|
PR BYP OTH/THN VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,253.00
|
|
|
Service Code
|
HCPCS 35661
|
| Min. Negotiated Rate |
$676.49 |
| Max. Negotiated Rate |
$1,686.42 |
| Rate for Payer: Aetna Commercial |
$1,389.38
|
| Rate for Payer: Aetna Medicare |
$1,078.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,493.06
|
| Rate for Payer: BCBS Complete |
$710.31
|
| Rate for Payer: BCBS MAPPO |
$1,036.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,546.17
|
| 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 |
$1,389.38
|
| Rate for Payer: Cofinity Commercial |
$1,493.06
|
| 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: Meridian Medicaid |
$710.31
|
| 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 Choice Medicaid |
$676.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,464.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,686.42
|
| Rate for Payer: Priority Health Medicare |
$1,036.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,686.42
|
| Rate for Payer: Priority Health SBD |
$1,686.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.85
|
| Rate for Payer: UHCCP Medicaid |
$676.49
|
| 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 |
$668.82 |
| Max. Negotiated Rate |
$1,669.93 |
| Rate for Payer: Aetna Commercial |
$1,375.97
|
| Rate for Payer: Aetna Medicare |
$1,067.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,478.65
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,026.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,054.49
|
| Rate for Payer: BCN Commercial |
$1,532.49
|
| 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 |
$1,375.97
|
| Rate for Payer: Cofinity Commercial |
$1,478.65
|
| 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: Meridian Medicaid |
$702.26
|
| 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 Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,669.93
|
| Rate for Payer: Priority Health Medicare |
$1,026.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,669.93
|
| Rate for Payer: Priority Health SBD |
$1,669.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,026.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.84
|
| Rate for Payer: UHCCP Medicaid |
$668.82
|
| 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 |
$732.08 |
| 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) |
$1,505.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,617.84
|
| Rate for Payer: BCBS Complete |
$768.68
|
| Rate for Payer: BCBS MAPPO |
$1,123.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.50
|
| Rate for Payer: BCN Commercial |
$1,673.23
|
| 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 |
$1,505.49
|
| Rate for Payer: Cofinity Commercial |
$1,617.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,123.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,179.68
|
| Rate for Payer: Meridian Medicaid |
$768.68
|
| 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 Choice Medicaid |
$732.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,978.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,828.41
|
| Rate for Payer: Priority Health Medicare |
$1,123.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,828.41
|
| Rate for Payer: Priority Health SBD |
$1,828.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,123.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,123.50
|
| Rate for Payer: UHCCP Medicaid |
$732.08
|
| 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 |
$703.75 |
| Max. Negotiated Rate |
$1,765.67 |
| Rate for Payer: Aetna Commercial |
$1,442.56
|
| Rate for Payer: Aetna Medicare |
$1,119.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,550.22
|
| Rate for Payer: BCBS Complete |
$738.94
|
| Rate for Payer: BCBS MAPPO |
$1,076.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.67
|
| Rate for Payer: BCN Commercial |
$1,621.43
|
| 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 |
$1,442.56
|
| Rate for Payer: Cofinity Commercial |
$1,550.22
|
| 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: Meridian Medicaid |
$738.94
|
| 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 Choice Medicaid |
$703.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,431.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.67
|
| Rate for Payer: Priority Health Medicare |
$1,076.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,765.67
|
| Rate for Payer: Priority Health SBD |
$1,765.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,076.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,076.54
|
| Rate for Payer: UHCCP Medicaid |
$703.75
|
| 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 |
$655.19 |
| Max. Negotiated Rate |
$2,601.35 |
| Rate for Payer: Aetna Commercial |
$1,350.12
|
| Rate for Payer: Aetna Medicare |
$1,047.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,450.87
|
| Rate for Payer: BCBS Complete |
$687.95
|
| Rate for Payer: BCBS MAPPO |
$1,007.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.35
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| 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 |
$1,350.12
|
| Rate for Payer: Cofinity Commercial |
$1,450.87
|
| 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: Meridian Medicaid |
$687.95
|
| 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 Choice Medicaid |
$655.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.64
|
| Rate for Payer: Priority Health Medicare |
$1,007.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,631.64
|
| Rate for Payer: Priority Health SBD |
$1,631.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,007.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,007.55
|
| Rate for Payer: UHCCP Medicaid |
$655.19
|
| 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 |
$921.44 |
| Max. Negotiated Rate |
$2,296.41 |
| Rate for Payer: Aetna Commercial |
$1,902.06
|
| Rate for Payer: Aetna Medicare |
$1,476.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,902.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.01
|
| Rate for Payer: BCBS Complete |
$967.51
|
| Rate for Payer: BCBS MAPPO |
$1,419.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$2,098.87
|
| 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 |
$1,902.06
|
| Rate for Payer: Cofinity Commercial |
$2,044.01
|
| 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: Meridian Medicaid |
$967.51
|
| 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 Choice Medicaid |
$921.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,296.41
|
| Rate for Payer: Priority Health Medicare |
$1,419.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,296.41
|
| Rate for Payer: Priority Health SBD |
$2,296.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,419.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,419.45
|
| Rate for Payer: UHCCP Medicaid |
$921.44
|
| 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 |
$826.01 |
| 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) |
$1,701.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,828.01
|
| Rate for Payer: BCBS Complete |
$867.31
|
| Rate for Payer: BCBS MAPPO |
$1,269.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,402.64
|
| Rate for Payer: BCN Commercial |
$1,886.79
|
| 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 |
$1,701.06
|
| Rate for Payer: Cofinity Commercial |
$1,828.01
|
| 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: Meridian Medicaid |
$867.31
|
| 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 Choice Medicaid |
$826.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,404.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,059.75
|
| Rate for Payer: Priority Health Medicare |
$1,269.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,059.75
|
| Rate for Payer: Priority Health SBD |
$2,059.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,269.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,269.45
|
| Rate for Payer: UHCCP Medicaid |
$826.01
|
| 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 |
$1,086.18 |
| Max. Negotiated Rate |
$4,118.44 |
| Rate for Payer: Aetna Commercial |
$3,386.10
|
| Rate for Payer: Aetna Medicare |
$2,628.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,386.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,638.79
|
| Rate for Payer: BCBS Complete |
$1,738.65
|
| Rate for Payer: BCBS MAPPO |
$2,526.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.18
|
| Rate for Payer: BCN Commercial |
$3,767.70
|
| 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 |
$3,386.10
|
| Rate for Payer: Cofinity Commercial |
$3,638.79
|
| 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: Meridian Medicaid |
$1,738.65
|
| 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 Choice Medicaid |
$1,655.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,576.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,118.44
|
| Rate for Payer: Priority Health Medicare |
$2,526.94
|
| Rate for Payer: Priority Health Narrow Network |
$4,118.44
|
| Rate for Payer: Priority Health SBD |
$4,118.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,526.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,526.94
|
| Rate for Payer: UHCCP Medicaid |
$1,655.86
|
| 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 |
$1,178.10 |
| Max. Negotiated Rate |
$2,929.82 |
| Rate for Payer: Aetna Commercial |
$2,405.27
|
| Rate for Payer: Aetna Medicare |
$1,866.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,405.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,584.77
|
| Rate for Payer: BCBS Complete |
$1,237.00
|
| Rate for Payer: BCBS MAPPO |
$1,794.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.66
|
| Rate for Payer: BCN Commercial |
$2,682.84
|
| 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 |
$2,405.27
|
| Rate for Payer: Cofinity Commercial |
$2,584.77
|
| 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: Meridian Medicaid |
$1,237.00
|
| 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 Choice Medicaid |
$1,178.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,929.82
|
| Rate for Payer: Priority Health Medicare |
$1,794.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,929.82
|
| Rate for Payer: Priority Health SBD |
$2,929.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,794.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,794.98
|
| Rate for Payer: UHCCP Medicaid |
$1,178.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,799.06
|
|
|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,136.00
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$1,100.98 |
| Max. Negotiated Rate |
$3,822.22 |
| Rate for Payer: Aetna Commercial |
$3,141.84
|
| Rate for Payer: Aetna Medicare |
$2,438.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,141.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,376.31
|
| Rate for Payer: BCBS Complete |
$1,614.08
|
| Rate for Payer: BCBS MAPPO |
$2,344.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$3,501.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,344.66
|
| Rate for Payer: Cash Price |
$4,108.80
|
| Rate for Payer: Cash Price |
$4,108.80
|
| Rate for Payer: Cofinity Commercial |
$3,141.84
|
| Rate for Payer: Cofinity Commercial |
$3,376.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,344.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,461.89
|
| Rate for Payer: Meridian Medicaid |
$1,614.08
|
| Rate for Payer: Nomi Health Commercial |
$2,813.59
|
| Rate for Payer: PACE SWMI |
$2,344.66
|
| Rate for Payer: PHP Commercial |
$3,282.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,344.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,537.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,338.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,822.22
|
| Rate for Payer: Priority Health Medicare |
$2,344.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,822.22
|
| Rate for Payer: Priority Health SBD |
$3,822.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,344.66
|
| Rate for Payer: UHC Medicare Advantage |
$2,344.66
|
| Rate for Payer: UHCCP Medicaid |
$1,537.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,362.56
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,602.00
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,126.86 |
| Max. Negotiated Rate |
$3,440.38 |
| Rate for Payer: Aetna Commercial |
$2,826.84
|
| Rate for Payer: Aetna Medicare |
$2,193.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,826.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,037.80
|
| Rate for Payer: BCBS Complete |
$1,453.05
|
| Rate for Payer: BCBS MAPPO |
$2,109.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.86
|
| Rate for Payer: BCN Commercial |
$3,149.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,109.58
|
| Rate for Payer: Cash Price |
$3,681.60
|
| Rate for Payer: Cash Price |
$3,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,826.84
|
| Rate for Payer: Cofinity Commercial |
$3,037.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,109.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,215.06
|
| Rate for Payer: Meridian Medicaid |
$1,453.05
|
| Rate for Payer: Nomi Health Commercial |
$2,531.50
|
| Rate for Payer: PACE SWMI |
$2,109.58
|
| Rate for Payer: PHP Commercial |
$2,953.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,109.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,991.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,440.38
|
| Rate for Payer: Priority Health Medicare |
$2,109.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,440.38
|
| Rate for Payer: Priority Health SBD |
$3,440.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,109.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,109.58
|
| Rate for Payer: UHCCP Medicaid |
$1,383.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,116.92
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$50.05 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.03
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$12.35 |
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$33.65 |
| Max. Negotiated Rate |
$189.13 |
| Rate for Payer: Aetna Commercial |
$45.09
|
| Rate for Payer: Aetna Medicare |
$35.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.46
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS MAPPO |
$33.65
|
| Rate for Payer: BCBS Trust/PPO |
$189.13
|
| Rate for Payer: BCN Commercial |
$63.04
|
| Rate for Payer: BCN Medicare Advantage |
$33.65
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$45.09
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.33
|
| Rate for Payer: Nomi Health Commercial |
$40.38
|
| Rate for Payer: PACE SWMI |
$33.65
|
| Rate for Payer: PHP Commercial |
$47.11
|
| Rate for Payer: PHP Medicare Advantage |
$33.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.94
|
| Rate for Payer: Priority Health Medicare |
$33.65
|
| Rate for Payer: Priority Health Narrow Network |
$47.94
|
| Rate for Payer: Priority Health SBD |
$47.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.65
|
| Rate for Payer: UHC Medicare Advantage |
$33.65
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$293.09 |
| Max. Negotiated Rate |
$2,419.61 |
| Rate for Payer: Aetna Commercial |
$572.35
|
| Rate for Payer: Aetna Medicare |
$444.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.07
|
| Rate for Payer: BCBS Complete |
$307.74
|
| Rate for Payer: BCBS MAPPO |
$427.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.61
|
| Rate for Payer: BCN Commercial |
$850.79
|
| Rate for Payer: BCN Medicare Advantage |
$427.13
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cofinity Commercial |
$572.35
|
| Rate for Payer: Cofinity Commercial |
$615.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.49
|
| Rate for Payer: Meridian Medicaid |
$307.74
|
| Rate for Payer: Nomi Health Commercial |
$512.56
|
| Rate for Payer: PACE SWMI |
$427.13
|
| Rate for Payer: PHP Commercial |
$597.98
|
| Rate for Payer: PHP Medicare Advantage |
$427.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$803.66
|
| Rate for Payer: Priority Health Medicare |
$427.13
|
| Rate for Payer: Priority Health Narrow Network |
$803.66
|
| Rate for Payer: Priority Health SBD |
$803.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.13
|
| Rate for Payer: UHC Medicare Advantage |
$427.13
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
| Rate for Payer: UMR Bronson Commercial |
$527.16
|
|
|
PR CANTHOTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 67715
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$523.55 |
| Rate for Payer: Aetna Commercial |
$134.76
|
| Rate for Payer: Aetna Medicare |
$104.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.82
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$100.57
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$388.50
|
| Rate for Payer: BCN Medicare Advantage |
$100.57
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$134.76
|
| Rate for Payer: Cofinity Commercial |
$144.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.60
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Nomi Health Commercial |
$120.68
|
| Rate for Payer: PACE SWMI |
$100.57
|
| Rate for Payer: PHP Commercial |
$140.80
|
| Rate for Payer: PHP Medicare Advantage |
$100.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.75
|
| Rate for Payer: Priority Health Medicare |
$100.57
|
| Rate for Payer: Priority Health Narrow Network |
$187.75
|
| Rate for Payer: Priority Health SBD |
$187.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.57
|
| Rate for Payer: UHC Medicare Advantage |
$100.57
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
| Rate for Payer: UMR Bronson Commercial |
$172.04
|
|
|
PR CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC
|
Professional
|
Both
|
$4,799.00
|
|
|
Service Code
|
HCPCS 27036
|
| Min. Negotiated Rate |
$197.75 |
| Max. Negotiated Rate |
$3,119.35 |
| Rate for Payer: Aetna Commercial |
$1,315.25
|
| Rate for Payer: Aetna Medicare |
$1,020.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.40
|
| Rate for Payer: BCBS Complete |
$694.88
|
| Rate for Payer: BCBS MAPPO |
$981.53
|
| Rate for Payer: BCBS Trust/PPO |
$197.75
|
| Rate for Payer: BCN Commercial |
$1,492.42
|
| Rate for Payer: BCN Medicare Advantage |
$981.53
|
| Rate for Payer: Cash Price |
$3,839.20
|
| Rate for Payer: Cash Price |
$3,839.20
|
| Rate for Payer: Cofinity Commercial |
$1,315.25
|
| Rate for Payer: Cofinity Commercial |
$1,413.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.61
|
| Rate for Payer: Meridian Medicaid |
$694.88
|
| Rate for Payer: Nomi Health Commercial |
$1,177.84
|
| Rate for Payer: PACE SWMI |
$981.53
|
| Rate for Payer: PHP Commercial |
$1,374.14
|
| Rate for Payer: PHP Medicare Advantage |
$981.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$661.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,119.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.31
|
| Rate for Payer: Priority Health Medicare |
$981.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,568.31
|
| Rate for Payer: Priority Health SBD |
$1,568.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.53
|
| Rate for Payer: UHC Medicare Advantage |
$981.53
|
| Rate for Payer: UHCCP Medicaid |
$661.79
|
| Rate for Payer: UMR Bronson Commercial |
$2,207.54
|
|
|
PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS
|
Professional
|
Both
|
$1,755.00
|
|
|
Service Code
|
HCPCS 25320
|
| Min. Negotiated Rate |
$400.98 |
| Max. Negotiated Rate |
$1,533.19 |
| Rate for Payer: Aetna Commercial |
$1,279.08
|
| Rate for Payer: Aetna Medicare |
$992.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.54
|
| Rate for Payer: BCBS Complete |
$681.24
|
| Rate for Payer: BCBS MAPPO |
$954.54
|
| Rate for Payer: BCBS Trust/PPO |
$400.98
|
| Rate for Payer: BCN Commercial |
$1,454.79
|
| Rate for Payer: BCN Medicare Advantage |
$954.54
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,279.08
|
| Rate for Payer: Cofinity Commercial |
$1,374.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.27
|
| Rate for Payer: Meridian Medicaid |
$681.24
|
| Rate for Payer: Nomi Health Commercial |
$1,145.45
|
| Rate for Payer: PACE SWMI |
$954.54
|
| Rate for Payer: PHP Commercial |
$1,336.36
|
| Rate for Payer: PHP Medicare Advantage |
$954.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.19
|
| Rate for Payer: Priority Health Medicare |
$954.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,533.19
|
| Rate for Payer: Priority Health SBD |
$1,533.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.54
|
| Rate for Payer: UHC Medicare Advantage |
$954.54
|
| Rate for Payer: UHCCP Medicaid |
$648.80
|
| Rate for Payer: UMR Bronson Commercial |
$807.30
|
|
|
PR CAPSULAR CONTRACTURE RELEASE
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 23020
|
| Min. Negotiated Rate |
$282.11 |
| Max. Negotiated Rate |
$1,306.50 |
| Rate for Payer: Aetna Commercial |
$895.48
|
| Rate for Payer: Aetna Medicare |
$695.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.31
|
| Rate for Payer: BCBS Complete |
$474.59
|
| Rate for Payer: BCBS MAPPO |
$668.27
|
| Rate for Payer: BCBS Trust/PPO |
$282.11
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: BCN Medicare Advantage |
$668.27
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cofinity Commercial |
$895.48
|
| Rate for Payer: Cofinity Commercial |
$962.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.68
|
| Rate for Payer: Meridian Medicaid |
$474.59
|
| Rate for Payer: Nomi Health Commercial |
$801.92
|
| Rate for Payer: PACE SWMI |
$668.27
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: PHP Medicare Advantage |
$668.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.61
|
| Rate for Payer: Priority Health Medicare |
$668.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.61
|
| Rate for Payer: Priority Health SBD |
$1,068.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.27
|
| Rate for Payer: UHC Medicare Advantage |
$668.27
|
| Rate for Payer: UHCCP Medicaid |
$451.99
|
| Rate for Payer: UMR Bronson Commercial |
$924.60
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$440.70 |
| Max. Negotiated Rate |
$1,128.45 |
| Rate for Payer: Aetna Commercial |
$849.90
|
| Rate for Payer: Aetna Medicare |
$659.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.32
|
| Rate for Payer: BCBS Complete |
$462.74
|
| Rate for Payer: BCBS MAPPO |
$634.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$1,021.83
|
| Rate for Payer: BCN Medicare Advantage |
$634.25
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$849.90
|
| Rate for Payer: Cofinity Commercial |
$913.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.96
|
| Rate for Payer: Meridian Medicaid |
$462.74
|
| Rate for Payer: Nomi Health Commercial |
$761.10
|
| Rate for Payer: PACE SWMI |
$634.25
|
| Rate for Payer: PHP Commercial |
$887.95
|
| Rate for Payer: PHP Medicare Advantage |
$634.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.97
|
| Rate for Payer: Priority Health Medicare |
$634.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.97
|
| Rate for Payer: Priority Health SBD |
$1,060.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.25
|
| Rate for Payer: UHC Medicare Advantage |
$634.25
|
| Rate for Payer: UHCCP Medicaid |
$440.70
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$437.50 |
| Max. Negotiated Rate |
$1,062.94 |
| Rate for Payer: Aetna Commercial |
$843.74
|
| Rate for Payer: Aetna Medicare |
$654.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.71
|
| Rate for Payer: BCBS Complete |
$459.38
|
| Rate for Payer: BCBS MAPPO |
$629.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$629.66
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$843.74
|
| Rate for Payer: Cofinity Commercial |
$906.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.14
|
| Rate for Payer: Meridian Medicaid |
$459.38
|
| Rate for Payer: Nomi Health Commercial |
$755.59
|
| Rate for Payer: PACE SWMI |
$629.66
|
| Rate for Payer: PHP Commercial |
$881.52
|
| Rate for Payer: PHP Medicare Advantage |
$629.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,054.87
|
| Rate for Payer: Priority Health Medicare |
$629.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,054.87
|
| Rate for Payer: Priority Health SBD |
$1,054.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.66
|
| Rate for Payer: UHC Medicare Advantage |
$629.66
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 28270
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$706.63 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.06
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCBS Trust/PPO |
$265.73
|
| Rate for Payer: BCN Commercial |
$706.63
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Commercial |
$448.25
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.47
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: Priority Health Narrow Network |
$515.47
|
| Rate for Payer: Priority Health SBD |
$515.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
| Rate for Payer: UMR Bronson Commercial |
$368.92
|
|
|
PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 26516
|
| Min. Negotiated Rate |
$480.95 |
| Max. Negotiated Rate |
$3,178.25 |
| Rate for Payer: Aetna Commercial |
$935.52
|
| Rate for Payer: Aetna Medicare |
$726.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.52
|
| Rate for Payer: BCBS Complete |
$505.00
|
| Rate for Payer: BCBS MAPPO |
$698.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,178.25
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: BCN Medicare Advantage |
$698.15
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$1,005.34
|
| Rate for Payer: Cofinity Commercial |
$935.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.06
|
| Rate for Payer: Meridian Medicaid |
$505.00
|
| Rate for Payer: Nomi Health Commercial |
$837.78
|
| Rate for Payer: PACE SWMI |
$698.15
|
| Rate for Payer: PHP Commercial |
$977.41
|
| Rate for Payer: PHP Medicare Advantage |
$698.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.53
|
| Rate for Payer: Priority Health Medicare |
$698.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.53
|
| Rate for Payer: Priority Health SBD |
$1,150.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.15
|
| Rate for Payer: UHC Medicare Advantage |
$698.15
|
| Rate for Payer: UHCCP Medicaid |
$480.95
|
| Rate for Payer: UMR Bronson Commercial |
$921.38
|
|
|
PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON
|
Professional
|
Both
|
$2,867.00
|
|
|
Service Code
|
HCPCS 23450
|
| Min. Negotiated Rate |
$146.45 |
| Max. Negotiated Rate |
$1,863.55 |
| Rate for Payer: Aetna Commercial |
$1,223.33
|
| Rate for Payer: Aetna Medicare |
$949.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.62
|
| Rate for Payer: BCBS Complete |
$645.00
|
| Rate for Payer: BCBS MAPPO |
$912.93
|
| Rate for Payer: BCBS Trust/PPO |
$146.45
|
| Rate for Payer: BCN Commercial |
$1,388.33
|
| Rate for Payer: BCN Medicare Advantage |
$912.93
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,223.33
|
| Rate for Payer: Cofinity Commercial |
$1,314.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$958.58
|
| Rate for Payer: Meridian Medicaid |
$645.00
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: PACE SWMI |
$912.93
|
| Rate for Payer: PHP Commercial |
$1,278.10
|
| Rate for Payer: PHP Medicare Advantage |
$912.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,455.86
|
| Rate for Payer: Priority Health Medicare |
$912.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,455.86
|
| Rate for Payer: Priority Health SBD |
$1,455.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$912.93
|
| Rate for Payer: UHC Medicare Advantage |
$912.93
|
| Rate for Payer: UHCCP Medicaid |
$614.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,318.82
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 23462
|
| Min. Negotiated Rate |
$313.71 |
| Max. Negotiated Rate |
$2,219.10 |
| Rate for Payer: Aetna Commercial |
$1,379.50
|
| Rate for Payer: Aetna Medicare |
$1,070.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.45
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCBS MAPPO |
$1,029.48
|
| Rate for Payer: BCBS Trust/PPO |
$313.71
|
| Rate for Payer: BCN Commercial |
$1,564.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.48
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.50
|
| Rate for Payer: Cofinity Commercial |
$1,482.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.95
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Nomi Health Commercial |
$1,235.38
|
| Rate for Payer: PACE SWMI |
$1,029.48
|
| Rate for Payer: PHP Commercial |
$1,441.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.57
|
| Rate for Payer: Priority Health Medicare |
$1,029.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,640.57
|
| Rate for Payer: Priority Health SBD |
$1,640.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,029.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.48
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.44
|
|
