|
PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 57426
|
| Min. Negotiated Rate |
$559.98 |
| Max. Negotiated Rate |
$1,306.09 |
| Rate for Payer: Aetna Commercial |
$1,118.71
|
| Rate for Payer: Aetna Medicare |
$868.25
|
| Rate for Payer: BCBS Complete |
$587.98
|
| Rate for Payer: BCBS MAPPO |
$834.86
|
| Rate for Payer: BCBS Trust/PPO |
$628.68
|
| Rate for Payer: BCN Commercial |
$1,275.45
|
| Rate for Payer: BCN Medicare Advantage |
$834.86
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$1,202.20
|
| Rate for Payer: Cofinity Commercial |
$1,118.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.86
|
| Rate for Payer: Mclaren Medicaid |
$559.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.60
|
| Rate for Payer: Meridian Medicaid |
$587.98
|
| Rate for Payer: Nomi Health Commercial |
$1,001.83
|
| Rate for Payer: PACE SWMI |
$834.86
|
| Rate for Payer: PHP Medicare Advantage |
$834.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,306.09
|
| Rate for Payer: Priority Health Medicare |
$843.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,306.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.86
|
| Rate for Payer: UHC Exchange |
$834.86
|
| Rate for Payer: UHC Medicare Advantage |
$834.86
|
| Rate for Payer: UHCCP Medicaid |
$559.98
|
|
|
PR REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV
|
Professional
|
Both
|
$2,230.00
|
|
|
Service Code
|
HCPCS 64569
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$1,449.50 |
| Rate for Payer: Aetna Commercial |
$1,019.55
|
| Rate for Payer: Aetna Medicare |
$791.29
|
| Rate for Payer: BCBS Complete |
$529.38
|
| Rate for Payer: BCBS MAPPO |
$760.86
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: BCN Commercial |
$1,132.26
|
| Rate for Payer: BCN Medicare Advantage |
$760.86
|
| Rate for Payer: Cash Price |
$1,784.00
|
| Rate for Payer: Cash Price |
$1,784.00
|
| Rate for Payer: Cofinity Commercial |
$1,095.64
|
| Rate for Payer: Cofinity Commercial |
$1,019.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.86
|
| Rate for Payer: Mclaren Medicaid |
$504.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.90
|
| Rate for Payer: Meridian Medicaid |
$529.38
|
| Rate for Payer: Nomi Health Commercial |
$913.03
|
| Rate for Payer: PACE SWMI |
$760.86
|
| Rate for Payer: PHP Medicare Advantage |
$760.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,335.34
|
| Rate for Payer: Priority Health Medicare |
$768.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,335.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.86
|
| Rate for Payer: UHC Exchange |
$760.86
|
| Rate for Payer: UHC Medicare Advantage |
$760.86
|
| Rate for Payer: UHCCP Medicaid |
$504.17
|
|
|
PR REVISION STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$3,917.00
|
|
|
Service Code
|
HCPCS 69662
|
| Min. Negotiated Rate |
$735.06 |
| Max. Negotiated Rate |
$3,121.20 |
| Rate for Payer: Aetna Commercial |
$1,448.30
|
| Rate for Payer: Aetna Medicare |
$1,124.05
|
| Rate for Payer: BCBS Complete |
$771.81
|
| Rate for Payer: BCBS MAPPO |
$1,080.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,121.20
|
| Rate for Payer: BCN Commercial |
$1,704.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.82
|
| Rate for Payer: Cash Price |
$3,133.60
|
| Rate for Payer: Cash Price |
$3,133.60
|
| Rate for Payer: Cofinity Commercial |
$1,556.38
|
| Rate for Payer: Cofinity Commercial |
$1,448.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.82
|
| Rate for Payer: Mclaren Medicaid |
$735.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,134.86
|
| Rate for Payer: Meridian Medicaid |
$771.81
|
| Rate for Payer: Nomi Health Commercial |
$1,296.98
|
| Rate for Payer: PACE SWMI |
$1,080.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,546.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,696.48
|
| Rate for Payer: Priority Health Medicare |
$1,091.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,080.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,080.82
|
| Rate for Payer: UHC Exchange |
$1,080.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.82
|
| Rate for Payer: UHCCP Medicaid |
$735.06
|
|
|
PR REVISION TRACHEOSTOMY SCAR
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 31830
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$982.11 |
| Rate for Payer: Aetna Commercial |
$464.81
|
| Rate for Payer: Aetna Medicare |
$360.74
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS MAPPO |
$346.87
|
| Rate for Payer: BCBS Trust/PPO |
$982.11
|
| Rate for Payer: BCN Commercial |
$733.51
|
| Rate for Payer: BCN Medicare Advantage |
$346.87
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$499.49
|
| Rate for Payer: Cofinity Commercial |
$464.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.87
|
| Rate for Payer: Mclaren Medicaid |
$237.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.21
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Nomi Health Commercial |
$416.24
|
| Rate for Payer: PACE SWMI |
$346.87
|
| Rate for Payer: PHP Medicare Advantage |
$346.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health HMO/PPO |
$516.77
|
| Rate for Payer: Priority Health Medicare |
$350.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$516.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.87
|
| Rate for Payer: UHC Exchange |
$346.87
|
| Rate for Payer: UHC Medicare Advantage |
$346.87
|
| Rate for Payer: UHCCP Medicaid |
$237.07
|
|
|
PR REVIS PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$2,060.00
|
|
|
Service Code
|
HCPCS 49426
|
| Min. Negotiated Rate |
$433.46 |
| Max. Negotiated Rate |
$1,339.00 |
| Rate for Payer: Aetna Commercial |
$873.80
|
| Rate for Payer: Aetna Medicare |
$678.17
|
| Rate for Payer: BCBS Complete |
$455.13
|
| Rate for Payer: BCBS MAPPO |
$652.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.94
|
| Rate for Payer: BCN Commercial |
$982.73
|
| Rate for Payer: BCN Medicare Advantage |
$652.09
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cash Price |
$1,648.00
|
| Rate for Payer: Cofinity Commercial |
$939.01
|
| Rate for Payer: Cofinity Commercial |
$873.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.09
|
| Rate for Payer: Mclaren Medicaid |
$433.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.69
|
| Rate for Payer: Meridian Medicaid |
$455.13
|
| Rate for Payer: Nomi Health Commercial |
$782.51
|
| Rate for Payer: PACE SWMI |
$652.09
|
| Rate for Payer: PHP Medicare Advantage |
$652.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,206.92
|
| Rate for Payer: Priority Health Medicare |
$658.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,206.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.09
|
| Rate for Payer: UHC Exchange |
$652.09
|
| Rate for Payer: UHC Medicare Advantage |
$652.09
|
| Rate for Payer: UHCCP Medicaid |
$433.46
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT
|
Professional
|
Both
|
$4,192.00
|
|
|
Service Code
|
HCPCS 23474
|
| Min. Negotiated Rate |
$341.30 |
| Max. Negotiated Rate |
$2,724.80 |
| Rate for Payer: Aetna Commercial |
$2,237.25
|
| Rate for Payer: Aetna Medicare |
$1,736.37
|
| Rate for Payer: BCBS Complete |
$1,173.49
|
| Rate for Payer: BCBS MAPPO |
$1,669.59
|
| Rate for Payer: BCBS Trust/PPO |
$341.30
|
| Rate for Payer: BCN Commercial |
$2,535.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,669.59
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cash Price |
$3,353.60
|
| Rate for Payer: Cofinity Commercial |
$2,404.21
|
| Rate for Payer: Cofinity Commercial |
$2,237.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,669.59
|
| Rate for Payer: Mclaren Medicaid |
$1,117.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,753.07
|
| Rate for Payer: Meridian Medicaid |
$1,173.49
|
| Rate for Payer: Nomi Health Commercial |
$2,003.51
|
| Rate for Payer: PACE SWMI |
$1,669.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,669.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,724.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,652.18
|
| Rate for Payer: Priority Health Medicare |
$1,686.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,652.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,669.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,669.59
|
| Rate for Payer: UHC Exchange |
$1,669.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.59
|
| Rate for Payer: UHCCP Medicaid |
$1,117.61
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT
|
Professional
|
Both
|
$3,586.00
|
|
|
Service Code
|
HCPCS 23473
|
| Min. Negotiated Rate |
$225.83 |
| Max. Negotiated Rate |
$2,457.28 |
| Rate for Payer: Aetna Commercial |
$2,071.59
|
| Rate for Payer: Aetna Medicare |
$1,607.80
|
| Rate for Payer: BCBS Complete |
$1,087.39
|
| Rate for Payer: BCBS MAPPO |
$1,545.96
|
| Rate for Payer: BCBS Trust/PPO |
$225.83
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,545.96
|
| Rate for Payer: Cash Price |
$2,868.80
|
| Rate for Payer: Cash Price |
$2,868.80
|
| Rate for Payer: Cofinity Commercial |
$2,226.18
|
| Rate for Payer: Cofinity Commercial |
$2,071.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,545.96
|
| Rate for Payer: Mclaren Medicaid |
$1,035.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.26
|
| Rate for Payer: Meridian Medicaid |
$1,087.39
|
| Rate for Payer: Nomi Health Commercial |
$1,855.15
|
| Rate for Payer: PACE SWMI |
$1,545.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,545.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,035.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,330.90
|
| Rate for Payer: Priority Health HMO/PPO |
$2,457.28
|
| Rate for Payer: Priority Health Medicare |
$1,561.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,457.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,545.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,545.96
|
| Rate for Payer: UHC Exchange |
$1,545.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,545.96
|
| Rate for Payer: UHCCP Medicaid |
$1,035.61
|
|
|
PR REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT
|
Professional
|
Both
|
$2,083.00
|
|
|
Service Code
|
HCPCS 25449
|
| Min. Negotiated Rate |
$671.38 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$1,334.28
|
| Rate for Payer: Aetna Medicare |
$1,035.56
|
| Rate for Payer: BCBS Complete |
$704.95
|
| Rate for Payer: BCBS MAPPO |
$995.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$1,516.36
|
| Rate for Payer: BCN Medicare Advantage |
$995.73
|
| Rate for Payer: Cash Price |
$1,666.40
|
| Rate for Payer: Cash Price |
$1,666.40
|
| Rate for Payer: Cofinity Commercial |
$1,433.85
|
| Rate for Payer: Cofinity Commercial |
$1,334.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.73
|
| Rate for Payer: Mclaren Medicaid |
$671.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.52
|
| Rate for Payer: Meridian Medicaid |
$704.95
|
| Rate for Payer: Nomi Health Commercial |
$1,194.88
|
| Rate for Payer: PACE SWMI |
$995.73
|
| Rate for Payer: PHP Medicare Advantage |
$995.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,589.17
|
| Rate for Payer: Priority Health Medicare |
$1,005.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,589.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$995.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.73
|
| Rate for Payer: UHC Exchange |
$995.73
|
| Rate for Payer: UHC Medicare Advantage |
$995.73
|
| Rate for Payer: UHCCP Medicaid |
$671.38
|
|
|
PR REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 44345
|
| Min. Negotiated Rate |
$674.57 |
| Max. Negotiated Rate |
$1,878.08 |
| Rate for Payer: Aetna Commercial |
$1,358.76
|
| Rate for Payer: Aetna Medicare |
$1,054.56
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,014.00
|
| Rate for Payer: BCBS Trust/PPO |
$697.88
|
| Rate for Payer: BCN Commercial |
$1,530.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$1,460.16
|
| Rate for Payer: Cofinity Commercial |
$1,358.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.00
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.70
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Nomi Health Commercial |
$1,216.80
|
| Rate for Payer: PACE SWMI |
$1,014.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,381.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,878.08
|
| Rate for Payer: Priority Health Medicare |
$1,024.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,878.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.00
|
| Rate for Payer: UHC Exchange |
$1,014.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.00
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 44340
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$1,133.52 |
| Rate for Payer: Aetna Commercial |
$809.04
|
| Rate for Payer: Aetna Medicare |
$627.91
|
| Rate for Payer: BCBS Complete |
$425.16
|
| Rate for Payer: BCBS MAPPO |
$603.76
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$918.23
|
| Rate for Payer: BCN Medicare Advantage |
$603.76
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$869.41
|
| Rate for Payer: Cofinity Commercial |
$809.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.76
|
| Rate for Payer: Mclaren Medicaid |
$404.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.95
|
| Rate for Payer: Meridian Medicaid |
$425.16
|
| Rate for Payer: Nomi Health Commercial |
$724.51
|
| Rate for Payer: PACE SWMI |
$603.76
|
| Rate for Payer: PHP Medicare Advantage |
$603.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,133.52
|
| Rate for Payer: Priority Health Medicare |
$609.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,133.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.76
|
| Rate for Payer: UHC Exchange |
$603.76
|
| Rate for Payer: UHC Medicare Advantage |
$603.76
|
| Rate for Payer: UHCCP Medicaid |
$404.91
|
|
|
PR REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX
|
Professional
|
Both
|
$2,861.00
|
|
|
Service Code
|
HCPCS 44346
|
| Min. Negotiated Rate |
$758.49 |
| Max. Negotiated Rate |
$2,111.95 |
| Rate for Payer: Aetna Commercial |
$1,530.33
|
| Rate for Payer: Aetna Medicare |
$1,187.72
|
| Rate for Payer: BCBS Complete |
$796.41
|
| Rate for Payer: BCBS MAPPO |
$1,142.04
|
| Rate for Payer: BCBS Trust/PPO |
$785.58
|
| Rate for Payer: BCN Commercial |
$1,720.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,142.04
|
| Rate for Payer: Cash Price |
$2,288.80
|
| Rate for Payer: Cash Price |
$2,288.80
|
| Rate for Payer: Cofinity Commercial |
$1,644.54
|
| Rate for Payer: Cofinity Commercial |
$1,530.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,142.04
|
| Rate for Payer: Mclaren Medicaid |
$758.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,199.14
|
| Rate for Payer: Meridian Medicaid |
$796.41
|
| Rate for Payer: Nomi Health Commercial |
$1,370.45
|
| Rate for Payer: PACE SWMI |
$1,142.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,142.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$758.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,859.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,111.95
|
| Rate for Payer: Priority Health Medicare |
$1,153.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,111.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,142.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,142.04
|
| Rate for Payer: UHC Exchange |
$1,142.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,142.04
|
| Rate for Payer: UHCCP Medicaid |
$758.49
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,619.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$774.47 |
| Max. Negotiated Rate |
$1,929.99 |
| Rate for Payer: Aetna Commercial |
$1,599.64
|
| Rate for Payer: Aetna Medicare |
$1,241.51
|
| Rate for Payer: BCBS Complete |
$813.19
|
| Rate for Payer: BCBS MAPPO |
$1,193.76
|
| Rate for Payer: BCBS Trust/PPO |
$926.64
|
| Rate for Payer: BCN Commercial |
$1,765.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.76
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cofinity Commercial |
$1,719.01
|
| Rate for Payer: Cofinity Commercial |
$1,599.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.76
|
| Rate for Payer: Mclaren Medicaid |
$774.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,253.45
|
| Rate for Payer: Meridian Medicaid |
$813.19
|
| Rate for Payer: Nomi Health Commercial |
$1,432.51
|
| Rate for Payer: PACE SWMI |
$1,193.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,929.99
|
| Rate for Payer: Priority Health Medicare |
$1,205.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,929.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,193.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,193.76
|
| Rate for Payer: UHC Exchange |
$1,193.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.76
|
| Rate for Payer: UHCCP Medicaid |
$774.47
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,362.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$745.07 |
| Max. Negotiated Rate |
$1,861.38 |
| Rate for Payer: Aetna Commercial |
$1,535.51
|
| Rate for Payer: Aetna Medicare |
$1,191.74
|
| Rate for Payer: BCBS Complete |
$782.32
|
| Rate for Payer: BCBS MAPPO |
$1,145.90
|
| Rate for Payer: BCBS Trust/PPO |
$876.98
|
| Rate for Payer: BCN Commercial |
$1,707.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.90
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cofinity Commercial |
$1,650.10
|
| Rate for Payer: Cofinity Commercial |
$1,535.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.90
|
| Rate for Payer: Mclaren Medicaid |
$745.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.20
|
| Rate for Payer: Meridian Medicaid |
$782.32
|
| Rate for Payer: Nomi Health Commercial |
$1,375.08
|
| Rate for Payer: PACE SWMI |
$1,145.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,535.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,861.38
|
| Rate for Payer: Priority Health Medicare |
$1,157.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,861.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,145.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,145.90
|
| Rate for Payer: UHC Exchange |
$1,145.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,145.90
|
| Rate for Payer: UHCCP Medicaid |
$745.07
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,384.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$163.77 |
| Max. Negotiated Rate |
$3,499.60 |
| Rate for Payer: Aetna Commercial |
$2,132.30
|
| Rate for Payer: Aetna Medicare |
$1,654.92
|
| Rate for Payer: BCBS Complete |
$1,102.59
|
| Rate for Payer: BCBS MAPPO |
$1,591.27
|
| Rate for Payer: BCBS Trust/PPO |
$163.77
|
| Rate for Payer: BCN Commercial |
$2,385.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.27
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cofinity Commercial |
$2,291.43
|
| Rate for Payer: Cofinity Commercial |
$2,132.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.27
|
| Rate for Payer: Mclaren Medicaid |
$1,050.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,670.83
|
| Rate for Payer: Meridian Medicaid |
$1,102.59
|
| Rate for Payer: Nomi Health Commercial |
$1,909.52
|
| Rate for Payer: PACE SWMI |
$1,591.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,499.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,923.91
|
| Rate for Payer: Priority Health Medicare |
$1,607.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,923.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,591.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,591.27
|
| Rate for Payer: UHC Exchange |
$1,591.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,591.27
|
| Rate for Payer: UHCCP Medicaid |
$1,050.09
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$1,794.56 |
| Rate for Payer: Aetna Commercial |
$1,292.68
|
| Rate for Payer: Aetna Medicare |
$1,003.28
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$964.69
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$1,462.12
|
| Rate for Payer: BCN Medicare Advantage |
$964.69
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$1,389.15
|
| Rate for Payer: Cofinity Commercial |
$1,292.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.69
|
| Rate for Payer: Mclaren Medicaid |
$642.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.92
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,157.63
|
| Rate for Payer: PACE SWMI |
$964.69
|
| Rate for Payer: PHP Medicare Advantage |
$964.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,794.56
|
| Rate for Payer: Priority Health Medicare |
$974.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,794.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.69
|
| Rate for Payer: UHC Exchange |
$964.69
|
| Rate for Payer: UHC Medicare Advantage |
$964.69
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$1,072.68 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare |
$598.42
|
| Rate for Payer: BCBS Complete |
$403.69
|
| Rate for Payer: BCBS MAPPO |
$575.40
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$575.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$828.58
|
| Rate for Payer: Cofinity Commercial |
$771.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.40
|
| Rate for Payer: Mclaren Medicaid |
$384.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.17
|
| Rate for Payer: Meridian Medicaid |
$403.69
|
| Rate for Payer: Nomi Health Commercial |
$690.48
|
| Rate for Payer: PACE SWMI |
$575.40
|
| Rate for Payer: PHP Medicare Advantage |
$575.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.68
|
| Rate for Payer: Priority Health Medicare |
$581.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.40
|
| Rate for Payer: UHC Exchange |
$575.40
|
| Rate for Payer: UHC Medicare Advantage |
$575.40
|
| Rate for Payer: UHCCP Medicaid |
$384.47
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,128.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$580.21 |
| Max. Negotiated Rate |
$2,683.20 |
| Rate for Payer: Aetna Commercial |
$1,166.62
|
| Rate for Payer: Aetna Medicare |
$905.43
|
| Rate for Payer: BCBS Complete |
$609.22
|
| Rate for Payer: BCBS MAPPO |
$870.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$1,305.75
|
| Rate for Payer: BCN Medicare Advantage |
$870.61
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,253.68
|
| Rate for Payer: Cofinity Commercial |
$1,166.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.61
|
| Rate for Payer: Mclaren Medicaid |
$580.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.14
|
| Rate for Payer: Meridian Medicaid |
$609.22
|
| Rate for Payer: Nomi Health Commercial |
$1,044.73
|
| Rate for Payer: PACE SWMI |
$870.61
|
| Rate for Payer: PHP Medicare Advantage |
$870.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,683.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,538.38
|
| Rate for Payer: Priority Health Medicare |
$879.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,538.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.61
|
| Rate for Payer: UHC Exchange |
$870.61
|
| Rate for Payer: UHC Medicare Advantage |
$870.61
|
| Rate for Payer: UHCCP Medicaid |
$580.21
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,817.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$3,131.05 |
| Rate for Payer: Aetna Commercial |
$578.84
|
| Rate for Payer: Aetna Medicare |
$449.25
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$431.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.26
|
| Rate for Payer: BCN Commercial |
$1,321.38
|
| Rate for Payer: BCN Medicare Advantage |
$431.97
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cofinity Commercial |
$622.04
|
| Rate for Payer: Cofinity Commercial |
$578.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.97
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.57
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Nomi Health Commercial |
$518.36
|
| Rate for Payer: PACE SWMI |
$431.97
|
| Rate for Payer: PHP Medicare Advantage |
$431.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.05
|
| Rate for Payer: Priority Health HMO/PPO |
$771.18
|
| Rate for Payer: Priority Health Medicare |
$436.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$771.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.97
|
| Rate for Payer: UHC Exchange |
$431.97
|
| Rate for Payer: UHC Medicare Advantage |
$431.97
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,825.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$576.80 |
| Max. Negotiated Rate |
$1,898.71 |
| Rate for Payer: Aetna Commercial |
$1,185.40
|
| Rate for Payer: Aetna Medicare |
$920.02
|
| Rate for Payer: BCBS Complete |
$605.64
|
| Rate for Payer: BCBS MAPPO |
$884.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.71
|
| Rate for Payer: BCN Commercial |
$1,316.01
|
| Rate for Payer: BCN Medicare Advantage |
$884.63
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cofinity Commercial |
$1,273.87
|
| Rate for Payer: Cofinity Commercial |
$1,185.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.63
|
| Rate for Payer: Mclaren Medicaid |
$576.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.86
|
| Rate for Payer: Meridian Medicaid |
$605.64
|
| Rate for Payer: Nomi Health Commercial |
$1,061.56
|
| Rate for Payer: PACE SWMI |
$884.63
|
| Rate for Payer: PHP Medicare Advantage |
$884.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,435.40
|
| Rate for Payer: Priority Health Medicare |
$893.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$884.63
|
| Rate for Payer: UHC Exchange |
$884.63
|
| Rate for Payer: UHC Medicare Advantage |
$884.63
|
| Rate for Payer: UHCCP Medicaid |
$576.80
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,119.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$639.85 |
| Max. Negotiated Rate |
$1,789.35 |
| Rate for Payer: Aetna Commercial |
$1,314.77
|
| Rate for Payer: Aetna Medicare |
$1,020.42
|
| Rate for Payer: BCBS Complete |
$671.84
|
| Rate for Payer: BCBS MAPPO |
$981.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,460.66
|
| Rate for Payer: BCN Medicare Advantage |
$981.17
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,412.88
|
| Rate for Payer: Cofinity Commercial |
$1,314.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.17
|
| Rate for Payer: Mclaren Medicaid |
$639.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.23
|
| Rate for Payer: Meridian Medicaid |
$671.84
|
| Rate for Payer: Nomi Health Commercial |
$1,177.40
|
| Rate for Payer: PACE SWMI |
$981.17
|
| Rate for Payer: PHP Medicare Advantage |
$981.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,604.51
|
| Rate for Payer: Priority Health Medicare |
$990.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$981.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.17
|
| Rate for Payer: UHC Exchange |
$981.17
|
| Rate for Payer: UHC Medicare Advantage |
$981.17
|
| Rate for Payer: UHCCP Medicaid |
$639.85
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,087.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$650.08 |
| Max. Negotiated Rate |
$2,276.44 |
| Rate for Payer: Aetna Commercial |
$1,279.16
|
| Rate for Payer: Aetna Medicare |
$992.78
|
| Rate for Payer: BCBS Complete |
$682.58
|
| Rate for Payer: BCBS MAPPO |
$954.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.44
|
| Rate for Payer: BCN Commercial |
$1,503.17
|
| Rate for Payer: BCN Medicare Advantage |
$954.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cofinity Commercial |
$1,374.62
|
| Rate for Payer: Cofinity Commercial |
$1,279.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.60
|
| Rate for Payer: Mclaren Medicaid |
$650.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.33
|
| Rate for Payer: Meridian Medicaid |
$682.58
|
| Rate for Payer: Nomi Health Commercial |
$1,145.52
|
| Rate for Payer: PACE SWMI |
$954.60
|
| Rate for Payer: PHP Medicare Advantage |
$954.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.17
|
| Rate for Payer: Priority Health Medicare |
$964.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,493.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.60
|
| Rate for Payer: UHC Exchange |
$954.60
|
| Rate for Payer: UHC Medicare Advantage |
$954.60
|
| Rate for Payer: UHCCP Medicaid |
$650.08
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,239.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$709.50 |
| Max. Negotiated Rate |
$1,642.45 |
| Rate for Payer: Aetna Commercial |
$1,393.48
|
| Rate for Payer: Aetna Medicare |
$1,081.51
|
| Rate for Payer: BCBS Complete |
$744.98
|
| Rate for Payer: BCBS MAPPO |
$1,039.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.15
|
| Rate for Payer: BCN Commercial |
$1,642.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.91
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,497.47
|
| Rate for Payer: Cofinity Commercial |
$1,393.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.91
|
| Rate for Payer: Mclaren Medicaid |
$709.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.91
|
| Rate for Payer: Meridian Medicaid |
$744.98
|
| Rate for Payer: Nomi Health Commercial |
$1,247.89
|
| Rate for Payer: PACE SWMI |
$1,039.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,631.79
|
| Rate for Payer: Priority Health Medicare |
$1,050.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,631.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,039.91
|
| Rate for Payer: UHC Exchange |
$1,039.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,039.91
|
| Rate for Payer: UHCCP Medicaid |
$709.50
|
|
|
PR REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 36832
|
| Min. Negotiated Rate |
$473.93 |
| Max. Negotiated Rate |
$1,757.65 |
| Rate for Payer: Aetna Commercial |
$968.02
|
| Rate for Payer: Aetna Medicare |
$751.30
|
| Rate for Payer: BCBS Complete |
$497.63
|
| Rate for Payer: BCBS MAPPO |
$722.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.65
|
| Rate for Payer: BCN Commercial |
$1,081.45
|
| Rate for Payer: BCN Medicare Advantage |
$722.40
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$968.02
|
| Rate for Payer: Cofinity Commercial |
$1,040.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.40
|
| Rate for Payer: Mclaren Medicaid |
$473.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.52
|
| Rate for Payer: Meridian Medicaid |
$497.63
|
| Rate for Payer: Nomi Health Commercial |
$866.88
|
| Rate for Payer: PACE SWMI |
$722.40
|
| Rate for Payer: PHP Medicare Advantage |
$722.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,182.24
|
| Rate for Payer: Priority Health Medicare |
$729.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.40
|
| Rate for Payer: UHC Exchange |
$722.40
|
| Rate for Payer: UHC Medicare Advantage |
$722.40
|
| Rate for Payer: UHCCP Medicaid |
$473.93
|
|
|
PR REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 36833
|
| Min. Negotiated Rate |
$505.66 |
| Max. Negotiated Rate |
$1,516.45 |
| Rate for Payer: Aetna Commercial |
$1,033.56
|
| Rate for Payer: Aetna Medicare |
$802.16
|
| Rate for Payer: BCBS Complete |
$530.94
|
| Rate for Payer: BCBS MAPPO |
$771.31
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$1,155.23
|
| Rate for Payer: BCN Medicare Advantage |
$771.31
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,110.69
|
| Rate for Payer: Cofinity Commercial |
$1,033.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.31
|
| Rate for Payer: Mclaren Medicaid |
$505.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.88
|
| Rate for Payer: Meridian Medicaid |
$530.94
|
| Rate for Payer: Nomi Health Commercial |
$925.57
|
| Rate for Payer: PACE SWMI |
$771.31
|
| Rate for Payer: PHP Medicare Advantage |
$771.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,260.96
|
| Rate for Payer: Priority Health Medicare |
$779.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.31
|
| Rate for Payer: UHC Exchange |
$771.31
|
| Rate for Payer: UHC Medicare Advantage |
$771.31
|
| Rate for Payer: UHCCP Medicaid |
$505.66
|
|
|
PR REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63688
|
| Min. Negotiated Rate |
$193.83 |
| Max. Negotiated Rate |
$1,182.35 |
| Rate for Payer: Aetna Commercial |
$387.23
|
| Rate for Payer: Aetna Medicare |
$300.54
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$288.98
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$547.80
|
| Rate for Payer: BCN Medicare Advantage |
$288.98
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$416.13
|
| Rate for Payer: Cofinity Commercial |
$387.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.98
|
| Rate for Payer: Mclaren Medicaid |
$193.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.43
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Nomi Health Commercial |
$346.78
|
| Rate for Payer: PACE SWMI |
$288.98
|
| Rate for Payer: PHP Medicare Advantage |
$288.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health HMO/PPO |
$516.96
|
| Rate for Payer: Priority Health Medicare |
$291.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$516.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.98
|
| Rate for Payer: UHC Exchange |
$288.98
|
| Rate for Payer: UHC Medicare Advantage |
$288.98
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
