|
PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER
|
Professional
|
Both
|
$6,362.00
|
|
|
Service Code
|
HCPCS 62141
|
| Min. Negotiated Rate |
$1,131.89 |
| Max. Negotiated Rate |
$4,135.30 |
| Rate for Payer: Aetna Commercial |
$1,516.73
|
| Rate for Payer: Aetna Medicare |
$1,177.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.73
|
| Rate for Payer: BCBS Complete |
$2,544.80
|
| Rate for Payer: BCBS MAPPO |
$1,131.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.89
|
| Rate for Payer: Cash Price |
$5,089.60
|
| Rate for Payer: Cash Price |
$5,089.60
|
| Rate for Payer: Cofinity Commercial |
$1,629.92
|
| Rate for Payer: Cofinity Commercial |
$1,516.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,188.48
|
| Rate for Payer: Nomi Health Commercial |
$1,358.27
|
| Rate for Payer: PACE SWMI |
$1,131.89
|
| Rate for Payer: PHP Commercial |
$1,584.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,135.30
|
| Rate for Payer: Priority Health Medicare |
$1,131.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,131.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,131.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,926.52
|
|
|
PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG
|
Professional
|
Both
|
$5,986.00
|
|
|
Service Code
|
HCPCS 62145
|
| Min. Negotiated Rate |
$1,388.99 |
| Max. Negotiated Rate |
$3,890.90 |
| Rate for Payer: Aetna Commercial |
$1,861.25
|
| Rate for Payer: Aetna Medicare |
$1,444.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.25
|
| Rate for Payer: BCBS Complete |
$2,394.40
|
| Rate for Payer: BCBS MAPPO |
$1,388.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,388.99
|
| Rate for Payer: Cash Price |
$4,788.80
|
| Rate for Payer: Cash Price |
$4,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,000.15
|
| Rate for Payer: Cofinity Commercial |
$1,861.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,388.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,458.44
|
| Rate for Payer: Nomi Health Commercial |
$1,666.79
|
| Rate for Payer: PACE SWMI |
$1,388.99
|
| Rate for Payer: PHP Commercial |
$1,944.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,388.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,890.90
|
| Rate for Payer: Priority Health Medicare |
$1,388.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,388.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,388.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,753.56
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT <5 CM DIAMETER
|
Professional
|
Both
|
$6,377.00
|
|
|
Service Code
|
HCPCS 62146
|
| Min. Negotiated Rate |
$1,242.36 |
| Max. Negotiated Rate |
$4,145.05 |
| Rate for Payer: Aetna Commercial |
$1,664.76
|
| Rate for Payer: Aetna Medicare |
$1,292.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,789.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.76
|
| Rate for Payer: BCBS Complete |
$2,550.80
|
| Rate for Payer: BCBS MAPPO |
$1,242.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.36
|
| Rate for Payer: Cash Price |
$5,101.60
|
| Rate for Payer: Cash Price |
$5,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,789.00
|
| Rate for Payer: Cofinity Commercial |
$1,664.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,304.48
|
| Rate for Payer: Nomi Health Commercial |
$1,490.83
|
| Rate for Payer: PACE SWMI |
$1,242.36
|
| Rate for Payer: PHP Commercial |
$1,739.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,145.05
|
| Rate for Payer: Priority Health Medicare |
$1,242.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,242.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,242.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,933.42
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER
|
Professional
|
Both
|
$7,296.00
|
|
|
Service Code
|
HCPCS 62147
|
| Min. Negotiated Rate |
$1,414.70 |
| Max. Negotiated Rate |
$4,742.40 |
| Rate for Payer: Aetna Commercial |
$1,895.70
|
| Rate for Payer: Aetna Medicare |
$1,471.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,037.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,895.70
|
| Rate for Payer: BCBS Complete |
$2,918.40
|
| Rate for Payer: BCBS MAPPO |
$1,414.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,414.70
|
| Rate for Payer: Cash Price |
$5,836.80
|
| Rate for Payer: Cash Price |
$5,836.80
|
| Rate for Payer: Cofinity Commercial |
$2,037.17
|
| Rate for Payer: Cofinity Commercial |
$1,895.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,414.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,485.43
|
| Rate for Payer: Nomi Health Commercial |
$1,697.64
|
| Rate for Payer: PACE SWMI |
$1,414.70
|
| Rate for Payer: PHP Commercial |
$1,980.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,414.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,742.40
|
| Rate for Payer: Priority Health Medicare |
$1,414.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,414.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,414.70
|
| Rate for Payer: UMR Bronson Commercial |
$3,356.16
|
|
|
PR CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG
|
Professional
|
Both
|
$7,866.00
|
|
|
Service Code
|
HCPCS 61540
|
| Min. Negotiated Rate |
$2,159.58 |
| Max. Negotiated Rate |
$5,112.90 |
| Rate for Payer: Aetna Commercial |
$2,893.84
|
| Rate for Payer: Aetna Medicare |
$2,245.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,109.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,893.84
|
| Rate for Payer: BCBS Complete |
$3,146.40
|
| Rate for Payer: BCBS MAPPO |
$2,159.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,159.58
|
| Rate for Payer: Cash Price |
$6,292.80
|
| Rate for Payer: Cash Price |
$6,292.80
|
| Rate for Payer: Cofinity Commercial |
$3,109.80
|
| Rate for Payer: Cofinity Commercial |
$2,893.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,159.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,267.56
|
| Rate for Payer: Nomi Health Commercial |
$2,591.50
|
| Rate for Payer: PACE SWMI |
$2,159.58
|
| Rate for Payer: PHP Commercial |
$3,023.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,159.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,112.90
|
| Rate for Payer: Priority Health Medicare |
$2,159.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,159.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,159.58
|
| Rate for Payer: UMR Bronson Commercial |
$3,618.36
|
|
|
PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA
|
Professional
|
Both
|
$6,696.00
|
|
|
Service Code
|
HCPCS 61545
|
| Min. Negotiated Rate |
$2,678.40 |
| Max. Negotiated Rate |
$4,550.52 |
| Rate for Payer: Aetna Commercial |
$4,234.51
|
| Rate for Payer: Aetna Medicare |
$3,286.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,550.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,234.51
|
| Rate for Payer: BCBS Complete |
$2,678.40
|
| Rate for Payer: BCBS MAPPO |
$3,160.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,160.08
|
| Rate for Payer: Cash Price |
$5,356.80
|
| Rate for Payer: Cash Price |
$5,356.80
|
| Rate for Payer: Cofinity Commercial |
$4,550.52
|
| Rate for Payer: Cofinity Commercial |
$4,234.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,160.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,318.08
|
| Rate for Payer: Nomi Health Commercial |
$3,792.10
|
| Rate for Payer: PACE SWMI |
$3,160.08
|
| Rate for Payer: PHP Commercial |
$4,424.11
|
| Rate for Payer: PHP Medicare Advantage |
$3,160.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,352.40
|
| Rate for Payer: Priority Health Medicare |
$3,160.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,160.08
|
| Rate for Payer: UHC Medicare Advantage |
$3,160.08
|
| Rate for Payer: UMR Bronson Commercial |
$3,080.16
|
|
|
PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 62121
|
| Min. Negotiated Rate |
$1,495.12 |
| Max. Negotiated Rate |
$3,647.80 |
| Rate for Payer: Aetna Commercial |
$2,003.46
|
| Rate for Payer: Aetna Medicare |
$1,554.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,152.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,003.46
|
| Rate for Payer: BCBS Complete |
$2,244.80
|
| Rate for Payer: BCBS MAPPO |
$1,495.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,495.12
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cofinity Commercial |
$2,152.97
|
| Rate for Payer: Cofinity Commercial |
$2,003.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,495.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.88
|
| Rate for Payer: Nomi Health Commercial |
$1,794.14
|
| Rate for Payer: PACE SWMI |
$1,495.12
|
| Rate for Payer: PHP Commercial |
$2,093.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,495.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health Medicare |
$1,495.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,495.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,495.12
|
| Rate for Payer: UMR Bronson Commercial |
$2,581.52
|
|
|
PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY
|
Professional
|
Both
|
$7,067.00
|
|
|
Service Code
|
HCPCS 61537
|
| Min. Negotiated Rate |
$2,439.18 |
| Max. Negotiated Rate |
$4,593.55 |
| Rate for Payer: Aetna Commercial |
$3,268.50
|
| Rate for Payer: Aetna Medicare |
$2,536.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,512.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,268.50
|
| Rate for Payer: BCBS Complete |
$2,826.80
|
| Rate for Payer: BCBS MAPPO |
$2,439.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,439.18
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cofinity Commercial |
$3,512.42
|
| Rate for Payer: Cofinity Commercial |
$3,268.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,439.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,561.14
|
| Rate for Payer: Nomi Health Commercial |
$2,927.02
|
| Rate for Payer: PACE SWMI |
$2,439.18
|
| Rate for Payer: PHP Commercial |
$3,414.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,439.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,593.55
|
| Rate for Payer: Priority Health Medicare |
$2,439.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,439.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,439.18
|
| Rate for Payer: UMR Bronson Commercial |
$3,250.82
|
|
|
PR CRICOPHARYNGEAL MYOTOMY
|
Professional
|
Both
|
$2,284.00
|
|
|
Service Code
|
HCPCS 43030
|
| Min. Negotiated Rate |
$502.34 |
| Max. Negotiated Rate |
$1,484.60 |
| Rate for Payer: Aetna Commercial |
$673.14
|
| Rate for Payer: Aetna Medicare |
$522.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.14
|
| Rate for Payer: BCBS Complete |
$913.60
|
| Rate for Payer: BCBS MAPPO |
$502.34
|
| Rate for Payer: BCN Medicare Advantage |
$502.34
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cofinity Commercial |
$723.37
|
| Rate for Payer: Cofinity Commercial |
$673.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.46
|
| Rate for Payer: Nomi Health Commercial |
$602.81
|
| Rate for Payer: PACE SWMI |
$502.34
|
| Rate for Payer: PHP Commercial |
$703.28
|
| Rate for Payer: PHP Medicare Advantage |
$502.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,484.60
|
| Rate for Payer: Priority Health Medicare |
$502.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.34
|
| Rate for Payer: UHC Medicare Advantage |
$502.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,050.64
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 99292
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$146.82 |
| Rate for Payer: Aetna Commercial |
$136.63
|
| Rate for Payer: Aetna Medicare |
$106.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.63
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$101.96
|
| Rate for Payer: BCN Medicare Advantage |
$101.96
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$146.82
|
| Rate for Payer: Cofinity Commercial |
$136.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.06
|
| Rate for Payer: Nomi Health Commercial |
$122.35
|
| Rate for Payer: PACE SWMI |
$101.96
|
| Rate for Payer: PHP Commercial |
$142.74
|
| Rate for Payer: PHP Medicare Advantage |
$101.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$101.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.96
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 99291
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$309.40 |
| Rate for Payer: Aetna Commercial |
$273.49
|
| Rate for Payer: Aetna Medicare |
$212.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.49
|
| Rate for Payer: BCBS Complete |
$190.40
|
| Rate for Payer: BCBS MAPPO |
$204.10
|
| Rate for Payer: BCN Medicare Advantage |
$204.10
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cofinity Commercial |
$293.90
|
| Rate for Payer: Cofinity Commercial |
$273.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.31
|
| Rate for Payer: Nomi Health Commercial |
$244.92
|
| Rate for Payer: PACE SWMI |
$204.10
|
| Rate for Payer: PHP Commercial |
$285.74
|
| Rate for Payer: PHP Medicare Advantage |
$204.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.40
|
| Rate for Payer: Priority Health Medicare |
$204.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.10
|
| Rate for Payer: UHC Medicare Advantage |
$204.10
|
| Rate for Payer: UMR Bronson Commercial |
$218.96
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN
|
Professional
|
Both
|
$582.00
|
|
|
Service Code
|
HCPCS 99466
|
| Min. Negotiated Rate |
$218.15 |
| Max. Negotiated Rate |
$378.30 |
| Rate for Payer: Aetna Commercial |
$292.32
|
| Rate for Payer: Aetna Medicare |
$226.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.32
|
| Rate for Payer: BCBS Complete |
$232.80
|
| Rate for Payer: BCBS MAPPO |
$218.15
|
| Rate for Payer: BCN Medicare Advantage |
$218.15
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cofinity Commercial |
$314.14
|
| Rate for Payer: Cofinity Commercial |
$292.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.06
|
| Rate for Payer: Nomi Health Commercial |
$261.78
|
| Rate for Payer: PACE SWMI |
$218.15
|
| Rate for Payer: PHP Commercial |
$305.41
|
| Rate for Payer: PHP Medicare Advantage |
$218.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.30
|
| Rate for Payer: Priority Health Medicare |
$218.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.15
|
| Rate for Payer: UHC Medicare Advantage |
$218.15
|
| Rate for Payer: UMR Bronson Commercial |
$267.72
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 99467
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$157.95 |
| Rate for Payer: Aetna Commercial |
$146.52
|
| Rate for Payer: Aetna Medicare |
$113.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.52
|
| Rate for Payer: BCBS Complete |
$97.20
|
| Rate for Payer: BCBS MAPPO |
$109.34
|
| Rate for Payer: BCN Medicare Advantage |
$109.34
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$157.45
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.81
|
| Rate for Payer: Nomi Health Commercial |
$131.21
|
| Rate for Payer: PACE SWMI |
$109.34
|
| Rate for Payer: PHP Commercial |
$153.08
|
| Rate for Payer: PHP Medicare Advantage |
$109.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$109.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.34
|
| Rate for Payer: UHC Medicare Advantage |
$109.34
|
| Rate for Payer: UMR Bronson Commercial |
$111.78
|
|
|
PR CRNEC/CRNOT DCMPRV W/WO DURAPLASTY W/O LOBECTOMY
|
Professional
|
Both
|
$5,018.00
|
|
|
Service Code
|
HCPCS 61322
|
| Min. Negotiated Rate |
$2,007.20 |
| Max. Negotiated Rate |
$3,399.48 |
| Rate for Payer: Aetna Commercial |
$3,163.41
|
| Rate for Payer: Aetna Medicare |
$2,455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,399.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,163.41
|
| Rate for Payer: BCBS Complete |
$2,007.20
|
| Rate for Payer: BCBS MAPPO |
$2,360.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,360.75
|
| Rate for Payer: Cash Price |
$4,014.40
|
| Rate for Payer: Cash Price |
$4,014.40
|
| Rate for Payer: Cofinity Commercial |
$3,399.48
|
| Rate for Payer: Cofinity Commercial |
$3,163.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,360.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,478.79
|
| Rate for Payer: Nomi Health Commercial |
$2,832.90
|
| Rate for Payer: PACE SWMI |
$2,360.75
|
| Rate for Payer: PHP Commercial |
$3,305.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,360.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.70
|
| Rate for Payer: Priority Health Medicare |
$2,360.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,360.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,360.75
|
| Rate for Payer: UMR Bronson Commercial |
$2,308.28
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC INFRATENTORIAL
|
Professional
|
Both
|
$4,357.00
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$1,742.80 |
| Max. Negotiated Rate |
$3,035.89 |
| Rate for Payer: Aetna Commercial |
$2,825.07
|
| Rate for Payer: Aetna Medicare |
$2,192.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,035.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,825.07
|
| Rate for Payer: BCBS Complete |
$1,742.80
|
| Rate for Payer: BCBS MAPPO |
$2,108.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,108.26
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cofinity Commercial |
$3,035.89
|
| Rate for Payer: Cofinity Commercial |
$2,825.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,108.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,213.67
|
| Rate for Payer: Nomi Health Commercial |
$2,529.91
|
| Rate for Payer: PACE SWMI |
$2,108.26
|
| Rate for Payer: PHP Commercial |
$2,951.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,108.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,832.05
|
| Rate for Payer: Priority Health Medicare |
$2,108.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,108.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,108.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,004.22
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC SUPRATENTORIAL
|
Professional
|
Both
|
$6,842.00
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$1,882.26 |
| Max. Negotiated Rate |
$4,447.30 |
| Rate for Payer: Aetna Commercial |
$2,522.23
|
| Rate for Payer: Aetna Medicare |
$1,957.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,710.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,522.23
|
| Rate for Payer: BCBS Complete |
$2,736.80
|
| Rate for Payer: BCBS MAPPO |
$1,882.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,882.26
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Cofinity Commercial |
$2,710.45
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,882.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,976.37
|
| Rate for Payer: Nomi Health Commercial |
$2,258.71
|
| Rate for Payer: PACE SWMI |
$1,882.26
|
| Rate for Payer: PHP Commercial |
$2,635.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,882.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,447.30
|
| Rate for Payer: Priority Health Medicare |
$1,882.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,882.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,882.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,147.32
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL INTRACEREBELLAR
|
Professional
|
Both
|
$7,040.00
|
|
|
Service Code
|
HCPCS 61315
|
| Min. Negotiated Rate |
$2,050.68 |
| Max. Negotiated Rate |
$4,576.00 |
| Rate for Payer: Aetna Commercial |
$2,747.91
|
| Rate for Payer: Aetna Medicare |
$2,132.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,952.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,747.91
|
| Rate for Payer: BCBS Complete |
$2,816.00
|
| Rate for Payer: BCBS MAPPO |
$2,050.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.68
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Cofinity Commercial |
$2,952.98
|
| Rate for Payer: Cofinity Commercial |
$2,747.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,153.21
|
| Rate for Payer: Nomi Health Commercial |
$2,460.82
|
| Rate for Payer: PACE SWMI |
$2,050.68
|
| Rate for Payer: PHP Commercial |
$2,870.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,576.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,050.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,238.40
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL XDRL/SDRL
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,810.79 |
| Max. Negotiated Rate |
$3,647.80 |
| Rate for Payer: Aetna Commercial |
$2,426.46
|
| Rate for Payer: Aetna Medicare |
$1,883.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,607.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,426.46
|
| Rate for Payer: BCBS Complete |
$2,244.80
|
| Rate for Payer: BCBS MAPPO |
$1,810.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.79
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cofinity Commercial |
$2,607.54
|
| Rate for Payer: Cofinity Commercial |
$2,426.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,901.33
|
| Rate for Payer: Nomi Health Commercial |
$2,172.95
|
| Rate for Payer: PACE SWMI |
$1,810.79
|
| Rate for Payer: PHP Commercial |
$2,535.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health Medicare |
$1,810.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,810.79
|
| Rate for Payer: UMR Bronson Commercial |
$2,581.52
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$4,171.00
|
|
|
Service Code
|
HCPCS 61313
|
| Min. Negotiated Rate |
$1,668.40 |
| Max. Negotiated Rate |
$2,835.35 |
| Rate for Payer: Aetna Commercial |
$2,638.45
|
| Rate for Payer: Aetna Medicare |
$2,047.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,835.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,638.45
|
| Rate for Payer: BCBS Complete |
$1,668.40
|
| Rate for Payer: BCBS MAPPO |
$1,968.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,968.99
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Cofinity Commercial |
$2,835.35
|
| Rate for Payer: Cofinity Commercial |
$2,638.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,968.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,067.44
|
| Rate for Payer: Nomi Health Commercial |
$2,362.79
|
| Rate for Payer: PACE SWMI |
$1,968.99
|
| Rate for Payer: PHP Commercial |
$2,756.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,968.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,711.15
|
| Rate for Payer: Priority Health Medicare |
$1,968.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,968.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,968.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,918.66
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL XDRL/SUBDURAL
|
Professional
|
Both
|
$7,129.00
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$2,053.45 |
| Max. Negotiated Rate |
$4,633.85 |
| Rate for Payer: Aetna Commercial |
$2,751.62
|
| Rate for Payer: Aetna Medicare |
$2,135.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,956.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,751.62
|
| Rate for Payer: BCBS Complete |
$2,851.60
|
| Rate for Payer: BCBS MAPPO |
$2,053.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,053.45
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Cofinity Commercial |
$2,956.97
|
| Rate for Payer: Cofinity Commercial |
$2,751.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,053.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,156.12
|
| Rate for Payer: Nomi Health Commercial |
$2,464.14
|
| Rate for Payer: PACE SWMI |
$2,053.45
|
| Rate for Payer: PHP Commercial |
$2,874.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,053.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,633.85
|
| Rate for Payer: Priority Health Medicare |
$2,053.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,053.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,053.45
|
| Rate for Payer: UMR Bronson Commercial |
$3,279.34
|
|
|
PR CRNEC/CRNOT W/WO DURAPLASTY WITH LOBECTOMY
|
Professional
|
Both
|
$8,807.00
|
|
|
Service Code
|
HCPCS 61323
|
| Min. Negotiated Rate |
$2,353.13 |
| Max. Negotiated Rate |
$5,724.55 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna Medicare |
$2,447.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,388.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,153.19
|
| Rate for Payer: BCBS Complete |
$3,522.80
|
| Rate for Payer: BCBS MAPPO |
$2,353.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,353.13
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cofinity Commercial |
$3,388.51
|
| Rate for Payer: Cofinity Commercial |
$3,153.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,353.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,470.79
|
| Rate for Payer: Nomi Health Commercial |
$2,823.76
|
| Rate for Payer: PACE SWMI |
$2,353.13
|
| Rate for Payer: PHP Commercial |
$3,294.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,353.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,724.55
|
| Rate for Payer: Priority Health Medicare |
$2,353.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,353.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,353.13
|
| Rate for Payer: UMR Bronson Commercial |
$4,051.22
|
|
|
PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA
|
Professional
|
Both
|
$8,419.00
|
|
|
Service Code
|
HCPCS 61518
|
| Min. Negotiated Rate |
$2,744.38 |
| Max. Negotiated Rate |
$5,472.35 |
| Rate for Payer: Aetna Commercial |
$3,677.47
|
| Rate for Payer: Aetna Medicare |
$2,854.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,951.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,677.47
|
| Rate for Payer: BCBS Complete |
$3,367.60
|
| Rate for Payer: BCBS MAPPO |
$2,744.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,744.38
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Cofinity Commercial |
$3,951.91
|
| Rate for Payer: Cofinity Commercial |
$3,677.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,744.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,881.60
|
| Rate for Payer: Nomi Health Commercial |
$3,293.26
|
| Rate for Payer: PACE SWMI |
$2,744.38
|
| Rate for Payer: PHP Commercial |
$3,842.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,744.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,472.35
|
| Rate for Payer: Priority Health Medicare |
$2,744.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,744.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,744.38
|
| Rate for Payer: UMR Bronson Commercial |
$3,872.74
|
|
|
PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA
|
Professional
|
Both
|
$7,858.00
|
|
|
Service Code
|
HCPCS 61530
|
| Min. Negotiated Rate |
$3,046.30 |
| Max. Negotiated Rate |
$5,107.70 |
| Rate for Payer: Aetna Commercial |
$4,082.04
|
| Rate for Payer: Aetna Medicare |
$3,168.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,386.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,082.04
|
| Rate for Payer: BCBS Complete |
$3,143.20
|
| Rate for Payer: BCBS MAPPO |
$3,046.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,046.30
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Cofinity Commercial |
$4,386.67
|
| Rate for Payer: Cofinity Commercial |
$4,082.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,046.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,198.61
|
| Rate for Payer: Nomi Health Commercial |
$3,655.56
|
| Rate for Payer: PACE SWMI |
$3,046.30
|
| Rate for Payer: PHP Commercial |
$4,264.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,046.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.70
|
| Rate for Payer: Priority Health Medicare |
$3,046.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,046.30
|
| Rate for Payer: UHC Medicare Advantage |
$3,046.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,614.68
|
|
|
PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA
|
Professional
|
Both
|
$8,718.00
|
|
|
Service Code
|
HCPCS 61519
|
| Min. Negotiated Rate |
$2,921.61 |
| Max. Negotiated Rate |
$5,666.70 |
| Rate for Payer: Aetna Commercial |
$3,914.96
|
| Rate for Payer: Aetna Medicare |
$3,038.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,207.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,914.96
|
| Rate for Payer: BCBS Complete |
$3,487.20
|
| Rate for Payer: BCBS MAPPO |
$2,921.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,921.61
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Cofinity Commercial |
$4,207.12
|
| Rate for Payer: Cofinity Commercial |
$3,914.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,921.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,067.69
|
| Rate for Payer: Nomi Health Commercial |
$3,505.93
|
| Rate for Payer: PACE SWMI |
$2,921.61
|
| Rate for Payer: PHP Commercial |
$4,090.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,921.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,666.70
|
| Rate for Payer: Priority Health Medicare |
$2,921.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,921.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.61
|
| Rate for Payer: UMR Bronson Commercial |
$4,010.28
|
|
|
PR CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS
|
Professional
|
Both
|
$6,227.00
|
|
|
Service Code
|
HCPCS 61522
|
| Min. Negotiated Rate |
$2,171.51 |
| Max. Negotiated Rate |
$4,047.55 |
| Rate for Payer: Aetna Commercial |
$2,909.82
|
| Rate for Payer: Aetna Medicare |
$2,258.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,126.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,909.82
|
| Rate for Payer: BCBS Complete |
$2,490.80
|
| Rate for Payer: BCBS MAPPO |
$2,171.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,171.51
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Cofinity Commercial |
$3,126.97
|
| Rate for Payer: Cofinity Commercial |
$2,909.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,171.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,280.09
|
| Rate for Payer: Nomi Health Commercial |
$2,605.81
|
| Rate for Payer: PACE SWMI |
$2,171.51
|
| Rate for Payer: PHP Commercial |
$3,040.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,171.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,047.55
|
| Rate for Payer: Priority Health Medicare |
$2,171.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,171.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,171.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,864.42
|
|
