|
PR BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$4,185.00
|
|
|
Service Code
|
HCPCS 35511
|
| Min. Negotiated Rate |
$1,079.75 |
| Max. Negotiated Rate |
$2,720.25 |
| Rate for Payer: Aetna Commercial |
$1,446.87
|
| Rate for Payer: Aetna Medicare |
$1,122.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,554.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.87
|
| Rate for Payer: BCBS Complete |
$1,674.00
|
| Rate for Payer: BCBS MAPPO |
$1,079.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,079.75
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cofinity Commercial |
$1,554.84
|
| Rate for Payer: Cofinity Commercial |
$1,446.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,079.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,133.74
|
| Rate for Payer: Nomi Health Commercial |
$1,295.70
|
| Rate for Payer: PACE SWMI |
$1,079.75
|
| Rate for Payer: PHP Commercial |
$1,511.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,079.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.25
|
| Rate for Payer: Priority Health Medicare |
$1,079.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,079.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,079.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,925.10
|
|
|
PR BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 35682
|
| Min. Negotiated Rate |
$282.40 |
| Max. Negotiated Rate |
$487.44 |
| Rate for Payer: Aetna Commercial |
$453.59
|
| Rate for Payer: Aetna Medicare |
$352.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.59
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$338.50
|
| Rate for Payer: BCN Medicare Advantage |
$338.50
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$487.44
|
| Rate for Payer: Cofinity Commercial |
$453.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.43
|
| Rate for Payer: Nomi Health Commercial |
$406.20
|
| Rate for Payer: PACE SWMI |
$338.50
|
| Rate for Payer: PHP Commercial |
$473.90
|
| Rate for Payer: PHP Medicare Advantage |
$338.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$338.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.50
|
| Rate for Payer: UHC Medicare Advantage |
$338.50
|
| Rate for Payer: UMR Bronson Commercial |
$324.76
|
|
|
PR BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 35683
|
| Min. Negotiated Rate |
$346.40 |
| Max. Negotiated Rate |
$568.87 |
| Rate for Payer: Aetna Commercial |
$529.37
|
| Rate for Payer: Aetna Medicare |
$410.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.37
|
| Rate for Payer: BCBS Complete |
$346.40
|
| Rate for Payer: BCBS MAPPO |
$395.05
|
| Rate for Payer: BCN Medicare Advantage |
$395.05
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$568.87
|
| Rate for Payer: Cofinity Commercial |
$529.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.80
|
| Rate for Payer: Nomi Health Commercial |
$474.06
|
| Rate for Payer: PACE SWMI |
$395.05
|
| Rate for Payer: PHP Commercial |
$553.07
|
| Rate for Payer: PHP Medicare Advantage |
$395.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.90
|
| Rate for Payer: Priority Health Medicare |
$395.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.05
|
| Rate for Payer: UHC Medicare Advantage |
$395.05
|
| Rate for Payer: UMR Bronson Commercial |
$398.36
|
|
|
PR BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL
|
Professional
|
Both
|
$4,830.00
|
|
|
Service Code
|
HCPCS 35566
|
| Min. Negotiated Rate |
$1,592.84 |
| Max. Negotiated Rate |
$3,139.50 |
| Rate for Payer: Aetna Commercial |
$2,134.41
|
| Rate for Payer: Aetna Medicare |
$1,656.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,293.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,134.41
|
| Rate for Payer: BCBS Complete |
$1,932.00
|
| Rate for Payer: BCBS MAPPO |
$1,592.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,592.84
|
| Rate for Payer: Cash Price |
$3,864.00
|
| Rate for Payer: Cash Price |
$3,864.00
|
| Rate for Payer: Cofinity Commercial |
$2,293.69
|
| Rate for Payer: Cofinity Commercial |
$2,134.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,592.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,672.48
|
| Rate for Payer: Nomi Health Commercial |
$1,911.41
|
| Rate for Payer: PACE SWMI |
$1,592.84
|
| Rate for Payer: PHP Commercial |
$2,229.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,592.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health Medicare |
$1,592.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,592.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,592.84
|
| Rate for Payer: UMR Bronson Commercial |
$2,221.80
|
|
|
PR BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC
|
Professional
|
Both
|
$1,964.00
|
|
|
Service Code
|
HCPCS 33891
|
| Min. Negotiated Rate |
$785.60 |
| Max. Negotiated Rate |
$1,337.03 |
| Rate for Payer: Aetna Commercial |
$1,244.18
|
| Rate for Payer: Aetna Medicare |
$965.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,337.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.18
|
| Rate for Payer: BCBS Complete |
$785.60
|
| Rate for Payer: BCBS MAPPO |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$928.49
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cofinity Commercial |
$1,337.03
|
| Rate for Payer: Cofinity Commercial |
$1,244.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.91
|
| Rate for Payer: Nomi Health Commercial |
$1,114.19
|
| Rate for Payer: PACE SWMI |
$928.49
|
| Rate for Payer: PHP Commercial |
$1,299.89
|
| Rate for Payer: PHP Medicare Advantage |
$928.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.60
|
| Rate for Payer: Priority Health Medicare |
$928.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.49
|
| Rate for Payer: UHC Medicare Advantage |
$928.49
|
| Rate for Payer: UMR Bronson Commercial |
$903.44
|
|
|
PR BYP OTH/THN VEIN AORTOBIFEMORAL
|
Professional
|
Both
|
$5,782.00
|
|
|
Service Code
|
HCPCS 35646
|
| Min. Negotiated Rate |
$1,632.04 |
| Max. Negotiated Rate |
$3,758.30 |
| Rate for Payer: Aetna Commercial |
$2,186.93
|
| Rate for Payer: Aetna Medicare |
$1,697.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,350.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,186.93
|
| Rate for Payer: BCBS Complete |
$2,312.80
|
| Rate for Payer: BCBS MAPPO |
$1,632.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,632.04
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cofinity Commercial |
$2,350.14
|
| Rate for Payer: Cofinity Commercial |
$2,186.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,632.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,713.64
|
| Rate for Payer: Nomi Health Commercial |
$1,958.45
|
| Rate for Payer: PACE SWMI |
$1,632.04
|
| Rate for Payer: PHP Commercial |
$2,284.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,632.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,758.30
|
| Rate for Payer: Priority Health Medicare |
$1,632.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,632.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,632.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,659.72
|
|
|
PR BYP OTH/THN VEIN AORTOBI-ILIAC
|
Professional
|
Both
|
$4,943.00
|
|
|
Service Code
|
HCPCS 35638
|
| Min. Negotiated Rate |
$1,675.27 |
| Max. Negotiated Rate |
$3,212.95 |
| Rate for Payer: Aetna Commercial |
$2,244.86
|
| Rate for Payer: Aetna Medicare |
$1,742.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,244.86
|
| Rate for Payer: BCBS Complete |
$1,977.20
|
| Rate for Payer: BCBS MAPPO |
$1,675.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,675.27
|
| Rate for Payer: Cash Price |
$3,954.40
|
| Rate for Payer: Cash Price |
$3,954.40
|
| Rate for Payer: Cofinity Commercial |
$2,412.39
|
| Rate for Payer: Cofinity Commercial |
$2,244.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,675.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,759.03
|
| Rate for Payer: Nomi Health Commercial |
$2,010.32
|
| Rate for Payer: PACE SWMI |
$1,675.27
|
| Rate for Payer: PHP Commercial |
$2,345.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,675.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,212.95
|
| Rate for Payer: Priority Health Medicare |
$1,675.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,675.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,675.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,273.78
|
|
|
PR BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL
|
Professional
|
Both
|
$5,066.00
|
|
|
Service Code
|
HCPCS 35631
|
| Min. Negotiated Rate |
$1,772.59 |
| Max. Negotiated Rate |
$3,292.90 |
| Rate for Payer: Aetna Commercial |
$2,375.27
|
| Rate for Payer: Aetna Medicare |
$1,843.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,552.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,375.27
|
| Rate for Payer: BCBS Complete |
$2,026.40
|
| Rate for Payer: BCBS MAPPO |
$1,772.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,772.59
|
| Rate for Payer: Cash Price |
$4,052.80
|
| Rate for Payer: Cash Price |
$4,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,552.53
|
| Rate for Payer: Cofinity Commercial |
$2,375.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,772.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,861.22
|
| Rate for Payer: Nomi Health Commercial |
$2,127.11
|
| Rate for Payer: PACE SWMI |
$1,772.59
|
| Rate for Payer: PHP Commercial |
$2,481.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,772.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,292.90
|
| Rate for Payer: Priority Health Medicare |
$1,772.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,772.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,772.59
|
| Rate for Payer: UMR Bronson Commercial |
$2,330.36
|
|
|
PR BYP OTH/THN VEIN AORTOFEMORAL
|
Professional
|
Both
|
$3,067.00
|
|
|
Service Code
|
HCPCS 35647
|
| Min. Negotiated Rate |
$1,226.80 |
| Max. Negotiated Rate |
$2,120.92 |
| Rate for Payer: Aetna Commercial |
$1,973.63
|
| Rate for Payer: Aetna Medicare |
$1,531.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,120.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.63
|
| Rate for Payer: BCBS Complete |
$1,226.80
|
| Rate for Payer: BCBS MAPPO |
$1,472.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,472.86
|
| Rate for Payer: Cash Price |
$2,453.60
|
| Rate for Payer: Cash Price |
$2,453.60
|
| Rate for Payer: Cofinity Commercial |
$2,120.92
|
| Rate for Payer: Cofinity Commercial |
$1,973.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,472.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,546.50
|
| Rate for Payer: Nomi Health Commercial |
$1,767.43
|
| Rate for Payer: PACE SWMI |
$1,472.86
|
| Rate for Payer: PHP Commercial |
$2,062.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,472.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,993.55
|
| Rate for Payer: Priority Health Medicare |
$1,472.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,472.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,410.82
|
|
|
PR BYP OTH/THN VEIN AORTOILIAC
|
Professional
|
Both
|
$3,635.00
|
|
|
Service Code
|
HCPCS 35637
|
| Min. Negotiated Rate |
$1,454.00 |
| Max. Negotiated Rate |
$2,362.75 |
| Rate for Payer: Aetna Commercial |
$2,141.75
|
| Rate for Payer: Aetna Medicare |
$1,662.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,301.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,141.75
|
| Rate for Payer: BCBS Complete |
$1,454.00
|
| Rate for Payer: BCBS MAPPO |
$1,598.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,598.32
|
| Rate for Payer: Cash Price |
$2,908.00
|
| Rate for Payer: Cash Price |
$2,908.00
|
| Rate for Payer: Cofinity Commercial |
$2,301.58
|
| Rate for Payer: Cofinity Commercial |
$2,141.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,598.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,678.24
|
| Rate for Payer: Nomi Health Commercial |
$1,917.98
|
| Rate for Payer: PACE SWMI |
$1,598.32
|
| Rate for Payer: PHP Commercial |
$2,237.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,598.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,362.75
|
| Rate for Payer: Priority Health Medicare |
$1,598.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,598.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,598.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,672.10
|
|
|
PR BYP OTH/THN VEIN AXILLARY-AXILLARY
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 35650
|
| Min. Negotiated Rate |
$886.00 |
| Max. Negotiated Rate |
$1,439.75 |
| Rate for Payer: Aetna Commercial |
$1,319.48
|
| Rate for Payer: Aetna Medicare |
$1,024.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,319.48
|
| Rate for Payer: BCBS Complete |
$886.00
|
| Rate for Payer: BCBS MAPPO |
$984.69
|
| Rate for Payer: BCN Medicare Advantage |
$984.69
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,417.95
|
| Rate for Payer: Cofinity Commercial |
$1,319.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.92
|
| Rate for Payer: Nomi Health Commercial |
$1,181.63
|
| Rate for Payer: PACE SWMI |
$984.69
|
| Rate for Payer: PHP Commercial |
$1,378.57
|
| Rate for Payer: PHP Medicare Advantage |
$984.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health Medicare |
$984.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.69
|
| Rate for Payer: UHC Medicare Advantage |
$984.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,018.90
|
|
|
PR BYP OTH/THN VEIN AXILLARY-FEMORAL
|
Professional
|
Both
|
$4,190.00
|
|
|
Service Code
|
HCPCS 35621
|
| Min. Negotiated Rate |
$1,050.35 |
| Max. Negotiated Rate |
$2,723.50 |
| Rate for Payer: Aetna Commercial |
$1,407.47
|
| Rate for Payer: Aetna Medicare |
$1,092.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.47
|
| Rate for Payer: BCBS Complete |
$1,676.00
|
| Rate for Payer: BCBS MAPPO |
$1,050.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,050.35
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,512.50
|
| Rate for Payer: Cofinity Commercial |
$1,407.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,050.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,102.87
|
| Rate for Payer: Nomi Health Commercial |
$1,260.42
|
| Rate for Payer: PACE SWMI |
$1,050.35
|
| Rate for Payer: PHP Commercial |
$1,470.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,050.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.50
|
| Rate for Payer: Priority Health Medicare |
$1,050.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,050.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,050.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,927.40
|
|
|
PR BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL
|
Professional
|
Both
|
$4,922.00
|
|
|
Service Code
|
HCPCS 35654
|
| Min. Negotiated Rate |
$1,310.50 |
| Max. Negotiated Rate |
$3,199.30 |
| Rate for Payer: Aetna Commercial |
$1,756.07
|
| Rate for Payer: Aetna Medicare |
$1,362.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,756.07
|
| Rate for Payer: BCBS Complete |
$1,968.80
|
| Rate for Payer: BCBS MAPPO |
$1,310.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,310.50
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,887.12
|
| Rate for Payer: Cofinity Commercial |
$1,756.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,376.03
|
| Rate for Payer: Nomi Health Commercial |
$1,572.60
|
| Rate for Payer: PACE SWMI |
$1,310.50
|
| Rate for Payer: PHP Commercial |
$1,834.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,310.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.30
|
| Rate for Payer: Priority Health Medicare |
$1,310.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,310.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,310.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,264.12
|
|
|
PR BYP OTH/THN VEIN CAROTID-SUBCLAVIAN
|
Professional
|
Both
|
$2,324.00
|
|
|
Service Code
|
HCPCS 35606
|
| Min. Negotiated Rate |
$929.60 |
| Max. Negotiated Rate |
$1,621.64 |
| Rate for Payer: Aetna Commercial |
$1,509.03
|
| Rate for Payer: Aetna Medicare |
$1,171.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.03
|
| Rate for Payer: BCBS Complete |
$929.60
|
| Rate for Payer: BCBS MAPPO |
$1,126.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.14
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cofinity Commercial |
$1,621.64
|
| Rate for Payer: Cofinity Commercial |
$1,509.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,182.45
|
| Rate for Payer: Nomi Health Commercial |
$1,351.37
|
| Rate for Payer: PACE SWMI |
$1,126.14
|
| Rate for Payer: PHP Commercial |
$1,576.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health Medicare |
$1,126.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,126.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,126.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.04
|
|
|
PR BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$2,942.00
|
|
|
Service Code
|
HCPCS 35601
|
| Min. Negotiated Rate |
$1,176.80 |
| Max. Negotiated Rate |
$1,944.81 |
| Rate for Payer: Aetna Commercial |
$1,809.75
|
| Rate for Payer: Aetna Medicare |
$1,404.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,944.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.75
|
| Rate for Payer: BCBS Complete |
$1,176.80
|
| Rate for Payer: BCBS MAPPO |
$1,350.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,350.56
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cofinity Commercial |
$1,944.81
|
| Rate for Payer: Cofinity Commercial |
$1,809.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,350.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,418.09
|
| Rate for Payer: Nomi Health Commercial |
$1,620.67
|
| Rate for Payer: PACE SWMI |
$1,350.56
|
| Rate for Payer: PHP Commercial |
$1,890.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,350.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.30
|
| Rate for Payer: Priority Health Medicare |
$1,350.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,350.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,350.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,353.32
|
|
|
PR BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL
|
Professional
|
Both
|
$4,208.00
|
|
|
Service Code
|
HCPCS 35666
|
| Min. Negotiated Rate |
$1,227.19 |
| Max. Negotiated Rate |
$2,735.20 |
| Rate for Payer: Aetna Commercial |
$1,644.43
|
| Rate for Payer: Aetna Medicare |
$1,276.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,767.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.43
|
| Rate for Payer: BCBS Complete |
$1,683.20
|
| Rate for Payer: BCBS MAPPO |
$1,227.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,227.19
|
| Rate for Payer: Cash Price |
$3,366.40
|
| Rate for Payer: Cash Price |
$3,366.40
|
| Rate for Payer: Cofinity Commercial |
$1,767.15
|
| Rate for Payer: Cofinity Commercial |
$1,644.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,227.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,288.55
|
| Rate for Payer: Nomi Health Commercial |
$1,472.63
|
| Rate for Payer: PACE SWMI |
$1,227.19
|
| Rate for Payer: PHP Commercial |
$1,718.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,227.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.20
|
| Rate for Payer: Priority Health Medicare |
$1,227.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,227.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,227.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,935.68
|
|
|
PR BYP OTH/THN VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,253.00
|
|
|
Service Code
|
HCPCS 35661
|
| Min. Negotiated Rate |
$901.20 |
| Max. Negotiated Rate |
$1,493.06 |
| Rate for Payer: Aetna Commercial |
$1,389.38
|
| Rate for Payer: Aetna Medicare |
$1,078.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.38
|
| Rate for Payer: BCBS Complete |
$901.20
|
| Rate for Payer: BCBS MAPPO |
$1,036.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.85
|
| Rate for Payer: Cash Price |
$1,802.40
|
| Rate for Payer: Cash Price |
$1,802.40
|
| Rate for Payer: Cofinity Commercial |
$1,493.06
|
| Rate for Payer: Cofinity Commercial |
$1,389.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,088.69
|
| Rate for Payer: Nomi Health Commercial |
$1,244.22
|
| Rate for Payer: PACE SWMI |
$1,036.85
|
| Rate for Payer: PHP Commercial |
$1,451.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,464.45
|
| Rate for Payer: Priority Health Medicare |
$1,036.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,036.38
|
|
|
PR BYP OTH/THN VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 35656
|
| Min. Negotiated Rate |
$911.20 |
| Max. Negotiated Rate |
$1,480.70 |
| Rate for Payer: Aetna Commercial |
$1,375.97
|
| Rate for Payer: Aetna Medicare |
$1,067.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,478.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.97
|
| Rate for Payer: BCBS Complete |
$911.20
|
| Rate for Payer: BCBS MAPPO |
$1,026.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,026.84
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$1,478.65
|
| Rate for Payer: Cofinity Commercial |
$1,375.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.18
|
| Rate for Payer: Nomi Health Commercial |
$1,232.21
|
| Rate for Payer: PACE SWMI |
$1,026.84
|
| Rate for Payer: PHP Commercial |
$1,437.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,026.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health Medicare |
$1,026.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,026.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.88
|
|
|
PR BYP OTH/THN VEIN ILIOFEMORAL
|
Professional
|
Both
|
$4,582.00
|
|
|
Service Code
|
HCPCS 35665
|
| Min. Negotiated Rate |
$1,123.50 |
| Max. Negotiated Rate |
$2,978.30 |
| Rate for Payer: Aetna Commercial |
$1,505.49
|
| Rate for Payer: Aetna Medicare |
$1,168.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,617.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,505.49
|
| Rate for Payer: BCBS Complete |
$1,832.80
|
| Rate for Payer: BCBS MAPPO |
$1,123.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,123.50
|
| Rate for Payer: Cash Price |
$3,665.60
|
| Rate for Payer: Cash Price |
$3,665.60
|
| Rate for Payer: Cofinity Commercial |
$1,617.84
|
| Rate for Payer: Cofinity Commercial |
$1,505.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,123.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,179.67
|
| Rate for Payer: Nomi Health Commercial |
$1,348.20
|
| Rate for Payer: PACE SWMI |
$1,123.50
|
| Rate for Payer: PHP Commercial |
$1,572.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,123.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,978.30
|
| Rate for Payer: Priority Health Medicare |
$1,123.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,123.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,123.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,107.72
|
|
|
PR BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART
|
Professional
|
Both
|
$2,203.00
|
|
|
Service Code
|
HCPCS 35671
|
| Min. Negotiated Rate |
$881.20 |
| Max. Negotiated Rate |
$1,550.22 |
| Rate for Payer: Aetna Commercial |
$1,442.56
|
| Rate for Payer: Aetna Medicare |
$1,119.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,550.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.56
|
| Rate for Payer: BCBS Complete |
$881.20
|
| Rate for Payer: BCBS MAPPO |
$1,076.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,076.54
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,550.22
|
| Rate for Payer: Cofinity Commercial |
$1,442.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,076.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,130.37
|
| Rate for Payer: Nomi Health Commercial |
$1,291.85
|
| Rate for Payer: PACE SWMI |
$1,076.54
|
| Rate for Payer: PHP Commercial |
$1,507.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,076.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,431.95
|
| Rate for Payer: Priority Health Medicare |
$1,076.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,076.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,013.38
|
|
|
PR BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$2,244.00
|
|
|
Service Code
|
HCPCS 35612
|
| Min. Negotiated Rate |
$897.60 |
| Max. Negotiated Rate |
$1,458.60 |
| Rate for Payer: Aetna Commercial |
$1,350.12
|
| Rate for Payer: Aetna Medicare |
$1,047.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,450.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.12
|
| Rate for Payer: BCBS Complete |
$897.60
|
| Rate for Payer: BCBS MAPPO |
$1,007.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,007.55
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cofinity Commercial |
$1,450.87
|
| Rate for Payer: Cofinity Commercial |
$1,350.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,007.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.93
|
| Rate for Payer: Nomi Health Commercial |
$1,209.06
|
| Rate for Payer: PACE SWMI |
$1,007.55
|
| Rate for Payer: PHP Commercial |
$1,410.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,007.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.60
|
| Rate for Payer: Priority Health Medicare |
$1,007.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,007.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,007.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,032.24
|
|
|
PR BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL
|
Professional
|
Both
|
$2,798.00
|
|
|
Service Code
|
HCPCS 35570
|
| Min. Negotiated Rate |
$1,119.20 |
| Max. Negotiated Rate |
$2,044.01 |
| Rate for Payer: Aetna Commercial |
$1,902.06
|
| Rate for Payer: Aetna Medicare |
$1,476.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,902.06
|
| Rate for Payer: BCBS Complete |
$1,119.20
|
| Rate for Payer: BCBS MAPPO |
$1,419.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,419.45
|
| Rate for Payer: Cash Price |
$2,238.40
|
| Rate for Payer: Cash Price |
$2,238.40
|
| Rate for Payer: Cofinity Commercial |
$2,044.01
|
| Rate for Payer: Cofinity Commercial |
$1,902.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,419.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,490.42
|
| Rate for Payer: Nomi Health Commercial |
$1,703.34
|
| Rate for Payer: PACE SWMI |
$1,419.45
|
| Rate for Payer: PHP Commercial |
$1,987.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,419.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.70
|
| Rate for Payer: Priority Health Medicare |
$1,419.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,419.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,419.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,287.08
|
|
|
PR BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL
|
Professional
|
Both
|
$5,238.00
|
|
|
Service Code
|
HCPCS 35571
|
| Min. Negotiated Rate |
$1,269.45 |
| Max. Negotiated Rate |
$3,404.70 |
| Rate for Payer: Aetna Commercial |
$1,701.06
|
| Rate for Payer: Aetna Medicare |
$1,320.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,828.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,701.06
|
| Rate for Payer: BCBS Complete |
$2,095.20
|
| Rate for Payer: BCBS MAPPO |
$1,269.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,269.45
|
| Rate for Payer: Cash Price |
$4,190.40
|
| Rate for Payer: Cash Price |
$4,190.40
|
| Rate for Payer: Cofinity Commercial |
$1,828.01
|
| Rate for Payer: Cofinity Commercial |
$1,701.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,269.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,332.92
|
| Rate for Payer: Nomi Health Commercial |
$1,523.34
|
| Rate for Payer: PACE SWMI |
$1,269.45
|
| Rate for Payer: PHP Commercial |
$1,777.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,269.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,404.70
|
| Rate for Payer: Priority Health Medicare |
$1,269.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,269.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,269.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,409.48
|
|
|
PR CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,502.00
|
|
|
Service Code
|
HCPCS 33536
|
| Min. Negotiated Rate |
$2,200.80 |
| Max. Negotiated Rate |
$3,638.79 |
| Rate for Payer: Aetna Commercial |
$3,386.10
|
| Rate for Payer: Aetna Medicare |
$2,628.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,638.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,386.10
|
| Rate for Payer: BCBS Complete |
$2,200.80
|
| Rate for Payer: BCBS MAPPO |
$2,526.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,526.94
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cofinity Commercial |
$3,638.79
|
| Rate for Payer: Cofinity Commercial |
$3,386.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,526.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,653.29
|
| Rate for Payer: Nomi Health Commercial |
$3,032.33
|
| Rate for Payer: PACE SWMI |
$2,526.94
|
| Rate for Payer: PHP Commercial |
$3,537.72
|
| Rate for Payer: PHP Medicare Advantage |
$2,526.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,576.30
|
| Rate for Payer: Priority Health Medicare |
$2,526.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,526.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,526.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,530.92
|
|
|
PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT
|
Professional
|
Both
|
$3,911.00
|
|
|
Service Code
|
HCPCS 33533
|
| Min. Negotiated Rate |
$1,564.40 |
| Max. Negotiated Rate |
$2,584.77 |
| Rate for Payer: Aetna Commercial |
$2,405.27
|
| Rate for Payer: Aetna Medicare |
$1,866.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,584.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,405.27
|
| Rate for Payer: BCBS Complete |
$1,564.40
|
| Rate for Payer: BCBS MAPPO |
$1,794.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,794.98
|
| Rate for Payer: Cash Price |
$3,128.80
|
| Rate for Payer: Cash Price |
$3,128.80
|
| Rate for Payer: Cofinity Commercial |
$2,584.77
|
| Rate for Payer: Cofinity Commercial |
$2,405.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,794.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,884.73
|
| Rate for Payer: Nomi Health Commercial |
$2,153.98
|
| Rate for Payer: PACE SWMI |
$1,794.98
|
| Rate for Payer: PHP Commercial |
$2,512.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,794.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.15
|
| Rate for Payer: Priority Health Medicare |
$1,794.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,794.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,794.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,799.06
|
|
