|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 63741
|
| Min. Negotiated Rate |
$248.83 |
| Max. Negotiated Rate |
$1,561.95 |
| Rate for Payer: Aetna Commercial |
$886.46
|
| Rate for Payer: Aetna Medicare |
$688.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.62
|
| Rate for Payer: BCBS Complete |
$462.28
|
| Rate for Payer: BCBS MAPPO |
$661.54
|
| Rate for Payer: BCBS Trust/PPO |
$248.83
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: BCN Medicare Advantage |
$661.54
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$886.46
|
| Rate for Payer: Cofinity Commercial |
$952.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.62
|
| Rate for Payer: Meridian Medicaid |
$462.28
|
| Rate for Payer: Nomi Health Commercial |
$793.85
|
| Rate for Payer: PACE SWMI |
$661.54
|
| Rate for Payer: PHP Commercial |
$926.16
|
| Rate for Payer: PHP Medicare Advantage |
$661.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,561.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,187.47
|
| Rate for Payer: Priority Health Medicare |
$661.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,187.47
|
| Rate for Payer: Priority Health SBD |
$1,187.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.54
|
| Rate for Payer: UHC Medicare Advantage |
$661.54
|
| Rate for Payer: UHCCP Medicaid |
$440.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,105.38
|
|
|
PR CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH
|
Professional
|
Both
|
$5,855.00
|
|
|
Service Code
|
HCPCS 62192
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$3,805.75 |
| Rate for Payer: Aetna Commercial |
$1,317.45
|
| Rate for Payer: Aetna Medicare |
$1,022.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,317.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,415.76
|
| Rate for Payer: BCBS Complete |
$682.80
|
| Rate for Payer: BCBS MAPPO |
$983.17
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$2,002.62
|
| Rate for Payer: BCN Medicare Advantage |
$983.17
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,317.45
|
| Rate for Payer: Cofinity Commercial |
$1,415.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$983.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,032.33
|
| Rate for Payer: Meridian Medicaid |
$682.80
|
| Rate for Payer: Nomi Health Commercial |
$1,179.80
|
| Rate for Payer: PACE SWMI |
$983.17
|
| Rate for Payer: PHP Commercial |
$1,376.44
|
| Rate for Payer: PHP Medicare Advantage |
$983.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,805.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,731.73
|
| Rate for Payer: Priority Health Medicare |
$983.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,731.73
|
| Rate for Payer: Priority Health SBD |
$1,731.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$983.17
|
| Rate for Payer: UHC Medicare Advantage |
$983.17
|
| Rate for Payer: UHCCP Medicaid |
$650.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,693.30
|
|
|
PR CRTJ SHUNT VENTRICULO-ATR-JUG-AUR
|
Professional
|
Both
|
$5,065.00
|
|
|
Service Code
|
HCPCS 62220
|
| Min. Negotiated Rate |
$635.38 |
| Max. Negotiated Rate |
$3,292.25 |
| Rate for Payer: Aetna Commercial |
$1,291.89
|
| Rate for Payer: Aetna Medicare |
$1,002.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,291.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.30
|
| Rate for Payer: BCBS Complete |
$667.15
|
| Rate for Payer: BCBS MAPPO |
$964.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.32
|
| Rate for Payer: BCN Commercial |
$1,984.31
|
| Rate for Payer: BCN Medicare Advantage |
$964.10
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Cofinity Commercial |
$1,291.89
|
| Rate for Payer: Cofinity Commercial |
$1,388.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.30
|
| Rate for Payer: Meridian Medicaid |
$667.15
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: PACE SWMI |
$964.10
|
| Rate for Payer: PHP Commercial |
$1,349.74
|
| Rate for Payer: PHP Medicare Advantage |
$964.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$635.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,292.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,691.36
|
| Rate for Payer: Priority Health Medicare |
$964.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.36
|
| Rate for Payer: Priority Health SBD |
$1,691.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.10
|
| Rate for Payer: UHC Medicare Advantage |
$964.10
|
| Rate for Payer: UHCCP Medicaid |
$635.38
|
| Rate for Payer: UMR Bronson Commercial |
$2,329.90
|
|
|
PR CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS
|
Professional
|
Both
|
$5,051.00
|
|
|
Service Code
|
HCPCS 62223
|
| Min. Negotiated Rate |
$672.87 |
| Max. Negotiated Rate |
$3,283.15 |
| Rate for Payer: Aetna Commercial |
$1,359.62
|
| Rate for Payer: Aetna Medicare |
$1,055.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.08
|
| Rate for Payer: BCBS Complete |
$706.51
|
| Rate for Payer: BCBS MAPPO |
$1,014.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.56
|
| Rate for Payer: BCN Commercial |
$2,125.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.64
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.62
|
| Rate for Payer: Cofinity Commercial |
$1,461.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.37
|
| Rate for Payer: Meridian Medicaid |
$706.51
|
| Rate for Payer: Nomi Health Commercial |
$1,217.57
|
| Rate for Payer: PACE SWMI |
$1,014.64
|
| Rate for Payer: PHP Commercial |
$1,420.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,283.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,794.86
|
| Rate for Payer: Priority Health Medicare |
$1,014.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,794.86
|
| Rate for Payer: Priority Health SBD |
$1,794.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.64
|
| Rate for Payer: UHCCP Medicaid |
$672.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,323.46
|
|
|
PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA
|
Professional
|
Both
|
$7,247.00
|
|
|
Service Code
|
HCPCS 62100
|
| Min. Negotiated Rate |
$1,019.84 |
| Max. Negotiated Rate |
$4,710.55 |
| Rate for Payer: Aetna Commercial |
$2,069.63
|
| Rate for Payer: Aetna Medicare |
$1,606.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,224.08
|
| Rate for Payer: BCBS Complete |
$1,070.83
|
| Rate for Payer: BCBS MAPPO |
$1,544.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.41
|
| Rate for Payer: BCN Commercial |
$3,210.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,544.50
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Cofinity Commercial |
$2,069.63
|
| Rate for Payer: Cofinity Commercial |
$2,224.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,544.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,621.72
|
| Rate for Payer: Meridian Medicaid |
$1,070.83
|
| Rate for Payer: Nomi Health Commercial |
$1,853.40
|
| Rate for Payer: PACE SWMI |
$1,544.50
|
| Rate for Payer: PHP Commercial |
$2,162.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,544.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,019.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,710.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,719.04
|
| Rate for Payer: Priority Health Medicare |
$1,544.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,719.04
|
| Rate for Payer: Priority Health SBD |
$2,719.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,544.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,544.50
|
| Rate for Payer: UHCCP Medicaid |
$1,019.84
|
| Rate for Payer: UMR Bronson Commercial |
$3,333.62
|
|
|
PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI
|
Professional
|
Both
|
$2,068.00
|
|
|
Service Code
|
HCPCS 55873
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$8,449.24 |
| Rate for Payer: Aetna Commercial |
$979.67
|
| Rate for Payer: Aetna Medicare |
$760.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.67
|
| Rate for Payer: BCBS Complete |
$514.62
|
| Rate for Payer: BCBS MAPPO |
$731.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,980.07
|
| Rate for Payer: BCN Commercial |
$8,449.24
|
| Rate for Payer: BCN Medicare Advantage |
$731.10
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,052.78
|
| Rate for Payer: Cofinity Commercial |
$979.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.66
|
| Rate for Payer: Meridian Medicaid |
$514.62
|
| Rate for Payer: Nomi Health Commercial |
$877.32
|
| Rate for Payer: PACE SWMI |
$731.10
|
| Rate for Payer: PHP Commercial |
$1,023.54
|
| Rate for Payer: PHP Medicare Advantage |
$731.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.46
|
| Rate for Payer: Priority Health Medicare |
$731.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.46
|
| Rate for Payer: Priority Health SBD |
$1,216.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.10
|
| Rate for Payer: UHC Medicare Advantage |
$731.10
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$951.28
|
|
|
PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 17340
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$145.43 |
| Rate for Payer: Aetna Commercial |
$62.32
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.97
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$46.51
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$76.72
|
| Rate for Payer: BCN Medicare Advantage |
$46.51
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$55.81
|
| Rate for Payer: PACE SWMI |
$46.51
|
| Rate for Payer: PHP Commercial |
$65.11
|
| Rate for Payer: PHP Medicare Advantage |
$46.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.37
|
| Rate for Payer: Priority Health Medicare |
$46.51
|
| Rate for Payer: Priority Health Narrow Network |
$66.37
|
| Rate for Payer: Priority Health SBD |
$66.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.51
|
| Rate for Payer: UHC Medicare Advantage |
$46.51
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC
|
Professional
|
Both
|
$4,560.00
|
|
|
Service Code
|
HCPCS 51595
|
| Min. Negotiated Rate |
$1,387.06 |
| Max. Negotiated Rate |
$3,447.52 |
| Rate for Payer: Aetna Commercial |
$2,788.79
|
| Rate for Payer: Aetna Medicare |
$2,164.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,788.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,996.91
|
| Rate for Payer: BCBS Complete |
$1,456.41
|
| Rate for Payer: BCBS MAPPO |
$2,081.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,019.16
|
| Rate for Payer: BCN Commercial |
$3,131.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,081.19
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Cofinity Commercial |
$2,788.79
|
| Rate for Payer: Cofinity Commercial |
$2,996.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,081.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,185.25
|
| Rate for Payer: Meridian Medicaid |
$1,456.41
|
| Rate for Payer: Nomi Health Commercial |
$2,497.43
|
| Rate for Payer: PACE SWMI |
$2,081.19
|
| Rate for Payer: PHP Commercial |
$2,913.67
|
| Rate for Payer: PHP Medicare Advantage |
$2,081.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,387.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,964.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,447.52
|
| Rate for Payer: Priority Health Medicare |
$2,081.19
|
| Rate for Payer: Priority Health Narrow Network |
$3,447.52
|
| Rate for Payer: Priority Health SBD |
$3,447.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,081.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,081.19
|
| Rate for Payer: UHCCP Medicaid |
$1,387.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,097.60
|
|
|
PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR
|
Professional
|
Both
|
$4,906.00
|
|
|
Service Code
|
HCPCS 51596
|
| Min. Negotiated Rate |
$1,498.46 |
| Max. Negotiated Rate |
$3,715.42 |
| Rate for Payer: Aetna Commercial |
$3,012.56
|
| Rate for Payer: Aetna Medicare |
$2,338.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,012.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,237.38
|
| Rate for Payer: BCBS Complete |
$1,573.38
|
| Rate for Payer: BCBS MAPPO |
$2,248.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.80
|
| Rate for Payer: BCN Commercial |
$3,380.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,248.18
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Cofinity Commercial |
$3,012.56
|
| Rate for Payer: Cofinity Commercial |
$3,237.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,248.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,360.59
|
| Rate for Payer: Meridian Medicaid |
$1,573.38
|
| Rate for Payer: Nomi Health Commercial |
$2,697.82
|
| Rate for Payer: PACE SWMI |
$2,248.18
|
| Rate for Payer: PHP Commercial |
$3,147.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,248.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,498.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,715.42
|
| Rate for Payer: Priority Health Medicare |
$2,248.18
|
| Rate for Payer: Priority Health Narrow Network |
$3,715.42
|
| Rate for Payer: Priority Health SBD |
$3,715.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,248.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,248.18
|
| Rate for Payer: UHCCP Medicaid |
$1,498.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,256.76
|
|
|
PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST
|
Professional
|
Both
|
$4,911.00
|
|
|
Service Code
|
HCPCS 51590
|
| Min. Negotiated Rate |
$1,226.24 |
| Max. Negotiated Rate |
$3,192.15 |
| Rate for Payer: Aetna Commercial |
$2,464.84
|
| Rate for Payer: Aetna Medicare |
$1,913.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,464.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,648.78
|
| Rate for Payer: BCBS Complete |
$1,287.55
|
| Rate for Payer: BCBS MAPPO |
$1,839.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.73
|
| Rate for Payer: BCN Commercial |
$2,767.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,839.43
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Cofinity Commercial |
$2,648.78
|
| Rate for Payer: Cofinity Commercial |
$2,464.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,839.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,931.40
|
| Rate for Payer: Meridian Medicaid |
$1,287.55
|
| Rate for Payer: Nomi Health Commercial |
$2,207.32
|
| Rate for Payer: PACE SWMI |
$1,839.43
|
| Rate for Payer: PHP Commercial |
$2,575.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,839.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,226.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.41
|
| Rate for Payer: Priority Health Medicare |
$1,839.43
|
| Rate for Payer: Priority Health Narrow Network |
$3,045.41
|
| Rate for Payer: Priority Health SBD |
$3,045.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,839.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,839.43
|
| Rate for Payer: UHCCP Medicaid |
$1,226.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,259.06
|
|
|
PR CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 51565
|
| Min. Negotiated Rate |
$820.90 |
| Max. Negotiated Rate |
$2,039.33 |
| Rate for Payer: Aetna Commercial |
$1,645.64
|
| Rate for Payer: Aetna Medicare |
$1,277.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,645.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,768.45
|
| Rate for Payer: BCBS Complete |
$861.94
|
| Rate for Payer: BCBS MAPPO |
$1,228.09
|
| Rate for Payer: BCN Commercial |
$1,851.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,228.09
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,645.64
|
| Rate for Payer: Cofinity Commercial |
$1,768.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,228.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,289.49
|
| Rate for Payer: Meridian Medicaid |
$861.94
|
| Rate for Payer: Nomi Health Commercial |
$1,473.71
|
| Rate for Payer: PACE SWMI |
$1,228.09
|
| Rate for Payer: PHP Commercial |
$1,719.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,228.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,039.33
|
| Rate for Payer: Priority Health Medicare |
$1,228.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,039.33
|
| Rate for Payer: Priority Health SBD |
$2,039.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,228.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,228.09
|
| Rate for Payer: UHCCP Medicaid |
$820.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.92
|
|
|
PR CSTOPLASTY/CSTOURTP PLSTC ANY
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 51800
|
| Min. Negotiated Rate |
$522.10 |
| Max. Negotiated Rate |
$3,574.48 |
| Rate for Payer: Aetna Commercial |
$1,326.80
|
| Rate for Payer: Aetna Medicare |
$1,029.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.82
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$990.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,574.48
|
| Rate for Payer: BCN Commercial |
$1,493.39
|
| Rate for Payer: BCN Medicare Advantage |
$990.15
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cofinity Commercial |
$1,326.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$990.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.66
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Nomi Health Commercial |
$1,188.18
|
| Rate for Payer: PACE SWMI |
$990.15
|
| Rate for Payer: PHP Commercial |
$1,386.21
|
| Rate for Payer: PHP Medicare Advantage |
$990.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,645.73
|
| Rate for Payer: Priority Health Medicare |
$990.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,645.73
|
| Rate for Payer: Priority Health SBD |
$1,645.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$990.15
|
| Rate for Payer: UHC Medicare Advantage |
$990.15
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
| Rate for Payer: UMR Bronson Commercial |
$522.10
|
|
|
PR CSTOURTP W/UNI/BI URTRONEOCSTOST
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 51820
|
| Min. Negotiated Rate |
$692.89 |
| Max. Negotiated Rate |
$4,989.27 |
| Rate for Payer: Aetna Commercial |
$1,386.98
|
| Rate for Payer: Aetna Medicare |
$1,076.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,490.49
|
| Rate for Payer: BCBS Complete |
$727.53
|
| Rate for Payer: BCBS MAPPO |
$1,035.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,989.27
|
| Rate for Payer: BCN Commercial |
$1,561.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.06
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cofinity Commercial |
$1,386.98
|
| Rate for Payer: Cofinity Commercial |
$1,490.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,086.81
|
| Rate for Payer: Meridian Medicaid |
$727.53
|
| Rate for Payer: Nomi Health Commercial |
$1,242.07
|
| Rate for Payer: PACE SWMI |
$1,035.06
|
| Rate for Payer: PHP Commercial |
$1,449.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,720.83
|
| Rate for Payer: Priority Health Medicare |
$1,035.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,720.83
|
| Rate for Payer: Priority Health SBD |
$1,720.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,035.06
|
| Rate for Payer: UHCCP Medicaid |
$692.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.82
|
|
|
PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 42972
|
| Min. Negotiated Rate |
$252.53 |
| Max. Negotiated Rate |
$915.17 |
| Rate for Payer: Aetna Commercial |
$648.40
|
| Rate for Payer: Aetna Medicare |
$503.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: BCBS Complete |
$343.53
|
| Rate for Payer: BCBS MAPPO |
$483.88
|
| Rate for Payer: BCBS Trust/PPO |
$252.53
|
| Rate for Payer: BCN Commercial |
$745.24
|
| Rate for Payer: BCN Medicare Advantage |
$483.88
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cofinity Commercial |
$648.40
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.07
|
| Rate for Payer: Meridian Medicaid |
$343.53
|
| Rate for Payer: Nomi Health Commercial |
$580.66
|
| Rate for Payer: PACE SWMI |
$483.88
|
| Rate for Payer: PHP Commercial |
$677.43
|
| Rate for Payer: PHP Medicare Advantage |
$483.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.17
|
| Rate for Payer: Priority Health Medicare |
$483.88
|
| Rate for Payer: Priority Health Narrow Network |
$915.17
|
| Rate for Payer: Priority Health SBD |
$915.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.88
|
| Rate for Payer: UHC Medicare Advantage |
$483.88
|
| Rate for Payer: UHCCP Medicaid |
$327.17
|
| Rate for Payer: UMR Bronson Commercial |
$431.02
|
|
|
PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 42970
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$743.96 |
| Rate for Payer: Aetna Commercial |
$524.78
|
| Rate for Payer: Aetna Medicare |
$407.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.95
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS MAPPO |
$391.63
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$604.99
|
| Rate for Payer: BCN Medicare Advantage |
$391.63
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$524.78
|
| Rate for Payer: Cofinity Commercial |
$563.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.21
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Nomi Health Commercial |
$469.96
|
| Rate for Payer: PACE SWMI |
$391.63
|
| Rate for Payer: PHP Commercial |
$548.28
|
| Rate for Payer: PHP Medicare Advantage |
$391.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.96
|
| Rate for Payer: Priority Health Medicare |
$391.63
|
| Rate for Payer: Priority Health Narrow Network |
$743.96
|
| Rate for Payer: Priority Health SBD |
$743.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.63
|
| Rate for Payer: UHC Medicare Advantage |
$391.63
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
| Rate for Payer: UMR Bronson Commercial |
$344.54
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 30905
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$835.24 |
| Rate for Payer: Aetna Commercial |
$137.64
|
| Rate for Payer: Aetna Medicare |
$106.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.92
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.72
|
| Rate for Payer: BCBS Trust/PPO |
$835.24
|
| Rate for Payer: BCN Commercial |
$519.95
|
| Rate for Payer: BCN Medicare Advantage |
$102.72
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.86
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Nomi Health Commercial |
$123.26
|
| Rate for Payer: PACE SWMI |
$102.72
|
| Rate for Payer: PHP Commercial |
$143.81
|
| Rate for Payer: PHP Medicare Advantage |
$102.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.46
|
| Rate for Payer: Priority Health Medicare |
$102.72
|
| Rate for Payer: Priority Health Narrow Network |
$146.46
|
| Rate for Payer: Priority Health SBD |
$146.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.72
|
| Rate for Payer: UHC Medicare Advantage |
$102.72
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$264.50
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 30906
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$907.62 |
| Rate for Payer: Aetna Commercial |
$170.70
|
| Rate for Payer: Aetna Medicare |
$132.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.44
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$127.39
|
| Rate for Payer: BCBS Trust/PPO |
$907.62
|
| Rate for Payer: BCN Commercial |
$551.23
|
| Rate for Payer: BCN Medicare Advantage |
$127.39
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cofinity Commercial |
$170.70
|
| Rate for Payer: Cofinity Commercial |
$183.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.76
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Nomi Health Commercial |
$152.87
|
| Rate for Payer: PACE SWMI |
$127.39
|
| Rate for Payer: PHP Commercial |
$178.35
|
| Rate for Payer: PHP Medicare Advantage |
$127.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.53
|
| Rate for Payer: Priority Health Medicare |
$127.39
|
| Rate for Payer: Priority Health Narrow Network |
$183.53
|
| Rate for Payer: Priority Health SBD |
$183.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.39
|
| Rate for Payer: UHC Medicare Advantage |
$127.39
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
| Rate for Payer: UMR Bronson Commercial |
$275.54
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ
|
Professional
|
Both
|
$780.00
|
|
|
Service Code
|
HCPCS 42961
|
| Min. Negotiated Rate |
$269.96 |
| Max. Negotiated Rate |
$758.87 |
| Rate for Payer: Aetna Commercial |
$534.35
|
| Rate for Payer: Aetna Medicare |
$414.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.23
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS MAPPO |
$398.77
|
| Rate for Payer: BCBS Trust/PPO |
$269.96
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$398.77
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Cofinity Commercial |
$534.35
|
| Rate for Payer: Cofinity Commercial |
$574.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.71
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Nomi Health Commercial |
$478.52
|
| Rate for Payer: PACE SWMI |
$398.77
|
| Rate for Payer: PHP Commercial |
$558.28
|
| Rate for Payer: PHP Medicare Advantage |
$398.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$507.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.87
|
| Rate for Payer: Priority Health Medicare |
$398.77
|
| Rate for Payer: Priority Health Narrow Network |
$758.87
|
| Rate for Payer: Priority Health SBD |
$758.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.77
|
| Rate for Payer: UHC Medicare Advantage |
$398.77
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
| Rate for Payer: UMR Bronson Commercial |
$358.80
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$1,901.00
|
|
|
Service Code
|
HCPCS 42962
|
| Min. Negotiated Rate |
$334.20 |
| Max. Negotiated Rate |
$1,235.65 |
| Rate for Payer: Aetna Commercial |
$659.90
|
| Rate for Payer: Aetna Medicare |
$512.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.14
|
| Rate for Payer: BCBS Complete |
$350.91
|
| Rate for Payer: BCBS MAPPO |
$492.46
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$763.31
|
| Rate for Payer: BCN Medicare Advantage |
$492.46
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Cofinity Commercial |
$659.90
|
| Rate for Payer: Cofinity Commercial |
$709.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.08
|
| Rate for Payer: Meridian Medicaid |
$350.91
|
| Rate for Payer: Nomi Health Commercial |
$590.95
|
| Rate for Payer: PACE SWMI |
$492.46
|
| Rate for Payer: PHP Commercial |
$689.44
|
| Rate for Payer: PHP Medicare Advantage |
$492.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$934.26
|
| Rate for Payer: Priority Health Medicare |
$492.46
|
| Rate for Payer: Priority Health Narrow Network |
$934.26
|
| Rate for Payer: Priority Health SBD |
$934.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.46
|
| Rate for Payer: UHC Medicare Advantage |
$492.46
|
| Rate for Payer: UHCCP Medicaid |
$334.20
|
| Rate for Payer: UMR Bronson Commercial |
$874.46
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 95929
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$350.35 |
| Rate for Payer: Aetna Commercial |
$286.55
|
| Rate for Payer: Aetna Medicare |
$222.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.93
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$213.84
|
| Rate for Payer: BCBS Trust/PPO |
$111.47
|
| Rate for Payer: BCN Commercial |
$349.40
|
| Rate for Payer: BCN Medicare Advantage |
$213.84
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$286.55
|
| Rate for Payer: Cofinity Commercial |
$307.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.53
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Nomi Health Commercial |
$256.61
|
| Rate for Payer: PACE SWMI |
$213.84
|
| Rate for Payer: PHP Commercial |
$299.38
|
| Rate for Payer: PHP Medicare Advantage |
$213.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.19
|
| Rate for Payer: Priority Health Medicare |
$213.84
|
| Rate for Payer: Priority Health Narrow Network |
$330.19
|
| Rate for Payer: Priority Health SBD |
$104.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.84
|
| Rate for Payer: UHC Medicare Advantage |
$213.84
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
| Rate for Payer: UMR Bronson Commercial |
$247.94
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 95928
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$344.03 |
| Rate for Payer: Aetna Commercial |
$286.26
|
| Rate for Payer: Aetna Commercial |
$286.26
|
| Rate for Payer: Aetna Medicare |
$222.18
|
| Rate for Payer: Aetna Medicare |
$222.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.63
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$213.63
|
| Rate for Payer: BCBS MAPPO |
$213.63
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: BCN Medicare Advantage |
$213.63
|
| Rate for Payer: BCN Medicare Advantage |
$213.63
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$286.26
|
| Rate for Payer: Cofinity Commercial |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$286.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.31
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Nomi Health Commercial |
$256.36
|
| Rate for Payer: Nomi Health Commercial |
$256.36
|
| Rate for Payer: PACE SWMI |
$213.63
|
| Rate for Payer: PACE SWMI |
$213.63
|
| Rate for Payer: PHP Commercial |
$299.08
|
| Rate for Payer: PHP Commercial |
$299.08
|
| Rate for Payer: PHP Medicare Advantage |
$213.63
|
| Rate for Payer: PHP Medicare Advantage |
$213.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.58
|
| Rate for Payer: Priority Health Medicare |
$213.63
|
| Rate for Payer: Priority Health Medicare |
$213.63
|
| Rate for Payer: Priority Health Narrow Network |
$326.58
|
| Rate for Payer: Priority Health Narrow Network |
$326.58
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.63
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
| Rate for Payer: UMR Bronson Commercial |
$228.62
|
| Rate for Payer: UMR Bronson Commercial |
$156.40
|
|
|
PR CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 95939
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$797.04 |
| Rate for Payer: Aetna Commercial |
$663.49
|
| Rate for Payer: Aetna Medicare |
$514.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.00
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$495.14
|
| Rate for Payer: BCBS Trust/PPO |
$596.45
|
| Rate for Payer: BCN Commercial |
$797.04
|
| Rate for Payer: BCN Medicare Advantage |
$495.14
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$663.49
|
| Rate for Payer: Cofinity Commercial |
$713.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.90
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PACE SWMI |
$495.14
|
| Rate for Payer: PHP Commercial |
$693.20
|
| Rate for Payer: PHP Medicare Advantage |
$495.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.17
|
| Rate for Payer: Priority Health Medicare |
$495.14
|
| Rate for Payer: Priority Health Narrow Network |
$757.17
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$495.14
|
| Rate for Payer: UHC Medicare Advantage |
$495.14
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$150.88
|
|
|
PR CURETTAGE POSTPARTUM
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 59160
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$516.15 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$189.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.17
|
| Rate for Payer: BCBS Complete |
$126.81
|
| Rate for Payer: BCBS MAPPO |
$182.06
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$405.60
|
| Rate for Payer: BCN Medicare Advantage |
$182.06
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$243.96
|
| Rate for Payer: Cofinity Commercial |
$262.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.16
|
| Rate for Payer: Meridian Medicaid |
$126.81
|
| Rate for Payer: Nomi Health Commercial |
$218.47
|
| Rate for Payer: PACE SWMI |
$182.06
|
| Rate for Payer: PHP Commercial |
$254.88
|
| Rate for Payer: PHP Medicare Advantage |
$182.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.41
|
| Rate for Payer: Priority Health Medicare |
$182.06
|
| Rate for Payer: Priority Health Narrow Network |
$266.41
|
| Rate for Payer: Priority Health SBD |
$266.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.06
|
| Rate for Payer: UHC Medicare Advantage |
$182.06
|
| Rate for Payer: UHCCP Medicaid |
$120.77
|
| Rate for Payer: UMR Bronson Commercial |
$251.16
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 46940
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$392.89 |
| Rate for Payer: Aetna Commercial |
$185.88
|
| Rate for Payer: Aetna Medicare |
$144.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.76
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$138.72
|
| Rate for Payer: BCN Commercial |
$392.89
|
| Rate for Payer: BCN Medicare Advantage |
$138.72
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$199.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.66
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: PACE SWMI |
$138.72
|
| Rate for Payer: PHP Commercial |
$194.21
|
| Rate for Payer: PHP Medicare Advantage |
$138.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.11
|
| Rate for Payer: Priority Health Medicare |
$138.72
|
| Rate for Payer: Priority Health Narrow Network |
$260.11
|
| Rate for Payer: Priority Health SBD |
$260.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.72
|
| Rate for Payer: UHC Medicare Advantage |
$138.72
|
| Rate for Payer: UHCCP Medicaid |
$93.29
|
| Rate for Payer: UMR Bronson Commercial |
$220.34
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 46942
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,144.83 |
| Rate for Payer: Aetna Commercial |
$166.35
|
| Rate for Payer: Aetna Medicare |
$129.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.76
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$124.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.83
|
| Rate for Payer: BCN Commercial |
$373.84
|
| Rate for Payer: BCN Medicare Advantage |
$124.14
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Cofinity Commercial |
$178.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.35
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$148.97
|
| Rate for Payer: PACE SWMI |
$124.14
|
| Rate for Payer: PHP Commercial |
$173.80
|
| Rate for Payer: PHP Medicare Advantage |
$124.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.87
|
| Rate for Payer: Priority Health Medicare |
$124.14
|
| Rate for Payer: Priority Health Narrow Network |
$233.87
|
| Rate for Payer: Priority Health SBD |
$233.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.14
|
| Rate for Payer: UHC Medicare Advantage |
$124.14
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
| Rate for Payer: UMR Bronson Commercial |
$154.10
|
|
