|
PR LIGATION OF FEMORAL VEIN
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 37650
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$81,598.00 |
| Rate for Payer: Aetna Commercial |
$594.92
|
| Rate for Payer: Aetna Medicare |
$461.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.32
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS MAPPO |
$443.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.88
|
| Rate for Payer: BCN Commercial |
$658.74
|
| Rate for Payer: BCN Medicare Advantage |
$443.97
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cofinity Commercial |
$639.32
|
| Rate for Payer: Cofinity Commercial |
$594.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.97
|
| Rate for Payer: Healthscope Commercial |
$821.34
|
| Rate for Payer: Healthscope Commercial |
$710.35
|
| Rate for Payer: Mclaren Medicaid |
$290.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.17
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,598.00
|
| Rate for Payer: Nomi Health Commercial |
$532.76
|
| Rate for Payer: PACE SWMI |
$443.97
|
| Rate for Payer: PHP Medicare Advantage |
$443.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.16
|
| Rate for Payer: Priority Health Medicare |
$443.97
|
| Rate for Payer: Priority Health Narrow Network |
$721.16
|
| Rate for Payer: Priority Health SBD |
$721.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.97
|
| Rate for Payer: UHC Exchange |
$536.35
|
| Rate for Payer: UHC Medicare Advantage |
$443.97
|
| Rate for Payer: UHCCP Medicaid |
$290.32
|
|
|
PR LIGATION OF INFERIOR VENA CAVA
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 37619
|
| Min. Negotiated Rate |
$980.00 |
| Max. Negotiated Rate |
$309,272.00 |
| Rate for Payer: Aetna Commercial |
$2,246.43
|
| Rate for Payer: Aetna Medicare |
$1,743.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,246.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,414.07
|
| Rate for Payer: BCBS Complete |
$1,157.61
|
| Rate for Payer: BCBS MAPPO |
$1,676.44
|
| Rate for Payer: BCBS Trust/PPO |
$980.00
|
| Rate for Payer: BCN Commercial |
$2,509.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,676.44
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cofinity Commercial |
$2,414.07
|
| Rate for Payer: Cofinity Commercial |
$2,246.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,676.44
|
| Rate for Payer: Healthscope Commercial |
$2,682.30
|
| Rate for Payer: Healthscope Commercial |
$3,101.41
|
| Rate for Payer: Mclaren Medicaid |
$1,102.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,760.26
|
| Rate for Payer: Meridian Medicaid |
$1,157.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309,272.00
|
| Rate for Payer: Nomi Health Commercial |
$2,011.73
|
| Rate for Payer: PACE SWMI |
$1,676.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,676.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.43
|
| Rate for Payer: Priority Health Medicare |
$1,676.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.43
|
| Rate for Payer: Priority Health SBD |
$2,739.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,676.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,676.44
|
| Rate for Payer: UHCCP Medicaid |
$1,102.49
|
|
|
PR LIGATION OF SPERM DUCT
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 55450
|
| Min. Negotiated Rate |
$260.40 |
| Max. Negotiated Rate |
$423.15 |
| Rate for Payer: Aetna Medicare |
$325.50
|
| Rate for Payer: BCBS Complete |
$260.40
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.15
|
|
|
PR LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37607
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$66,033.00 |
| Rate for Payer: Aetna Commercial |
$479.10
|
| Rate for Payer: Aetna Medicare |
$371.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.86
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$357.54
|
| Rate for Payer: BCBS Trust/PPO |
$929.28
|
| Rate for Payer: BCN Commercial |
$538.04
|
| Rate for Payer: BCN Medicare Advantage |
$357.54
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$514.86
|
| Rate for Payer: Cofinity Commercial |
$479.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.54
|
| Rate for Payer: Healthscope Commercial |
$661.45
|
| Rate for Payer: Healthscope Commercial |
$572.06
|
| Rate for Payer: Mclaren Medicaid |
$236.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.42
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,033.00
|
| Rate for Payer: Nomi Health Commercial |
$429.05
|
| Rate for Payer: PACE SWMI |
$357.54
|
| Rate for Payer: PHP Medicare Advantage |
$357.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$588.73
|
| Rate for Payer: Priority Health Medicare |
$357.54
|
| Rate for Payer: Priority Health Narrow Network |
$588.73
|
| Rate for Payer: Priority Health SBD |
$588.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.54
|
| Rate for Payer: UHC Exchange |
$466.69
|
| Rate for Payer: UHC Medicare Advantage |
$357.54
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
OP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$539.28 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$727.60
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.30
|
| Rate for Payer: BCN Commercial |
$1,330.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$736.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$599.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$770.40
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$727.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$539.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.91
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$103,439.00 |
| Rate for Payer: Aetna Commercial |
$751.94
|
| Rate for Payer: Aetna Medicare |
$583.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.06
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$561.15
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: BCN Medicare Advantage |
$561.15
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cofinity Commercial |
$808.06
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.15
|
| Rate for Payer: Healthscope Commercial |
$897.84
|
| Rate for Payer: Healthscope Commercial |
$1,038.13
|
| Rate for Payer: Mclaren Medicaid |
$366.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.21
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103,439.00
|
| Rate for Payer: Nomi Health Commercial |
$673.38
|
| Rate for Payer: PACE SWMI |
$561.15
|
| Rate for Payer: PHP Medicare Advantage |
$561.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Medicare |
$561.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: Priority Health SBD |
$913.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.15
|
| Rate for Payer: UHC Exchange |
$967.62
|
| Rate for Payer: UHC Medicare Advantage |
$561.15
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
IP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$539.28 |
| Max. Negotiated Rate |
$770.40 |
| Rate for Payer: Aetna Commercial |
$727.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.40
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$736.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$599.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Healthscope Commercial |
$770.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: PHP Commercial |
$727.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: Priority Health SBD |
$539.28
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$103,439.00 |
| Rate for Payer: Aetna Commercial |
$751.94
|
| Rate for Payer: Aetna Medicare |
$583.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.06
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$561.15
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: BCN Medicare Advantage |
$561.15
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cofinity Commercial |
$808.06
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.15
|
| Rate for Payer: Healthscope Commercial |
$897.84
|
| Rate for Payer: Healthscope Commercial |
$1,038.13
|
| Rate for Payer: Mclaren Medicaid |
$366.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.21
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103,439.00
|
| Rate for Payer: Nomi Health Commercial |
$673.38
|
| Rate for Payer: PACE SWMI |
$561.15
|
| Rate for Payer: PHP Medicare Advantage |
$561.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Medicare |
$561.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: Priority Health SBD |
$913.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.15
|
| Rate for Payer: UHC Exchange |
$967.62
|
| Rate for Payer: UHC Medicare Advantage |
$561.15
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
|
|
PR LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 37700
|
| Min. Negotiated Rate |
$150.57 |
| Max. Negotiated Rate |
$43,222.00 |
| Rate for Payer: Aetna Commercial |
$313.67
|
| Rate for Payer: Aetna Medicare |
$243.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.08
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$234.08
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$353.80
|
| Rate for Payer: BCN Medicare Advantage |
$234.08
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$337.08
|
| Rate for Payer: Cofinity Commercial |
$313.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.08
|
| Rate for Payer: Healthscope Commercial |
$433.05
|
| Rate for Payer: Healthscope Commercial |
$374.53
|
| Rate for Payer: Mclaren Medicaid |
$155.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.78
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,222.00
|
| Rate for Payer: Nomi Health Commercial |
$280.90
|
| Rate for Payer: PACE SWMI |
$234.08
|
| Rate for Payer: PHP Medicare Advantage |
$234.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.11
|
| Rate for Payer: Priority Health Medicare |
$234.08
|
| Rate for Payer: Priority Health Narrow Network |
$386.11
|
| Rate for Payer: Priority Health SBD |
$386.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.08
|
| Rate for Payer: UHC Exchange |
$482.87
|
| Rate for Payer: UHC Medicare Advantage |
$234.08
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR LIG DIV & STRIPPING SHORT SAPHENOUS VEIN
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 37718
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$69,793.00 |
| Rate for Payer: Aetna Commercial |
$508.81
|
| Rate for Payer: Aetna Medicare |
$394.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.78
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$379.71
|
| Rate for Payer: BCBS Trust/PPO |
$219.24
|
| Rate for Payer: BCN Commercial |
$564.43
|
| Rate for Payer: BCN Medicare Advantage |
$379.71
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$546.78
|
| Rate for Payer: Cofinity Commercial |
$508.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.71
|
| Rate for Payer: Healthscope Commercial |
$702.46
|
| Rate for Payer: Healthscope Commercial |
$607.54
|
| Rate for Payer: Mclaren Medicaid |
$248.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.70
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69,793.00
|
| Rate for Payer: Nomi Health Commercial |
$455.65
|
| Rate for Payer: PACE SWMI |
$379.71
|
| Rate for Payer: PHP Medicare Advantage |
$379.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.45
|
| Rate for Payer: Priority Health Medicare |
$379.71
|
| Rate for Payer: Priority Health Narrow Network |
$617.45
|
| Rate for Payer: Priority Health SBD |
$617.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.71
|
| Rate for Payer: UHC Exchange |
$430.68
|
| Rate for Payer: UHC Medicare Advantage |
$379.71
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
|
PR LIG DIV&STRPG LONG SAPH SAPHFEM JUNCT KNE/BELW
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 37722
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$82,505.00 |
| Rate for Payer: Aetna Commercial |
$590.42
|
| Rate for Payer: Aetna Medicare |
$458.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.48
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$440.61
|
| Rate for Payer: BCBS Trust/PPO |
$407.85
|
| Rate for Payer: BCN Commercial |
$669.00
|
| Rate for Payer: BCN Medicare Advantage |
$440.61
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$634.48
|
| Rate for Payer: Cofinity Commercial |
$590.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.61
|
| Rate for Payer: Healthscope Commercial |
$815.13
|
| Rate for Payer: Healthscope Commercial |
$704.98
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.64
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,505.00
|
| Rate for Payer: Nomi Health Commercial |
$528.73
|
| Rate for Payer: PACE SWMI |
$440.61
|
| Rate for Payer: PHP Medicare Advantage |
$440.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.88
|
| Rate for Payer: Priority Health Medicare |
$440.61
|
| Rate for Payer: Priority Health Narrow Network |
$724.88
|
| Rate for Payer: Priority Health SBD |
$724.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.61
|
| Rate for Payer: UHC Exchange |
$528.91
|
| Rate for Payer: UHC Medicare Advantage |
$440.61
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$270.48 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.26
|
| Rate for Payer: BCN Commercial |
$1,140.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.48
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 37785
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$44,847.00 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: Aetna Medicare |
$249.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.13
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$240.37
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$240.37
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.37
|
| Rate for Payer: Healthscope Commercial |
$444.68
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.39
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,847.00
|
| Rate for Payer: Nomi Health Commercial |
$288.44
|
| Rate for Payer: PACE SWMI |
$240.37
|
| Rate for Payer: PHP Medicare Advantage |
$240.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.12
|
| Rate for Payer: Priority Health Medicare |
$240.37
|
| Rate for Payer: Priority Health Narrow Network |
$403.12
|
| Rate for Payer: Priority Health SBD |
$403.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.37
|
| Rate for Payer: UHC Exchange |
$466.18
|
| Rate for Payer: UHC Medicare Advantage |
$240.37
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$610.47 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health SBD |
$610.47
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$44,847.00 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: Aetna Medicare |
$249.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.13
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$240.37
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$240.37
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.37
|
| Rate for Payer: Healthscope Commercial |
$444.68
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.39
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,847.00
|
| Rate for Payer: Nomi Health Commercial |
$288.44
|
| Rate for Payer: PACE SWMI |
$240.37
|
| Rate for Payer: PHP Medicare Advantage |
$240.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.12
|
| Rate for Payer: Priority Health Medicare |
$240.37
|
| Rate for Payer: Priority Health Narrow Network |
$403.12
|
| Rate for Payer: Priority Health SBD |
$403.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.37
|
| Rate for Payer: UHC Exchange |
$466.18
|
| Rate for Payer: UHC Medicare Advantage |
$240.37
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
|
|
PR LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 37780
|
| Min. Negotiated Rate |
$149.95 |
| Max. Negotiated Rate |
$41,654.00 |
| Rate for Payer: Aetna Commercial |
$304.17
|
| Rate for Payer: Aetna Medicare |
$236.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.87
|
| Rate for Payer: BCBS Complete |
$157.45
|
| Rate for Payer: BCBS MAPPO |
$226.99
|
| Rate for Payer: BCBS Trust/PPO |
$438.49
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$226.99
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$326.87
|
| Rate for Payer: Cofinity Commercial |
$304.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.99
|
| Rate for Payer: Healthscope Commercial |
$419.93
|
| Rate for Payer: Healthscope Commercial |
$363.18
|
| Rate for Payer: Mclaren Medicaid |
$149.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.34
|
| Rate for Payer: Meridian Medicaid |
$157.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,654.00
|
| Rate for Payer: Nomi Health Commercial |
$272.39
|
| Rate for Payer: PACE SWMI |
$226.99
|
| Rate for Payer: PHP Medicare Advantage |
$226.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.82
|
| Rate for Payer: Priority Health Medicare |
$226.99
|
| Rate for Payer: Priority Health Narrow Network |
$372.82
|
| Rate for Payer: Priority Health SBD |
$372.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.99
|
| Rate for Payer: UHC Exchange |
$306.66
|
| Rate for Payer: UHC Medicare Advantage |
$226.99
|
| Rate for Payer: UHCCP Medicaid |
$149.95
|
|
|
PR LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR
|
Professional
|
Both
|
$2,234.00
|
|
|
Service Code
|
HCPCS 27429
|
| Min. Negotiated Rate |
$819.84 |
| Max. Negotiated Rate |
$223,067.00 |
| Rate for Payer: Aetna Commercial |
$1,628.27
|
| Rate for Payer: Aetna Medicare |
$1,263.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,749.79
|
| Rate for Payer: BCBS Complete |
$860.83
|
| Rate for Payer: BCBS MAPPO |
$1,215.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,210.41
|
| Rate for Payer: BCN Commercial |
$1,846.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.13
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cofinity Commercial |
$1,749.79
|
| Rate for Payer: Cofinity Commercial |
$1,628.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.13
|
| Rate for Payer: Healthscope Commercial |
$2,247.99
|
| Rate for Payer: Healthscope Commercial |
$1,944.21
|
| Rate for Payer: Mclaren Medicaid |
$819.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,275.89
|
| Rate for Payer: Meridian Medicaid |
$860.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223,067.00
|
| Rate for Payer: Nomi Health Commercial |
$1,458.16
|
| Rate for Payer: PACE SWMI |
$1,215.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$819.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,452.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,940.80
|
| Rate for Payer: Priority Health Medicare |
$1,215.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,940.80
|
| Rate for Payer: Priority Health SBD |
$1,940.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,215.13
|
| Rate for Payer: UHC Exchange |
$1,365.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,215.13
|
| Rate for Payer: UHCCP Medicaid |
$819.84
|
|
|
PR LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG
|
Professional
|
Both
|
$1,126.00
|
|
|
Service Code
|
HCPCS 37761
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$95,650.00 |
| Rate for Payer: Aetna Commercial |
$683.53
|
| Rate for Payer: Aetna Medicare |
$530.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.54
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$510.10
|
| Rate for Payer: BCBS Trust/PPO |
$898.64
|
| Rate for Payer: BCN Commercial |
$778.46
|
| Rate for Payer: BCN Medicare Advantage |
$510.10
|
| Rate for Payer: Cash Price |
$900.80
|
| Rate for Payer: Cash Price |
$900.80
|
| Rate for Payer: Cofinity Commercial |
$734.54
|
| Rate for Payer: Cofinity Commercial |
$683.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.10
|
| Rate for Payer: Healthscope Commercial |
$816.16
|
| Rate for Payer: Healthscope Commercial |
$943.68
|
| Rate for Payer: Mclaren Medicaid |
$336.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.60
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,650.00
|
| Rate for Payer: Nomi Health Commercial |
$612.12
|
| Rate for Payer: PACE SWMI |
$510.10
|
| Rate for Payer: PHP Medicare Advantage |
$510.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.60
|
| Rate for Payer: Priority Health Medicare |
$510.10
|
| Rate for Payer: Priority Health Narrow Network |
$845.60
|
| Rate for Payer: Priority Health SBD |
$845.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.10
|
| Rate for Payer: UHC Medicare Advantage |
$510.10
|
| Rate for Payer: UHCCP Medicaid |
$336.11
|
|
|
PR LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 58611
|
| Min. Negotiated Rate |
$47.93 |
| Max. Negotiated Rate |
$13,597.00 |
| Rate for Payer: Aetna Commercial |
$97.16
|
| Rate for Payer: Aetna Medicare |
$75.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.16
|
| Rate for Payer: BCBS Complete |
$50.33
|
| Rate for Payer: BCBS MAPPO |
$72.51
|
| Rate for Payer: BCBS Trust/PPO |
$194.94
|
| Rate for Payer: BCN Commercial |
$110.45
|
| Rate for Payer: BCN Medicare Advantage |
$72.51
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$97.16
|
| Rate for Payer: Cofinity Commercial |
$104.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.51
|
| Rate for Payer: Healthscope Commercial |
$134.14
|
| Rate for Payer: Healthscope Commercial |
$116.02
|
| Rate for Payer: Mclaren Medicaid |
$47.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.14
|
| Rate for Payer: Meridian Medicaid |
$50.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,597.00
|
| Rate for Payer: Nomi Health Commercial |
$87.01
|
| Rate for Payer: PACE SWMI |
$72.51
|
| Rate for Payer: PHP Medicare Advantage |
$72.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.62
|
| Rate for Payer: Priority Health Medicare |
$72.51
|
| Rate for Payer: Priority Health Narrow Network |
$111.62
|
| Rate for Payer: Priority Health SBD |
$111.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.51
|
| Rate for Payer: UHC Exchange |
$131.89
|
| Rate for Payer: UHC Medicare Advantage |
$72.51
|
| Rate for Payer: UHCCP Medicaid |
$47.93
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 58600
|
| Min. Negotiated Rate |
$78.19 |
| Max. Negotiated Rate |
$66,199.00 |
| Rate for Payer: Aetna Commercial |
$476.41
|
| Rate for Payer: Aetna Medicare |
$369.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.96
|
| Rate for Payer: BCBS Complete |
$250.49
|
| Rate for Payer: BCBS MAPPO |
$355.53
|
| Rate for Payer: BCBS Trust/PPO |
$78.19
|
| Rate for Payer: BCN Commercial |
$545.36
|
| Rate for Payer: BCN Medicare Advantage |
$355.53
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$511.96
|
| Rate for Payer: Cofinity Commercial |
$476.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.53
|
| Rate for Payer: Healthscope Commercial |
$657.73
|
| Rate for Payer: Healthscope Commercial |
$568.85
|
| Rate for Payer: Mclaren Medicaid |
$238.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.31
|
| Rate for Payer: Meridian Medicaid |
$250.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,199.00
|
| Rate for Payer: Nomi Health Commercial |
$426.64
|
| Rate for Payer: PACE SWMI |
$355.53
|
| Rate for Payer: PHP Medicare Advantage |
$355.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.06
|
| Rate for Payer: Priority Health Medicare |
$355.53
|
| Rate for Payer: Priority Health Narrow Network |
$557.06
|
| Rate for Payer: Priority Health SBD |
$557.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.53
|
| Rate for Payer: UHC Exchange |
$579.87
|
| Rate for Payer: UHC Medicare Advantage |
$355.53
|
| Rate for Payer: UHCCP Medicaid |
$238.56
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 58605
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$60,154.00 |
| Rate for Payer: Aetna Commercial |
$431.94
|
| Rate for Payer: Aetna Medicare |
$335.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.17
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$322.34
|
| Rate for Payer: BCBS Trust/PPO |
$264.15
|
| Rate for Payer: BCN Commercial |
$496.00
|
| Rate for Payer: BCN Medicare Advantage |
$322.34
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$464.17
|
| Rate for Payer: Cofinity Commercial |
$431.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.34
|
| Rate for Payer: Healthscope Commercial |
$596.33
|
| Rate for Payer: Healthscope Commercial |
$515.74
|
| Rate for Payer: Mclaren Medicaid |
$216.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.46
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,154.00
|
| Rate for Payer: Nomi Health Commercial |
$386.81
|
| Rate for Payer: PACE SWMI |
$322.34
|
| Rate for Payer: PHP Medicare Advantage |
$322.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.47
|
| Rate for Payer: Priority Health Medicare |
$322.34
|
| Rate for Payer: Priority Health Narrow Network |
$506.47
|
| Rate for Payer: Priority Health SBD |
$506.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.34
|
| Rate for Payer: UHC Exchange |
$527.17
|
| Rate for Payer: UHC Medicare Advantage |
$322.34
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
|
|
PR LILETTA, 52 MG
|
Professional
|
Both
|
$880.00
|
|
|
Service Code
|
HCPCS J7297
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$86,200.00 |
| Rate for Payer: Aetna Commercial |
$845.10
|
| Rate for Payer: Aetna Medicare |
$440.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.10
|
| Rate for Payer: BCBS Complete |
$1,037.01
|
| Rate for Payer: BCBS Trust/PPO |
$856.93
|
| Rate for Payer: BCN Commercial |
$856.93
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Mclaren Medicaid |
$987.63
|
| Rate for Payer: Meridian Medicaid |
$1,037.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,200.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.82
|
| Rate for Payer: UHC Exchange |
$968.82
|
| Rate for Payer: UHCCP Medicaid |
$987.63
|
|
|
PR LIMITED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 92081
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$4,737.00 |
| Rate for Payer: Aetna Commercial |
$40.87
|
| Rate for Payer: Aetna Medicare |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.92
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$30.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.47
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$30.50
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$43.92
|
| Rate for Payer: Cofinity Commercial |
$40.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.50
|
| Rate for Payer: Healthscope Commercial |
$56.42
|
| Rate for Payer: Healthscope Commercial |
$48.80
|
| Rate for Payer: Mclaren Medicaid |
$10.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.02
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,737.00
|
| Rate for Payer: Nomi Health Commercial |
$36.60
|
| Rate for Payer: PACE SWMI |
$30.50
|
| Rate for Payer: PHP Medicare Advantage |
$30.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.53
|
| Rate for Payer: Priority Health Medicare |
$30.50
|
| Rate for Payer: Priority Health Narrow Network |
$41.53
|
| Rate for Payer: Priority Health SBD |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.50
|
| Rate for Payer: UHC Exchange |
$89.84
|
| Rate for Payer: UHC Medicare Advantage |
$30.50
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
|
|
PR LINCOMYCIN INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J2010
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$1,105.00 |
| Rate for Payer: Aetna Commercial |
$7.52
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.08
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$7.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$8.08
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$10.38
|
| Rate for Payer: Healthscope Commercial |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.00
|
| Rate for Payer: Nomi Health Commercial |
$6.73
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Exchange |
$7.13
|
| Rate for Payer: UHC Medicare Advantage |
$5.61
|
|
|
PR LITHOLAPAXY COMP/LG > 2.5 CM
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 52318
|
| Min. Negotiated Rate |
$298.63 |
| Max. Negotiated Rate |
$82,775.00 |
| Rate for Payer: Aetna Commercial |
$601.74
|
| Rate for Payer: Aetna Medicare |
$467.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.74
|
| Rate for Payer: BCBS Complete |
$313.56
|
| Rate for Payer: BCBS MAPPO |
$449.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,353.50
|
| Rate for Payer: BCN Commercial |
$674.37
|
| Rate for Payer: BCN Medicare Advantage |
$449.06
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cofinity Commercial |
$646.65
|
| Rate for Payer: Cofinity Commercial |
$601.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.06
|
| Rate for Payer: Healthscope Commercial |
$830.76
|
| Rate for Payer: Healthscope Commercial |
$718.50
|
| Rate for Payer: Mclaren Medicaid |
$298.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.51
|
| Rate for Payer: Meridian Medicaid |
$313.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,775.00
|
| Rate for Payer: Nomi Health Commercial |
$538.87
|
| Rate for Payer: PACE SWMI |
$449.06
|
| Rate for Payer: PHP Medicare Advantage |
$449.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.45
|
| Rate for Payer: Priority Health Medicare |
$449.06
|
| Rate for Payer: Priority Health Narrow Network |
$742.45
|
| Rate for Payer: Priority Health SBD |
$742.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.06
|
| Rate for Payer: UHC Exchange |
$620.92
|
| Rate for Payer: UHC Medicare Advantage |
$449.06
|
| Rate for Payer: UHCCP Medicaid |
$298.63
|
|
