|
PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN
|
Professional
|
Both
|
$3,434.00
|
|
|
Service Code
|
HCPCS 50825
|
| Min. Negotiated Rate |
$1,373.60 |
| Max. Negotiated Rate |
$2,258.48 |
| Rate for Payer: Aetna Commercial |
$2,101.64
|
| Rate for Payer: Aetna Medicare |
$1,631.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,258.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,101.64
|
| Rate for Payer: BCBS Complete |
$1,373.60
|
| Rate for Payer: BCBS MAPPO |
$1,568.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.39
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Cofinity Commercial |
$2,258.48
|
| Rate for Payer: Cofinity Commercial |
$2,101.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.81
|
| Rate for Payer: Nomi Health Commercial |
$1,882.07
|
| Rate for Payer: PACE SWMI |
$1,568.39
|
| Rate for Payer: PHP Commercial |
$2,195.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,232.10
|
| Rate for Payer: Priority Health Medicare |
$1,568.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,579.64
|
|
|
PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX
|
Professional
|
Both
|
$4,041.00
|
|
|
Service Code
|
HCPCS 44316
|
| Min. Negotiated Rate |
$1,376.44 |
| Max. Negotiated Rate |
$2,626.65 |
| Rate for Payer: Aetna Commercial |
$1,844.43
|
| Rate for Payer: Aetna Medicare |
$1,431.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,982.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.43
|
| Rate for Payer: BCBS Complete |
$1,616.40
|
| Rate for Payer: BCBS MAPPO |
$1,376.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,376.44
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Cofinity Commercial |
$1,982.07
|
| Rate for Payer: Cofinity Commercial |
$1,844.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,376.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,445.26
|
| Rate for Payer: Nomi Health Commercial |
$1,651.73
|
| Rate for Payer: PACE SWMI |
$1,376.44
|
| Rate for Payer: PHP Commercial |
$1,927.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,376.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,626.65
|
| Rate for Payer: Priority Health Medicare |
$1,376.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,376.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,376.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,858.86
|
|
|
PR CONT INTRAOP NEURO MONITOR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS G0453
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.89
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$29.77
|
| Rate for Payer: BCN Medicare Advantage |
$29.77
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.26
|
| Rate for Payer: Nomi Health Commercial |
$35.72
|
| Rate for Payer: PACE SWMI |
$29.77
|
| Rate for Payer: PHP Commercial |
$41.68
|
| Rate for Payer: PHP Medicare Advantage |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$29.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.77
|
| Rate for Payer: UHC Medicare Advantage |
$29.77
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 95251
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$48.10 |
| Rate for Payer: Aetna Commercial |
$43.83
|
| Rate for Payer: Aetna Medicare |
$34.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.83
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS MAPPO |
$32.71
|
| Rate for Payer: BCN Medicare Advantage |
$32.71
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$47.10
|
| Rate for Payer: Cofinity Commercial |
$43.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.35
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE SWMI |
$32.71
|
| Rate for Payer: PHP Commercial |
$45.79
|
| Rate for Payer: PHP Medicare Advantage |
$32.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Medicare |
$32.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.71
|
| Rate for Payer: UHC Medicare Advantage |
$32.71
|
| Rate for Payer: UMR Bronson Commercial |
$34.04
|
|
|
PR CONTINUOUS INHALATION TREATMENT 1ST HR
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 94644
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$73.66 |
| Rate for Payer: Aetna Commercial |
$68.54
|
| Rate for Payer: Aetna Medicare |
$53.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.54
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$51.15
|
| Rate for Payer: BCN Medicare Advantage |
$51.15
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$73.66
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.71
|
| Rate for Payer: Nomi Health Commercial |
$61.38
|
| Rate for Payer: PACE SWMI |
$51.15
|
| Rate for Payer: PHP Commercial |
$71.61
|
| Rate for Payer: PHP Medicare Advantage |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$51.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.15
|
| Rate for Payer: UHC Medicare Advantage |
$51.15
|
| Rate for Payer: UMR Bronson Commercial |
$38.64
|
|
|
PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 49465
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.94 |
| Rate for Payer: Aetna Commercial |
$38.10
|
| Rate for Payer: Aetna Medicare |
$29.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.10
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$28.43
|
| Rate for Payer: BCN Medicare Advantage |
$28.43
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$38.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.85
|
| Rate for Payer: Nomi Health Commercial |
$34.12
|
| Rate for Payer: PACE SWMI |
$28.43
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$28.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$28.43
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 30903
|
| Min. Negotiated Rate |
$75.09 |
| Max. Negotiated Rate |
$257.40 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: Aetna Medicare |
$78.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.62
|
| Rate for Payer: BCBS Complete |
$158.40
|
| Rate for Payer: BCBS MAPPO |
$75.09
|
| Rate for Payer: BCN Medicare Advantage |
$75.09
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cofinity Commercial |
$108.13
|
| Rate for Payer: Cofinity Commercial |
$100.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.84
|
| Rate for Payer: Nomi Health Commercial |
$90.11
|
| Rate for Payer: PACE SWMI |
$75.09
|
| Rate for Payer: PHP Commercial |
$105.13
|
| Rate for Payer: PHP Medicare Advantage |
$75.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.40
|
| Rate for Payer: Priority Health Medicare |
$75.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.09
|
| Rate for Payer: UHC Medicare Advantage |
$75.09
|
| Rate for Payer: UMR Bronson Commercial |
$182.16
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$54.49 |
| Max. Negotiated Rate |
$171.60 |
| Rate for Payer: Aetna Commercial |
$73.02
|
| Rate for Payer: Aetna Medicare |
$56.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.02
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS MAPPO |
$54.49
|
| Rate for Payer: BCN Medicare Advantage |
$54.49
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$78.47
|
| Rate for Payer: Cofinity Commercial |
$73.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.21
|
| Rate for Payer: Nomi Health Commercial |
$65.39
|
| Rate for Payer: PACE SWMI |
$54.49
|
| Rate for Payer: PHP Commercial |
$76.29
|
| Rate for Payer: PHP Medicare Advantage |
$54.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$54.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.49
|
| Rate for Payer: UHC Medicare Advantage |
$54.49
|
| Rate for Payer: UMR Bronson Commercial |
$121.44
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$130.40 |
| Max. Negotiated Rate |
$222.06 |
| Rate for Payer: Aetna Commercial |
$206.64
|
| Rate for Payer: Aetna Medicare |
$160.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.64
|
| Rate for Payer: BCBS Complete |
$130.40
|
| Rate for Payer: BCBS MAPPO |
$154.21
|
| Rate for Payer: BCN Medicare Advantage |
$154.21
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$222.06
|
| Rate for Payer: Cofinity Commercial |
$206.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.92
|
| Rate for Payer: Nomi Health Commercial |
$185.05
|
| Rate for Payer: PACE SWMI |
$154.21
|
| Rate for Payer: PHP Commercial |
$215.89
|
| Rate for Payer: PHP Medicare Advantage |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health Medicare |
$154.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.21
|
| Rate for Payer: UHC Medicare Advantage |
$154.21
|
| Rate for Payer: UMR Bronson Commercial |
$149.96
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$138.32 |
| Max. Negotiated Rate |
$1,362.40 |
| Rate for Payer: Aetna Commercial |
$185.35
|
| Rate for Payer: Aetna Medicare |
$143.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.35
|
| Rate for Payer: BCBS Complete |
$838.40
|
| Rate for Payer: BCBS MAPPO |
$138.32
|
| Rate for Payer: BCN Medicare Advantage |
$138.32
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cofinity Commercial |
$199.18
|
| Rate for Payer: Cofinity Commercial |
$185.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.24
|
| Rate for Payer: Nomi Health Commercial |
$165.98
|
| Rate for Payer: PACE SWMI |
$138.32
|
| Rate for Payer: PHP Commercial |
$193.65
|
| Rate for Payer: PHP Medicare Advantage |
$138.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.40
|
| Rate for Payer: Priority Health Medicare |
$138.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.32
|
| Rate for Payer: UHC Medicare Advantage |
$138.32
|
| Rate for Payer: UMR Bronson Commercial |
$964.16
|
|
|
PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,455.00
|
|
|
Service Code
|
HCPCS 27132
|
| Min. Negotiated Rate |
$1,382.00 |
| Max. Negotiated Rate |
$2,315.46 |
| Rate for Payer: Aetna Commercial |
$2,154.67
|
| Rate for Payer: Aetna Medicare |
$1,672.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,315.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,154.67
|
| Rate for Payer: BCBS Complete |
$1,382.00
|
| Rate for Payer: BCBS MAPPO |
$1,607.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,607.96
|
| Rate for Payer: Cash Price |
$2,764.00
|
| Rate for Payer: Cash Price |
$2,764.00
|
| Rate for Payer: Cofinity Commercial |
$2,315.46
|
| Rate for Payer: Cofinity Commercial |
$2,154.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,607.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,688.36
|
| Rate for Payer: Nomi Health Commercial |
$1,929.55
|
| Rate for Payer: PACE SWMI |
$1,607.96
|
| Rate for Payer: PHP Commercial |
$2,251.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,607.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.75
|
| Rate for Payer: Priority Health Medicare |
$1,607.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,607.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,607.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,589.30
|
|
|
PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 23415
|
| Min. Negotiated Rate |
$677.03 |
| Max. Negotiated Rate |
$1,153.75 |
| Rate for Payer: Aetna Commercial |
$907.22
|
| Rate for Payer: Aetna Medicare |
$704.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.22
|
| Rate for Payer: BCBS Complete |
$710.00
|
| Rate for Payer: BCBS MAPPO |
$677.03
|
| Rate for Payer: BCN Medicare Advantage |
$677.03
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$974.92
|
| Rate for Payer: Cofinity Commercial |
$907.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.88
|
| Rate for Payer: Nomi Health Commercial |
$812.44
|
| Rate for Payer: PACE SWMI |
$677.03
|
| Rate for Payer: PHP Commercial |
$947.84
|
| Rate for Payer: PHP Medicare Advantage |
$677.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health Medicare |
$677.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.03
|
| Rate for Payer: UHC Medicare Advantage |
$677.03
|
| Rate for Payer: UMR Bronson Commercial |
$816.50
|
|
|
PR CORDOCENTESIS INTRAUTERINE
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 59012
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$348.40 |
| Rate for Payer: Aetna Commercial |
$263.19
|
| Rate for Payer: Aetna Medicare |
$204.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.19
|
| Rate for Payer: BCBS Complete |
$214.40
|
| Rate for Payer: BCBS MAPPO |
$196.41
|
| Rate for Payer: BCN Medicare Advantage |
$196.41
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Commercial |
$282.83
|
| Rate for Payer: Cofinity Commercial |
$263.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.23
|
| Rate for Payer: Nomi Health Commercial |
$235.69
|
| Rate for Payer: PACE SWMI |
$196.41
|
| Rate for Payer: PHP Commercial |
$274.97
|
| Rate for Payer: PHP Medicare Advantage |
$196.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.40
|
| Rate for Payer: Priority Health Medicare |
$196.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.41
|
| Rate for Payer: UHC Medicare Advantage |
$196.41
|
| Rate for Payer: UMR Bronson Commercial |
$246.56
|
|
|
PR CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 32408
|
| Min. Negotiated Rate |
$143.42 |
| Max. Negotiated Rate |
$240.50 |
| Rate for Payer: Aetna Commercial |
$192.18
|
| Rate for Payer: Aetna Medicare |
$149.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.18
|
| Rate for Payer: BCBS Complete |
$148.00
|
| Rate for Payer: BCBS MAPPO |
$143.42
|
| Rate for Payer: BCN Medicare Advantage |
$143.42
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$206.52
|
| Rate for Payer: Cofinity Commercial |
$192.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.59
|
| Rate for Payer: Nomi Health Commercial |
$172.10
|
| Rate for Payer: PACE SWMI |
$143.42
|
| Rate for Payer: PHP Commercial |
$200.79
|
| Rate for Payer: PHP Medicare Advantage |
$143.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health Medicare |
$143.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.42
|
| Rate for Payer: UHC Medicare Advantage |
$143.42
|
| Rate for Payer: UMR Bronson Commercial |
$170.20
|
|
|
PR CORF RELATED SERV 15 MINS EA
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0409
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$30.67 |
| Rate for Payer: Aetna Commercial |
$28.54
|
| Rate for Payer: Aetna Medicare |
$22.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.54
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$21.30
|
| Rate for Payer: BCN Medicare Advantage |
$21.30
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$30.67
|
| Rate for Payer: Cofinity Commercial |
$28.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.36
|
| Rate for Payer: Nomi Health Commercial |
$25.56
|
| Rate for Payer: PACE SWMI |
$21.30
|
| Rate for Payer: PHP Commercial |
$29.82
|
| Rate for Payer: PHP Medicare Advantage |
$21.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$21.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.30
|
| Rate for Payer: UHC Medicare Advantage |
$21.30
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$4,046.00
|
|
|
Service Code
|
HCPCS 33510
|
| Min. Negotiated Rate |
$1,618.40 |
| Max. Negotiated Rate |
$2,668.46 |
| Rate for Payer: Aetna Commercial |
$2,483.15
|
| Rate for Payer: Aetna Medicare |
$1,927.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,668.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,483.15
|
| Rate for Payer: BCBS Complete |
$1,618.40
|
| Rate for Payer: BCBS MAPPO |
$1,853.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,853.10
|
| Rate for Payer: Cash Price |
$3,236.80
|
| Rate for Payer: Cash Price |
$3,236.80
|
| Rate for Payer: Cofinity Commercial |
$2,668.46
|
| Rate for Payer: Cofinity Commercial |
$2,483.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,853.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,945.76
|
| Rate for Payer: Nomi Health Commercial |
$2,223.72
|
| Rate for Payer: PACE SWMI |
$1,853.10
|
| Rate for Payer: PHP Commercial |
$2,594.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,853.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,629.90
|
| Rate for Payer: Priority Health Medicare |
$1,853.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,853.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,853.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,861.16
|
|
|
PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$4,444.00
|
|
|
Service Code
|
HCPCS 33511
|
| Min. Negotiated Rate |
$1,777.60 |
| Max. Negotiated Rate |
$2,931.57 |
| Rate for Payer: Aetna Commercial |
$2,727.99
|
| Rate for Payer: Aetna Medicare |
$2,117.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,931.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,727.99
|
| Rate for Payer: BCBS Complete |
$1,777.60
|
| Rate for Payer: BCBS MAPPO |
$2,035.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,035.81
|
| Rate for Payer: Cash Price |
$3,555.20
|
| Rate for Payer: Cash Price |
$3,555.20
|
| Rate for Payer: Cofinity Commercial |
$2,931.57
|
| Rate for Payer: Cofinity Commercial |
$2,727.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,035.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,137.60
|
| Rate for Payer: Nomi Health Commercial |
$2,442.97
|
| Rate for Payer: PACE SWMI |
$2,035.81
|
| Rate for Payer: PHP Commercial |
$2,850.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,035.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,888.60
|
| Rate for Payer: Priority Health Medicare |
$2,035.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,035.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,035.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,044.24
|
|
|
PR CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$9,917.00
|
|
|
Service Code
|
HCPCS 33512
|
| Min. Negotiated Rate |
$2,317.44 |
| Max. Negotiated Rate |
$6,446.05 |
| Rate for Payer: Aetna Commercial |
$3,105.37
|
| Rate for Payer: Aetna Medicare |
$2,410.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,337.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,105.37
|
| Rate for Payer: BCBS Complete |
$3,966.80
|
| Rate for Payer: BCBS MAPPO |
$2,317.44
|
| Rate for Payer: BCN Medicare Advantage |
$2,317.44
|
| Rate for Payer: Cash Price |
$7,933.60
|
| Rate for Payer: Cash Price |
$7,933.60
|
| Rate for Payer: Cofinity Commercial |
$3,337.11
|
| Rate for Payer: Cofinity Commercial |
$3,105.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,317.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,433.31
|
| Rate for Payer: Nomi Health Commercial |
$2,780.93
|
| Rate for Payer: PACE SWMI |
$2,317.44
|
| Rate for Payer: PHP Commercial |
$3,244.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,317.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,446.05
|
| Rate for Payer: Priority Health Medicare |
$2,317.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,317.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,317.44
|
| Rate for Payer: UMR Bronson Commercial |
$4,561.82
|
|
|
PR CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$10,120.00
|
|
|
Service Code
|
HCPCS 33513
|
| Min. Negotiated Rate |
$2,368.98 |
| Max. Negotiated Rate |
$6,578.00 |
| Rate for Payer: Aetna Commercial |
$3,174.43
|
| Rate for Payer: Aetna Medicare |
$2,463.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,411.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,174.43
|
| Rate for Payer: BCBS Complete |
$4,048.00
|
| Rate for Payer: BCBS MAPPO |
$2,368.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,368.98
|
| Rate for Payer: Cash Price |
$8,096.00
|
| Rate for Payer: Cash Price |
$8,096.00
|
| Rate for Payer: Cofinity Commercial |
$3,411.33
|
| Rate for Payer: Cofinity Commercial |
$3,174.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,368.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,487.43
|
| Rate for Payer: Nomi Health Commercial |
$2,842.78
|
| Rate for Payer: PACE SWMI |
$2,368.98
|
| Rate for Payer: PHP Commercial |
$3,316.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,368.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,578.00
|
| Rate for Payer: Priority Health Medicare |
$2,368.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,368.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,368.98
|
| Rate for Payer: UMR Bronson Commercial |
$4,655.20
|
|
|
PR CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$11,382.00
|
|
|
Service Code
|
HCPCS 33516
|
| Min. Negotiated Rate |
$2,579.30 |
| Max. Negotiated Rate |
$7,398.30 |
| Rate for Payer: Aetna Commercial |
$3,456.26
|
| Rate for Payer: Aetna Medicare |
$2,682.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,456.26
|
| Rate for Payer: BCBS Complete |
$4,552.80
|
| Rate for Payer: BCBS MAPPO |
$2,579.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,579.30
|
| Rate for Payer: Cash Price |
$9,105.60
|
| Rate for Payer: Cash Price |
$9,105.60
|
| Rate for Payer: Cofinity Commercial |
$3,714.19
|
| Rate for Payer: Cofinity Commercial |
$3,456.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,579.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,708.26
|
| Rate for Payer: Nomi Health Commercial |
$3,095.16
|
| Rate for Payer: PACE SWMI |
$2,579.30
|
| Rate for Payer: PHP Commercial |
$3,611.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,579.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,398.30
|
| Rate for Payer: Priority Health Medicare |
$2,579.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,579.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,579.30
|
| Rate for Payer: UMR Bronson Commercial |
$5,235.72
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 33517
|
| Min. Negotiated Rate |
$179.08 |
| Max. Negotiated Rate |
$522.60 |
| Rate for Payer: Aetna Commercial |
$239.97
|
| Rate for Payer: Aetna Medicare |
$186.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.97
|
| Rate for Payer: BCBS Complete |
$321.60
|
| Rate for Payer: BCBS MAPPO |
$179.08
|
| Rate for Payer: BCN Medicare Advantage |
$179.08
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$257.88
|
| Rate for Payer: Cofinity Commercial |
$239.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.03
|
| Rate for Payer: Nomi Health Commercial |
$214.90
|
| Rate for Payer: PACE SWMI |
$179.08
|
| Rate for Payer: PHP Commercial |
$250.71
|
| Rate for Payer: PHP Medicare Advantage |
$179.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health Medicare |
$179.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.08
|
| Rate for Payer: UHC Medicare Advantage |
$179.08
|
| Rate for Payer: UMR Bronson Commercial |
$369.84
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN
|
Professional
|
Both
|
$1,325.00
|
|
|
Service Code
|
HCPCS 33518
|
| Min. Negotiated Rate |
$394.31 |
| Max. Negotiated Rate |
$861.25 |
| Rate for Payer: Aetna Commercial |
$528.38
|
| Rate for Payer: Aetna Medicare |
$410.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.38
|
| Rate for Payer: BCBS Complete |
$530.00
|
| Rate for Payer: BCBS MAPPO |
$394.31
|
| Rate for Payer: BCN Medicare Advantage |
$394.31
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cofinity Commercial |
$567.81
|
| Rate for Payer: Cofinity Commercial |
$528.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.03
|
| Rate for Payer: Nomi Health Commercial |
$473.17
|
| Rate for Payer: PACE SWMI |
$394.31
|
| Rate for Payer: PHP Commercial |
$552.03
|
| Rate for Payer: PHP Medicare Advantage |
$394.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.25
|
| Rate for Payer: Priority Health Medicare |
$394.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.31
|
| Rate for Payer: UHC Medicare Advantage |
$394.31
|
| Rate for Payer: UMR Bronson Commercial |
$609.50
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 33519
|
| Min. Negotiated Rate |
$520.05 |
| Max. Negotiated Rate |
$1,254.50 |
| Rate for Payer: Aetna Commercial |
$696.87
|
| Rate for Payer: Aetna Medicare |
$540.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.87
|
| Rate for Payer: BCBS Complete |
$772.00
|
| Rate for Payer: BCBS MAPPO |
$520.05
|
| Rate for Payer: BCN Medicare Advantage |
$520.05
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$748.87
|
| Rate for Payer: Cofinity Commercial |
$696.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$546.05
|
| Rate for Payer: Nomi Health Commercial |
$624.06
|
| Rate for Payer: PACE SWMI |
$520.05
|
| Rate for Payer: PHP Commercial |
$728.07
|
| Rate for Payer: PHP Medicare Advantage |
$520.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.50
|
| Rate for Payer: Priority Health Medicare |
$520.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.05
|
| Rate for Payer: UHC Medicare Advantage |
$520.05
|
| Rate for Payer: UMR Bronson Commercial |
$887.80
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN
|
Professional
|
Both
|
$2,591.00
|
|
|
Service Code
|
HCPCS 33521
|
| Min. Negotiated Rate |
$624.42 |
| Max. Negotiated Rate |
$1,684.15 |
| Rate for Payer: Aetna Commercial |
$836.72
|
| Rate for Payer: Aetna Medicare |
$649.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.72
|
| Rate for Payer: BCBS Complete |
$1,036.40
|
| Rate for Payer: BCBS MAPPO |
$624.42
|
| Rate for Payer: BCN Medicare Advantage |
$624.42
|
| Rate for Payer: Cash Price |
$2,072.80
|
| Rate for Payer: Cash Price |
$2,072.80
|
| Rate for Payer: Cofinity Commercial |
$899.16
|
| Rate for Payer: Cofinity Commercial |
$836.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.64
|
| Rate for Payer: Nomi Health Commercial |
$749.30
|
| Rate for Payer: PACE SWMI |
$624.42
|
| Rate for Payer: PHP Commercial |
$874.19
|
| Rate for Payer: PHP Medicare Advantage |
$624.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.15
|
| Rate for Payer: Priority Health Medicare |
$624.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.42
|
| Rate for Payer: UHC Medicare Advantage |
$624.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,191.86
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN
|
Professional
|
Both
|
$3,292.00
|
|
|
Service Code
|
HCPCS 33522
|
| Min. Negotiated Rate |
$701.26 |
| Max. Negotiated Rate |
$2,139.80 |
| Rate for Payer: Aetna Commercial |
$939.69
|
| Rate for Payer: Aetna Medicare |
$729.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.81
|
| Rate for Payer: BCBS Complete |
$1,316.80
|
| Rate for Payer: BCBS MAPPO |
$701.26
|
| Rate for Payer: BCN Medicare Advantage |
$701.26
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cash Price |
$2,633.60
|
| Rate for Payer: Cofinity Commercial |
$939.69
|
| Rate for Payer: Cofinity Commercial |
$1,009.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$841.51
|
| Rate for Payer: PACE SWMI |
$701.26
|
| Rate for Payer: PHP Commercial |
$981.76
|
| Rate for Payer: PHP Medicare Advantage |
$701.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,139.80
|
| Rate for Payer: Priority Health Medicare |
$701.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.26
|
| Rate for Payer: UHC Medicare Advantage |
$701.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,514.32
|
|
