|
PR AAA REPAIR,AORTO-AORTIC TUBE PROSTH
|
Professional
|
Both
|
$3,937.00
|
|
|
Service Code
|
HCPCS 34800
|
| Min. Negotiated Rate |
$1,574.80 |
| Max. Negotiated Rate |
$2,559.05 |
| Rate for Payer: Aetna Medicare |
$1,968.50
|
| Rate for Payer: BCBS Complete |
$1,574.80
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,559.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,811.02
|
|
|
PR AAA REPAIR,MODULR BIFURCATED PROSTH
|
Professional
|
Both
|
$2,555.00
|
|
|
Service Code
|
HCPCS 34802
|
| Min. Negotiated Rate |
$1,022.00 |
| Max. Negotiated Rate |
$1,660.75 |
| Rate for Payer: Aetna Medicare |
$1,277.50
|
| Rate for Payer: BCBS Complete |
$1,022.00
|
| Rate for Payer: Cash Price |
$2,044.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,660.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,175.30
|
|
|
PR AAA REPAIR,MODULR BIFUR PROSTH,2-DOCK
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
HCPCS 34803
|
| Min. Negotiated Rate |
$1,048.80 |
| Max. Negotiated Rate |
$1,704.30 |
| Rate for Payer: Aetna Medicare |
$1,311.00
|
| Rate for Payer: BCBS Complete |
$1,048.80
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,704.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,206.12
|
|
|
PR AAA REPAIR,UNIBODY BIFURCATED PROSTH
|
Professional
|
Both
|
$5,512.00
|
|
|
Service Code
|
HCPCS 34804
|
| Min. Negotiated Rate |
$2,204.80 |
| Max. Negotiated Rate |
$3,582.80 |
| Rate for Payer: Aetna Medicare |
$2,756.00
|
| Rate for Payer: BCBS Complete |
$2,204.80
|
| Rate for Payer: Cash Price |
$4,409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.80
|
| Rate for Payer: UMR Bronson Commercial |
$2,535.52
|
|
|
PR AAA REPR,1ST VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$2,698.00
|
|
|
Service Code
|
HCPCS 34825
|
| Min. Negotiated Rate |
$1,079.20 |
| Max. Negotiated Rate |
$1,753.70 |
| Rate for Payer: Aetna Medicare |
$1,349.00
|
| Rate for Payer: BCBS Complete |
$1,079.20
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,753.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,241.08
|
|
|
PR AAA REPR,ADD VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$436.00
|
|
|
Service Code
|
HCPCS 34826
|
| Min. Negotiated Rate |
$174.40 |
| Max. Negotiated Rate |
$283.40 |
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: BCBS Complete |
$174.40
|
| Rate for Payer: Cash Price |
$348.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.40
|
| Rate for Payer: UMR Bronson Commercial |
$200.56
|
|
|
PR ABATACEPT INJECTION
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS J0129
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$63.52 |
| Rate for Payer: Aetna Commercial |
$59.11
|
| Rate for Payer: Aetna Medicare |
$45.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.11
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS MAPPO |
$44.11
|
| Rate for Payer: BCN Medicare Advantage |
$44.11
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$63.52
|
| Rate for Payer: Cofinity Commercial |
$59.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.32
|
| Rate for Payer: Nomi Health Commercial |
$52.93
|
| Rate for Payer: PACE SWMI |
$44.11
|
| Rate for Payer: PHP Commercial |
$61.75
|
| Rate for Payer: PHP Medicare Advantage |
$44.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Medicare |
$44.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.11
|
| Rate for Payer: UHC Medicare Advantage |
$44.11
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
PR ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 38747
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$370.89 |
| Rate for Payer: Aetna Commercial |
$345.13
|
| Rate for Payer: Aetna Medicare |
$267.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.13
|
| Rate for Payer: BCBS Complete |
$193.20
|
| Rate for Payer: BCBS MAPPO |
$257.56
|
| Rate for Payer: BCN Medicare Advantage |
$257.56
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$370.89
|
| Rate for Payer: Cofinity Commercial |
$345.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.44
|
| Rate for Payer: Nomi Health Commercial |
$309.07
|
| Rate for Payer: PACE SWMI |
$257.56
|
| Rate for Payer: PHP Commercial |
$360.58
|
| Rate for Payer: PHP Medicare Advantage |
$257.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.95
|
| Rate for Payer: Priority Health Medicare |
$257.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.56
|
| Rate for Payer: UHC Medicare Advantage |
$257.56
|
| Rate for Payer: UMR Bronson Commercial |
$222.18
|
|
|
PR ABDOMINOPLASTY (2HRS)
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 00364
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.92
|
|
|
PR ABDOMINOPLASTY (3HRS)
|
Professional
|
Both
|
$4,284.00
|
|
|
Service Code
|
HCPCS 00365
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,713.60 |
| Max. Negotiated Rate |
$2,784.60 |
| Rate for Payer: Aetna Medicare |
$2,142.00
|
| Rate for Payer: BCBS Complete |
$1,713.60
|
| Rate for Payer: Cash Price |
$3,427.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,784.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,970.64
|
|
|
PR ABDOMINOPLASTY W/ BREAST AUGMENT
|
Professional
|
Both
|
$7,446.00
|
|
|
Service Code
|
HCPCS 00256
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,978.40 |
| Max. Negotiated Rate |
$4,839.90 |
| Rate for Payer: Aetna Medicare |
$3,723.00
|
| Rate for Payer: BCBS Complete |
$2,978.40
|
| Rate for Payer: Cash Price |
$5,956.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,839.90
|
| Rate for Payer: UMR Bronson Commercial |
$3,425.16
|
|
|
PR ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL
|
Professional
|
Both
|
$2,628.00
|
|
|
Service Code
|
HCPCS 51845
|
| Min. Negotiated Rate |
$557.77 |
| Max. Negotiated Rate |
$1,708.20 |
| Rate for Payer: Aetna Commercial |
$747.41
|
| Rate for Payer: Aetna Medicare |
$580.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.19
|
| Rate for Payer: BCBS Complete |
$1,051.20
|
| Rate for Payer: BCBS MAPPO |
$557.77
|
| Rate for Payer: BCN Medicare Advantage |
$557.77
|
| Rate for Payer: Cash Price |
$2,102.40
|
| Rate for Payer: Cash Price |
$2,102.40
|
| Rate for Payer: Cofinity Commercial |
$747.41
|
| Rate for Payer: Cofinity Commercial |
$803.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.66
|
| Rate for Payer: Nomi Health Commercial |
$669.32
|
| Rate for Payer: PACE SWMI |
$557.77
|
| Rate for Payer: PHP Commercial |
$780.88
|
| Rate for Payer: PHP Medicare Advantage |
$557.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,708.20
|
| Rate for Payer: Priority Health Medicare |
$557.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.77
|
| Rate for Payer: UHC Medicare Advantage |
$557.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,208.88
|
|
|
PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 49083
|
| Min. Negotiated Rate |
$100.28 |
| Max. Negotiated Rate |
$308.75 |
| Rate for Payer: Aetna Commercial |
$134.38
|
| Rate for Payer: Aetna Medicare |
$104.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.38
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: BCBS MAPPO |
$100.28
|
| Rate for Payer: BCN Medicare Advantage |
$100.28
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$144.40
|
| Rate for Payer: Cofinity Commercial |
$134.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.29
|
| Rate for Payer: Nomi Health Commercial |
$120.34
|
| Rate for Payer: PACE SWMI |
$100.28
|
| Rate for Payer: PHP Commercial |
$140.39
|
| Rate for Payer: PHP Medicare Advantage |
$100.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
| Rate for Payer: Priority Health Medicare |
$100.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.28
|
| Rate for Payer: UHC Medicare Advantage |
$100.28
|
| Rate for Payer: UMR Bronson Commercial |
$218.50
|
|
|
PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 49082
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: Aetna Commercial |
$92.90
|
| Rate for Payer: Aetna Medicare |
$72.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.90
|
| Rate for Payer: BCBS Complete |
$104.00
|
| Rate for Payer: BCBS MAPPO |
$69.33
|
| Rate for Payer: BCN Medicare Advantage |
$69.33
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$99.84
|
| Rate for Payer: Cofinity Commercial |
$92.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.80
|
| Rate for Payer: Nomi Health Commercial |
$83.20
|
| Rate for Payer: PACE SWMI |
$69.33
|
| Rate for Payer: PHP Commercial |
$97.06
|
| Rate for Payer: PHP Medicare Advantage |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health Medicare |
$69.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.33
|
| Rate for Payer: UHC Medicare Advantage |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
PR ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN
|
Professional
|
Both
|
$876.00
|
|
|
Service Code
|
HCPCS 93657
|
| Min. Negotiated Rate |
$291.34 |
| Max. Negotiated Rate |
$569.40 |
| Rate for Payer: Aetna Commercial |
$390.40
|
| Rate for Payer: Aetna Medicare |
$302.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.40
|
| Rate for Payer: BCBS Complete |
$350.40
|
| Rate for Payer: BCBS MAPPO |
$291.34
|
| Rate for Payer: BCN Medicare Advantage |
$291.34
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cofinity Commercial |
$419.53
|
| Rate for Payer: Cofinity Commercial |
$390.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.91
|
| Rate for Payer: Nomi Health Commercial |
$349.61
|
| Rate for Payer: PACE SWMI |
$291.34
|
| Rate for Payer: PHP Commercial |
$407.88
|
| Rate for Payer: PHP Medicare Advantage |
$291.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$569.40
|
| Rate for Payer: Priority Health Medicare |
$291.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.34
|
| Rate for Payer: UHC Medicare Advantage |
$291.34
|
| Rate for Payer: UMR Bronson Commercial |
$402.96
|
|
|
PR ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE
|
Professional
|
Both
|
$7,268.00
|
|
|
Service Code
|
HCPCS 20982
|
| Min. Negotiated Rate |
$351.15 |
| Max. Negotiated Rate |
$4,724.20 |
| Rate for Payer: Aetna Commercial |
$470.54
|
| Rate for Payer: Aetna Medicare |
$365.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.54
|
| Rate for Payer: BCBS Complete |
$2,907.20
|
| Rate for Payer: BCBS MAPPO |
$351.15
|
| Rate for Payer: BCN Medicare Advantage |
$351.15
|
| Rate for Payer: Cash Price |
$5,814.40
|
| Rate for Payer: Cash Price |
$5,814.40
|
| Rate for Payer: Cofinity Commercial |
$505.66
|
| Rate for Payer: Cofinity Commercial |
$470.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.71
|
| Rate for Payer: Nomi Health Commercial |
$421.38
|
| Rate for Payer: PACE SWMI |
$351.15
|
| Rate for Payer: PHP Commercial |
$491.61
|
| Rate for Payer: PHP Medicare Advantage |
$351.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,724.20
|
| Rate for Payer: Priority Health Medicare |
$351.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.15
|
| Rate for Payer: UHC Medicare Advantage |
$351.15
|
| Rate for Payer: UMR Bronson Commercial |
$3,343.28
|
|
|
PR ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS
|
Professional
|
Both
|
$3,766.00
|
|
|
Service Code
|
HCPCS 33256
|
| Min. Negotiated Rate |
$1,506.40 |
| Max. Negotiated Rate |
$2,652.52 |
| Rate for Payer: Aetna Commercial |
$2,468.32
|
| Rate for Payer: Aetna Medicare |
$1,915.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,468.32
|
| Rate for Payer: BCBS Complete |
$1,506.40
|
| Rate for Payer: BCBS MAPPO |
$1,842.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,842.03
|
| Rate for Payer: Cash Price |
$3,012.80
|
| Rate for Payer: Cash Price |
$3,012.80
|
| Rate for Payer: Cofinity Commercial |
$2,652.52
|
| Rate for Payer: Cofinity Commercial |
$2,468.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,842.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,934.13
|
| Rate for Payer: Nomi Health Commercial |
$2,210.44
|
| Rate for Payer: PACE SWMI |
$1,842.03
|
| Rate for Payer: PHP Commercial |
$2,578.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,842.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,447.90
|
| Rate for Payer: Priority Health Medicare |
$1,842.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,842.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,842.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,732.36
|
|
|
PR ABLATION & RECONSTRUCTION ATRIA LIMITED
|
Professional
|
Both
|
$3,359.00
|
|
|
Service Code
|
HCPCS 33254
|
| Min. Negotiated Rate |
$1,303.39 |
| Max. Negotiated Rate |
$2,183.35 |
| Rate for Payer: Aetna Commercial |
$1,746.54
|
| Rate for Payer: Aetna Medicare |
$1,355.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,876.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,746.54
|
| Rate for Payer: BCBS Complete |
$1,343.60
|
| Rate for Payer: BCBS MAPPO |
$1,303.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,303.39
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Cofinity Commercial |
$1,876.88
|
| Rate for Payer: Cofinity Commercial |
$1,746.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,303.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,368.56
|
| Rate for Payer: Nomi Health Commercial |
$1,564.07
|
| Rate for Payer: PACE SWMI |
$1,303.39
|
| Rate for Payer: PHP Commercial |
$1,824.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,303.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.35
|
| Rate for Payer: Priority Health Medicare |
$1,303.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,303.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,303.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,545.14
|
|
|
PR ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL
|
Professional
|
Both
|
$557.00
|
|
|
Service Code
|
HCPCS 30802
|
| Min. Negotiated Rate |
$186.43 |
| Max. Negotiated Rate |
$362.05 |
| Rate for Payer: Aetna Commercial |
$249.82
|
| Rate for Payer: Aetna Medicare |
$193.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.82
|
| Rate for Payer: BCBS Complete |
$222.80
|
| Rate for Payer: BCBS MAPPO |
$186.43
|
| Rate for Payer: BCN Medicare Advantage |
$186.43
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cofinity Commercial |
$268.46
|
| Rate for Payer: Cofinity Commercial |
$249.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.75
|
| Rate for Payer: Nomi Health Commercial |
$223.72
|
| Rate for Payer: PACE SWMI |
$186.43
|
| Rate for Payer: PHP Commercial |
$261.00
|
| Rate for Payer: PHP Medicare Advantage |
$186.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.05
|
| Rate for Payer: Priority Health Medicare |
$186.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.43
|
| Rate for Payer: UHC Medicare Advantage |
$186.43
|
| Rate for Payer: UMR Bronson Commercial |
$256.22
|
|
|
PR ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 30801
|
| Min. Negotiated Rate |
$137.54 |
| Max. Negotiated Rate |
$241.80 |
| Rate for Payer: Aetna Commercial |
$184.30
|
| Rate for Payer: Aetna Medicare |
$143.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.30
|
| Rate for Payer: BCBS Complete |
$148.80
|
| Rate for Payer: BCBS MAPPO |
$137.54
|
| Rate for Payer: BCN Medicare Advantage |
$137.54
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$198.06
|
| Rate for Payer: Cofinity Commercial |
$184.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.42
|
| Rate for Payer: Nomi Health Commercial |
$165.05
|
| Rate for Payer: PACE SWMI |
$137.54
|
| Rate for Payer: PHP Commercial |
$192.56
|
| Rate for Payer: PHP Medicare Advantage |
$137.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health Medicare |
$137.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.54
|
| Rate for Payer: UHC Medicare Advantage |
$137.54
|
| Rate for Payer: UMR Bronson Commercial |
$171.12
|
|
|
PR ABRASION 1 LESION
|
Professional
|
Both
|
$441.66
|
|
|
Service Code
|
HCPCS 15786
|
| Hospital Charge Code |
15786
|
| Min. Negotiated Rate |
$128.00 |
| Max. Negotiated Rate |
$287.08 |
| Rate for Payer: Aetna Commercial |
$171.52
|
| Rate for Payer: Aetna Medicare |
$133.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.52
|
| Rate for Payer: BCBS Complete |
$176.66
|
| Rate for Payer: BCBS MAPPO |
$128.00
|
| Rate for Payer: BCN Medicare Advantage |
$128.00
|
| Rate for Payer: Cash Price |
$353.33
|
| Rate for Payer: Cash Price |
$353.33
|
| Rate for Payer: Cofinity Commercial |
$171.52
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.40
|
| Rate for Payer: Nomi Health Commercial |
$153.60
|
| Rate for Payer: PACE SWMI |
$128.00
|
| Rate for Payer: PHP Commercial |
$179.20
|
| Rate for Payer: PHP Medicare Advantage |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.08
|
| Rate for Payer: Priority Health Medicare |
$128.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.00
|
| Rate for Payer: UHC Medicare Advantage |
$128.00
|
| Rate for Payer: UMR Bronson Commercial |
$203.16
|
|
|
PR ABRASION 1 LESION
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
CPT 15786
|
| Hospital Charge Code |
15786
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$287.30
|
| Rate for Payer: Aetna Commercial |
$375.70
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$309.40
|
| Rate for Payer: Cofinity Commercial |
$380.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$397.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.50
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.70
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$375.70
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.30
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$278.46
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$163.54
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.50
|
|
|
PR ABRASION 1 LESION
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
CPT 15786
|
| Hospital Charge Code |
15786
|
| Min. Negotiated Rate |
$194.48 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna American Axle |
$287.30
|
| Rate for Payer: Aetna Commercial |
$375.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.30
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$309.40
|
| Rate for Payer: Cofinity Commercial |
$380.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.60
|
| Rate for Payer: Healthscope Commercial |
$397.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.70
|
| Rate for Payer: PHP Commercial |
$375.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.30
|
| Rate for Payer: Priority Health SBD |
$278.46
|
| Rate for Payer: UMR Bronson Commercial |
$194.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.50
|
|
|
PR ABRASION 1 LESION
|
Professional
|
Both
|
$441.66
|
|
|
Service Code
|
HCPCS 15786
|
| Min. Negotiated Rate |
$128.00 |
| Max. Negotiated Rate |
$287.08 |
| Rate for Payer: Aetna Commercial |
$171.52
|
| Rate for Payer: Aetna Medicare |
$133.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.52
|
| Rate for Payer: BCBS Complete |
$176.66
|
| Rate for Payer: BCBS MAPPO |
$128.00
|
| Rate for Payer: BCN Medicare Advantage |
$128.00
|
| Rate for Payer: Cash Price |
$353.33
|
| Rate for Payer: Cash Price |
$353.33
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Cofinity Commercial |
$171.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.40
|
| Rate for Payer: Nomi Health Commercial |
$153.60
|
| Rate for Payer: PACE SWMI |
$128.00
|
| Rate for Payer: PHP Commercial |
$179.20
|
| Rate for Payer: PHP Medicare Advantage |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.08
|
| Rate for Payer: Priority Health Medicare |
$128.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.00
|
| Rate for Payer: UHC Medicare Advantage |
$128.00
|
| Rate for Payer: UMR Bronson Commercial |
$203.16
|
|
|
PR ACETABULOPLASTY RESECTION FEMORAL HEAD
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 27122
|
| Min. Negotiated Rate |
$790.40 |
| Max. Negotiated Rate |
$1,529.94 |
| Rate for Payer: Aetna Commercial |
$1,423.70
|
| Rate for Payer: Aetna Medicare |
$1,104.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.70
|
| Rate for Payer: BCBS Complete |
$790.40
|
| Rate for Payer: BCBS MAPPO |
$1,062.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,062.46
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cofinity Commercial |
$1,529.94
|
| Rate for Payer: Cofinity Commercial |
$1,423.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,062.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,115.58
|
| Rate for Payer: Nomi Health Commercial |
$1,274.95
|
| Rate for Payer: PACE SWMI |
$1,062.46
|
| Rate for Payer: PHP Commercial |
$1,487.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,062.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health Medicare |
$1,062.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,062.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,062.46
|
| Rate for Payer: UMR Bronson Commercial |
$908.96
|
|
