate for Payer: Healthscope Commercial |
$1,317.33
|
| Rate for Payer: Healthscope Commercial |
$1,139.31
|
| Rate for Payer: Mclaren Medicaid |
$463.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.67
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,216.00
|
| Rate for Payer: Nomi Health Commercial |
$854.48
|
| Rate for Payer: PACE SWMI |
$712.07
|
| Rate for Payer: PHP Medicare Advantage |
$712.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.59
|
| Rate for Payer: Priority Health Medicare |
$712.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.59
|
| Rate for Payer: Priority Health SBD |
$1,154.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.07
|
| Rate for Payer: UHC Exchange |
$838.77
|
| Rate for Payer: UHC Medicare Advantage |
$712.07
|
| Rate for Payer: UHCCP Medicaid |
$463.49
|
|
|
PR LIGATION INTERNAL JUGULAR VEIN
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 37565
|
| Min. Negotiated Rate |
$463.28 |
| Max. Negotiated Rate |
$129,222.00 |
| Rate for Payer: Aetna Commercial |
$931.89
|
| Rate for Payer: Aetna Medicare |
$723.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.89
|
| Rate for Payer: BCBS Complete |
$486.44
|
| Rate for Payer: BCBS MAPPO |
$695.44
|
| Rate for Payer: BCN Commercial |
$1,057.01
|
| Rate for Payer: BCN Medicare Advantage |
$695.44
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$931.89
|
| Rate for Payer: Cofinity Commercial |
$1,001.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.44
|
| Rate for Payer: Healthscope Commercial |
$1,286.56
|
| Rate for Payer: Healthscope Commercial |
$1,112.70
|
| Rate for Payer: Mclaren Medicaid |
$463.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.21
|
| Rate for Payer: Meridian Medicaid |
$486.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129,222.00
|
| Rate for Payer: Nomi Health Commercial |
$834.53
|
| Rate for Payer: PACE SWMI |
$695.44
|
| Rate for Payer: PHP Medicare Advantage |
$695.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.66
|
| Rate for Payer: Priority Health Medicare |
$695.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.66
|
| Rate for Payer: Priority Health SBD |
$1,155.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.44
|
| Rate for Payer: UHC Exchange |
$674.80
|
| Rate for Payer: UHC Medicare Advantage |
$695.44
|
| Rate for Payer: UHCCP Medicaid |
$463.28
|
|
|
PR LIGATION MAJOR ARTERY ABDOMEN
|
Professional
|
Both
|
$3,271.00
|
|
|
Service Code
|
HCPCS 37617
|
| Min. Negotiated Rate |
$839.01 |
| Max. Negotiated Rate |
$234,713.00 |
| Rate for Payer: Aetna Commercial |
$1,709.28
|
| Rate for Payer: Aetna Medicare |
$1,326.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,836.84
|
| Rate for Payer: BCBS Complete |
$880.96
|
| Rate for Payer: BCBS MAPPO |
$1,275.58
|
| Rate for Payer: BCBS Trust/PPO |
$999.54
|
| Rate for Payer: BCN Commercial |
$1,902.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.58
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Cofinity Commercial |
$1,836.84
|
| Rate for Payer: Cofinity Commercial |
$1,709.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.58
|
| Rate for Payer: Healthscope Commercial |
$2,359.82
|
| Rate for Payer: Healthscope Commercial |
$2,040.93
|
| Rate for Payer: Mclaren Medicaid |
$839.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.36
|
| Rate for Payer: Meridian Medicaid |
$880.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234,713.00
|
| Rate for Payer: Nomi Health Commercial |
$1,530.70
|
| Rate for Payer: PACE SWMI |
$1,275.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,090.60
|
| Rate for Payer: Priority Health Medicare |
$1,275.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,090.60
|
| Rate for Payer: Priority Health SBD |
$2,090.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,317.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.58
|
| Rate for Payer: UHC Exchange |
$1,317.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.58
|
| Rate for Payer: UHCCP Medicaid |
$839.01
|
|
|
PR LIGATION MAJOR ARTERY CHEST
|
Professional
|
Both
|
$3,387.00
|
|
|
Service Code
|
HCPCS 37616
|
| Min. Negotiated Rate |
$727.40 |
| Max. Negotiated Rate |
$196,551.00 |
| Rate for Payer: Aetna Commercial |
$1,474.23
|
| Rate for Payer: Aetna Medicare |
$1,144.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,474.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,584.24
|
| Rate for Payer: BCBS Complete |
$763.77
|
| Rate for Payer: BCBS MAPPO |
$1,100.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,100.17
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cofinity Commercial |
$1,584.24
|
| Rate for Payer: Cofinity Commercial |
$1,474.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,100.17
|
| Rate for Payer: Healthscope Commercial |
$2,035.31
|
| Rate for Payer: Healthscope Commercial |
$1,760.27
|
| Rate for Payer: Mclaren Medicaid |
$727.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,155.18
|
| Rate for Payer: Meridian Medicaid |
$763.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196,551.00
|
| Rate for Payer: Nomi Health Commercial |
$1,320.20
|
| Rate for Payer: PACE SWMI |
$1,100.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,100.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.61
|
| Rate for Payer: Priority Health Medicare |
$1,100.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,781.61
|
| Rate for Payer: Priority Health SBD |
$1,781.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,100.17
|
| Rate for Payer: UHC Exchange |
$1,146.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,100.17
|
| Rate for Payer: UHCCP Medicaid |
$727.40
|
|
|
PR LIGATION MAJOR ARTERY EXTREMITY
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 37618
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$68,954.00 |
| Rate for Payer: Aetna Commercial |
$502.06
|
| Rate for Payer: Aetna Medicare |
$389.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.52
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCBS MAPPO |
$374.67
|
| Rate for Payer: BCBS Trust/PPO |
$848.45
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$374.67
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$539.52
|
| Rate for Payer: Cofinity Commercial |
$502.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.67
|
| Rate for Payer: Healthscope Commercial |
$693.14
|
| Rate for Payer: Healthscope Commercial |
$599.47
|
| Rate for Payer: Mclaren Medicaid |
$249.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.40
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,954.00
|
| Rate for Payer: Nomi Health Commercial |
$449.60
|
| Rate for Payer: PACE SWMI |
$374.67
|
| Rate for Payer: PHP Medicare Advantage |
$374.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$623.83
|
| Rate for Payer: Priority Health Medicare |
$374.67
|
| Rate for Payer: Priority Health Narrow Network |
$623.83
|
| Rate for Payer: Priority Health SBD |
$623.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$460.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.67
|
| Rate for Payer: UHC Exchange |
$460.80
|
| Rate for Payer: UHC Medicare Advantage |
$374.67
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
|
|
PR LIGATION MAJOR ARTERY NECK
|
Professional
|
Both
|
$1,213.00
|
|
|
Service Code
|
HCPCS 37615
|
| Min. Negotiated Rate |
$331.00 |
| Max. Negotiated Rate |
$91,157.00 |
| Rate for Payer: Aetna Commercial |
$660.74
|
| Rate for Payer: Aetna Medicare |
$512.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.05
|
| Rate for Payer: BCBS Complete |
$347.55
|
| Rate for Payer: BCBS MAPPO |
$493.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.20
|
| Rate for Payer: BCN Commercial |
$750.61
|
| Rate for Payer: BCN Medicare Advantage |
$493.09
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cofinity Commercial |
$710.05
|
| Rate for Payer: Cofinity Commercial |
$660.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.09
|
| Rate for Payer: Healthscope Commercial |
$912.22
|
| Rate for Payer: Healthscope Commercial |
$788.94
|
| Rate for Payer: Mclaren Medicaid |
$331.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.74
|
| Rate for Payer: Meridian Medicaid |
$347.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,157.00
|
| Rate for Payer: Nomi Health Commercial |
$591.71
|
| Rate for Payer: PACE SWMI |
$493.09
|
| Rate for Payer: PHP Medicare Advantage |
$493.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.67
|
| Rate for Payer: Priority Health Medicare |
$493.09
|
| Rate for Payer: Priority Health Narrow Network |
$821.67
|
| Rate for Payer: Priority Health SBD |
$821.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.09
|
| Rate for Payer: UHC Exchange |
$516.17
|
| Rate for Payer: UHC Medicare Advantage |
$493.09
|
| Rate for Payer: UHCCP Medicaid |
$331.00
|
|
