|
PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK
|
Facility
|
OP
|
$4,600.00
|
|
|
Service Code
|
CPT 15734
|
| Hospital Charge Code |
15734
|
| Min. Negotiated Rate |
$1,411.51 |
| Max. Negotiated Rate |
$11,273.70 |
| Rate for Payer: Aetna Commercial |
$3,910.00
|
| Rate for Payer: Aetna Medicare |
$3,730.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,990.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,483.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,483.69
|
| Rate for Payer: BCBS Complete |
$2,018.74
|
| Rate for Payer: BCBS MAPPO |
$3,586.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,411.51
|
| Rate for Payer: BCN Commercial |
$1,411.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,586.95
|
| Rate for Payer: Cash Price |
$3,680.00
|
| Rate for Payer: Cash Price |
$3,680.00
|
| Rate for Payer: Cash Price |
$3,680.00
|
| Rate for Payer: Cofinity Commercial |
$3,220.00
|
| Rate for Payer: Cofinity Commercial |
$3,956.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,220.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,680.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,586.95
|
| Rate for Payer: Healthscope Commercial |
$4,140.00
|
| Rate for Payer: Mclaren Medicaid |
$1,922.61
|
| Rate for Payer: Mclaren Medicare |
$3,586.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,766.30
|
| Rate for Payer: Meridian Medicaid |
$2,018.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,124.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,910.00
|
| Rate for Payer: Nomi Health Commercial |
$7,532.60
|
| Rate for Payer: PACE Medicare |
$3,407.60
|
| Rate for Payer: PACE SWMI |
$3,586.95
|
| Rate for Payer: PHP Commercial |
$3,910.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,586.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,922.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,273.70
|
| Rate for Payer: Priority Health Medicare |
$3,586.95
|
| Rate for Payer: Priority Health Narrow Network |
$9,018.96
|
| Rate for Payer: Priority Health SBD |
$2,898.00
|
| Rate for Payer: Railroad Medicare Medicare |
$3,586.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,597.64
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,586.95
|
| Rate for Payer: UHC Medicare Advantage |
$3,586.95
|
| Rate for Payer: UHCCP Medicaid |
$2,019.45
|
| Rate for Payer: VA VA |
$3,586.95
|
|
|
PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 15736
|
| Min. Negotiated Rate |
$783.41 |
| Max. Negotiated Rate |
$214,279.00 |
| Rate for Payer: Aetna Commercial |
$1,555.53
|
| Rate for Payer: Aetna Medicare |
$1,207.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,555.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.61
|
| Rate for Payer: BCBS Complete |
$822.58
|
| Rate for Payer: BCBS MAPPO |
$1,160.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,648.76
|
| Rate for Payer: BCN Commercial |
$1,774.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.84
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cofinity Commercial |
$1,671.61
|
| Rate for Payer: Cofinity Commercial |
$1,555.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.84
|
| Rate for Payer: Healthscope Commercial |
$2,147.55
|
| Rate for Payer: Healthscope Commercial |
$1,857.34
|
| Rate for Payer: Mclaren Medicaid |
$783.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.88
|
| Rate for Payer: Meridian Medicaid |
$822.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214,279.00
|
| Rate for Payer: Nomi Health Commercial |
$1,393.01
|
| Rate for Payer: PACE SWMI |
$1,160.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,498.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.19
|
| Rate for Payer: Priority Health Medicare |
$1,160.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,651.19
|
| Rate for Payer: Priority Health SBD |
$1,651.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,446.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,160.84
|
| Rate for Payer: UHC Exchange |
$1,446.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.84
|
| Rate for Payer: UHCCP Medicaid |
$783.41
|
|
|
PR MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 15733
|
| Min. Negotiated Rate |
$660.94 |
| Max. Negotiated Rate |
$181,825.00 |
| Rate for Payer: Aetna Commercial |
$1,314.83
|
| Rate for Payer: Aetna Medicare |
$1,020.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.96
|
| Rate for Payer: BCBS Complete |
$693.99
|
| Rate for Payer: BCBS MAPPO |
$981.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,152.77
|
| Rate for Payer: BCN Commercial |
$1,502.19
|
| Rate for Payer: BCN Medicare Advantage |
$981.22
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$1,412.96
|
| Rate for Payer: Cofinity Commercial |
$1,314.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.22
|
| Rate for Payer: Healthscope Commercial |
$1,569.95
|
| Rate for Payer: Healthscope Commercial |
$1,815.26
|
| Rate for Payer: Mclaren Medicaid |
$660.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.28
|
| Rate for Payer: Meridian Medicaid |
$693.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181,825.00
|
| Rate for Payer: Nomi Health Commercial |
$1,177.46
|
| Rate for Payer: PACE SWMI |
$981.22
|
| Rate for Payer: PHP Medicare Advantage |
$981.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.93
|
| Rate for Payer: Priority Health Medicare |
$981.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,392.93
|
| Rate for Payer: Priority Health SBD |
$1,392.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.22
|
| Rate for Payer: UHC Medicare Advantage |
$981.22
|
| Rate for Payer: UHCCP Medicaid |
$660.94
|
|
|
PR MYOCARDIAL RESECTION
|
Professional
|
Both
|
$6,268.00
|
|
|
Service Code
|
HCPCS 33542
|
| Min. Negotiated Rate |
$841.58 |
| Max. Negotiated Rate |
$464,414.00 |
| Rate for Payer: Aetna Commercial |
$3,378.82
|
| Rate for Payer: Aetna Medicare |
$2,622.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,378.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,630.97
|
| Rate for Payer: BCBS Complete |
$1,734.63
|
| Rate for Payer: BCBS MAPPO |
$2,521.51
|
| Rate for Payer: BCBS Trust/PPO |
$841.58
|
| Rate for Payer: BCN Commercial |
$3,754.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,521.51
|
| Rate for Payer: Cash Price |
$5,014.40
|
| Rate for Payer: Cash Price |
$5,014.40
|
| Rate for Payer: Cofinity Commercial |
$3,630.97
|
| Rate for Payer: Cofinity Commercial |
$3,378.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,521.51
|
| Rate for Payer: Healthscope Commercial |
$4,664.79
|
| Rate for Payer: Healthscope Commercial |
$4,034.42
|
| Rate for Payer: Mclaren Medicaid |
$1,652.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,647.59
|
| Rate for Payer: Meridian Medicaid |
$1,734.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464,414.00
|
| Rate for Payer: Nomi Health Commercial |
$3,025.81
|
| Rate for Payer: PACE SWMI |
$2,521.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,521.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,074.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,097.18
|
| Rate for Payer: Priority Health Medicare |
$2,521.51
|
| Rate for Payer: Priority Health Narrow Network |
$4,097.18
|
| Rate for Payer: Priority Health SBD |
$4,097.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,046.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,521.51
|
| Rate for Payer: UHC Exchange |
$3,046.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,521.51
|
| Rate for Payer: UHCCP Medicaid |
$1,652.03
|
|
|
PR MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR
|
Professional
|
Both
|
$1,961.00
|
|
|
Service Code
|
HCPCS 58145
|
| Min. Negotiated Rate |
$361.04 |
| Max. Negotiated Rate |
$101,237.00 |
| Rate for Payer: Aetna Commercial |
$720.71
|
| Rate for Payer: Aetna Medicare |
$559.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.49
|
| Rate for Payer: BCBS Complete |
$379.09
|
| Rate for Payer: BCBS MAPPO |
$537.84
|
| Rate for Payer: BCBS Trust/PPO |
$876.45
|
| Rate for Payer: BCN Commercial |
$834.66
|
| Rate for Payer: BCN Medicare Advantage |
$537.84
|
| Rate for Payer: Cash Price |
$1,568.80
|
| Rate for Payer: Cash Price |
$1,568.80
|
| Rate for Payer: Cofinity Commercial |
$774.49
|
| Rate for Payer: Cofinity Commercial |
$720.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.84
|
| Rate for Payer: Healthscope Commercial |
$995.00
|
| Rate for Payer: Healthscope Commercial |
$860.54
|
| Rate for Payer: Mclaren Medicaid |
$361.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.73
|
| Rate for Payer: Meridian Medicaid |
$379.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,237.00
|
| Rate for Payer: Nomi Health Commercial |
$645.41
|
| Rate for Payer: PACE SWMI |
$537.84
|
| Rate for Payer: PHP Medicare Advantage |
$537.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,274.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$854.19
|
| Rate for Payer: Priority Health Medicare |
$537.84
|
| Rate for Payer: Priority Health Narrow Network |
$854.19
|
| Rate for Payer: Priority Health SBD |
$854.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.84
|
| Rate for Payer: UHC Exchange |
$731.66
|
| Rate for Payer: UHC Medicare Advantage |
$537.84
|
| Rate for Payer: UHCCP Medicaid |
$361.04
|
|
|
PR MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR
|
Professional
|
Both
|
$3,033.00
|
|
|
Service Code
|
HCPCS 58140
|
| Min. Negotiated Rate |
$590.22 |
| Max. Negotiated Rate |
$167,134.00 |
| Rate for Payer: Aetna Commercial |
$1,185.18
|
| Rate for Payer: Aetna Medicare |
$919.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.62
|
| Rate for Payer: BCBS Complete |
$619.73
|
| Rate for Payer: BCBS MAPPO |
$884.46
|
| Rate for Payer: BCBS Trust/PPO |
$737.51
|
| Rate for Payer: BCN Commercial |
$1,370.25
|
| Rate for Payer: BCN Medicare Advantage |
$884.46
|
| Rate for Payer: Cash Price |
$2,426.40
|
| Rate for Payer: Cash Price |
$2,426.40
|
| Rate for Payer: Cofinity Commercial |
$1,273.62
|
| Rate for Payer: Cofinity Commercial |
$1,185.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.46
|
| Rate for Payer: Healthscope Commercial |
$1,636.25
|
| Rate for Payer: Healthscope Commercial |
$1,415.14
|
| Rate for Payer: Mclaren Medicaid |
$590.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.68
|
| Rate for Payer: Meridian Medicaid |
$619.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167,134.00
|
| Rate for Payer: Nomi Health Commercial |
$1,061.35
|
| Rate for Payer: PACE SWMI |
$884.46
|
| Rate for Payer: PHP Medicare Advantage |
$884.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,971.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,378.02
|
| Rate for Payer: Priority Health Medicare |
$884.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,378.02
|
| Rate for Payer: Priority Health SBD |
$1,378.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,152.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$884.46
|
| Rate for Payer: UHC Exchange |
$1,152.44
|
| Rate for Payer: UHC Medicare Advantage |
$884.46
|
| Rate for Payer: UHCCP Medicaid |
$590.22
|
|
|
PR MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 58146
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$206,912.00 |
| Rate for Payer: Aetna Commercial |
$1,487.09
|
| Rate for Payer: Aetna Medicare |
$1,154.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.07
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS MAPPO |
$1,109.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,587.61
|
| Rate for Payer: BCN Commercial |
$1,692.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.77
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,598.07
|
| Rate for Payer: Cofinity Commercial |
$1,487.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.77
|
| Rate for Payer: Healthscope Commercial |
$2,053.07
|
| Rate for Payer: Healthscope Commercial |
$1,775.63
|
| Rate for Payer: Mclaren Medicaid |
$738.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.26
|
| Rate for Payer: Meridian Medicaid |
$775.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206,912.00
|
| Rate for Payer: Nomi Health Commercial |
$1,331.72
|
| Rate for Payer: PACE SWMI |
$1,109.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.76
|
| Rate for Payer: Priority Health Medicare |
$1,109.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.76
|
| Rate for Payer: Priority Health SBD |
$1,723.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,261.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.77
|
| Rate for Payer: UHC Exchange |
$1,261.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.77
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
|
|
PR MYRINGOPLASTY
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 69620
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$87,046.00 |
| Rate for Payer: Aetna Commercial |
$625.95
|
| Rate for Payer: Aetna Medicare |
$485.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.67
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS MAPPO |
$467.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.84
|
| Rate for Payer: BCN Commercial |
$1,099.04
|
| Rate for Payer: BCN Medicare Advantage |
$467.13
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cofinity Commercial |
$672.67
|
| Rate for Payer: Cofinity Commercial |
$625.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.13
|
| Rate for Payer: Healthscope Commercial |
$864.19
|
| Rate for Payer: Healthscope Commercial |
$747.41
|
| Rate for Payer: Mclaren Medicaid |
$319.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.49
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87,046.00
|
| Rate for Payer: Nomi Health Commercial |
$560.56
|
| Rate for Payer: PACE SWMI |
$467.13
|
| Rate for Payer: PHP Medicare Advantage |
$467.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$728.10
|
| Rate for Payer: Priority Health Medicare |
$467.13
|
| Rate for Payer: Priority Health Narrow Network |
$728.10
|
| Rate for Payer: Priority Health SBD |
$728.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.13
|
| Rate for Payer: UHC Exchange |
$547.61
|
| Rate for Payer: UHC Medicare Advantage |
$467.13
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
|
|
PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 69420
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$21,056.00 |
| Rate for Payer: Aetna Commercial |
$152.51
|
| Rate for Payer: Aetna Medicare |
$118.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.89
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$113.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.18
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: BCN Medicare Advantage |
$113.81
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$152.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.81
|
| Rate for Payer: Healthscope Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$182.10
|
| Rate for Payer: Mclaren Medicaid |
$78.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.50
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,056.00
|
| Rate for Payer: Nomi Health Commercial |
$136.57
|
| Rate for Payer: PACE SWMI |
$113.81
|
| Rate for Payer: PHP Medicare Advantage |
$113.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.01
|
| Rate for Payer: Priority Health Medicare |
$113.81
|
| Rate for Payer: Priority Health Narrow Network |
$178.01
|
| Rate for Payer: Priority Health SBD |
$178.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.81
|
| Rate for Payer: UHC Exchange |
$179.29
|
| Rate for Payer: UHC Medicare Advantage |
$113.81
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 69421
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$26,669.00 |
| Rate for Payer: Aetna Commercial |
$190.95
|
| Rate for Payer: Aetna Medicare |
$148.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.20
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCBS MAPPO |
$142.50
|
| Rate for Payer: BCBS Trust/PPO |
$178.04
|
| Rate for Payer: BCN Commercial |
$223.81
|
| Rate for Payer: BCN Medicare Advantage |
$142.50
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$205.20
|
| Rate for Payer: Cofinity Commercial |
$190.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.50
|
| Rate for Payer: Healthscope Commercial |
$263.62
|
| Rate for Payer: Healthscope Commercial |
$228.00
|
| Rate for Payer: Mclaren Medicaid |
$97.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.62
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,669.00
|
| Rate for Payer: Nomi Health Commercial |
$171.00
|
| Rate for Payer: PACE SWMI |
$142.50
|
| Rate for Payer: PHP Medicare Advantage |
$142.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.25
|
| Rate for Payer: Priority Health Medicare |
$142.50
|
| Rate for Payer: Priority Health Narrow Network |
$223.25
|
| Rate for Payer: Priority Health SBD |
$223.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.50
|
| Rate for Payer: UHC Exchange |
$220.76
|
| Rate for Payer: UHC Medicare Advantage |
$142.50
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
|
|
PR NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 31231
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$11,493.00 |
| Rate for Payer: Aetna Commercial |
$82.28
|
| Rate for Payer: Aetna Medicare |
$63.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.42
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$61.40
|
| Rate for Payer: BCBS Trust/PPO |
$698.94
|
| Rate for Payer: BCN Commercial |
$223.82
|
| Rate for Payer: BCN Medicare Advantage |
$61.40
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$88.42
|
| Rate for Payer: Cofinity Commercial |
$82.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.40
|
| Rate for Payer: Healthscope Commercial |
$98.24
|
| Rate for Payer: Healthscope Commercial |
$113.59
|
| Rate for Payer: Mclaren Medicaid |
$41.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.47
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,493.00
|
| Rate for Payer: Nomi Health Commercial |
$73.68
|
| Rate for Payer: PACE SWMI |
$61.40
|
| Rate for Payer: PHP Medicare Advantage |
$61.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.12
|
| Rate for Payer: Priority Health Medicare |
$61.40
|
| Rate for Payer: Priority Health Narrow Network |
$86.12
|
| Rate for Payer: Priority Health SBD |
$86.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.40
|
| Rate for Payer: UHC Exchange |
$187.99
|
| Rate for Payer: UHC Medicare Advantage |
$61.40
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 31233
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$23,823.00 |
| Rate for Payer: Aetna Commercial |
$172.14
|
| Rate for Payer: Aetna Medicare |
$133.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.98
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$128.46
|
| Rate for Payer: BCBS Trust/PPO |
$844.75
|
| Rate for Payer: BCN Commercial |
$404.62
|
| Rate for Payer: BCN Medicare Advantage |
$128.46
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$184.98
|
| Rate for Payer: Cofinity Commercial |
$172.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.46
|
| Rate for Payer: Healthscope Commercial |
$237.65
|
| Rate for Payer: Healthscope Commercial |
$205.54
|
| Rate for Payer: Mclaren Medicaid |
$86.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.88
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,823.00
|
| Rate for Payer: Nomi Health Commercial |
$154.15
|
| Rate for Payer: PACE SWMI |
$128.46
|
| Rate for Payer: PHP Medicare Advantage |
$128.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.17
|
| Rate for Payer: Priority Health Medicare |
$128.46
|
| Rate for Payer: Priority Health Narrow Network |
$188.17
|
| Rate for Payer: Priority Health SBD |
$188.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.46
|
| Rate for Payer: UHC Exchange |
$271.50
|
| Rate for Payer: UHC Medicare Advantage |
$128.46
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 31235
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$28,058.00 |
| Rate for Payer: Aetna Commercial |
$205.33
|
| Rate for Payer: Aetna Medicare |
$159.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.65
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS MAPPO |
$153.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.09
|
| Rate for Payer: BCN Commercial |
$457.89
|
| Rate for Payer: BCN Medicare Advantage |
$153.23
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$220.65
|
| Rate for Payer: Cofinity Commercial |
$205.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.23
|
| Rate for Payer: Healthscope Commercial |
$283.48
|
| Rate for Payer: Healthscope Commercial |
$245.17
|
| Rate for Payer: Mclaren Medicaid |
$102.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.89
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,058.00
|
| Rate for Payer: Nomi Health Commercial |
$183.88
|
| Rate for Payer: PACE SWMI |
$153.23
|
| Rate for Payer: PHP Medicare Advantage |
$153.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Medicare |
$153.23
|
| Rate for Payer: Priority Health Narrow Network |
$221.53
|
| Rate for Payer: Priority Health SBD |
$221.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.23
|
| Rate for Payer: UHC Exchange |
$315.04
|
| Rate for Payer: UHC Medicare Advantage |
$153.23
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
|
|
PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
Professional
|
Both
|
$541.00
|
|
|
Service Code
|
HCPCS 31256
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$31,916.00 |
| Rate for Payer: Aetna Commercial |
$231.86
|
| Rate for Payer: Aetna Medicare |
$179.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.16
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$173.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.73
|
| Rate for Payer: BCN Commercial |
$261.93
|
| Rate for Payer: BCN Medicare Advantage |
$173.03
|
| Rate for Payer: Cash Price |
$432.80
|
| Rate for Payer: Cash Price |
$432.80
|
| Rate for Payer: Cofinity Commercial |
$249.16
|
| Rate for Payer: Cofinity Commercial |
$231.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.03
|
| Rate for Payer: Healthscope Commercial |
$320.11
|
| Rate for Payer: Healthscope Commercial |
$276.85
|
| Rate for Payer: Mclaren Medicaid |
$115.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.68
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,916.00
|
| Rate for Payer: Nomi Health Commercial |
$207.64
|
| Rate for Payer: PACE SWMI |
$173.03
|
| Rate for Payer: PHP Medicare Advantage |
$173.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.88
|
| Rate for Payer: Priority Health Medicare |
$173.03
|
| Rate for Payer: Priority Health Narrow Network |
$248.88
|
| Rate for Payer: Priority Health SBD |
$248.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.03
|
| Rate for Payer: UHC Exchange |
$301.86
|
| Rate for Payer: UHC Medicare Advantage |
$173.03
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
|
|
PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 31287
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$35,744.00 |
| Rate for Payer: Aetna Commercial |
$257.28
|
| Rate for Payer: Aetna Medicare |
$199.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.48
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$192.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.67
|
| Rate for Payer: BCN Commercial |
$293.21
|
| Rate for Payer: BCN Medicare Advantage |
$192.00
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$276.48
|
| Rate for Payer: Cofinity Commercial |
$257.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.00
|
| Rate for Payer: Healthscope Commercial |
$355.20
|
| Rate for Payer: Healthscope Commercial |
$307.20
|
| Rate for Payer: Mclaren Medicaid |
$128.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.60
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,744.00
|
| Rate for Payer: Nomi Health Commercial |
$230.40
|
| Rate for Payer: PACE SWMI |
$192.00
|
| Rate for Payer: PHP Medicare Advantage |
$192.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.09
|
| Rate for Payer: Priority Health Medicare |
$192.00
|
| Rate for Payer: Priority Health Narrow Network |
$278.09
|
| Rate for Payer: Priority Health SBD |
$278.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.00
|
| Rate for Payer: UHC Exchange |
$381.97
|
| Rate for Payer: UHC Medicare Advantage |
$192.00
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV
|
Professional
|
Both
|
$4,457.00
|
|
|
Service Code
|
HCPCS 31243
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$2,897.05 |
| Rate for Payer: Aetna Commercial |
$201.62
|
| Rate for Payer: Aetna Medicare |
$156.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.66
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$150.46
|
| Rate for Payer: BCN Medicare Advantage |
$150.46
|
| Rate for Payer: Cash Price |
$3,565.60
|
| Rate for Payer: Cash Price |
$3,565.60
|
| Rate for Payer: Cofinity Commercial |
$216.66
|
| Rate for Payer: Cofinity Commercial |
$201.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.46
|
| Rate for Payer: Healthscope Commercial |
$278.35
|
| Rate for Payer: Healthscope Commercial |
$240.74
|
| Rate for Payer: Mclaren Medicaid |
$100.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.98
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,897.05
|
| Rate for Payer: Nomi Health Commercial |
$180.55
|
| Rate for Payer: PACE SWMI |
$150.46
|
| Rate for Payer: PHP Medicare Advantage |
$150.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,897.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.76
|
| Rate for Payer: Priority Health Medicare |
$150.46
|
| Rate for Payer: Priority Health Narrow Network |
$218.76
|
| Rate for Payer: Priority Health SBD |
$218.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.46
|
| Rate for Payer: UHC Medicare Advantage |
$150.46
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
|
|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 31290
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$203,267.00 |
| Rate for Payer: Aetna Commercial |
$1,466.17
|
| Rate for Payer: Aetna Medicare |
$1,137.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,466.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,575.59
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS MAPPO |
$1,094.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.13
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.16
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$1,575.59
|
| Rate for Payer: Cofinity Commercial |
$1,466.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.16
|
| Rate for Payer: Healthscope Commercial |
$2,024.20
|
| Rate for Payer: Healthscope Commercial |
$1,750.66
|
| Rate for Payer: Mclaren Medicaid |
$733.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.87
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203,267.00
|
| Rate for Payer: Nomi Health Commercial |
$1,312.99
|
| Rate for Payer: PACE SWMI |
$1,094.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.90
|
| Rate for Payer: Priority Health Medicare |
$1,094.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,586.90
|
| Rate for Payer: Priority Health SBD |
$1,586.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,484.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,094.16
|
| Rate for Payer: UHC Exchange |
$1,484.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.16
|
| Rate for Payer: UHCCP Medicaid |
$733.79
|
|
|
PR NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID
|
Professional
|
Both
|
$2,318.00
|
|
|
Service Code
|
HCPCS 31291
|
| Min. Negotiated Rate |
$785.54 |
| Max. Negotiated Rate |
$216,497.00 |
| Rate for Payer: Aetna Commercial |
$1,573.86
|
| Rate for Payer: Aetna Medicare |
$1,221.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,573.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,691.31
|
| Rate for Payer: BCBS Complete |
$824.82
|
| Rate for Payer: BCBS MAPPO |
$1,174.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,581.20
|
| Rate for Payer: BCN Commercial |
$1,781.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,174.52
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Cofinity Commercial |
$1,691.31
|
| Rate for Payer: Cofinity Commercial |
$1,573.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,174.52
|
| Rate for Payer: Healthscope Commercial |
$2,172.86
|
| Rate for Payer: Healthscope Commercial |
$1,879.23
|
| Rate for Payer: Mclaren Medicaid |
$785.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,233.25
|
| Rate for Payer: Meridian Medicaid |
$824.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216,497.00
|
| Rate for Payer: Nomi Health Commercial |
$1,409.42
|
| Rate for Payer: PACE SWMI |
$1,174.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,174.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$785.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,506.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,702.31
|
| Rate for Payer: Priority Health Medicare |
$1,174.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,702.31
|
| Rate for Payer: Priority Health SBD |
$1,702.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,558.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,174.52
|
| Rate for Payer: UHC Exchange |
$1,558.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,174.52
|
| Rate for Payer: UHCCP Medicaid |
$785.54
|
|
|
PR NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 31292
|
| Min. Negotiated Rate |
$633.25 |
| Max. Negotiated Rate |
$176,449.00 |
| Rate for Payer: Aetna Commercial |
$1,262.19
|
| Rate for Payer: Aetna Medicare |
$979.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.38
|
| Rate for Payer: BCBS Complete |
$664.91
|
| Rate for Payer: BCBS MAPPO |
$941.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.67
|
| Rate for Payer: BCN Commercial |
$1,455.28
|
| Rate for Payer: BCN Medicare Advantage |
$941.93
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,356.38
|
| Rate for Payer: Cofinity Commercial |
$1,262.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.93
|
| Rate for Payer: Healthscope Commercial |
$1,742.57
|
| Rate for Payer: Healthscope Commercial |
$1,507.09
|
| Rate for Payer: Mclaren Medicaid |
$633.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.03
|
| Rate for Payer: Meridian Medicaid |
$664.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,449.00
|
| Rate for Payer: Nomi Health Commercial |
$1,130.32
|
| Rate for Payer: PACE SWMI |
$941.93
|
| Rate for Payer: PHP Medicare Advantage |
$941.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,375.10
|
| Rate for Payer: Priority Health Medicare |
$941.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.10
|
| Rate for Payer: Priority Health SBD |
$1,375.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$941.93
|
| Rate for Payer: UHC Exchange |
$1,204.56
|
| Rate for Payer: UHC Medicare Advantage |
$941.93
|
| Rate for Payer: UHCCP Medicaid |
$633.25
|
|
|
PR NASAL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 31237
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$28,235.00 |
| Rate for Payer: Aetna Commercial |
$205.18
|
| Rate for Payer: Aetna Medicare |
$159.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.49
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS MAPPO |
$153.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.07
|
| Rate for Payer: BCN Commercial |
$303.13
|
| Rate for Payer: BCN Medicare Advantage |
$153.12
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$220.49
|
| Rate for Payer: Cofinity Commercial |
$205.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.12
|
| Rate for Payer: Healthscope Commercial |
$283.27
|
| Rate for Payer: Healthscope Commercial |
$244.99
|
| Rate for Payer: Mclaren Medicaid |
$102.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.78
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,235.00
|
| Rate for Payer: Nomi Health Commercial |
$183.74
|
| Rate for Payer: PACE SWMI |
$153.12
|
| Rate for Payer: PHP Medicare Advantage |
$153.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.00
|
| Rate for Payer: Priority Health Medicare |
$153.12
|
| Rate for Payer: Priority Health Narrow Network |
$222.00
|
| Rate for Payer: Priority Health SBD |
$222.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.12
|
| Rate for Payer: UHC Exchange |
$341.55
|
| Rate for Payer: UHC Medicare Advantage |
$153.12
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
|
|
PR NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 31240
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$28,073.00 |
| Rate for Payer: Aetna Commercial |
$203.64
|
| Rate for Payer: Aetna Medicare |
$158.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.84
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCBS MAPPO |
$151.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.18
|
| Rate for Payer: BCN Commercial |
$231.15
|
| Rate for Payer: BCN Medicare Advantage |
$151.97
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$218.84
|
| Rate for Payer: Cofinity Commercial |
$203.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.97
|
| Rate for Payer: Healthscope Commercial |
$281.14
|
| Rate for Payer: Healthscope Commercial |
$243.15
|
| Rate for Payer: Mclaren Medicaid |
$102.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.57
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,073.00
|
| Rate for Payer: Nomi Health Commercial |
$182.36
|
| Rate for Payer: PACE SWMI |
$151.97
|
| Rate for Payer: PHP Medicare Advantage |
$151.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.61
|
| Rate for Payer: Priority Health Medicare |
$151.97
|
| Rate for Payer: Priority Health Narrow Network |
$220.61
|
| Rate for Payer: Priority Health SBD |
$220.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.97
|
| Rate for Payer: UHC Exchange |
$239.42
|
| Rate for Payer: UHC Medicare Advantage |
$151.97
|
| Rate for Payer: UHCCP Medicaid |
$102.03
|
|
|
PR NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMORRHAGE
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 31238
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$29,488.00 |
| Rate for Payer: Aetna Commercial |
$213.62
|
| Rate for Payer: Aetna Medicare |
$165.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.56
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS MAPPO |
$159.42
|
| Rate for Payer: BCBS Trust/PPO |
$993.73
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$159.42
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$229.56
|
| Rate for Payer: Cofinity Commercial |
$213.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.42
|
| Rate for Payer: Healthscope Commercial |
$294.93
|
| Rate for Payer: Healthscope Commercial |
$255.07
|
| Rate for Payer: Mclaren Medicaid |
$107.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.39
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,488.00
|
| Rate for Payer: Nomi Health Commercial |
$191.30
|
| Rate for Payer: PACE SWMI |
$159.42
|
| Rate for Payer: PHP Medicare Advantage |
$159.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.20
|
| Rate for Payer: Priority Health Medicare |
$159.42
|
| Rate for Payer: Priority Health Narrow Network |
$232.20
|
| Rate for Payer: Priority Health SBD |
$232.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.42
|
| Rate for Payer: UHC Exchange |
$355.80
|
| Rate for Payer: UHC Medicare Advantage |
$159.42
|
| Rate for Payer: UHCCP Medicaid |
$107.14
|
|
|
PR NASAL/SINUS NDSC SURG W/DACRYOCYSTORHINOSTOMY
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 31239
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$106,340.00 |
| Rate for Payer: Aetna Commercial |
$767.93
|
| Rate for Payer: Aetna Medicare |
$596.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.24
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS MAPPO |
$573.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.83
|
| Rate for Payer: BCN Commercial |
$883.53
|
| Rate for Payer: BCN Medicare Advantage |
$573.08
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$825.24
|
| Rate for Payer: Cofinity Commercial |
$767.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.08
|
| Rate for Payer: Healthscope Commercial |
$916.93
|
| Rate for Payer: Healthscope Commercial |
$1,060.20
|
| Rate for Payer: Mclaren Medicaid |
$389.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.73
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,340.00
|
| Rate for Payer: Nomi Health Commercial |
$687.70
|
| Rate for Payer: PACE SWMI |
$573.08
|
| Rate for Payer: PHP Medicare Advantage |
$573.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$842.59
|
| Rate for Payer: Priority Health Medicare |
$573.08
|
| Rate for Payer: Priority Health Narrow Network |
$842.59
|
| Rate for Payer: Priority Health SBD |
$842.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$573.08
|
| Rate for Payer: UHC Exchange |
$855.42
|
| Rate for Payer: UHC Medicare Advantage |
$573.08
|
| Rate for Payer: UHCCP Medicaid |
$389.36
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 31296
|
| Min. Negotiated Rate |
$115.23 |
| Max. Negotiated Rate |
$31,799.00 |
| Rate for Payer: Aetna Commercial |
$230.92
|
| Rate for Payer: Aetna Medicare |
$179.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.16
|
| Rate for Payer: BCBS Complete |
$120.99
|
| Rate for Payer: BCBS MAPPO |
$172.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.37
|
| Rate for Payer: BCN Commercial |
$2,519.62
|
| Rate for Payer: BCN Medicare Advantage |
$172.33
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cofinity Commercial |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$230.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.33
|
| Rate for Payer: Healthscope Commercial |
$275.73
|
| Rate for Payer: Healthscope Commercial |
$318.81
|
| Rate for Payer: Mclaren Medicaid |
$115.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.95
|
| Rate for Payer: Meridian Medicaid |
$120.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,799.00
|
| Rate for Payer: Nomi Health Commercial |
$206.80
|
| Rate for Payer: PACE SWMI |
$172.33
|
| Rate for Payer: PHP Medicare Advantage |
$172.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.96
|
| Rate for Payer: Priority Health Medicare |
$172.33
|
| Rate for Payer: Priority Health Narrow Network |
$247.96
|
| Rate for Payer: Priority Health SBD |
$247.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.33
|
| Rate for Payer: UHC Medicare Advantage |
$172.33
|
| Rate for Payer: UHCCP Medicaid |
$115.23
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS
|
Professional
|
Both
|
$3,993.00
|
|
|
Service Code
|
HCPCS 31295
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$27,900.00 |
| Rate for Payer: Aetna Commercial |
$202.00
|
| Rate for Payer: Aetna Medicare |
$156.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.08
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$150.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,788.82
|
| Rate for Payer: BCN Commercial |
$2,482.00
|
| Rate for Payer: BCN Medicare Advantage |
$150.75
|
| Rate for Payer: Cash Price |
$3,194.40
|
| Rate for Payer: Cash Price |
$3,194.40
|
| Rate for Payer: Cofinity Commercial |
$217.08
|
| Rate for Payer: Cofinity Commercial |
$202.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.75
|
| Rate for Payer: Healthscope Commercial |
$241.20
|
| Rate for Payer: Healthscope Commercial |
$278.89
|
| Rate for Payer: Mclaren Medicaid |
$100.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.29
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,900.00
|
| Rate for Payer: Nomi Health Commercial |
$180.90
|
| Rate for Payer: PACE SWMI |
$150.75
|
| Rate for Payer: PHP Medicare Advantage |
$150.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,595.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.29
|
| Rate for Payer: Priority Health Medicare |
$150.75
|
| Rate for Payer: Priority Health Narrow Network |
$218.29
|
| Rate for Payer: Priority Health SBD |
$218.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.75
|
| Rate for Payer: UHC Medicare Advantage |
$150.75
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
|
