|
PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$4,444.00
|
|
|
Service Code
|
HCPCS 33511
|
| Min. Negotiated Rate |
$1,241.51 |
| Max. Negotiated Rate |
$3,321.78 |
| Rate for Payer: Aetna Commercial |
$2,727.99
|
| Rate for Payer: Aetna Medicare |
$2,117.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,727.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,931.57
|
| Rate for Payer: BCBS Complete |
$1,402.51
|
| Rate for Payer: BCBS MAPPO |
$2,035.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.51
|
| Rate for Payer: BCN Commercial |
$3,041.04
|
| 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 |
$2,727.99
|
| Rate for Payer: Cofinity Commercial |
$2,931.57
|
| 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: Meridian Medicaid |
$1,402.51
|
| 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 Choice Medicaid |
$1,335.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,888.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,321.78
|
| Rate for Payer: Priority Health Medicare |
$2,035.81
|
| Rate for Payer: Priority Health Narrow Network |
$3,321.78
|
| Rate for Payer: Priority Health SBD |
$3,321.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,035.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,035.81
|
| Rate for Payer: UHCCP Medicaid |
$1,335.72
|
| 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 |
$1,337.66 |
| 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) |
$3,105.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,337.11
|
| Rate for Payer: BCBS Complete |
$1,595.75
|
| Rate for Payer: BCBS MAPPO |
$2,317.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.66
|
| Rate for Payer: BCN Commercial |
$3,467.66
|
| 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 |
$3,105.37
|
| Rate for Payer: Cofinity Commercial |
$3,337.11
|
| 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: Meridian Medicaid |
$1,595.75
|
| 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 Choice Medicaid |
$1,519.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,446.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,783.94
|
| Rate for Payer: Priority Health Medicare |
$2,317.44
|
| Rate for Payer: Priority Health Narrow Network |
$3,783.94
|
| Rate for Payer: Priority Health SBD |
$3,783.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,317.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,317.44
|
| Rate for Payer: UHCCP Medicaid |
$1,519.76
|
| 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 |
$1,257.88 |
| 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) |
$3,174.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,411.33
|
| Rate for Payer: BCBS Complete |
$1,630.41
|
| Rate for Payer: BCBS MAPPO |
$2,368.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.88
|
| Rate for Payer: BCN Commercial |
$3,547.31
|
| 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 |
$3,174.43
|
| Rate for Payer: Cofinity Commercial |
$3,411.33
|
| 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: Meridian Medicaid |
$1,630.41
|
| 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 Choice Medicaid |
$1,552.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,578.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,863.71
|
| Rate for Payer: Priority Health Medicare |
$2,368.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,863.71
|
| Rate for Payer: Priority Health SBD |
$3,863.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,368.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,368.98
|
| Rate for Payer: UHCCP Medicaid |
$1,552.77
|
| 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 |
$1,382.03 |
| 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) |
$3,456.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.19
|
| Rate for Payer: BCBS Complete |
$1,775.56
|
| Rate for Payer: BCBS MAPPO |
$2,579.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,382.03
|
| Rate for Payer: BCN Commercial |
$3,858.60
|
| 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 |
$3,456.26
|
| Rate for Payer: Cofinity Commercial |
$3,714.19
|
| 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: Meridian Medicaid |
$1,775.56
|
| 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 Choice Medicaid |
$1,691.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,398.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,204.08
|
| Rate for Payer: Priority Health Medicare |
$2,579.30
|
| Rate for Payer: Priority Health Narrow Network |
$4,204.08
|
| Rate for Payer: Priority Health SBD |
$4,204.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,579.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,579.30
|
| Rate for Payer: UHCCP Medicaid |
$1,691.01
|
| 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 |
$116.72 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$239.97
|
| Rate for Payer: Aetna Medicare |
$186.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.88
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$179.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: BCN Commercial |
$266.33
|
| 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 |
$239.97
|
| Rate for Payer: Cofinity Commercial |
$257.88
|
| 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: Meridian Medicaid |
$122.56
|
| 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 Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.45
|
| Rate for Payer: Priority Health Medicare |
$179.08
|
| Rate for Payer: Priority Health Narrow Network |
$291.45
|
| Rate for Payer: Priority Health SBD |
$291.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.08
|
| Rate for Payer: UHC Medicare Advantage |
$179.08
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| 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 |
$256.88 |
| Max. Negotiated Rate |
$1,337.66 |
| Rate for Payer: Aetna Commercial |
$528.38
|
| Rate for Payer: Aetna Medicare |
$410.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.81
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$394.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.66
|
| Rate for Payer: BCN Commercial |
$586.90
|
| 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 |
$528.38
|
| Rate for Payer: Cofinity Commercial |
$567.81
|
| 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: Meridian Medicaid |
$269.72
|
| 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 Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.19
|
| Rate for Payer: Priority Health Medicare |
$394.31
|
| Rate for Payer: Priority Health Narrow Network |
$638.19
|
| Rate for Payer: Priority Health SBD |
$638.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.31
|
| Rate for Payer: UHC Medicare Advantage |
$394.31
|
| Rate for Payer: UHCCP Medicaid |
$256.88
|
| 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 |
$338.88 |
| 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) |
$696.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.87
|
| Rate for Payer: BCBS Complete |
$355.82
|
| Rate for Payer: BCBS MAPPO |
$520.05
|
| Rate for Payer: BCBS Trust/PPO |
$987.39
|
| Rate for Payer: BCN Commercial |
$775.53
|
| 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 |
$696.87
|
| Rate for Payer: Cofinity Commercial |
$748.87
|
| 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: Meridian Medicaid |
$355.82
|
| 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 Choice Medicaid |
$338.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.54
|
| Rate for Payer: Priority Health Medicare |
$520.05
|
| Rate for Payer: Priority Health Narrow Network |
$844.54
|
| Rate for Payer: Priority Health SBD |
$844.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.05
|
| Rate for Payer: UHC Medicare Advantage |
$520.05
|
| Rate for Payer: UHCCP Medicaid |
$338.88
|
| 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 |
$158.49 |
| 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) |
$836.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.16
|
| Rate for Payer: BCBS Complete |
$427.17
|
| Rate for Payer: BCBS MAPPO |
$624.42
|
| Rate for Payer: BCBS Trust/PPO |
$158.49
|
| Rate for Payer: BCN Commercial |
$929.47
|
| 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 |
$836.72
|
| Rate for Payer: Cofinity Commercial |
$899.16
|
| 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: Meridian Medicaid |
$427.17
|
| 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 Choice Medicaid |
$406.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,012.06
|
| Rate for Payer: Priority Health Medicare |
$624.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.06
|
| Rate for Payer: Priority Health SBD |
$1,012.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.42
|
| Rate for Payer: UHC Medicare Advantage |
$624.42
|
| Rate for Payer: UHCCP Medicaid |
$406.83
|
| 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 |
$456.89 |
| 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) |
$1,009.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.69
|
| Rate for Payer: BCBS Complete |
$479.73
|
| Rate for Payer: BCBS MAPPO |
$701.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.94
|
| Rate for Payer: BCN Commercial |
$1,044.31
|
| 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 |
$1,009.81
|
| Rate for Payer: Cofinity Commercial |
$939.69
|
| 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: Meridian Medicaid |
$479.73
|
| 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 Choice Medicaid |
$456.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,139.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,137.57
|
| Rate for Payer: Priority Health Medicare |
$701.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,137.57
|
| Rate for Payer: Priority Health SBD |
$1,137.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.26
|
| Rate for Payer: UHC Medicare Advantage |
$701.26
|
| Rate for Payer: UHCCP Medicaid |
$456.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,514.32
|
|
|
PR CORONARY ENDARTERCOMY OPEN ANY METHOD
|
Professional
|
Both
|
$1,295.00
|
|
|
Service Code
|
HCPCS 33572
|
| Min. Negotiated Rate |
$143.35 |
| Max. Negotiated Rate |
$863.77 |
| Rate for Payer: Aetna Commercial |
$294.68
|
| Rate for Payer: Aetna Medicare |
$228.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.67
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: BCBS MAPPO |
$219.91
|
| Rate for Payer: BCBS Trust/PPO |
$863.77
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: BCN Medicare Advantage |
$219.91
|
| Rate for Payer: Cash Price |
$1,036.00
|
| Rate for Payer: Cash Price |
$1,036.00
|
| Rate for Payer: Cofinity Commercial |
$294.68
|
| Rate for Payer: Cofinity Commercial |
$316.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.91
|
| Rate for Payer: Meridian Medicaid |
$150.52
|
| Rate for Payer: Nomi Health Commercial |
$263.89
|
| Rate for Payer: PACE SWMI |
$219.91
|
| Rate for Payer: PHP Commercial |
$307.87
|
| Rate for Payer: PHP Medicare Advantage |
$219.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.98
|
| Rate for Payer: Priority Health Medicare |
$219.91
|
| Rate for Payer: Priority Health Narrow Network |
$358.98
|
| Rate for Payer: Priority Health SBD |
$358.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.91
|
| Rate for Payer: UHC Medicare Advantage |
$219.91
|
| Rate for Payer: UHCCP Medicaid |
$143.35
|
| Rate for Payer: UMR Bronson Commercial |
$595.70
|
|
|
PR CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 54430
|
| Min. Negotiated Rate |
$410.66 |
| Max. Negotiated Rate |
$3,265.16 |
| Rate for Payer: Aetna Commercial |
$819.30
|
| Rate for Payer: Aetna Medicare |
$635.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.44
|
| Rate for Payer: BCBS Complete |
$431.19
|
| Rate for Payer: BCBS MAPPO |
$611.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.16
|
| Rate for Payer: BCN Commercial |
$922.62
|
| Rate for Payer: BCN Medicare Advantage |
$611.42
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cofinity Commercial |
$819.30
|
| Rate for Payer: Cofinity Commercial |
$880.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.99
|
| Rate for Payer: Meridian Medicaid |
$431.19
|
| Rate for Payer: Nomi Health Commercial |
$733.70
|
| Rate for Payer: PACE SWMI |
$611.42
|
| Rate for Payer: PHP Commercial |
$855.99
|
| Rate for Payer: PHP Medicare Advantage |
$611.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.39
|
| Rate for Payer: Priority Health Medicare |
$611.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.39
|
| Rate for Payer: Priority Health SBD |
$1,019.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$611.42
|
| Rate for Payer: UHC Medicare Advantage |
$611.42
|
| Rate for Payer: UHCCP Medicaid |
$410.66
|
| Rate for Payer: UMR Bronson Commercial |
$862.04
|
|
|
PR CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 54435
|
| Min. Negotiated Rate |
$267.53 |
| Max. Negotiated Rate |
$1,738.11 |
| Rate for Payer: Aetna Commercial |
$531.54
|
| Rate for Payer: Aetna Medicare |
$412.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.20
|
| Rate for Payer: BCBS Complete |
$280.91
|
| Rate for Payer: BCBS MAPPO |
$396.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.11
|
| Rate for Payer: BCN Commercial |
$600.09
|
| Rate for Payer: BCN Medicare Advantage |
$396.67
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$531.54
|
| Rate for Payer: Cofinity Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.50
|
| Rate for Payer: Meridian Medicaid |
$280.91
|
| Rate for Payer: Nomi Health Commercial |
$476.00
|
| Rate for Payer: PACE SWMI |
$396.67
|
| Rate for Payer: PHP Commercial |
$555.34
|
| Rate for Payer: PHP Medicare Advantage |
$396.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$664.16
|
| Rate for Payer: Priority Health Medicare |
$396.67
|
| Rate for Payer: Priority Health Narrow Network |
$664.16
|
| Rate for Payer: Priority Health SBD |
$664.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.67
|
| Rate for Payer: UHC Medicare Advantage |
$396.67
|
| Rate for Payer: UHCCP Medicaid |
$267.53
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 54420
|
| Min. Negotiated Rate |
$450.50 |
| Max. Negotiated Rate |
$2,612.13 |
| Rate for Payer: Aetna Commercial |
$899.97
|
| Rate for Payer: Aetna Medicare |
$698.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.13
|
| Rate for Payer: BCBS Complete |
$473.02
|
| Rate for Payer: BCBS MAPPO |
$671.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,612.13
|
| Rate for Payer: BCN Commercial |
$1,014.00
|
| Rate for Payer: BCN Medicare Advantage |
$671.62
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cofinity Commercial |
$899.97
|
| Rate for Payer: Cofinity Commercial |
$967.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.20
|
| Rate for Payer: Meridian Medicaid |
$473.02
|
| Rate for Payer: Nomi Health Commercial |
$805.94
|
| Rate for Payer: PACE SWMI |
$671.62
|
| Rate for Payer: PHP Commercial |
$940.27
|
| Rate for Payer: PHP Medicare Advantage |
$671.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,119.52
|
| Rate for Payer: Priority Health Medicare |
$671.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,119.52
|
| Rate for Payer: Priority Health SBD |
$1,119.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$671.62
|
| Rate for Payer: UHC Medicare Advantage |
$671.62
|
| Rate for Payer: UHCCP Medicaid |
$450.50
|
| Rate for Payer: UMR Bronson Commercial |
$620.08
|
|
|
PR CORRECT BUNION,SIMPLE
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 28290
|
| Min. Negotiated Rate |
$553.60 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Medicare |
$692.00
|
| Rate for Payer: BCBS Complete |
$553.60
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: UMR Bronson Commercial |
$636.64
|
|
|
PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE
|
Professional
|
Both
|
$938.00
|
|
|
Service Code
|
HCPCS 28286
|
| Min. Negotiated Rate |
$192.13 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Aetna Commercial |
$378.72
|
| Rate for Payer: Aetna Medicare |
$293.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.99
|
| Rate for Payer: BCBS Complete |
$201.74
|
| Rate for Payer: BCBS MAPPO |
$282.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,002.26
|
| Rate for Payer: BCN Commercial |
$639.19
|
| Rate for Payer: BCN Medicare Advantage |
$282.63
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cofinity Commercial |
$378.72
|
| Rate for Payer: Cofinity Commercial |
$406.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.76
|
| Rate for Payer: Meridian Medicaid |
$201.74
|
| Rate for Payer: Nomi Health Commercial |
$339.16
|
| Rate for Payer: PACE SWMI |
$282.63
|
| Rate for Payer: PHP Commercial |
$395.68
|
| Rate for Payer: PHP Medicare Advantage |
$282.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$458.99
|
| Rate for Payer: Priority Health Medicare |
$282.63
|
| Rate for Payer: Priority Health Narrow Network |
$458.99
|
| Rate for Payer: Priority Health SBD |
$458.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.63
|
| Rate for Payer: UHC Medicare Advantage |
$282.63
|
| Rate for Payer: UHCCP Medicaid |
$192.13
|
| Rate for Payer: UMR Bronson Commercial |
$431.48
|
|
|
PR CORRECTION HAMMERTOE
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 28285
|
| Min. Negotiated Rate |
$253.04 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Aetna Commercial |
$497.60
|
| Rate for Payer: Aetna Medicare |
$386.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.73
|
| Rate for Payer: BCBS Complete |
$265.69
|
| Rate for Payer: BCBS MAPPO |
$371.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.65
|
| Rate for Payer: BCN Commercial |
$860.92
|
| Rate for Payer: BCN Medicare Advantage |
$371.34
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$497.60
|
| Rate for Payer: Cofinity Commercial |
$534.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.91
|
| Rate for Payer: Meridian Medicaid |
$265.69
|
| Rate for Payer: Nomi Health Commercial |
$445.61
|
| Rate for Payer: PACE SWMI |
$371.34
|
| Rate for Payer: PHP Commercial |
$519.88
|
| Rate for Payer: PHP Medicare Advantage |
$371.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.89
|
| Rate for Payer: Priority Health Medicare |
$371.34
|
| Rate for Payer: Priority Health Narrow Network |
$596.89
|
| Rate for Payer: Priority Health SBD |
$596.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.34
|
| Rate for Payer: UHC Medicare Advantage |
$371.34
|
| Rate for Payer: UHCCP Medicaid |
$253.04
|
| Rate for Payer: UMR Bronson Commercial |
$439.76
|
|
|
PR CORRECTION INVERTED NIPPLES
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 19355
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$1,109.79 |
| Rate for Payer: Aetna Commercial |
$792.14
|
| Rate for Payer: Aetna Medicare |
$614.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.26
|
| Rate for Payer: BCBS Complete |
$420.01
|
| Rate for Payer: BCBS MAPPO |
$591.15
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$1,109.79
|
| Rate for Payer: BCN Medicare Advantage |
$591.15
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$792.14
|
| Rate for Payer: Cofinity Commercial |
$851.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.71
|
| Rate for Payer: Meridian Medicaid |
$420.01
|
| Rate for Payer: Nomi Health Commercial |
$709.38
|
| Rate for Payer: PACE SWMI |
$591.15
|
| Rate for Payer: PHP Commercial |
$827.61
|
| Rate for Payer: PHP Medicare Advantage |
$591.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.36
|
| Rate for Payer: Priority Health Medicare |
$591.15
|
| Rate for Payer: Priority Health Narrow Network |
$839.36
|
| Rate for Payer: Priority Health SBD |
$839.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.15
|
| Rate for Payer: UHC Medicare Advantage |
$591.15
|
| Rate for Payer: UHCCP Medicaid |
$400.01
|
| Rate for Payer: UMR Bronson Commercial |
$761.30
|
|
|
PR CORRECTION TRICHIASIS EPILATION FORCEPS ONLY
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 67820
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$668.83 |
| Rate for Payer: Aetna Commercial |
$27.52
|
| Rate for Payer: Aetna Medicare |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.58
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$20.54
|
| Rate for Payer: BCBS Trust/PPO |
$668.83
|
| Rate for Payer: BCN Commercial |
$22.39
|
| Rate for Payer: BCN Medicare Advantage |
$20.54
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$27.52
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Nomi Health Commercial |
$24.65
|
| Rate for Payer: PACE SWMI |
$20.54
|
| Rate for Payer: PHP Commercial |
$28.76
|
| Rate for Payer: PHP Medicare Advantage |
$20.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.60
|
| Rate for Payer: Priority Health Medicare |
$20.54
|
| Rate for Payer: Priority Health Narrow Network |
$38.60
|
| Rate for Payer: Priority Health SBD |
$38.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.54
|
| Rate for Payer: UHC Medicare Advantage |
$20.54
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT
|
Professional
|
Both
|
$2,241.00
|
|
|
Service Code
|
HCPCS 28296
|
| Min. Negotiated Rate |
$334.62 |
| Max. Negotiated Rate |
$1,456.65 |
| Rate for Payer: Aetna Commercial |
$661.13
|
| Rate for Payer: Aetna Medicare |
$513.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.47
|
| Rate for Payer: BCBS Complete |
$351.35
|
| Rate for Payer: BCBS MAPPO |
$493.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.56
|
| Rate for Payer: BCN Commercial |
$1,288.16
|
| Rate for Payer: BCN Medicare Advantage |
$493.38
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cofinity Commercial |
$661.13
|
| Rate for Payer: Cofinity Commercial |
$710.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.05
|
| Rate for Payer: Meridian Medicaid |
$351.35
|
| Rate for Payer: Nomi Health Commercial |
$592.06
|
| Rate for Payer: PACE SWMI |
$493.38
|
| Rate for Payer: PHP Commercial |
$690.73
|
| Rate for Payer: PHP Medicare Advantage |
$493.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.25
|
| Rate for Payer: Priority Health Medicare |
$493.38
|
| Rate for Payer: Priority Health Narrow Network |
$790.25
|
| Rate for Payer: Priority Health SBD |
$790.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.38
|
| Rate for Payer: UHC Medicare Advantage |
$493.38
|
| Rate for Payer: UHCCP Medicaid |
$334.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,030.86
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Facility
|
IP
|
$1,978.00
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
28297
|
| Min. Negotiated Rate |
$870.32 |
| Max. Negotiated Rate |
$1,780.20 |
| Rate for Payer: Aetna American Axle |
$1,285.70
|
| Rate for Payer: Aetna Commercial |
$1,681.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.70
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,384.60
|
| Rate for Payer: Cofinity Commercial |
$1,701.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,384.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.40
|
| Rate for Payer: Healthscope Commercial |
$1,780.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,384.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.30
|
| Rate for Payer: PHP Commercial |
$1,681.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.70
|
| Rate for Payer: Priority Health SBD |
$1,246.14
|
| Rate for Payer: UMR Bronson Commercial |
$870.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.50
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Professional
|
Both
|
$1,978.00
|
|
|
Service Code
|
HCPCS 28297
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,499.26 |
| Rate for Payer: Aetna Commercial |
$767.94
|
| Rate for Payer: Aetna Medicare |
$596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.25
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$573.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.37
|
| Rate for Payer: BCN Commercial |
$1,499.26
|
| Rate for Payer: BCN Medicare Advantage |
$573.09
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cofinity Commercial |
$767.94
|
| Rate for Payer: Cofinity Commercial |
$825.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.74
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Nomi Health Commercial |
$687.71
|
| Rate for Payer: PACE SWMI |
$573.09
|
| Rate for Payer: PHP Commercial |
$802.33
|
| Rate for Payer: PHP Medicare Advantage |
$573.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$925.62
|
| Rate for Payer: Priority Health Medicare |
$573.09
|
| Rate for Payer: Priority Health Narrow Network |
$925.62
|
| Rate for Payer: Priority Health SBD |
$925.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$573.09
|
| Rate for Payer: UHC Medicare Advantage |
$573.09
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
| Rate for Payer: UMR Bronson Commercial |
$909.88
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Facility
|
OP
|
$1,978.00
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
28297
|
| Min. Negotiated Rate |
$579.37 |
| Max. Negotiated Rate |
$39,622.51 |
| Rate for Payer: Aetna American Axle |
$1,285.70
|
| Rate for Payer: Aetna Commercial |
$1,681.30
|
| Rate for Payer: Aetna Medicare |
$13,110.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,758.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,758.31
|
| Rate for Payer: BCBS Complete |
$7,095.02
|
| Rate for Payer: BCBS MAPPO |
$12,606.65
|
| Rate for Payer: BCBS Trust/PPO |
$6,587.82
|
| Rate for Payer: BCN Commercial |
$6,587.82
|
| Rate for Payer: BCN Medicare Advantage |
$12,606.65
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,701.08
|
| Rate for Payer: Cofinity Commercial |
$1,384.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,384.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,606.65
|
| Rate for Payer: Healthscope Commercial |
$1,780.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,384.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.50
|
| Rate for Payer: Mclaren Medicaid |
$6,757.16
|
| Rate for Payer: Mclaren Medicare |
$12,606.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,236.98
|
| Rate for Payer: Meridian Medicaid |
$7,095.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,497.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.30
|
| Rate for Payer: Nomi Health Commercial |
$26,473.96
|
| Rate for Payer: PACE Medicare |
$11,976.32
|
| Rate for Payer: PACE SWMI |
$12,606.65
|
| Rate for Payer: PHP Commercial |
$1,681.30
|
| Rate for Payer: PHP Medicare Advantage |
$12,606.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,757.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39,622.51
|
| Rate for Payer: Priority Health Medicare |
$12,606.65
|
| Rate for Payer: Priority Health Narrow Network |
$31,698.01
|
| Rate for Payer: Priority Health SBD |
$1,246.14
|
| Rate for Payer: Railroad Medicare Medicare |
$12,606.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.31
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,606.65
|
| Rate for Payer: UHC Exchange |
$579.37
|
| Rate for Payer: UHC Medicare Advantage |
$12,606.65
|
| Rate for Payer: UHCCP Medicaid |
$6,757.16
|
| Rate for Payer: UMR Bronson Commercial |
$731.86
|
| Rate for Payer: VA VA |
$12,606.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.50
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Professional
|
Both
|
$1,978.00
|
|
|
Service Code
|
HCPCS 28297
|
| Hospital Charge Code |
28297
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,499.26 |
| Rate for Payer: Cofinity Commercial |
$825.25
|
| Rate for Payer: Cofinity Commercial |
$767.94
|
| Rate for Payer: Aetna Commercial |
$767.94
|
| Rate for Payer: Aetna Medicare |
$596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.25
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$573.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.37
|
| Rate for Payer: BCN Commercial |
$1,499.26
|
| Rate for Payer: BCN Medicare Advantage |
$573.09
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.74
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Nomi Health Commercial |
$687.71
|
| Rate for Payer: PACE SWMI |
$573.09
|
| Rate for Payer: PHP Commercial |
$802.33
|
| Rate for Payer: PHP Medicare Advantage |
$573.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$925.62
|
| Rate for Payer: Priority Health Medicare |
$573.09
|
| Rate for Payer: Priority Health Narrow Network |
$925.62
|
| Rate for Payer: Priority Health SBD |
$925.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$573.09
|
| Rate for Payer: UHC Medicare Advantage |
$573.09
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
| Rate for Payer: UMR Bronson Commercial |
$909.88
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 28295
|
| Min. Negotiated Rate |
$388.73 |
| Max. Negotiated Rate |
$1,564.75 |
| Rate for Payer: Aetna Commercial |
$767.10
|
| Rate for Payer: Aetna Medicare |
$595.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.34
|
| Rate for Payer: BCBS Complete |
$408.17
|
| Rate for Payer: BCBS MAPPO |
$572.46
|
| Rate for Payer: BCBS Trust/PPO |
$982.11
|
| Rate for Payer: BCN Commercial |
$1,564.75
|
| Rate for Payer: BCN Medicare Advantage |
$572.46
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$767.10
|
| Rate for Payer: Cofinity Commercial |
$824.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.08
|
| Rate for Payer: Meridian Medicaid |
$408.17
|
| Rate for Payer: Nomi Health Commercial |
$686.95
|
| Rate for Payer: PACE SWMI |
$572.46
|
| Rate for Payer: PHP Commercial |
$801.44
|
| Rate for Payer: PHP Medicare Advantage |
$572.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$572.46
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.46
|
| Rate for Payer: UHC Medicare Advantage |
$572.46
|
| Rate for Payer: UHCCP Medicaid |
$388.73
|
| Rate for Payer: UMR Bronson Commercial |
$756.24
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT
|
Professional
|
Both
|
$1,911.00
|
|
|
Service Code
|
HCPCS 28298
|
| Min. Negotiated Rate |
$329.09 |
| Max. Negotiated Rate |
$1,491.48 |
| Rate for Payer: Aetna Commercial |
$650.18
|
| Rate for Payer: Aetna Medicare |
$504.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.70
|
| Rate for Payer: BCBS Complete |
$345.54
|
| Rate for Payer: BCBS MAPPO |
$485.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.48
|
| Rate for Payer: BCN Commercial |
$1,212.90
|
| Rate for Payer: BCN Medicare Advantage |
$485.21
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$650.18
|
| Rate for Payer: Cofinity Commercial |
$698.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.47
|
| Rate for Payer: Meridian Medicaid |
$345.54
|
| Rate for Payer: Nomi Health Commercial |
$582.25
|
| Rate for Payer: PACE SWMI |
$485.21
|
| Rate for Payer: PHP Commercial |
$679.29
|
| Rate for Payer: PHP Medicare Advantage |
$485.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$782.63
|
| Rate for Payer: Priority Health Medicare |
$485.21
|
| Rate for Payer: Priority Health Narrow Network |
$782.63
|
| Rate for Payer: Priority Health SBD |
$782.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.21
|
| Rate for Payer: UHC Medicare Advantage |
$485.21
|
| Rate for Payer: UHCCP Medicaid |
$329.09
|
| Rate for Payer: UMR Bronson Commercial |
$879.06
|
|
