|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$1,227.20 |
| Rate for Payer: Aetna Commercial |
$726.66
|
| Rate for Payer: Aetna Medicare |
$563.97
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$542.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$826.36
|
| Rate for Payer: BCN Medicare Advantage |
$542.28
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$780.88
|
| Rate for Payer: Cofinity Commercial |
$726.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.28
|
| Rate for Payer: Mclaren Medicaid |
$367.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.39
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Nomi Health Commercial |
$650.74
|
| Rate for Payer: PACE SWMI |
$542.28
|
| Rate for Payer: PHP Medicare Advantage |
$542.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health HMO/PPO |
$868.11
|
| Rate for Payer: Priority Health Medicare |
$547.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.28
|
| Rate for Payer: UHC Exchange |
$542.28
|
| Rate for Payer: UHC Medicare Advantage |
$542.28
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$424.08 |
| Max. Negotiated Rate |
$1,552.85 |
| Rate for Payer: Aetna Commercial |
$838.46
|
| Rate for Payer: Aetna Medicare |
$650.75
|
| Rate for Payer: BCBS Complete |
$445.28
|
| Rate for Payer: BCBS MAPPO |
$625.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.22
|
| Rate for Payer: BCN Commercial |
$953.41
|
| Rate for Payer: BCN Medicare Advantage |
$625.72
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cofinity Commercial |
$901.04
|
| Rate for Payer: Cofinity Commercial |
$838.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.72
|
| Rate for Payer: Mclaren Medicaid |
$424.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.01
|
| Rate for Payer: Meridian Medicaid |
$445.28
|
| Rate for Payer: Nomi Health Commercial |
$750.86
|
| Rate for Payer: PACE SWMI |
$625.72
|
| Rate for Payer: PHP Medicare Advantage |
$625.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,002.97
|
| Rate for Payer: Priority Health Medicare |
$631.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.72
|
| Rate for Payer: UHC Exchange |
$625.72
|
| Rate for Payer: UHC Medicare Advantage |
$625.72
|
| Rate for Payer: UHCCP Medicaid |
$424.08
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT
|
Professional
|
Both
|
$733.00
|
|
|
Service Code
|
HCPCS 28024
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$678.87 |
| Rate for Payer: Aetna Commercial |
$398.52
|
| Rate for Payer: Aetna Medicare |
$309.30
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$297.40
|
| Rate for Payer: BCBS Trust/PPO |
$678.87
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$297.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cofinity Commercial |
$428.26
|
| Rate for Payer: Cofinity Commercial |
$398.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.40
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.27
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Nomi Health Commercial |
$356.88
|
| Rate for Payer: PACE SWMI |
$297.40
|
| Rate for Payer: PHP Medicare Advantage |
$297.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.45
|
| Rate for Payer: Priority Health HMO/PPO |
$475.79
|
| Rate for Payer: Priority Health Medicare |
$300.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$475.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.40
|
| Rate for Payer: UHC Exchange |
$297.40
|
| Rate for Payer: UHC Medicare Advantage |
$297.40
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$708.10 |
| Rate for Payer: Aetna Commercial |
$419.73
|
| Rate for Payer: Aetna Medicare |
$325.76
|
| Rate for Payer: BCBS Complete |
$223.87
|
| Rate for Payer: BCBS MAPPO |
$313.23
|
| Rate for Payer: BCBS Trust/PPO |
$383.55
|
| Rate for Payer: BCN Commercial |
$708.10
|
| Rate for Payer: BCN Medicare Advantage |
$313.23
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cofinity Commercial |
$451.05
|
| Rate for Payer: Cofinity Commercial |
$419.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.23
|
| Rate for Payer: Mclaren Medicaid |
$213.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.89
|
| Rate for Payer: Meridian Medicaid |
$223.87
|
| Rate for Payer: Nomi Health Commercial |
$375.88
|
| Rate for Payer: PACE SWMI |
$313.23
|
| Rate for Payer: PHP Medicare Advantage |
$313.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health HMO/PPO |
$505.29
|
| Rate for Payer: Priority Health Medicare |
$316.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.23
|
| Rate for Payer: UHC Exchange |
$313.23
|
| Rate for Payer: UHC Medicare Advantage |
$313.23
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$235.58 |
| Max. Negotiated Rate |
$1,710.64 |
| Rate for Payer: Aetna Commercial |
$464.43
|
| Rate for Payer: Aetna Medicare |
$360.45
|
| Rate for Payer: BCBS Complete |
$247.36
|
| Rate for Payer: BCBS MAPPO |
$346.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,710.64
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$346.59
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$499.09
|
| Rate for Payer: Cofinity Commercial |
$464.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.59
|
| Rate for Payer: Mclaren Medicaid |
$235.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.92
|
| Rate for Payer: Meridian Medicaid |
$247.36
|
| Rate for Payer: Nomi Health Commercial |
$415.91
|
| Rate for Payer: PACE SWMI |
$346.59
|
| Rate for Payer: PHP Medicare Advantage |
$346.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO |
$563.82
|
| Rate for Payer: Priority Health Medicare |
$350.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.59
|
| Rate for Payer: UHC Exchange |
$346.59
|
| Rate for Payer: UHC Medicare Advantage |
$346.59
|
| Rate for Payer: UHCCP Medicaid |
$235.58
|
|
|
PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 25101
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$895.05 |
| Rate for Payer: Aetna Commercial |
$527.68
|
| Rate for Payer: Aetna Medicare |
$409.54
|
| Rate for Payer: BCBS Complete |
$282.47
|
| Rate for Payer: BCBS MAPPO |
$393.79
|
| Rate for Payer: BCBS Trust/PPO |
$107.77
|
| Rate for Payer: BCN Commercial |
$601.07
|
| Rate for Payer: BCN Medicare Advantage |
$393.79
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$567.06
|
| Rate for Payer: Cofinity Commercial |
$527.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.79
|
| Rate for Payer: Mclaren Medicaid |
$269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.48
|
| Rate for Payer: Meridian Medicaid |
$282.47
|
| Rate for Payer: Nomi Health Commercial |
$472.55
|
| Rate for Payer: PACE SWMI |
$393.79
|
| Rate for Payer: PHP Medicare Advantage |
$393.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$636.07
|
| Rate for Payer: Priority Health Medicare |
$397.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.79
|
| Rate for Payer: UHC Exchange |
$393.79
|
| Rate for Payer: UHC Medicare Advantage |
$393.79
|
| Rate for Payer: UHCCP Medicaid |
$269.02
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,781.00
|
|
|
Service Code
|
HCPCS 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$500.34 |
| Max. Negotiated Rate |
$1,807.65 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: Aetna Medicare |
$770.33
|
| Rate for Payer: BCBS Complete |
$525.36
|
| Rate for Payer: BCBS MAPPO |
$740.70
|
| Rate for Payer: BCBS Trust/PPO |
$901.28
|
| Rate for Payer: BCN Commercial |
$1,127.38
|
| Rate for Payer: BCN Medicare Advantage |
$740.70
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$992.54
|
| Rate for Payer: Cofinity Commercial |
$1,066.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.70
|
| Rate for Payer: Mclaren Medicaid |
$500.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.74
|
| Rate for Payer: Meridian Medicaid |
$525.36
|
| Rate for Payer: Nomi Health Commercial |
$888.84
|
| Rate for Payer: PACE SWMI |
$740.70
|
| Rate for Payer: PHP Medicare Advantage |
$740.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,185.65
|
| Rate for Payer: Priority Health Medicare |
$748.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,185.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.70
|
| Rate for Payer: UHC Exchange |
$740.70
|
| Rate for Payer: UHC Medicare Advantage |
$740.70
|
| Rate for Payer: UHCCP Medicaid |
$500.34
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,781.00
|
|
|
Service Code
|
HCPCS 27335
|
| Min. Negotiated Rate |
$500.34 |
| Max. Negotiated Rate |
$1,807.65 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: Aetna Medicare |
$770.33
|
| Rate for Payer: BCBS Complete |
$525.36
|
| Rate for Payer: BCBS MAPPO |
$740.70
|
| Rate for Payer: BCBS Trust/PPO |
$901.28
|
| Rate for Payer: BCN Commercial |
$1,127.38
|
| Rate for Payer: BCN Medicare Advantage |
$740.70
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$992.54
|
| Rate for Payer: Cofinity Commercial |
$1,066.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.70
|
| Rate for Payer: Mclaren Medicaid |
$500.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.74
|
| Rate for Payer: Meridian Medicaid |
$525.36
|
| Rate for Payer: Nomi Health Commercial |
$888.84
|
| Rate for Payer: PACE SWMI |
$740.70
|
| Rate for Payer: PHP Medicare Advantage |
$740.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,185.65
|
| Rate for Payer: Priority Health Medicare |
$748.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,185.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.70
|
| Rate for Payer: UHC Exchange |
$740.70
|
| Rate for Payer: UHC Medicare Advantage |
$740.70
|
| Rate for Payer: UHCCP Medicaid |
$500.34
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Facility
|
IP
|
$2,781.00
|
|
|
Service Code
|
CPT 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$1,807.65 |
| Max. Negotiated Rate |
$2,502.90 |
| Rate for Payer: Aetna Commercial |
$2,363.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.13
|
| Rate for Payer: BCN Commercial |
$2,149.16
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$2,391.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.80
|
| Rate for Payer: Healthscope Commercial |
$2,502.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,085.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,363.85
|
| Rate for Payer: Nomi Health Commercial |
$2,280.42
|
| Rate for Payer: PHP Commercial |
$2,363.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,419.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,863.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,447.28
|
| Rate for Payer: UHC Core |
$2,322.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,085.75
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Facility
|
OP
|
$2,781.00
|
|
|
Service Code
|
CPT 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$660.49 |
| Max. Negotiated Rate |
$5,313.85 |
| Rate for Payer: Aetna Commercial |
$2,363.85
|
| Rate for Payer: Aetna Medicare |
$723.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$869.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$869.06
|
| Rate for Payer: BCBS Complete |
$5,313.85
|
| Rate for Payer: BCBS MAPPO |
$695.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,286.26
|
| Rate for Payer: BCN Commercial |
$2,162.23
|
| Rate for Payer: BCN Medicare Advantage |
$695.25
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$2,391.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.25
|
| Rate for Payer: Healthscope Commercial |
$2,502.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,085.75
|
| Rate for Payer: Mclaren Medicaid |
$5,060.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.01
|
| Rate for Payer: Meridian Medicaid |
$5,313.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,363.85
|
| Rate for Payer: Nomi Health Commercial |
$2,280.42
|
| Rate for Payer: PACE Senior Care Partners |
$660.49
|
| Rate for Payer: PACE SWMI |
$695.25
|
| Rate for Payer: PHP Commercial |
$2,363.85
|
| Rate for Payer: PHP Medicare Advantage |
$695.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,060.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,419.47
|
| Rate for Payer: Priority Health Medicare |
$702.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,863.27
|
| Rate for Payer: Railroad Medicare Medicare |
$695.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,447.28
|
| Rate for Payer: UHC Core |
$2,322.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.25
|
| Rate for Payer: UHC Exchange |
$695.25
|
| Rate for Payer: UHC Medicare Advantage |
$695.25
|
| Rate for Payer: UHCCP Medicaid |
$5,060.48
|
| Rate for Payer: VA VA |
$695.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,085.75
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-CERVICAL
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 58321
|
| Min. Negotiated Rate |
$46.44 |
| Max. Negotiated Rate |
$121.19 |
| Rate for Payer: Aetna Commercial |
$62.23
|
| Rate for Payer: Aetna Medicare |
$48.30
|
| Rate for Payer: BCBS Complete |
$53.60
|
| Rate for Payer: BCBS MAPPO |
$46.44
|
| Rate for Payer: BCBS Trust/PPO |
$80.30
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$46.44
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$66.87
|
| Rate for Payer: Cofinity Commercial |
$62.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.76
|
| Rate for Payer: Nomi Health Commercial |
$55.73
|
| Rate for Payer: PACE SWMI |
$46.44
|
| Rate for Payer: PHP Medicare Advantage |
$46.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health HMO/PPO |
$71.42
|
| Rate for Payer: Priority Health Medicare |
$46.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.44
|
| Rate for Payer: UHC Exchange |
$46.44
|
| Rate for Payer: UHC Medicare Advantage |
$46.44
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 58322
|
| Min. Negotiated Rate |
$55.08 |
| Max. Negotiated Rate |
$307.47 |
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: Aetna Medicare |
$57.28
|
| Rate for Payer: BCBS Complete |
$98.00
|
| Rate for Payer: BCBS MAPPO |
$55.08
|
| Rate for Payer: BCBS Trust/PPO |
$307.47
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$55.08
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$79.32
|
| Rate for Payer: Cofinity Commercial |
$73.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.83
|
| Rate for Payer: Nomi Health Commercial |
$66.10
|
| Rate for Payer: PACE SWMI |
$55.08
|
| Rate for Payer: PHP Medicare Advantage |
$55.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.31
|
| Rate for Payer: Priority Health Medicare |
$55.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.08
|
| Rate for Payer: UHC Exchange |
$55.08
|
| Rate for Payer: UHC Medicare Advantage |
$55.08
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 36625
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$664.07 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: Aetna Medicare |
$103.97
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$99.97
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$99.97
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$143.96
|
| Rate for Payer: Cofinity Commercial |
$133.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.97
|
| Rate for Payer: Mclaren Medicaid |
$66.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.97
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Nomi Health Commercial |
$119.96
|
| Rate for Payer: PACE SWMI |
$99.97
|
| Rate for Payer: PHP Medicare Advantage |
$99.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health HMO/PPO |
$164.86
|
| Rate for Payer: Priority Health Medicare |
$100.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.97
|
| Rate for Payer: UHC Exchange |
$99.97
|
| Rate for Payer: UHC Medicare Advantage |
$99.97
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$962.03 |
| Rate for Payer: Aetna Commercial |
$55.70
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$41.57
|
| Rate for Payer: BCBS Trust/PPO |
$962.03
|
| Rate for Payer: BCN Commercial |
$64.02
|
| Rate for Payer: BCN Medicare Advantage |
$41.57
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$59.86
|
| Rate for Payer: Cofinity Commercial |
$55.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.57
|
| Rate for Payer: Mclaren Medicaid |
$27.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.65
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Nomi Health Commercial |
$49.88
|
| Rate for Payer: PACE SWMI |
$41.57
|
| Rate for Payer: PHP Medicare Advantage |
$41.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health HMO/PPO |
$69.13
|
| Rate for Payer: Priority Health Medicare |
$41.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.57
|
| Rate for Payer: UHC Exchange |
$41.57
|
| Rate for Payer: UHC Medicare Advantage |
$41.57
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
|
|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$802.49 |
| Rate for Payer: Aetna Commercial |
$147.72
|
| Rate for Payer: Aetna Medicare |
$114.65
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$110.24
|
| Rate for Payer: BCBS Trust/PPO |
$802.49
|
| Rate for Payer: BCN Commercial |
$168.11
|
| Rate for Payer: BCN Medicare Advantage |
$110.24
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cofinity Commercial |
$158.75
|
| Rate for Payer: Cofinity Commercial |
$147.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.24
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.75
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Nomi Health Commercial |
$132.29
|
| Rate for Payer: PACE SWMI |
$110.24
|
| Rate for Payer: PHP Medicare Advantage |
$110.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health HMO/PPO |
$186.14
|
| Rate for Payer: Priority Health Medicare |
$111.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.24
|
| Rate for Payer: UHC Exchange |
$110.24
|
| Rate for Payer: UHC Medicare Advantage |
$110.24
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$457.31 |
| Max. Negotiated Rate |
$1,134.92 |
| Rate for Payer: Aetna Commercial |
$934.54
|
| Rate for Payer: Aetna Medicare |
$725.32
|
| Rate for Payer: BCBS Complete |
$480.18
|
| Rate for Payer: BCBS MAPPO |
$697.42
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$697.42
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cofinity Commercial |
$934.54
|
| Rate for Payer: Cofinity Commercial |
$1,004.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.42
|
| Rate for Payer: Mclaren Medicaid |
$457.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.29
|
| Rate for Payer: Meridian Medicaid |
$480.18
|
| Rate for Payer: Nomi Health Commercial |
$836.90
|
| Rate for Payer: PACE SWMI |
$697.42
|
| Rate for Payer: PHP Medicare Advantage |
$697.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,134.92
|
| Rate for Payer: Priority Health Medicare |
$704.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,134.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.42
|
| Rate for Payer: UHC Exchange |
$697.42
|
| Rate for Payer: UHC Medicare Advantage |
$697.42
|
| Rate for Payer: UHCCP Medicaid |
$457.31
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,435.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$1,582.75 |
| Rate for Payer: Aetna Commercial |
$934.37
|
| Rate for Payer: Aetna Medicare |
$725.18
|
| Rate for Payer: BCBS Complete |
$479.28
|
| Rate for Payer: BCBS MAPPO |
$697.29
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$1,044.31
|
| Rate for Payer: BCN Medicare Advantage |
$697.29
|
| Rate for Payer: Cash Price |
$1,948.00
|
| Rate for Payer: Cash Price |
$1,948.00
|
| Rate for Payer: Cofinity Commercial |
$934.37
|
| Rate for Payer: Cofinity Commercial |
$1,004.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.29
|
| Rate for Payer: Mclaren Medicaid |
$456.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.15
|
| Rate for Payer: Meridian Medicaid |
$479.28
|
| Rate for Payer: Nomi Health Commercial |
$836.75
|
| Rate for Payer: PACE SWMI |
$697.29
|
| Rate for Payer: PHP Medicare Advantage |
$697.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,140.77
|
| Rate for Payer: Priority Health Medicare |
$704.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.29
|
| Rate for Payer: UHC Exchange |
$697.29
|
| Rate for Payer: UHC Medicare Advantage |
$697.29
|
| Rate for Payer: UHCCP Medicaid |
$456.46
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$2,009.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$431.75 |
| Max. Negotiated Rate |
$1,305.85 |
| Rate for Payer: Aetna Commercial |
$882.38
|
| Rate for Payer: Aetna Medicare |
$684.83
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$658.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$986.64
|
| Rate for Payer: BCN Medicare Advantage |
$658.49
|
| Rate for Payer: Cash Price |
$1,607.20
|
| Rate for Payer: Cash Price |
$1,607.20
|
| Rate for Payer: Cofinity Commercial |
$948.23
|
| Rate for Payer: Cofinity Commercial |
$882.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.49
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.41
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Nomi Health Commercial |
$790.19
|
| Rate for Payer: PACE SWMI |
$658.49
|
| Rate for Payer: PHP Medicare Advantage |
$658.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,077.47
|
| Rate for Payer: Priority Health Medicare |
$665.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.49
|
| Rate for Payer: UHC Exchange |
$658.49
|
| Rate for Payer: UHC Medicare Advantage |
$658.49
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,427.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$404.15 |
| Max. Negotiated Rate |
$5,477.55 |
| Rate for Payer: Aetna Commercial |
$3,459.61
|
| Rate for Payer: Aetna Medicare |
$2,685.07
|
| Rate for Payer: BCBS Complete |
$1,775.33
|
| Rate for Payer: BCBS MAPPO |
$2,581.80
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: BCN Commercial |
$3,832.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,581.80
|
| Rate for Payer: Cash Price |
$6,741.60
|
| Rate for Payer: Cash Price |
$6,741.60
|
| Rate for Payer: Cofinity Commercial |
$3,717.79
|
| Rate for Payer: Cofinity Commercial |
$3,459.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,581.80
|
| Rate for Payer: Mclaren Medicaid |
$1,690.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,710.89
|
| Rate for Payer: Meridian Medicaid |
$1,775.33
|
| Rate for Payer: Nomi Health Commercial |
$3,098.16
|
| Rate for Payer: PACE SWMI |
$2,581.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,581.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,690.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,477.55
|
| Rate for Payer: Priority Health HMO/PPO |
$4,495.12
|
| Rate for Payer: Priority Health Medicare |
$2,607.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,495.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,581.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,581.80
|
| Rate for Payer: UHC Exchange |
$2,581.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,581.80
|
| Rate for Payer: UHCCP Medicaid |
$1,690.79
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,087.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$652.21 |
| Max. Negotiated Rate |
$1,845.88 |
| Rate for Payer: Aetna Commercial |
$1,272.91
|
| Rate for Payer: Aetna Medicare |
$987.93
|
| Rate for Payer: BCBS Complete |
$684.82
|
| Rate for Payer: BCBS MAPPO |
$949.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$1,491.93
|
| Rate for Payer: BCN Medicare Advantage |
$949.93
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cofinity Commercial |
$1,367.90
|
| Rate for Payer: Cofinity Commercial |
$1,272.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$949.93
|
| Rate for Payer: Mclaren Medicaid |
$652.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.43
|
| Rate for Payer: Meridian Medicaid |
$684.82
|
| Rate for Payer: Nomi Health Commercial |
$1,139.92
|
| Rate for Payer: PACE SWMI |
$949.93
|
| Rate for Payer: PHP Medicare Advantage |
$949.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,413.11
|
| Rate for Payer: Priority Health Medicare |
$959.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,413.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$949.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$949.93
|
| Rate for Payer: UHC Exchange |
$949.93
|
| Rate for Payer: UHC Medicare Advantage |
$949.93
|
| Rate for Payer: UHCCP Medicaid |
$652.21
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,622.00
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$745.43 |
| Max. Negotiated Rate |
$4,902.36 |
| Rate for Payer: Aetna Commercial |
$4,036.09
|
| Rate for Payer: Aetna Medicare |
$3,132.49
|
| Rate for Payer: BCBS Complete |
$2,068.09
|
| Rate for Payer: BCBS MAPPO |
$3,012.01
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$4,494.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,012.01
|
| Rate for Payer: Cash Price |
$5,297.60
|
| Rate for Payer: Cash Price |
$5,297.60
|
| Rate for Payer: Cofinity Commercial |
$4,337.29
|
| Rate for Payer: Cofinity Commercial |
$4,036.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,012.01
|
| Rate for Payer: Mclaren Medicaid |
$1,969.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,162.61
|
| Rate for Payer: Meridian Medicaid |
$2,068.09
|
| Rate for Payer: Nomi Health Commercial |
$3,614.41
|
| Rate for Payer: PACE SWMI |
$3,012.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,012.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,969.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,304.30
|
| Rate for Payer: Priority Health HMO/PPO |
$4,902.36
|
| Rate for Payer: Priority Health Medicare |
$3,042.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,902.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,012.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,012.01
|
| Rate for Payer: UHC Exchange |
$3,012.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,012.01
|
| Rate for Payer: UHCCP Medicaid |
$1,969.61
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$7,125.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$313.81 |
| Max. Negotiated Rate |
$5,288.99 |
| Rate for Payer: Aetna Commercial |
$4,356.31
|
| Rate for Payer: Aetna Medicare |
$3,381.02
|
| Rate for Payer: BCBS Complete |
$2,231.81
|
| Rate for Payer: BCBS MAPPO |
$3,250.98
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$4,851.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,250.98
|
| Rate for Payer: Cash Price |
$5,700.00
|
| Rate for Payer: Cash Price |
$5,700.00
|
| Rate for Payer: Cofinity Commercial |
$4,681.41
|
| Rate for Payer: Cofinity Commercial |
$4,356.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,250.98
|
| Rate for Payer: Mclaren Medicaid |
$2,125.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,413.53
|
| Rate for Payer: Meridian Medicaid |
$2,231.81
|
| Rate for Payer: Nomi Health Commercial |
$3,901.18
|
| Rate for Payer: PACE SWMI |
$3,250.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,250.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,125.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.25
|
| Rate for Payer: Priority Health HMO/PPO |
$5,288.99
|
| Rate for Payer: Priority Health Medicare |
$3,283.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,288.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,250.98
|
| Rate for Payer: UHC Exchange |
$3,250.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,250.98
|
| Rate for Payer: UHCCP Medicaid |
$2,125.53
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,111.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,128.45 |
| Max. Negotiated Rate |
$3,802.01 |
| Rate for Payer: Aetna Commercial |
$3,128.78
|
| Rate for Payer: Aetna Medicare |
$2,428.31
|
| Rate for Payer: BCBS Complete |
$1,604.69
|
| Rate for Payer: BCBS MAPPO |
$2,334.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$3,484.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,334.91
|
| Rate for Payer: Cash Price |
$4,088.80
|
| Rate for Payer: Cash Price |
$4,088.80
|
| Rate for Payer: Cofinity Commercial |
$3,362.27
|
| Rate for Payer: Cofinity Commercial |
$3,128.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,334.91
|
| Rate for Payer: Mclaren Medicaid |
$1,528.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,451.66
|
| Rate for Payer: Meridian Medicaid |
$1,604.69
|
| Rate for Payer: Nomi Health Commercial |
$2,801.89
|
| Rate for Payer: PACE SWMI |
$2,334.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,334.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,528.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,322.15
|
| Rate for Payer: Priority Health HMO/PPO |
$3,802.01
|
| Rate for Payer: Priority Health Medicare |
$2,358.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,802.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,334.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,334.91
|
| Rate for Payer: UHC Exchange |
$2,334.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,334.91
|
| Rate for Payer: UHCCP Medicaid |
$1,528.28
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$10,055.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$4,022.00 |
| Max. Negotiated Rate |
$6,535.75 |
| Rate for Payer: Aetna Medicare |
$5,027.50
|
| Rate for Payer: BCBS Complete |
$4,022.00
|
| Rate for Payer: Cash Price |
$8,044.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,535.75
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,228.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,166.49 |
| Max. Negotiated Rate |
$5,006.60 |
| Rate for Payer: Aetna Commercial |
$4,126.44
|
| Rate for Payer: Aetna Medicare |
$3,202.61
|
| Rate for Payer: BCBS Complete |
$2,113.94
|
| Rate for Payer: BCBS MAPPO |
$3,079.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.49
|
| Rate for Payer: BCN Commercial |
$4,594.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,079.43
|
| Rate for Payer: Cash Price |
$4,182.40
|
| Rate for Payer: Cash Price |
$4,182.40
|
| Rate for Payer: Cofinity Commercial |
$4,434.38
|
| Rate for Payer: Cofinity Commercial |
$4,126.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,079.43
|
| Rate for Payer: Mclaren Medicaid |
$2,013.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,233.40
|
| Rate for Payer: Meridian Medicaid |
$2,113.94
|
| Rate for Payer: Nomi Health Commercial |
$3,695.32
|
| Rate for Payer: PACE SWMI |
$3,079.43
|
| Rate for Payer: PHP Medicare Advantage |
$3,079.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,013.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,398.20
|
| Rate for Payer: Priority Health HMO/PPO |
$5,006.60
|
| Rate for Payer: Priority Health Medicare |
$3,110.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,006.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,079.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,079.43
|
| Rate for Payer: UHC Exchange |
$3,079.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,079.43
|
| Rate for Payer: UHCCP Medicaid |
$2,013.28
|
|
