|
PR BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 35506
|
| Min. Negotiated Rate |
$797.05 |
| Max. Negotiated Rate |
$1,983.70 |
| Rate for Payer: Aetna Commercial |
$1,646.39
|
| Rate for Payer: Aetna Medicare |
$1,277.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,769.26
|
| Rate for Payer: BCBS Complete |
$836.90
|
| Rate for Payer: BCBS MAPPO |
$1,228.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,044.98
|
| Rate for Payer: BCN Commercial |
$1,814.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,228.65
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,646.39
|
| Rate for Payer: Cofinity Commercial |
$1,769.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,228.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,290.08
|
| Rate for Payer: Meridian Medicaid |
$836.90
|
| Rate for Payer: Nomi Health Commercial |
$1,474.38
|
| Rate for Payer: PACE SWMI |
$1,228.65
|
| Rate for Payer: PHP Commercial |
$1,720.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,228.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,983.70
|
| Rate for Payer: Priority Health Medicare |
$1,228.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,983.70
|
| Rate for Payer: Priority Health SBD |
$1,983.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,228.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,228.65
|
| Rate for Payer: UHCCP Medicaid |
$797.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,227.28
|
|
|
PR BYPASS W/VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$3,083.00
|
|
|
Service Code
|
HCPCS 35501
|
| Min. Negotiated Rate |
$844.22 |
| Max. Negotiated Rate |
$2,271.95 |
| Rate for Payer: Aetna Commercial |
$1,883.17
|
| Rate for Payer: Aetna Medicare |
$1,461.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,883.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,023.70
|
| Rate for Payer: BCBS Complete |
$957.00
|
| Rate for Payer: BCBS MAPPO |
$1,405.35
|
| Rate for Payer: BCBS Trust/PPO |
$844.22
|
| Rate for Payer: BCN Commercial |
$2,078.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,405.35
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cofinity Commercial |
$1,883.17
|
| Rate for Payer: Cofinity Commercial |
$2,023.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,405.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,475.62
|
| Rate for Payer: Meridian Medicaid |
$957.00
|
| Rate for Payer: Nomi Health Commercial |
$1,686.42
|
| Rate for Payer: PACE SWMI |
$1,405.35
|
| Rate for Payer: PHP Commercial |
$1,967.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,405.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$911.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,271.95
|
| Rate for Payer: Priority Health Medicare |
$1,405.35
|
| Rate for Payer: Priority Health Narrow Network |
$2,271.95
|
| Rate for Payer: Priority Health SBD |
$2,271.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,405.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,405.35
|
| Rate for Payer: UHCCP Medicaid |
$911.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,418.18
|
|
|
PR BYPASS W/VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,413.00
|
|
|
Service Code
|
HCPCS 35558
|
| Min. Negotiated Rate |
$721.66 |
| Max. Negotiated Rate |
$1,930.53 |
| Rate for Payer: Aetna Commercial |
$1,569.50
|
| Rate for Payer: Aetna Medicare |
$1,218.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,569.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,686.63
|
| Rate for Payer: BCBS Complete |
$802.01
|
| Rate for Payer: BCBS MAPPO |
$1,171.27
|
| Rate for Payer: BCBS Trust/PPO |
$721.66
|
| Rate for Payer: BCN Commercial |
$1,759.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.27
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cofinity Commercial |
$1,569.50
|
| Rate for Payer: Cofinity Commercial |
$1,686.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,229.83
|
| Rate for Payer: Meridian Medicaid |
$802.01
|
| Rate for Payer: Nomi Health Commercial |
$1,405.52
|
| Rate for Payer: PACE SWMI |
$1,171.27
|
| Rate for Payer: PHP Commercial |
$1,639.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,930.53
|
| Rate for Payer: Priority Health Medicare |
$1,171.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,930.53
|
| Rate for Payer: Priority Health SBD |
$1,930.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,171.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,171.27
|
| Rate for Payer: UHCCP Medicaid |
$763.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.98
|
|
|
PR BYPASS W/VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,750.00
|
|
|
Service Code
|
HCPCS 35556
|
| Min. Negotiated Rate |
$869.68 |
| Max. Negotiated Rate |
$2,167.72 |
| Rate for Payer: Aetna Commercial |
$1,790.04
|
| Rate for Payer: Aetna Medicare |
$1,389.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,923.62
|
| Rate for Payer: BCBS Complete |
$913.16
|
| Rate for Payer: BCBS MAPPO |
$1,335.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.54
|
| Rate for Payer: BCN Commercial |
$1,986.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,335.85
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,790.04
|
| Rate for Payer: Cofinity Commercial |
$1,923.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,335.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,402.64
|
| Rate for Payer: Meridian Medicaid |
$913.16
|
| Rate for Payer: Nomi Health Commercial |
$1,603.02
|
| Rate for Payer: PACE SWMI |
$1,335.85
|
| Rate for Payer: PHP Commercial |
$1,870.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,335.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,167.72
|
| Rate for Payer: Priority Health Medicare |
$1,335.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,167.72
|
| Rate for Payer: Priority Health SBD |
$2,167.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,335.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,335.85
|
| Rate for Payer: UHCCP Medicaid |
$869.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,265.00
|
|
|
PR BYPASS W/VEIN HEPATORENAL
|
Professional
|
Both
|
$3,934.00
|
|
|
Service Code
|
HCPCS 35535
|
| Min. Negotiated Rate |
$638.71 |
| Max. Negotiated Rate |
$2,962.26 |
| Rate for Payer: Aetna Commercial |
$2,457.08
|
| Rate for Payer: Aetna Medicare |
$1,906.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,457.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,640.44
|
| Rate for Payer: BCBS Complete |
$1,247.97
|
| Rate for Payer: BCBS MAPPO |
$1,833.64
|
| Rate for Payer: BCBS Trust/PPO |
$638.71
|
| Rate for Payer: BCN Commercial |
$2,709.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,833.64
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cofinity Commercial |
$2,457.08
|
| Rate for Payer: Cofinity Commercial |
$2,640.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,833.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,925.32
|
| Rate for Payer: Meridian Medicaid |
$1,247.97
|
| Rate for Payer: Nomi Health Commercial |
$2,200.37
|
| Rate for Payer: PACE SWMI |
$1,833.64
|
| Rate for Payer: PHP Commercial |
$2,567.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,833.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,188.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,557.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,962.26
|
| Rate for Payer: Priority Health Medicare |
$1,833.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,962.26
|
| Rate for Payer: Priority Health SBD |
$2,962.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,833.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,833.64
|
| Rate for Payer: UHCCP Medicaid |
$1,188.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,809.64
|
|
|
PR BYPASS W/VEIN ILIOFEMORAL
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 35565
|
| Min. Negotiated Rate |
$817.92 |
| Max. Negotiated Rate |
$2,043.28 |
| Rate for Payer: Aetna Commercial |
$1,683.29
|
| Rate for Payer: Aetna Medicare |
$1,306.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.91
|
| Rate for Payer: BCBS Complete |
$858.82
|
| Rate for Payer: BCBS MAPPO |
$1,256.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: BCN Commercial |
$1,867.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.19
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$1,683.29
|
| Rate for Payer: Cofinity Commercial |
$1,808.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.00
|
| Rate for Payer: Meridian Medicaid |
$858.82
|
| Rate for Payer: Nomi Health Commercial |
$1,507.43
|
| Rate for Payer: PACE SWMI |
$1,256.19
|
| Rate for Payer: PHP Commercial |
$1,758.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$817.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,690.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,043.28
|
| Rate for Payer: Priority Health Medicare |
$1,256.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,043.28
|
| Rate for Payer: Priority Health SBD |
$2,043.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.19
|
| Rate for Payer: UHCCP Medicaid |
$817.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.46
|
|
|
PR BYPASS W/VEIN ILIOILIAC
|
Professional
|
Both
|
$2,815.00
|
|
|
Service Code
|
HCPCS 35563
|
| Min. Negotiated Rate |
$828.57 |
| Max. Negotiated Rate |
$2,063.49 |
| Rate for Payer: Aetna Commercial |
$1,709.92
|
| Rate for Payer: Aetna Medicare |
$1,327.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.53
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS MAPPO |
$1,276.06
|
| Rate for Payer: BCBS Trust/PPO |
$927.69
|
| Rate for Payer: BCN Commercial |
$1,886.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.06
|
| Rate for Payer: Cash Price |
$2,252.00
|
| Rate for Payer: Cash Price |
$2,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,709.92
|
| Rate for Payer: Cofinity Commercial |
$1,837.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.86
|
| Rate for Payer: Meridian Medicaid |
$870.00
|
| Rate for Payer: Nomi Health Commercial |
$1,531.27
|
| Rate for Payer: PACE SWMI |
$1,276.06
|
| Rate for Payer: PHP Commercial |
$1,786.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,829.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,063.49
|
| Rate for Payer: Priority Health Medicare |
$1,276.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,063.49
|
| Rate for Payer: Priority Health SBD |
$2,063.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.06
|
| Rate for Payer: UHCCP Medicaid |
$828.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,294.90
|
|
|
PR BYPASS W/VEIN SPLENORENAL
|
Professional
|
Both
|
$4,905.00
|
|
|
Service Code
|
HCPCS 35536
|
| Min. Negotiated Rate |
$997.96 |
| Max. Negotiated Rate |
$3,188.25 |
| Rate for Payer: Aetna Commercial |
$2,182.52
|
| Rate for Payer: Aetna Medicare |
$1,693.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,182.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,345.40
|
| Rate for Payer: BCBS Complete |
$1,109.08
|
| Rate for Payer: BCBS MAPPO |
$1,628.75
|
| Rate for Payer: BCBS Trust/PPO |
$997.96
|
| Rate for Payer: BCN Commercial |
$2,408.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,628.75
|
| Rate for Payer: Cash Price |
$3,924.00
|
| Rate for Payer: Cash Price |
$3,924.00
|
| Rate for Payer: Cofinity Commercial |
$2,182.52
|
| Rate for Payer: Cofinity Commercial |
$2,345.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,628.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,710.19
|
| Rate for Payer: Meridian Medicaid |
$1,109.08
|
| Rate for Payer: Nomi Health Commercial |
$1,954.50
|
| Rate for Payer: PACE SWMI |
$1,628.75
|
| Rate for Payer: PHP Commercial |
$2,280.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,628.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,056.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,630.93
|
| Rate for Payer: Priority Health Medicare |
$1,628.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,630.93
|
| Rate for Payer: Priority Health SBD |
$2,630.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,628.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,628.75
|
| Rate for Payer: UHCCP Medicaid |
$1,056.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,256.30
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-BRACHIAL
|
Professional
|
Both
|
$2,544.00
|
|
|
Service Code
|
HCPCS 35512
|
| Min. Negotiated Rate |
$754.02 |
| Max. Negotiated Rate |
$1,878.40 |
| Rate for Payer: Aetna Commercial |
$1,556.88
|
| Rate for Payer: Aetna Medicare |
$1,208.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,673.06
|
| Rate for Payer: BCBS Complete |
$791.72
|
| Rate for Payer: BCBS MAPPO |
$1,161.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.84
|
| Rate for Payer: BCN Commercial |
$1,716.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,161.85
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cofinity Commercial |
$1,556.88
|
| Rate for Payer: Cofinity Commercial |
$1,673.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,161.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,219.94
|
| Rate for Payer: Meridian Medicaid |
$791.72
|
| Rate for Payer: Nomi Health Commercial |
$1,394.22
|
| Rate for Payer: PACE SWMI |
$1,161.85
|
| Rate for Payer: PHP Commercial |
$1,626.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,161.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,878.40
|
| Rate for Payer: Priority Health Medicare |
$1,161.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,878.40
|
| Rate for Payer: Priority Health SBD |
$1,878.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,161.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,161.85
|
| Rate for Payer: UHCCP Medicaid |
$754.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.24
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$4,185.00
|
|
|
Service Code
|
HCPCS 35511
|
| Min. Negotiated Rate |
$700.77 |
| Max. Negotiated Rate |
$2,720.25 |
| Rate for Payer: Aetna Commercial |
$1,446.86
|
| Rate for Payer: Aetna Medicare |
$1,122.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,554.84
|
| Rate for Payer: BCBS Complete |
$735.81
|
| Rate for Payer: BCBS MAPPO |
$1,079.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.69
|
| Rate for Payer: BCN Commercial |
$1,596.02
|
| 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 |
$1,446.86
|
| Rate for Payer: Cofinity Commercial |
$1,554.84
|
| 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: Meridian Medicaid |
$735.81
|
| 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 Choice Medicaid |
$700.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,745.46
|
| Rate for Payer: Priority Health Medicare |
$1,079.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,745.46
|
| Rate for Payer: Priority Health SBD |
$1,745.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,079.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,079.75
|
| Rate for Payer: UHCCP Medicaid |
$700.77
|
| 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 |
$218.75 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$453.59
|
| Rate for Payer: Aetna Medicare |
$352.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.44
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$338.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$500.41
|
| 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 |
$453.59
|
| Rate for Payer: Cofinity Commercial |
$487.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.42
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| 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 Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.25
|
| Rate for Payer: Priority Health Medicare |
$338.50
|
| Rate for Payer: Priority Health Narrow Network |
$547.25
|
| Rate for Payer: Priority Health SBD |
$547.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.50
|
| Rate for Payer: UHC Medicare Advantage |
$338.50
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
| 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 |
$254.96 |
| Max. Negotiated Rate |
$1,813.65 |
| Rate for Payer: Aetna Commercial |
$529.37
|
| Rate for Payer: Aetna Medicare |
$410.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.87
|
| Rate for Payer: BCBS Complete |
$267.71
|
| Rate for Payer: BCBS MAPPO |
$395.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.65
|
| Rate for Payer: BCN Commercial |
$581.53
|
| 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 |
$529.37
|
| Rate for Payer: Cofinity Commercial |
$568.87
|
| 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: Meridian Medicaid |
$267.71
|
| 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 Choice Medicaid |
$254.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.94
|
| Rate for Payer: Priority Health Medicare |
$395.05
|
| Rate for Payer: Priority Health Narrow Network |
$633.94
|
| Rate for Payer: Priority Health SBD |
$633.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.05
|
| Rate for Payer: UHC Medicare Advantage |
$395.05
|
| Rate for Payer: UHCCP Medicaid |
$254.96
|
| 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 |
$803.02 |
| 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) |
$2,134.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,293.69
|
| Rate for Payer: BCBS Complete |
$1,087.16
|
| Rate for Payer: BCBS MAPPO |
$1,592.84
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$2,368.62
|
| 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 |
$2,134.41
|
| Rate for Payer: Cofinity Commercial |
$2,293.69
|
| 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: Meridian Medicaid |
$1,087.16
|
| 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 Choice Medicaid |
$1,035.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,584.66
|
| Rate for Payer: Priority Health Medicare |
$1,592.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,584.66
|
| Rate for Payer: Priority Health SBD |
$2,584.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,592.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,592.84
|
| Rate for Payer: UHCCP Medicaid |
$1,035.39
|
| 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 |
$599.38 |
| Max. Negotiated Rate |
$1,493.36 |
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Aetna Commercial |
$1,244.18
|
| Rate for Payer: Aetna Medicare |
$965.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,337.03
|
| Rate for Payer: BCBS Complete |
$629.35
|
| Rate for Payer: BCBS MAPPO |
$928.49
|
| Rate for Payer: BCBS Trust/PPO |
$745.96
|
| Rate for Payer: BCN Commercial |
$1,368.30
|
| Rate for Payer: BCN Medicare Advantage |
$928.49
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cofinity Commercial |
$1,244.18
|
| Rate for Payer: Cofinity Commercial |
$1,337.03
|
| 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: Meridian Medicaid |
$629.35
|
| 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 Choice Medicaid |
$599.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,493.36
|
| Rate for Payer: Priority Health Medicare |
$928.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.36
|
| Rate for Payer: Priority Health SBD |
$1,493.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.49
|
| Rate for Payer: UHC Medicare Advantage |
$928.49
|
| Rate for Payer: UHCCP Medicaid |
$599.38
|
| 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 |
$1,061.81 |
| 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) |
$2,186.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,350.14
|
| Rate for Payer: BCBS Complete |
$1,114.90
|
| Rate for Payer: BCBS MAPPO |
$1,632.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.92
|
| Rate for Payer: BCN Commercial |
$2,430.68
|
| 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 |
$2,186.93
|
| Rate for Payer: Cofinity Commercial |
$2,350.14
|
| 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: Meridian Medicaid |
$1,114.90
|
| 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 Choice Medicaid |
$1,061.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,758.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,652.74
|
| Rate for Payer: Priority Health Medicare |
$1,632.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,652.74
|
| Rate for Payer: Priority Health SBD |
$2,652.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,632.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,632.04
|
| Rate for Payer: UHCCP Medicaid |
$1,061.81
|
| 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 |
$1,090.35 |
| 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) |
$2,244.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.39
|
| Rate for Payer: BCBS Complete |
$1,144.87
|
| Rate for Payer: BCBS MAPPO |
$1,675.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: BCN Commercial |
$2,473.20
|
| 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 |
$2,244.86
|
| Rate for Payer: Cofinity Commercial |
$2,412.39
|
| 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: Meridian Medicaid |
$1,144.87
|
| 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 Choice Medicaid |
$1,090.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,212.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,699.01
|
| Rate for Payer: Priority Health Medicare |
$1,675.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,699.01
|
| Rate for Payer: Priority Health SBD |
$2,699.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,675.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,675.27
|
| Rate for Payer: UHCCP Medicaid |
$1,090.35
|
| 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 |
$1,152.33 |
| 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) |
$2,375.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,552.53
|
| Rate for Payer: BCBS Complete |
$1,209.95
|
| Rate for Payer: BCBS MAPPO |
$1,772.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.50
|
| Rate for Payer: BCN Commercial |
$2,633.48
|
| 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 |
$2,375.27
|
| Rate for Payer: Cofinity Commercial |
$2,552.53
|
| 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: Meridian Medicaid |
$1,209.95
|
| 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 Choice Medicaid |
$1,152.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,292.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,883.56
|
| Rate for Payer: Priority Health Medicare |
$1,772.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,883.56
|
| Rate for Payer: Priority Health SBD |
$2,883.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,772.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,772.59
|
| Rate for Payer: UHCCP Medicaid |
$1,152.33
|
| 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 |
$958.29 |
| Max. Negotiated Rate |
$2,412.88 |
| Rate for Payer: Aetna Commercial |
$1,973.63
|
| Rate for Payer: Aetna Medicare |
$1,531.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,120.92
|
| Rate for Payer: BCBS Complete |
$1,006.20
|
| Rate for Payer: BCBS MAPPO |
$1,472.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,996.45
|
| Rate for Payer: BCN Commercial |
$2,211.76
|
| 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 |
$1,973.63
|
| Rate for Payer: Cofinity Commercial |
$2,120.92
|
| 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: Meridian Medicaid |
$1,006.20
|
| 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 Choice Medicaid |
$958.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,993.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,412.88
|
| Rate for Payer: Priority Health Medicare |
$1,472.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,412.88
|
| Rate for Payer: Priority Health SBD |
$2,412.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,472.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.86
|
| Rate for Payer: UHCCP Medicaid |
$958.29
|
| 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 |
$801.58 |
| Max. Negotiated Rate |
$2,582.01 |
| Rate for Payer: Aetna Commercial |
$2,141.75
|
| Rate for Payer: Aetna Medicare |
$1,662.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,141.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,301.58
|
| Rate for Payer: BCBS Complete |
$1,088.50
|
| Rate for Payer: BCBS MAPPO |
$1,598.32
|
| Rate for Payer: BCBS Trust/PPO |
$801.58
|
| Rate for Payer: BCN Commercial |
$2,362.27
|
| 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 |
$2,141.75
|
| Rate for Payer: Cofinity Commercial |
$2,301.58
|
| 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: Meridian Medicaid |
$1,088.50
|
| 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 Choice Medicaid |
$1,036.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,362.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,582.01
|
| Rate for Payer: Priority Health Medicare |
$1,598.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,582.01
|
| Rate for Payer: Priority Health SBD |
$2,582.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,598.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,598.32
|
| Rate for Payer: UHCCP Medicaid |
$1,036.67
|
| 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 |
$639.43 |
| Max. Negotiated Rate |
$1,592.29 |
| Rate for Payer: Aetna Commercial |
$1,319.48
|
| Rate for Payer: Aetna Medicare |
$1,024.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,319.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.95
|
| Rate for Payer: BCBS Complete |
$671.40
|
| Rate for Payer: BCBS MAPPO |
$984.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCN Commercial |
$1,456.75
|
| 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 |
$1,319.48
|
| Rate for Payer: Cofinity Commercial |
$1,417.95
|
| 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: Meridian Medicaid |
$671.40
|
| 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 Choice Medicaid |
$639.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,592.29
|
| Rate for Payer: Priority Health Medicare |
$984.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,592.29
|
| Rate for Payer: Priority Health SBD |
$1,592.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.69
|
| Rate for Payer: UHC Medicare Advantage |
$984.69
|
| Rate for Payer: UHCCP Medicaid |
$639.43
|
| 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 |
$683.73 |
| 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) |
$1,407.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.50
|
| Rate for Payer: BCBS Complete |
$717.92
|
| Rate for Payer: BCBS MAPPO |
$1,050.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.78
|
| Rate for Payer: BCN Commercial |
$1,565.23
|
| 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 |
$1,407.47
|
| Rate for Payer: Cofinity Commercial |
$1,512.50
|
| 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: Meridian Medicaid |
$717.92
|
| 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 Choice Medicaid |
$683.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,707.16
|
| Rate for Payer: Priority Health Medicare |
$1,050.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,707.16
|
| Rate for Payer: Priority Health SBD |
$1,707.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,050.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,050.35
|
| Rate for Payer: UHCCP Medicaid |
$683.73
|
| 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 |
$853.07 |
| 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) |
$1,756.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.12
|
| Rate for Payer: BCBS Complete |
$895.72
|
| Rate for Payer: BCBS MAPPO |
$1,310.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.11
|
| Rate for Payer: BCN Commercial |
$1,943.47
|
| 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 |
$1,756.07
|
| Rate for Payer: Cofinity Commercial |
$1,887.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,376.02
|
| Rate for Payer: Meridian Medicaid |
$895.72
|
| 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 Choice Medicaid |
$853.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,122.51
|
| Rate for Payer: Priority Health Medicare |
$1,310.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,122.51
|
| Rate for Payer: Priority Health SBD |
$2,122.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,310.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,310.50
|
| Rate for Payer: UHCCP Medicaid |
$853.07
|
| 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 |
$733.57 |
| Max. Negotiated Rate |
$1,832.13 |
| Rate for Payer: Aetna Commercial |
$1,509.03
|
| Rate for Payer: Aetna Medicare |
$1,171.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.64
|
| Rate for Payer: BCBS Complete |
$770.25
|
| Rate for Payer: BCBS MAPPO |
$1,126.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.77
|
| Rate for Payer: BCN Commercial |
$1,673.72
|
| 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 |
$1,509.03
|
| Rate for Payer: Cofinity Commercial |
$1,621.64
|
| 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: Meridian Medicaid |
$770.25
|
| 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 Choice Medicaid |
$733.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,832.13
|
| Rate for Payer: Priority Health Medicare |
$1,126.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,832.13
|
| Rate for Payer: Priority Health SBD |
$1,832.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,126.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,126.14
|
| Rate for Payer: UHCCP Medicaid |
$733.57
|
| 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 |
$879.05 |
| Max. Negotiated Rate |
$2,180.48 |
| Rate for Payer: Aetna Commercial |
$1,809.75
|
| Rate for Payer: Aetna Medicare |
$1,404.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,944.81
|
| Rate for Payer: BCBS Complete |
$923.00
|
| Rate for Payer: BCBS MAPPO |
$1,350.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.45
|
| Rate for Payer: BCN Commercial |
$2,000.16
|
| 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 |
$1,809.75
|
| Rate for Payer: Cofinity Commercial |
$1,944.81
|
| 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: Meridian Medicaid |
$923.00
|
| 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 Choice Medicaid |
$879.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,180.48
|
| Rate for Payer: Priority Health Medicare |
$1,350.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,180.48
|
| Rate for Payer: Priority Health SBD |
$2,180.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,350.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,350.56
|
| Rate for Payer: UHCCP Medicaid |
$879.05
|
| 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 |
$802.16 |
| 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) |
$1,644.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,767.15
|
| Rate for Payer: BCBS Complete |
$842.27
|
| Rate for Payer: BCBS MAPPO |
$1,227.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.71
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| 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 |
$1,644.43
|
| Rate for Payer: Cofinity Commercial |
$1,767.15
|
| 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: Meridian Medicaid |
$842.27
|
| 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 Choice Medicaid |
$802.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,005.51
|
| Rate for Payer: Priority Health Medicare |
$1,227.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,005.51
|
| Rate for Payer: Priority Health SBD |
$2,005.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,227.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,227.19
|
| Rate for Payer: UHCCP Medicaid |
$802.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,935.68
|
|
