|
PR COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 63066
|
| Min. Negotiated Rate |
$203.53 |
| Max. Negotiated Rate |
$1,394.25 |
| Rate for Payer: Aetna Commercial |
$272.73
|
| Rate for Payer: Aetna Medicare |
$211.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.73
|
| Rate for Payer: BCBS Complete |
$858.00
|
| Rate for Payer: BCBS MAPPO |
$203.53
|
| Rate for Payer: BCN Medicare Advantage |
$203.53
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cofinity Commercial |
$293.08
|
| Rate for Payer: Cofinity Commercial |
$272.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.71
|
| Rate for Payer: Nomi Health Commercial |
$244.24
|
| Rate for Payer: PACE SWMI |
$203.53
|
| Rate for Payer: PHP Commercial |
$284.94
|
| Rate for Payer: PHP Medicare Advantage |
$203.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.25
|
| Rate for Payer: Priority Health Medicare |
$203.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.53
|
| Rate for Payer: UHC Medicare Advantage |
$203.53
|
| Rate for Payer: UMR Bronson Commercial |
$986.70
|
|
|
PR COUDE TIP URINARY CATHETER
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4352
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$10.97 |
| Rate for Payer: Aetna Commercial |
$10.21
|
| Rate for Payer: Aetna Medicare |
$7.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.21
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$7.62
|
| Rate for Payer: BCN Medicare Advantage |
$7.62
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$10.97
|
| Rate for Payer: Cofinity Commercial |
$10.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.00
|
| Rate for Payer: Nomi Health Commercial |
$9.14
|
| Rate for Payer: PACE SWMI |
$7.62
|
| Rate for Payer: PHP Commercial |
$10.67
|
| Rate for Payer: PHP Medicare Advantage |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: Priority Health Medicare |
$7.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.62
|
| Rate for Payer: UHC Medicare Advantage |
$7.62
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
|
PR COUNSEL IMMUNE <21 16-30 M
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS G0314
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR COUNSEL IMMUNE <21 5-15 M
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0315
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR CPAP VENTILATION CPAP INITIATION&MGMT
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 94660
|
| Min. Negotiated Rate |
$34.73 |
| Max. Negotiated Rate |
$151.45 |
| Rate for Payer: Aetna Commercial |
$46.54
|
| Rate for Payer: Aetna Medicare |
$36.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.54
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: BCBS MAPPO |
$34.73
|
| Rate for Payer: BCN Medicare Advantage |
$34.73
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Cofinity Commercial |
$50.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.47
|
| Rate for Payer: Nomi Health Commercial |
$41.68
|
| Rate for Payer: PACE SWMI |
$34.73
|
| Rate for Payer: PHP Commercial |
$48.62
|
| Rate for Payer: PHP Medicare Advantage |
$34.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.45
|
| Rate for Payer: Priority Health Medicare |
$34.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.73
|
| Rate for Payer: UHC Medicare Advantage |
$34.73
|
| Rate for Payer: UMR Bronson Commercial |
$107.18
|
|
|
PR CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 99489
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$66.83 |
| Rate for Payer: Aetna Commercial |
$62.19
|
| Rate for Payer: Aetna Medicare |
$48.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.19
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$46.41
|
| Rate for Payer: BCN Medicare Advantage |
$46.41
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Cofinity Commercial |
$62.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: PACE SWMI |
$46.41
|
| Rate for Payer: PHP Commercial |
$64.97
|
| Rate for Payer: PHP Medicare Advantage |
$46.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Medicare |
$46.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.41
|
| Rate for Payer: UHC Medicare Advantage |
$46.41
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$10,302.00
|
|
|
Service Code
|
HCPCS 61698
|
| Min. Negotiated Rate |
$4,120.80 |
| Max. Negotiated Rate |
$6,696.30 |
| Rate for Payer: Aetna Commercial |
$6,138.85
|
| Rate for Payer: Aetna Medicare |
$4,764.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,596.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,138.85
|
| Rate for Payer: BCBS Complete |
$4,120.80
|
| Rate for Payer: BCBS MAPPO |
$4,581.23
|
| Rate for Payer: BCN Medicare Advantage |
$4,581.23
|
| Rate for Payer: Cash Price |
$8,241.60
|
| Rate for Payer: Cash Price |
$8,241.60
|
| Rate for Payer: Cofinity Commercial |
$6,596.97
|
| Rate for Payer: Cofinity Commercial |
$6,138.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,581.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,810.29
|
| Rate for Payer: Nomi Health Commercial |
$5,497.48
|
| Rate for Payer: PACE SWMI |
$4,581.23
|
| Rate for Payer: PHP Commercial |
$6,413.72
|
| Rate for Payer: PHP Medicare Advantage |
$4,581.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,696.30
|
| Rate for Payer: Priority Health Medicare |
$4,581.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,581.23
|
| Rate for Payer: UHC Medicare Advantage |
$4,581.23
|
| Rate for Payer: UMR Bronson Commercial |
$4,738.92
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 0055T
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: UMR Bronson Commercial |
$234.60
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 0054T
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$173.55 |
| Rate for Payer: Aetna Medicare |
$133.50
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 20985
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$200.32 |
| Rate for Payer: Aetna Commercial |
$186.41
|
| Rate for Payer: Aetna Medicare |
$144.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.41
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: BCBS MAPPO |
$139.11
|
| Rate for Payer: BCN Medicare Advantage |
$139.11
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$186.41
|
| Rate for Payer: Cofinity Commercial |
$200.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.07
|
| Rate for Payer: Nomi Health Commercial |
$166.93
|
| Rate for Payer: PACE SWMI |
$139.11
|
| Rate for Payer: PHP Commercial |
$194.75
|
| Rate for Payer: PHP Medicare Advantage |
$139.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health Medicare |
$139.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.11
|
| Rate for Payer: UHC Medicare Advantage |
$139.11
|
| Rate for Payer: UMR Bronson Commercial |
$130.18
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$200.32 |
| Rate for Payer: Aetna Commercial |
$186.41
|
| Rate for Payer: Aetna Medicare |
$144.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.41
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: BCBS MAPPO |
$139.11
|
| Rate for Payer: BCN Medicare Advantage |
$139.11
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$186.41
|
| Rate for Payer: Cofinity Commercial |
$200.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.07
|
| Rate for Payer: Nomi Health Commercial |
$166.93
|
| Rate for Payer: PACE SWMI |
$139.11
|
| Rate for Payer: PHP Commercial |
$194.75
|
| Rate for Payer: PHP Medicare Advantage |
$139.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health Medicare |
$139.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.11
|
| Rate for Payer: UHC Medicare Advantage |
$139.11
|
| Rate for Payer: UMR Bronson Commercial |
$130.18
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
IP
|
$283.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$124.52 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Aetna American Axle |
$183.95
|
| Rate for Payer: Aetna Commercial |
$240.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.95
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$243.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.40
|
| Rate for Payer: Healthscope Commercial |
$254.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.55
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health SBD |
$178.29
|
| Rate for Payer: UMR Bronson Commercial |
$124.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.25
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
OP
|
$283.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$104.71 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Aetna American Axle |
$183.95
|
| Rate for Payer: Aetna Commercial |
$240.55
|
| Rate for Payer: Aetna Medicare |
$141.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.95
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$243.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.40
|
| Rate for Payer: Healthscope Commercial |
$254.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.55
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health SBD |
$178.29
|
| Rate for Payer: UMR Bronson Commercial |
$104.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.25
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT
|
Professional
|
Both
|
$7,294.00
|
|
|
Service Code
|
HCPCS 61582
|
| Min. Negotiated Rate |
$2,917.60 |
| Max. Negotiated Rate |
$4,741.10 |
| Rate for Payer: Aetna Commercial |
$3,925.76
|
| Rate for Payer: Aetna Medicare |
$3,046.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,218.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,925.76
|
| Rate for Payer: BCBS Complete |
$2,917.60
|
| Rate for Payer: BCBS MAPPO |
$2,929.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,929.67
|
| Rate for Payer: Cash Price |
$5,835.20
|
| Rate for Payer: Cash Price |
$5,835.20
|
| Rate for Payer: Cofinity Commercial |
$4,218.72
|
| Rate for Payer: Cofinity Commercial |
$3,925.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,929.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,076.15
|
| Rate for Payer: Nomi Health Commercial |
$3,515.60
|
| Rate for Payer: PACE SWMI |
$2,929.67
|
| Rate for Payer: PHP Commercial |
$4,101.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,929.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,741.10
|
| Rate for Payer: Priority Health Medicare |
$2,929.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,929.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,929.67
|
| Rate for Payer: UMR Bronson Commercial |
$3,355.24
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE
|
Professional
|
Both
|
$7,968.00
|
|
|
Service Code
|
HCPCS 61583
|
| Min. Negotiated Rate |
$2,860.79 |
| Max. Negotiated Rate |
$5,179.20 |
| Rate for Payer: Aetna Commercial |
$3,833.46
|
| Rate for Payer: Aetna Medicare |
$2,975.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,119.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,833.46
|
| Rate for Payer: BCBS Complete |
$3,187.20
|
| Rate for Payer: BCBS MAPPO |
$2,860.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,860.79
|
| Rate for Payer: Cash Price |
$6,374.40
|
| Rate for Payer: Cash Price |
$6,374.40
|
| Rate for Payer: Cofinity Commercial |
$4,119.54
|
| Rate for Payer: Cofinity Commercial |
$3,833.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,860.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,003.83
|
| Rate for Payer: Nomi Health Commercial |
$3,432.95
|
| Rate for Payer: PACE SWMI |
$2,860.79
|
| Rate for Payer: PHP Commercial |
$4,005.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,860.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,179.20
|
| Rate for Payer: Priority Health Medicare |
$2,860.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,860.79
|
| Rate for Payer: UHC Medicare Advantage |
$2,860.79
|
| Rate for Payer: UMR Bronson Commercial |
$3,665.28
|
|
|
PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP
|
Professional
|
Both
|
$3,387.00
|
|
|
Service Code
|
HCPCS 61557
|
| Min. Negotiated Rate |
$1,354.80 |
| Max. Negotiated Rate |
$2,411.16 |
| Rate for Payer: Aetna Commercial |
$2,243.72
|
| Rate for Payer: Aetna Medicare |
$1,741.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,411.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,243.72
|
| Rate for Payer: BCBS Complete |
$1,354.80
|
| Rate for Payer: BCBS MAPPO |
$1,674.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,674.42
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cofinity Commercial |
$2,411.16
|
| Rate for Payer: Cofinity Commercial |
$2,243.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,674.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,758.14
|
| Rate for Payer: Nomi Health Commercial |
$2,009.30
|
| Rate for Payer: PACE SWMI |
$1,674.42
|
| Rate for Payer: PHP Commercial |
$2,344.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,674.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.55
|
| Rate for Payer: Priority Health Medicare |
$1,674.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,674.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,674.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,558.02
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN
|
Professional
|
Both
|
$9,394.00
|
|
|
Service Code
|
HCPCS 61570
|
| Min. Negotiated Rate |
$1,857.11 |
| Max. Negotiated Rate |
$6,106.10 |
| Rate for Payer: Aetna Commercial |
$2,488.53
|
| Rate for Payer: Aetna Medicare |
$1,931.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,674.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,488.53
|
| Rate for Payer: BCBS Complete |
$3,757.60
|
| Rate for Payer: BCBS MAPPO |
$1,857.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,857.11
|
| Rate for Payer: Cash Price |
$7,515.20
|
| Rate for Payer: Cash Price |
$7,515.20
|
| Rate for Payer: Cofinity Commercial |
$2,674.24
|
| Rate for Payer: Cofinity Commercial |
$2,488.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,857.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,949.97
|
| Rate for Payer: Nomi Health Commercial |
$2,228.53
|
| Rate for Payer: PACE SWMI |
$1,857.11
|
| Rate for Payer: PHP Commercial |
$2,599.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,857.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,106.10
|
| Rate for Payer: Priority Health Medicare |
$1,857.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,857.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,857.11
|
| Rate for Payer: UMR Bronson Commercial |
$4,321.24
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL
|
Professional
|
Both
|
$4,188.00
|
|
|
Service Code
|
HCPCS 61305
|
| Min. Negotiated Rate |
$1,675.20 |
| Max. Negotiated Rate |
$2,866.20 |
| Rate for Payer: Aetna Commercial |
$2,667.16
|
| Rate for Payer: Aetna Medicare |
$2,070.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,866.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,667.16
|
| Rate for Payer: BCBS Complete |
$1,675.20
|
| Rate for Payer: BCBS MAPPO |
$1,990.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,990.42
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cofinity Commercial |
$2,866.20
|
| Rate for Payer: Cofinity Commercial |
$2,667.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,990.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,089.94
|
| Rate for Payer: Nomi Health Commercial |
$2,388.50
|
| Rate for Payer: PACE SWMI |
$1,990.42
|
| Rate for Payer: PHP Commercial |
$2,786.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,990.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,722.20
|
| Rate for Payer: Priority Health Medicare |
$1,990.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,990.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,990.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,926.48
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL
|
Professional
|
Both
|
$5,463.00
|
|
|
Service Code
|
HCPCS 61304
|
| Min. Negotiated Rate |
$1,626.97 |
| Max. Negotiated Rate |
$3,550.95 |
| Rate for Payer: Aetna Commercial |
$2,180.14
|
| Rate for Payer: Aetna Medicare |
$1,692.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,342.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,180.14
|
| Rate for Payer: BCBS Complete |
$2,185.20
|
| Rate for Payer: BCBS MAPPO |
$1,626.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,626.97
|
| Rate for Payer: Cash Price |
$4,370.40
|
| Rate for Payer: Cash Price |
$4,370.40
|
| Rate for Payer: Cofinity Commercial |
$2,342.84
|
| Rate for Payer: Cofinity Commercial |
$2,180.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,626.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.32
|
| Rate for Payer: Nomi Health Commercial |
$1,952.36
|
| Rate for Payer: PACE SWMI |
$1,626.97
|
| Rate for Payer: PHP Commercial |
$2,277.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,626.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,550.95
|
| Rate for Payer: Priority Health Medicare |
$1,626.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,626.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,626.97
|
| Rate for Payer: UMR Bronson Commercial |
$2,512.98
|
|
|
PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN
|
Professional
|
Both
|
$8,983.00
|
|
|
Service Code
|
HCPCS 61571
|
| Min. Negotiated Rate |
$1,976.86 |
| Max. Negotiated Rate |
$5,838.95 |
| Rate for Payer: Aetna Commercial |
$2,648.99
|
| Rate for Payer: Aetna Medicare |
$2,055.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,846.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,648.99
|
| Rate for Payer: BCBS Complete |
$3,593.20
|
| Rate for Payer: BCBS MAPPO |
$1,976.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,976.86
|
| Rate for Payer: Cash Price |
$7,186.40
|
| Rate for Payer: Cash Price |
$7,186.40
|
| Rate for Payer: Cofinity Commercial |
$2,846.68
|
| Rate for Payer: Cofinity Commercial |
$2,648.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,976.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,075.70
|
| Rate for Payer: Nomi Health Commercial |
$2,372.23
|
| Rate for Payer: PACE SWMI |
$1,976.86
|
| Rate for Payer: PHP Commercial |
$2,767.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,976.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,838.95
|
| Rate for Payer: Priority Health Medicare |
$1,976.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,976.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,976.86
|
| Rate for Payer: UMR Bronson Commercial |
$4,132.18
|
|
|
PR CRANIECTOMY FOR OSTEOMYELITIS
|
Professional
|
Both
|
$5,360.00
|
|
|
Service Code
|
HCPCS 61501
|
| Min. Negotiated Rate |
$1,103.87 |
| Max. Negotiated Rate |
$3,484.00 |
| Rate for Payer: Aetna Commercial |
$1,479.19
|
| Rate for Payer: Aetna Medicare |
$1,148.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.19
|
| Rate for Payer: BCBS Complete |
$2,144.00
|
| Rate for Payer: BCBS MAPPO |
$1,103.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.87
|
| Rate for Payer: Cash Price |
$4,288.00
|
| Rate for Payer: Cash Price |
$4,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,589.57
|
| Rate for Payer: Cofinity Commercial |
$1,479.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,159.06
|
| Rate for Payer: Nomi Health Commercial |
$1,324.64
|
| Rate for Payer: PACE SWMI |
$1,103.87
|
| Rate for Payer: PHP Commercial |
$1,545.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,484.00
|
| Rate for Payer: Priority Health Medicare |
$1,103.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,103.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,103.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,465.60
|
|
|
PR CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NRV
|
Professional
|
Both
|
$6,301.00
|
|
|
Service Code
|
HCPCS 61460
|
| Min. Negotiated Rate |
$2,090.12 |
| Max. Negotiated Rate |
$4,095.65 |
| Rate for Payer: Aetna Commercial |
$2,800.76
|
| Rate for Payer: Aetna Medicare |
$2,173.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,009.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,800.76
|
| Rate for Payer: BCBS Complete |
$2,520.40
|
| Rate for Payer: BCBS MAPPO |
$2,090.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,090.12
|
| Rate for Payer: Cash Price |
$5,040.80
|
| Rate for Payer: Cash Price |
$5,040.80
|
| Rate for Payer: Cofinity Commercial |
$3,009.77
|
| Rate for Payer: Cofinity Commercial |
$2,800.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,090.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,194.63
|
| Rate for Payer: Nomi Health Commercial |
$2,508.14
|
| Rate for Payer: PACE SWMI |
$2,090.12
|
| Rate for Payer: PHP Commercial |
$2,926.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,090.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,095.65
|
| Rate for Payer: Priority Health Medicare |
$2,090.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,090.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,090.12
|
| Rate for Payer: UMR Bronson Commercial |
$2,898.46
|
|
|
PR CRANIECTOMY W/EXCISION TUMOR/OTH BONE LESION SKL
|
Professional
|
Both
|
$2,739.00
|
|
|
Service Code
|
HCPCS 61500
|
| Min. Negotiated Rate |
$1,095.60 |
| Max. Negotiated Rate |
$1,822.52 |
| Rate for Payer: Aetna Commercial |
$1,695.96
|
| Rate for Payer: Aetna Medicare |
$1,316.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,822.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,695.96
|
| Rate for Payer: BCBS Complete |
$1,095.60
|
| Rate for Payer: BCBS MAPPO |
$1,265.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,265.64
|
| Rate for Payer: Cash Price |
$2,191.20
|
| Rate for Payer: Cash Price |
$2,191.20
|
| Rate for Payer: Cofinity Commercial |
$1,822.52
|
| Rate for Payer: Cofinity Commercial |
$1,695.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,265.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,328.92
|
| Rate for Payer: Nomi Health Commercial |
$1,518.77
|
| Rate for Payer: PACE SWMI |
$1,265.64
|
| Rate for Payer: PHP Commercial |
$1,771.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,265.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,780.35
|
| Rate for Payer: Priority Health Medicare |
$1,265.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,265.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,265.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.94
|
|
|
PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ
|
Professional
|
Both
|
$5,312.00
|
|
|
Service Code
|
HCPCS 61580
|
| Min. Negotiated Rate |
$2,124.80 |
| Max. Negotiated Rate |
$3,452.80 |
| Rate for Payer: Aetna Commercial |
$3,174.67
|
| Rate for Payer: Aetna Medicare |
$2,463.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,411.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,174.67
|
| Rate for Payer: BCBS Complete |
$2,124.80
|
| Rate for Payer: BCBS MAPPO |
$2,369.16
|
| Rate for Payer: BCN Medicare Advantage |
$2,369.16
|
| Rate for Payer: Cash Price |
$4,249.60
|
| Rate for Payer: Cash Price |
$4,249.60
|
| Rate for Payer: Cofinity Commercial |
$3,411.59
|
| Rate for Payer: Cofinity Commercial |
$3,174.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,369.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,487.62
|
| Rate for Payer: Nomi Health Commercial |
$2,842.99
|
| Rate for Payer: PACE SWMI |
$2,369.16
|
| Rate for Payer: PHP Commercial |
$3,316.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,369.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.80
|
| Rate for Payer: Priority Health Medicare |
$2,369.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,369.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,369.16
|
| Rate for Payer: UMR Bronson Commercial |
$2,443.52
|
|
|
PR CRANIOPLASTY SKULL DEFECT <5 CM DIAMETER
|
Professional
|
Both
|
$5,342.00
|
|
|
Service Code
|
HCPCS 62140
|
| Min. Negotiated Rate |
$1,006.89 |
| Max. Negotiated Rate |
$3,472.30 |
| Rate for Payer: Aetna Commercial |
$1,349.23
|
| Rate for Payer: Aetna Medicare |
$1,047.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.23
|
| Rate for Payer: BCBS Complete |
$2,136.80
|
| Rate for Payer: BCBS MAPPO |
$1,006.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.89
|
| Rate for Payer: Cash Price |
$4,273.60
|
| Rate for Payer: Cash Price |
$4,273.60
|
| Rate for Payer: Cofinity Commercial |
$1,449.92
|
| Rate for Payer: Cofinity Commercial |
$1,349.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.23
|
| Rate for Payer: Nomi Health Commercial |
$1,208.27
|
| Rate for Payer: PACE SWMI |
$1,006.89
|
| Rate for Payer: PHP Commercial |
$1,409.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,472.30
|
| Rate for Payer: Priority Health Medicare |
$1,006.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,006.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,457.32
|
|
