|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$313.23 |
| Max. Negotiated Rate |
$543.40 |
| Rate for Payer: Aetna Commercial |
$419.73
|
| Rate for Payer: Aetna Medicare |
$325.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.73
|
| Rate for Payer: BCBS Complete |
$334.40
|
| Rate for Payer: BCBS MAPPO |
$313.23
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.89
|
| Rate for Payer: Nomi Health Commercial |
$375.88
|
| Rate for Payer: PACE SWMI |
$313.23
|
| Rate for Payer: PHP Commercial |
$438.52
|
| Rate for Payer: PHP Medicare Advantage |
$313.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health Medicare |
$313.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.23
|
| Rate for Payer: UHC Medicare Advantage |
$313.23
|
| Rate for Payer: UMR Bronson Commercial |
$384.56
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$346.59 |
| Max. Negotiated Rate |
$597.35 |
| Rate for Payer: Aetna Commercial |
$464.43
|
| Rate for Payer: Aetna Medicare |
$360.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.43
|
| Rate for Payer: BCBS Complete |
$367.60
|
| Rate for Payer: BCBS MAPPO |
$346.59
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.92
|
| Rate for Payer: Nomi Health Commercial |
$415.91
|
| Rate for Payer: PACE SWMI |
$346.59
|
| Rate for Payer: PHP Commercial |
$485.23
|
| Rate for Payer: PHP Medicare Advantage |
$346.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health Medicare |
$346.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.59
|
| Rate for Payer: UHC Medicare Advantage |
$346.59
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
|
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 |
$393.79 |
| Max. Negotiated Rate |
$895.05 |
| Rate for Payer: Aetna Commercial |
$527.68
|
| Rate for Payer: Aetna Medicare |
$409.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.68
|
| Rate for Payer: BCBS Complete |
$550.80
|
| Rate for Payer: BCBS MAPPO |
$393.79
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.48
|
| Rate for Payer: Nomi Health Commercial |
$472.55
|
| Rate for Payer: PACE SWMI |
$393.79
|
| Rate for Payer: PHP Commercial |
$551.31
|
| Rate for Payer: PHP Medicare Advantage |
$393.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health Medicare |
$393.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.79
|
| Rate for Payer: UHC Medicare Advantage |
$393.79
|
| Rate for Payer: UMR Bronson Commercial |
$633.42
|
|
|
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 |
$740.70 |
| Max. Negotiated Rate |
$1,807.65 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: Aetna Medicare |
$770.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.61
|
| Rate for Payer: BCBS Complete |
$1,112.40
|
| Rate for Payer: BCBS MAPPO |
$740.70
|
| 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 |
$1,066.61
|
| Rate for Payer: Cofinity Commercial |
$992.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.74
|
| Rate for Payer: Nomi Health Commercial |
$888.84
|
| Rate for Payer: PACE SWMI |
$740.70
|
| Rate for Payer: PHP Commercial |
$1,036.98
|
| Rate for Payer: PHP Medicare Advantage |
$740.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health Medicare |
$740.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.70
|
| Rate for Payer: UHC Medicare Advantage |
$740.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,279.26
|
|
|
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 |
$1,223.64 |
| Max. Negotiated Rate |
$2,502.90 |
| Rate for Payer: Aetna American Axle |
$1,807.65
|
| Rate for Payer: Aetna Commercial |
$2,363.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,807.65
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$1,946.70
|
| Rate for Payer: Cofinity Commercial |
$2,391.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,946.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.80
|
| Rate for Payer: Healthscope Commercial |
$2,502.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,946.70
|
| 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: PHP Commercial |
$2,363.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health SBD |
$1,752.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,223.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,085.75
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,781.00
|
|
|
Service Code
|
HCPCS 27335
|
| Min. Negotiated Rate |
$740.70 |
| Max. Negotiated Rate |
$1,807.65 |
| Rate for Payer: Aetna Commercial |
$992.54
|
| Rate for Payer: Aetna Medicare |
$770.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.61
|
| Rate for Payer: BCBS Complete |
$1,112.40
|
| Rate for Payer: BCBS MAPPO |
$740.70
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.74
|
| Rate for Payer: Nomi Health Commercial |
$888.84
|
| Rate for Payer: PACE SWMI |
$740.70
|
| Rate for Payer: PHP Commercial |
$1,036.98
|
| Rate for Payer: PHP Medicare Advantage |
$740.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health Medicare |
$740.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.70
|
| Rate for Payer: UHC Medicare Advantage |
$740.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,279.26
|
|
|
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 |
$1,028.97 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna American Axle |
$1,807.65
|
| Rate for Payer: Aetna Commercial |
$2,363.85
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,807.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cash Price |
$2,224.80
|
| Rate for Payer: Cofinity Commercial |
$1,946.70
|
| Rate for Payer: Cofinity Commercial |
$2,391.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,946.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,502.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,946.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,085.75
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,363.85
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$2,363.85
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.65
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$1,752.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$13,314.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,028.97
|
| Rate for Payer: VA VA |
$6,967.14
|
| 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 |
$87.10 |
| Rate for Payer: Aetna Commercial |
$62.23
|
| Rate for Payer: Aetna Medicare |
$48.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.23
|
| Rate for Payer: BCBS Complete |
$53.60
|
| Rate for Payer: BCBS MAPPO |
$46.44
|
| 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 Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$46.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Medicare |
$46.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.44
|
| Rate for Payer: UHC Medicare Advantage |
$46.44
|
| Rate for Payer: UMR Bronson Commercial |
$61.64
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 58322
|
| Min. Negotiated Rate |
$55.08 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: Aetna Medicare |
$57.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.81
|
| Rate for Payer: BCBS Complete |
$98.00
|
| Rate for Payer: BCBS MAPPO |
$55.08
|
| 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 Commercial |
$77.11
|
| Rate for Payer: PHP Medicare Advantage |
$55.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.25
|
| Rate for Payer: Priority Health Medicare |
$55.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.08
|
| Rate for Payer: UHC Medicare Advantage |
$55.08
|
| Rate for Payer: UMR Bronson Commercial |
$112.70
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 36625
|
| Min. Negotiated Rate |
$99.97 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: Aetna Medicare |
$103.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.96
|
| Rate for Payer: BCBS Complete |
$128.00
|
| Rate for Payer: BCBS MAPPO |
$99.97
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.97
|
| Rate for Payer: Nomi Health Commercial |
$119.96
|
| Rate for Payer: PACE SWMI |
$99.97
|
| Rate for Payer: PHP Commercial |
$139.96
|
| Rate for Payer: PHP Medicare Advantage |
$99.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health Medicare |
$99.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.97
|
| Rate for Payer: UHC Medicare Advantage |
$99.97
|
| Rate for Payer: UMR Bronson Commercial |
$147.20
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$205.40 |
| Rate for Payer: Aetna Commercial |
$55.70
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.70
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$41.57
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.65
|
| Rate for Payer: Nomi Health Commercial |
$49.88
|
| Rate for Payer: PACE SWMI |
$41.57
|
| Rate for Payer: PHP Commercial |
$58.20
|
| Rate for Payer: PHP Medicare Advantage |
$41.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.57
|
| Rate for Payer: UHC Medicare Advantage |
$41.57
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$110.24 |
| Max. Negotiated Rate |
$362.70 |
| Rate for Payer: Aetna Commercial |
$147.72
|
| Rate for Payer: Aetna Medicare |
$114.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$110.24
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.75
|
| Rate for Payer: Nomi Health Commercial |
$132.29
|
| Rate for Payer: PACE SWMI |
$110.24
|
| Rate for Payer: PHP Commercial |
$154.34
|
| Rate for Payer: PHP Medicare Advantage |
$110.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health Medicare |
$110.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.24
|
| Rate for Payer: UHC Medicare Advantage |
$110.24
|
| Rate for Payer: UMR Bronson Commercial |
$256.68
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$609.60 |
| Max. Negotiated Rate |
$1,004.28 |
| Rate for Payer: Aetna Commercial |
$934.54
|
| Rate for Payer: Aetna Medicare |
$725.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.28
|
| Rate for Payer: BCBS Complete |
$609.60
|
| Rate for Payer: BCBS MAPPO |
$697.42
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.29
|
| Rate for Payer: Nomi Health Commercial |
$836.90
|
| Rate for Payer: PACE SWMI |
$697.42
|
| Rate for Payer: PHP Commercial |
$976.39
|
| Rate for Payer: PHP Medicare Advantage |
$697.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.60
|
| Rate for Payer: Priority Health Medicare |
$697.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.42
|
| Rate for Payer: UHC Medicare Advantage |
$697.42
|
| Rate for Payer: UMR Bronson Commercial |
$701.04
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,435.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$697.29 |
| Max. Negotiated Rate |
$1,582.75 |
| Rate for Payer: Aetna Commercial |
$934.37
|
| Rate for Payer: Aetna Medicare |
$725.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$934.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.10
|
| Rate for Payer: BCBS Complete |
$974.00
|
| Rate for Payer: BCBS MAPPO |
$697.29
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$732.15
|
| Rate for Payer: Nomi Health Commercial |
$836.75
|
| Rate for Payer: PACE SWMI |
$697.29
|
| Rate for Payer: PHP Commercial |
$976.21
|
| Rate for Payer: PHP Medicare Advantage |
$697.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.75
|
| Rate for Payer: Priority Health Medicare |
$697.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$697.29
|
| Rate for Payer: UHC Medicare Advantage |
$697.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,120.10
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$2,009.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$658.49 |
| Max. Negotiated Rate |
$1,305.85 |
| Rate for Payer: Aetna Commercial |
$882.38
|
| Rate for Payer: Aetna Medicare |
$684.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.38
|
| Rate for Payer: BCBS Complete |
$803.60
|
| Rate for Payer: BCBS MAPPO |
$658.49
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.41
|
| Rate for Payer: Nomi Health Commercial |
$790.19
|
| Rate for Payer: PACE SWMI |
$658.49
|
| Rate for Payer: PHP Commercial |
$921.89
|
| Rate for Payer: PHP Medicare Advantage |
$658.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.85
|
| Rate for Payer: Priority Health Medicare |
$658.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.49
|
| Rate for Payer: UHC Medicare Advantage |
$658.49
|
| Rate for Payer: UMR Bronson Commercial |
$924.14
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,427.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$2,581.80 |
| 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: Aetna New Business (MI Preferred) |
$3,717.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,459.61
|
| Rate for Payer: BCBS Complete |
$3,370.80
|
| Rate for Payer: BCBS MAPPO |
$2,581.80
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,710.89
|
| Rate for Payer: Nomi Health Commercial |
$3,098.16
|
| Rate for Payer: PACE SWMI |
$2,581.80
|
| Rate for Payer: PHP Commercial |
$3,614.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,581.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,477.55
|
| Rate for Payer: Priority Health Medicare |
$2,581.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,581.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,581.80
|
| Rate for Payer: UMR Bronson Commercial |
$3,876.42
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,087.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$834.80 |
| Max. Negotiated Rate |
$1,367.90 |
| Rate for Payer: Aetna Commercial |
$1,272.91
|
| Rate for Payer: Aetna Medicare |
$987.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.91
|
| Rate for Payer: BCBS Complete |
$834.80
|
| Rate for Payer: BCBS MAPPO |
$949.93
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.43
|
| Rate for Payer: Nomi Health Commercial |
$1,139.92
|
| Rate for Payer: PACE SWMI |
$949.93
|
| Rate for Payer: PHP Commercial |
$1,329.90
|
| Rate for Payer: PHP Medicare Advantage |
$949.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.55
|
| Rate for Payer: Priority Health Medicare |
$949.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$949.93
|
| Rate for Payer: UHC Medicare Advantage |
$949.93
|
| Rate for Payer: UMR Bronson Commercial |
$960.02
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,622.00
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$2,648.80 |
| Max. Negotiated Rate |
$4,337.29 |
| Rate for Payer: Aetna Commercial |
$4,036.09
|
| Rate for Payer: Aetna Medicare |
$3,132.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,337.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,036.09
|
| Rate for Payer: BCBS Complete |
$2,648.80
|
| Rate for Payer: BCBS MAPPO |
$3,012.01
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,162.61
|
| Rate for Payer: Nomi Health Commercial |
$3,614.41
|
| Rate for Payer: PACE SWMI |
$3,012.01
|
| Rate for Payer: PHP Commercial |
$4,216.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,012.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,304.30
|
| Rate for Payer: Priority Health Medicare |
$3,012.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,012.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,012.01
|
| Rate for Payer: UMR Bronson Commercial |
$3,046.12
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$7,125.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$2,850.00 |
| Max. Negotiated Rate |
$4,681.41 |
| Rate for Payer: Aetna Commercial |
$4,356.31
|
| Rate for Payer: Aetna Medicare |
$3,381.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,681.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,356.31
|
| Rate for Payer: BCBS Complete |
$2,850.00
|
| Rate for Payer: BCBS MAPPO |
$3,250.98
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,413.53
|
| Rate for Payer: Nomi Health Commercial |
$3,901.18
|
| Rate for Payer: PACE SWMI |
$3,250.98
|
| Rate for Payer: PHP Commercial |
$4,551.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,250.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.25
|
| Rate for Payer: Priority Health Medicare |
$3,250.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,250.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,250.98
|
| Rate for Payer: UMR Bronson Commercial |
$3,277.50
|
|
|
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 |
$2,044.40 |
| Max. Negotiated Rate |
$3,362.27 |
| Rate for Payer: Aetna Commercial |
$3,128.78
|
| Rate for Payer: Aetna Medicare |
$2,428.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,362.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,128.78
|
| Rate for Payer: BCBS Complete |
$2,044.40
|
| Rate for Payer: BCBS MAPPO |
$2,334.91
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,451.66
|
| Rate for Payer: Nomi Health Commercial |
$2,801.89
|
| Rate for Payer: PACE SWMI |
$2,334.91
|
| Rate for Payer: PHP Commercial |
$3,268.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,334.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,322.15
|
| Rate for Payer: Priority Health Medicare |
$2,334.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,334.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,334.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,351.06
|
|
|
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
|
| Rate for Payer: UMR Bronson Commercial |
$4,625.30
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,228.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$2,091.20 |
| Max. Negotiated Rate |
$4,434.38 |
| Rate for Payer: Aetna Commercial |
$4,126.44
|
| Rate for Payer: Aetna Medicare |
$3,202.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,126.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,434.38
|
| Rate for Payer: BCBS Complete |
$2,091.20
|
| Rate for Payer: BCBS MAPPO |
$3,079.43
|
| 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 |
$4,126.44
|
| Rate for Payer: Cofinity Commercial |
$4,434.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,079.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,233.40
|
| Rate for Payer: Nomi Health Commercial |
$3,695.32
|
| Rate for Payer: PACE SWMI |
$3,079.43
|
| Rate for Payer: PHP Commercial |
$4,311.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,079.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,398.20
|
| Rate for Payer: Priority Health Medicare |
$3,079.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,079.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,079.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,404.88
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$46.07 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Commercial |
$61.73
|
| Rate for Payer: Aetna Medicare |
$47.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.73
|
| Rate for Payer: BCBS Complete |
$64.80
|
| Rate for Payer: BCBS MAPPO |
$46.07
|
| Rate for Payer: BCN Medicare Advantage |
$46.07
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$66.34
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.37
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PACE SWMI |
$46.07
|
| Rate for Payer: PHP Commercial |
$64.50
|
| Rate for Payer: PHP Medicare Advantage |
$46.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
| Rate for Payer: Priority Health Medicare |
$46.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.07
|
| Rate for Payer: UHC Medicare Advantage |
$46.07
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$98.80 |
| Max. Negotiated Rate |
$193.38 |
| Rate for Payer: Aetna Commercial |
$179.95
|
| Rate for Payer: Aetna Medicare |
$139.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.95
|
| Rate for Payer: BCBS Complete |
$98.80
|
| Rate for Payer: BCBS MAPPO |
$134.29
|
| Rate for Payer: BCN Medicare Advantage |
$134.29
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$193.38
|
| Rate for Payer: Cofinity Commercial |
$179.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.00
|
| Rate for Payer: Nomi Health Commercial |
$161.15
|
| Rate for Payer: PACE SWMI |
$134.29
|
| Rate for Payer: PHP Commercial |
$188.01
|
| Rate for Payer: PHP Medicare Advantage |
$134.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health Medicare |
$134.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.29
|
| Rate for Payer: UHC Medicare Advantage |
$134.29
|
| Rate for Payer: UMR Bronson Commercial |
$113.62
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$80.60 |
| Rate for Payer: Aetna Commercial |
$49.96
|
| Rate for Payer: Aetna Medicare |
$38.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.96
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$37.28
|
| Rate for Payer: BCN Medicare Advantage |
$37.28
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$49.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.14
|
| Rate for Payer: Nomi Health Commercial |
$44.74
|
| Rate for Payer: PACE SWMI |
$37.28
|
| Rate for Payer: PHP Commercial |
$52.19
|
| Rate for Payer: PHP Medicare Advantage |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$37.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.28
|
| Rate for Payer: UHC Medicare Advantage |
$37.28
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
|
