|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$397.64 |
| Rate for Payer: Aetna Commercial |
$167.06
|
| Rate for Payer: Aetna Medicare |
$129.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.52
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$124.67
|
| Rate for Payer: BCBS Trust/PPO |
$372.29
|
| Rate for Payer: BCN Commercial |
$397.64
|
| Rate for Payer: BCN Medicare Advantage |
$124.67
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$167.06
|
| Rate for Payer: Cofinity Commercial |
$179.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.90
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Nomi Health Commercial |
$149.60
|
| Rate for Payer: PACE SWMI |
$124.67
|
| Rate for Payer: PHP Commercial |
$174.54
|
| Rate for Payer: PHP Medicare Advantage |
$124.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.75
|
| Rate for Payer: Priority Health Medicare |
$124.67
|
| Rate for Payer: Priority Health Narrow Network |
$180.75
|
| Rate for Payer: Priority Health SBD |
$180.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.67
|
| Rate for Payer: UHC Medicare Advantage |
$124.67
|
| Rate for Payer: UHCCP Medicaid |
$83.07
|
| Rate for Payer: UMR Bronson Commercial |
$274.16
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$1,147.47 |
| Rate for Payer: Aetna Commercial |
$168.45
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.02
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$371.40
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cofinity Commercial |
$168.45
|
| Rate for Payer: Cofinity Commercial |
$181.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Nomi Health Commercial |
$150.85
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$175.99
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.68
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$181.68
|
| Rate for Payer: Priority Health SBD |
$181.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
| Rate for Payer: UMR Bronson Commercial |
$278.30
|
|
|
PR BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 31630
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$786.64 |
| Rate for Payer: Aetna Commercial |
$251.04
|
| Rate for Payer: Aetna Medicare |
$194.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.77
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$187.34
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$283.43
|
| Rate for Payer: BCN Medicare Advantage |
$187.34
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$251.04
|
| Rate for Payer: Cofinity Commercial |
$269.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.71
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Nomi Health Commercial |
$224.81
|
| Rate for Payer: PACE SWMI |
$187.34
|
| Rate for Payer: PHP Commercial |
$262.28
|
| Rate for Payer: PHP Medicare Advantage |
$187.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.73
|
| Rate for Payer: Priority Health Medicare |
$187.34
|
| Rate for Payer: Priority Health Narrow Network |
$269.73
|
| Rate for Payer: Priority Health SBD |
$269.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.34
|
| Rate for Payer: UHC Medicare Advantage |
$187.34
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$1,284.30 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.79
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PHP Commercial |
$81.27
|
| Rate for Payer: PHP Commercial |
$81.27
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$58.05
|
| Rate for Payer: Priority Health Medicare |
$58.05
|
| Rate for Payer: Priority Health Narrow Network |
$85.48
|
| Rate for Payer: Priority Health Narrow Network |
$85.48
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UMR Bronson Commercial |
$63.48
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$791.92 |
| Rate for Payer: Aetna Commercial |
$84.27
|
| Rate for Payer: Aetna Medicare |
$65.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.56
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$62.89
|
| Rate for Payer: BCBS Trust/PPO |
$791.92
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: BCN Medicare Advantage |
$62.89
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$84.27
|
| Rate for Payer: Cofinity Commercial |
$90.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.03
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$75.47
|
| Rate for Payer: PACE SWMI |
$62.89
|
| Rate for Payer: PHP Commercial |
$88.05
|
| Rate for Payer: PHP Medicare Advantage |
$62.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.83
|
| Rate for Payer: Priority Health Medicare |
$62.89
|
| Rate for Payer: Priority Health Narrow Network |
$90.83
|
| Rate for Payer: Priority Health SBD |
$90.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.89
|
| Rate for Payer: UHC Medicare Advantage |
$62.89
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$2,953.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$838.58 |
| Max. Negotiated Rate |
$1,919.45 |
| Rate for Payer: Aetna Commercial |
$1,710.70
|
| Rate for Payer: Aetna Medicare |
$1,327.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,710.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,838.36
|
| Rate for Payer: BCBS Complete |
$880.51
|
| Rate for Payer: BCBS MAPPO |
$1,276.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.92
|
| Rate for Payer: BCN Commercial |
$1,909.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.64
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,710.70
|
| Rate for Payer: Cofinity Commercial |
$1,838.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.47
|
| Rate for Payer: Meridian Medicaid |
$880.51
|
| Rate for Payer: Nomi Health Commercial |
$1,531.97
|
| Rate for Payer: PACE SWMI |
$1,276.64
|
| Rate for Payer: PHP Commercial |
$1,787.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$838.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,919.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,818.64
|
| Rate for Payer: Priority Health Medicare |
$1,276.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,818.64
|
| Rate for Payer: Priority Health SBD |
$1,818.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.64
|
| Rate for Payer: UHCCP Medicaid |
$838.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,358.38
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$508.71 |
| Rate for Payer: Aetna Commercial |
$196.14
|
| Rate for Payer: Aetna Medicare |
$152.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.77
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.37
|
| Rate for Payer: BCBS Trust/PPO |
$463.32
|
| Rate for Payer: BCN Commercial |
$508.71
|
| Rate for Payer: BCN Medicare Advantage |
$146.37
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$196.14
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.69
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Nomi Health Commercial |
$175.64
|
| Rate for Payer: PACE SWMI |
$146.37
|
| Rate for Payer: PHP Commercial |
$204.92
|
| Rate for Payer: PHP Medicare Advantage |
$146.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.27
|
| Rate for Payer: Priority Health Medicare |
$146.37
|
| Rate for Payer: Priority Health Narrow Network |
$212.27
|
| Rate for Payer: Priority Health SBD |
$212.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$146.37
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
| Rate for Payer: UMR Bronson Commercial |
$298.08
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$116.94 |
| Max. Negotiated Rate |
$818.35 |
| Rate for Payer: Aetna Commercial |
$235.33
|
| Rate for Payer: Aetna Medicare |
$182.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.89
|
| Rate for Payer: BCBS Complete |
$122.79
|
| Rate for Payer: BCBS MAPPO |
$175.62
|
| Rate for Payer: BCBS Trust/PPO |
$499.77
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$175.62
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$235.33
|
| Rate for Payer: Cofinity Commercial |
$252.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.40
|
| Rate for Payer: Meridian Medicaid |
$122.79
|
| Rate for Payer: Nomi Health Commercial |
$210.74
|
| Rate for Payer: PACE SWMI |
$175.62
|
| Rate for Payer: PHP Commercial |
$245.87
|
| Rate for Payer: PHP Medicare Advantage |
$175.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.51
|
| Rate for Payer: Priority Health Medicare |
$175.62
|
| Rate for Payer: Priority Health Narrow Network |
$253.51
|
| Rate for Payer: Priority Health SBD |
$253.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.62
|
| Rate for Payer: UHC Medicare Advantage |
$175.62
|
| Rate for Payer: UHCCP Medicaid |
$116.94
|
| Rate for Payer: UMR Bronson Commercial |
$579.14
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$1,591.62 |
| Rate for Payer: Aetna Commercial |
$121.34
|
| Rate for Payer: Aetna Medicare |
$94.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.39
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$90.55
|
| Rate for Payer: BCBS Trust/PPO |
$684.15
|
| Rate for Payer: BCN Commercial |
$1,591.62
|
| Rate for Payer: BCN Medicare Advantage |
$90.55
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$121.34
|
| Rate for Payer: Cofinity Commercial |
$130.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.08
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Nomi Health Commercial |
$108.66
|
| Rate for Payer: PACE SWMI |
$90.55
|
| Rate for Payer: PHP Commercial |
$126.77
|
| Rate for Payer: PHP Medicare Advantage |
$90.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.70
|
| Rate for Payer: Priority Health Medicare |
$90.55
|
| Rate for Payer: Priority Health Narrow Network |
$130.70
|
| Rate for Payer: Priority Health SBD |
$130.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.55
|
| Rate for Payer: UHC Medicare Advantage |
$90.55
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
| Rate for Payer: UMR Bronson Commercial |
$79.58
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$310.36
|
| Rate for Payer: Aetna Medicare |
$240.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.52
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$231.61
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$231.61
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$310.36
|
| Rate for Payer: Cofinity Commercial |
$333.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.19
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Nomi Health Commercial |
$277.93
|
| Rate for Payer: PACE SWMI |
$231.61
|
| Rate for Payer: PHP Commercial |
$324.25
|
| Rate for Payer: PHP Medicare Advantage |
$231.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.55
|
| Rate for Payer: Priority Health Medicare |
$231.61
|
| Rate for Payer: Priority Health Narrow Network |
$335.55
|
| Rate for Payer: Priority Health SBD |
$335.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.61
|
| Rate for Payer: UHC Medicare Advantage |
$231.61
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
| Rate for Payer: UMR Bronson Commercial |
$239.66
|
|
|
PR BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 31631
|
| Min. Negotiated Rate |
$142.07 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$285.98
|
| Rate for Payer: Aetna Medicare |
$221.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.32
|
| Rate for Payer: BCBS Complete |
$149.17
|
| Rate for Payer: BCBS MAPPO |
$213.42
|
| Rate for Payer: BCN Commercial |
$323.50
|
| Rate for Payer: BCN Medicare Advantage |
$213.42
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$285.98
|
| Rate for Payer: Cofinity Commercial |
$307.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.09
|
| Rate for Payer: Meridian Medicaid |
$149.17
|
| Rate for Payer: Nomi Health Commercial |
$256.10
|
| Rate for Payer: PACE SWMI |
$213.42
|
| Rate for Payer: PHP Commercial |
$298.79
|
| Rate for Payer: PHP Medicare Advantage |
$213.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.28
|
| Rate for Payer: Priority Health Medicare |
$213.42
|
| Rate for Payer: Priority Health Narrow Network |
$307.28
|
| Rate for Payer: Priority Health SBD |
$307.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.42
|
| Rate for Payer: UHC Medicare Advantage |
$213.42
|
| Rate for Payer: UHCCP Medicaid |
$142.07
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$109.91 |
| Max. Negotiated Rate |
$972.60 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$171.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.53
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$164.95
|
| Rate for Payer: BCBS Trust/PPO |
$972.60
|
| Rate for Payer: BCN Commercial |
$425.15
|
| Rate for Payer: BCN Medicare Advantage |
$164.95
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$221.03
|
| Rate for Payer: Cofinity Commercial |
$237.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.20
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| Rate for Payer: Nomi Health Commercial |
$197.94
|
| Rate for Payer: PACE SWMI |
$164.95
|
| Rate for Payer: PHP Commercial |
$230.93
|
| Rate for Payer: PHP Medicare Advantage |
$164.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.68
|
| Rate for Payer: Priority Health Medicare |
$164.95
|
| Rate for Payer: Priority Health Narrow Network |
$238.68
|
| Rate for Payer: Priority Health SBD |
$238.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.95
|
| Rate for Payer: UHC Medicare Advantage |
$164.95
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
| Rate for Payer: UMR Bronson Commercial |
$523.02
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$92.23 |
| Max. Negotiated Rate |
$667.24 |
| Rate for Payer: Aetna Commercial |
$185.27
|
| Rate for Payer: Aetna Medicare |
$143.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.09
|
| Rate for Payer: BCBS Complete |
$96.84
|
| Rate for Payer: BCBS MAPPO |
$138.26
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$397.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.26
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$185.27
|
| Rate for Payer: Cofinity Commercial |
$199.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.17
|
| Rate for Payer: Meridian Medicaid |
$96.84
|
| Rate for Payer: Nomi Health Commercial |
$165.91
|
| Rate for Payer: PACE SWMI |
$138.26
|
| Rate for Payer: PHP Commercial |
$193.56
|
| Rate for Payer: PHP Medicare Advantage |
$138.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.21
|
| Rate for Payer: Priority Health Medicare |
$138.26
|
| Rate for Payer: Priority Health Narrow Network |
$200.21
|
| Rate for Payer: Priority Health SBD |
$200.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.26
|
| Rate for Payer: UHC Medicare Advantage |
$138.26
|
| Rate for Payer: UHCCP Medicaid |
$92.23
|
| Rate for Payer: UMR Bronson Commercial |
$316.94
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,008.00 |
| Rate for Payer: Aetna Commercial |
$179.64
|
| Rate for Payer: Aetna Medicare |
$139.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.05
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$134.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.00
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$134.06
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$179.64
|
| Rate for Payer: Cofinity Commercial |
$193.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.76
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$160.87
|
| Rate for Payer: PACE SWMI |
$134.06
|
| Rate for Payer: PHP Commercial |
$187.68
|
| Rate for Payer: PHP Medicare Advantage |
$134.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.27
|
| Rate for Payer: Priority Health Medicare |
$134.06
|
| Rate for Payer: Priority Health Narrow Network |
$193.27
|
| Rate for Payer: Priority Health SBD |
$193.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.06
|
| Rate for Payer: UHC Medicare Advantage |
$134.06
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$915.54 |
| Rate for Payer: Aetna Commercial |
$220.35
|
| Rate for Payer: Aetna Medicare |
$171.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.79
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$164.44
|
| Rate for Payer: BCBS Trust/PPO |
$915.54
|
| Rate for Payer: BCN Commercial |
$597.26
|
| Rate for Payer: BCN Medicare Advantage |
$164.44
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Cofinity Commercial |
$236.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.66
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$197.33
|
| Rate for Payer: PACE SWMI |
$164.44
|
| Rate for Payer: PHP Commercial |
$230.22
|
| Rate for Payer: PHP Medicare Advantage |
$164.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.68
|
| Rate for Payer: Priority Health Medicare |
$164.44
|
| Rate for Payer: Priority Health Narrow Network |
$238.68
|
| Rate for Payer: Priority Health SBD |
$238.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.44
|
| Rate for Payer: UHC Medicare Advantage |
$164.44
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
| Rate for Payer: UMR Bronson Commercial |
$349.60
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$996.90 |
| Rate for Payer: Aetna Commercial |
$60.96
|
| Rate for Payer: Aetna Medicare |
$47.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.51
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$45.49
|
| Rate for Payer: BCBS Trust/PPO |
$996.90
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$45.49
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$60.96
|
| Rate for Payer: Cofinity Commercial |
$65.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.76
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Nomi Health Commercial |
$54.59
|
| Rate for Payer: PACE SWMI |
$45.49
|
| Rate for Payer: PHP Commercial |
$63.69
|
| Rate for Payer: PHP Medicare Advantage |
$45.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$45.49
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Priority Health SBD |
$66.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.49
|
| Rate for Payer: UHC Medicare Advantage |
$45.49
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
| Rate for Payer: UMR Bronson Commercial |
$59.34
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$724.83 |
| Rate for Payer: Aetna Commercial |
$79.62
|
| Rate for Payer: Aetna Medicare |
$61.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.56
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS MAPPO |
$59.42
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$59.42
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Cofinity Commercial |
$85.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.39
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$71.30
|
| Rate for Payer: PACE SWMI |
$59.42
|
| Rate for Payer: PHP Commercial |
$83.19
|
| Rate for Payer: PHP Medicare Advantage |
$59.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.28
|
| Rate for Payer: Priority Health Medicare |
$59.42
|
| Rate for Payer: Priority Health Narrow Network |
$85.28
|
| Rate for Payer: Priority Health SBD |
$85.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.42
|
| Rate for Payer: UHC Medicare Advantage |
$59.42
|
| Rate for Payer: UHCCP Medicaid |
$39.41
|
| Rate for Payer: UMR Bronson Commercial |
$45.54
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 00532
|
|
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 BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$5,993.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$3,895.45 |
| Rate for Payer: Aetna Commercial |
$2,792.36
|
| Rate for Payer: Aetna Medicare |
$2,167.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,792.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,000.74
|
| Rate for Payer: BCBS Complete |
$1,459.98
|
| Rate for Payer: BCBS MAPPO |
$2,083.85
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$3,158.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,083.85
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cofinity Commercial |
$2,792.36
|
| Rate for Payer: Cofinity Commercial |
$3,000.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,083.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,188.04
|
| Rate for Payer: Meridian Medicaid |
$1,459.98
|
| Rate for Payer: Nomi Health Commercial |
$2,500.62
|
| Rate for Payer: PACE SWMI |
$2,083.85
|
| Rate for Payer: PHP Commercial |
$2,917.39
|
| Rate for Payer: PHP Medicare Advantage |
$2,083.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,390.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,895.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,235.71
|
| Rate for Payer: Priority Health Medicare |
$2,083.85
|
| Rate for Payer: Priority Health Narrow Network |
$3,235.71
|
| Rate for Payer: Priority Health SBD |
$3,235.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,083.85
|
| Rate for Payer: UHC Medicare Advantage |
$2,083.85
|
| Rate for Payer: UHCCP Medicaid |
$1,390.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,756.78
|
|
|
PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION
|
Professional
|
Both
|
$5,240.00
|
|
|
Service Code
|
HCPCS 58953
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$3,406.00 |
| Rate for Payer: Aetna Commercial |
$2,578.79
|
| Rate for Payer: Aetna Medicare |
$2,001.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,578.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,771.24
|
| Rate for Payer: BCBS Complete |
$1,349.06
|
| Rate for Payer: BCBS MAPPO |
$1,924.47
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$2,921.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,924.47
|
| Rate for Payer: Cash Price |
$4,192.00
|
| Rate for Payer: Cash Price |
$4,192.00
|
| Rate for Payer: Cofinity Commercial |
$2,578.79
|
| Rate for Payer: Cofinity Commercial |
$2,771.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,924.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,020.69
|
| Rate for Payer: Meridian Medicaid |
$1,349.06
|
| Rate for Payer: Nomi Health Commercial |
$2,309.36
|
| Rate for Payer: PACE SWMI |
$1,924.47
|
| Rate for Payer: PHP Commercial |
$2,694.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,924.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,284.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,990.17
|
| Rate for Payer: Priority Health Medicare |
$1,924.47
|
| Rate for Payer: Priority Health Narrow Network |
$2,990.17
|
| Rate for Payer: Priority Health SBD |
$2,990.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,924.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,924.47
|
| Rate for Payer: UHCCP Medicaid |
$1,284.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,410.40
|
|
|
PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC
|
Professional
|
Both
|
$2,430.00
|
|
|
Service Code
|
HCPCS 58956
|
| Min. Negotiated Rate |
$502.94 |
| Max. Negotiated Rate |
$2,035.29 |
| Rate for Payer: Aetna Commercial |
$1,753.00
|
| Rate for Payer: Aetna Medicare |
$1,360.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,753.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,883.82
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCBS MAPPO |
$1,308.21
|
| Rate for Payer: BCBS Trust/PPO |
$502.94
|
| Rate for Payer: BCN Commercial |
$1,986.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,308.21
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cofinity Commercial |
$1,883.82
|
| Rate for Payer: Cofinity Commercial |
$1,753.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,308.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,373.62
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Nomi Health Commercial |
$1,569.85
|
| Rate for Payer: PACE SWMI |
$1,308.21
|
| Rate for Payer: PHP Commercial |
$1,831.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,308.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,579.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.29
|
| Rate for Payer: Priority Health Medicare |
$1,308.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,035.29
|
| Rate for Payer: Priority Health SBD |
$2,035.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,308.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,308.21
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,117.80
|
|
|
PR BUDESONIDE NON-COMP UNIT
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS J7626
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$5.85 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: Aetna Medicare |
$1.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.71
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$1.28
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Medicare Advantage |
$1.28
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$1.71
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.34
|
| Rate for Payer: Nomi Health Commercial |
$1.53
|
| Rate for Payer: PACE SWMI |
$1.28
|
| Rate for Payer: PHP Commercial |
$1.78
|
| Rate for Payer: PHP Medicare Advantage |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health Medicare |
$1.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.28
|
| Rate for Payer: UHC Medicare Advantage |
$1.28
|
| Rate for Payer: UMR Bronson Commercial |
$4.14
|
|
|
PR BURR HOLE FOR VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$1,871.00
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$493.73 |
| Max. Negotiated Rate |
$1,670.48 |
| Rate for Payer: Aetna Commercial |
$997.19
|
| Rate for Payer: Aetna Medicare |
$773.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,071.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$997.19
|
| Rate for Payer: BCBS Complete |
$518.42
|
| Rate for Payer: BCBS MAPPO |
$744.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$1,112.23
|
| Rate for Payer: BCN Medicare Advantage |
$744.17
|
| Rate for Payer: Cash Price |
$1,496.80
|
| Rate for Payer: Cash Price |
$1,496.80
|
| Rate for Payer: Cofinity Commercial |
$1,071.60
|
| Rate for Payer: Cofinity Commercial |
$997.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$781.38
|
| Rate for Payer: Meridian Medicaid |
$518.42
|
| Rate for Payer: Nomi Health Commercial |
$893.00
|
| Rate for Payer: PACE SWMI |
$744.17
|
| Rate for Payer: PHP Commercial |
$1,041.84
|
| Rate for Payer: PHP Medicare Advantage |
$744.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$744.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,309.75
|
| Rate for Payer: Priority Health SBD |
$1,309.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$744.17
|
| Rate for Payer: UHC Medicare Advantage |
$744.17
|
| Rate for Payer: UHCCP Medicaid |
$493.73
|
| Rate for Payer: UMR Bronson Commercial |
$860.66
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$2,554.00
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$1,660.10 |
| Rate for Payer: Aetna Commercial |
$486.63
|
| Rate for Payer: Aetna Medicare |
$377.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.95
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$363.16
|
| Rate for Payer: BCBS Trust/PPO |
$324.90
|
| Rate for Payer: BCN Commercial |
$745.05
|
| Rate for Payer: BCN Medicare Advantage |
$363.16
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cofinity Commercial |
$486.63
|
| Rate for Payer: Cofinity Commercial |
$522.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.32
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Nomi Health Commercial |
$435.79
|
| Rate for Payer: PACE SWMI |
$363.16
|
| Rate for Payer: PHP Commercial |
$508.42
|
| Rate for Payer: PHP Medicare Advantage |
$363.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,660.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.29
|
| Rate for Payer: Priority Health Medicare |
$363.16
|
| Rate for Payer: Priority Health Narrow Network |
$627.29
|
| Rate for Payer: Priority Health SBD |
$627.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.16
|
| Rate for Payer: UHC Medicare Advantage |
$363.16
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,174.84
|
|
|
PR BURR HOLE/TREPHINE STTL EXPL N/FLWD OTH SURG
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$570.41 |
| Max. Negotiated Rate |
$1,771.25 |
| Rate for Payer: Aetna Commercial |
$1,155.60
|
| Rate for Payer: Aetna Medicare |
$896.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.84
|
| Rate for Payer: BCBS Complete |
$598.93
|
| Rate for Payer: BCBS MAPPO |
$862.39
|
| Rate for Payer: BCBS Trust/PPO |
$918.19
|
| Rate for Payer: BCN Commercial |
$1,288.16
|
| Rate for Payer: BCN Medicare Advantage |
$862.39
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,155.60
|
| Rate for Payer: Cofinity Commercial |
$1,241.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.51
|
| Rate for Payer: Meridian Medicaid |
$598.93
|
| Rate for Payer: Nomi Health Commercial |
$1,034.87
|
| Rate for Payer: PACE SWMI |
$862.39
|
| Rate for Payer: PHP Commercial |
$1,207.35
|
| Rate for Payer: PHP Medicare Advantage |
$862.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,512.79
|
| Rate for Payer: Priority Health Medicare |
$862.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,512.79
|
| Rate for Payer: Priority Health SBD |
$1,512.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.39
|
| Rate for Payer: UHC Medicare Advantage |
$862.39
|
| Rate for Payer: UHCCP Medicaid |
$570.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,253.50
|
|
