|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$137.95 |
| Max. Negotiated Rate |
$463.55 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: Aetna Medicare |
$258.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.91
|
| Rate for Payer: BCN Commercial |
$137.95
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$374.38
|
| Rate for Payer: Priority Health SBD |
$374.38
|
| Rate for Payer: Priority Health Tiered Network |
$374.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.55
|
| Rate for Payer: UHC Core |
$463.55
|
| Rate for Payer: UHC Exchange |
$463.55
|
| Rate for Payer: UMR Bronson Commercial |
$237.36
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,104.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$1,578.00 |
| Rate for Payer: Aetna Commercial |
$268.83
|
| Rate for Payer: Aetna Medicare |
$208.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.89
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$200.62
|
| Rate for Payer: BCN Commercial |
$346.10
|
| Rate for Payer: BCN Medicare Advantage |
$200.62
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cofinity Commercial |
$268.83
|
| Rate for Payer: Cofinity Commercial |
$288.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.65
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.68
|
| Rate for Payer: Nomi Health Commercial |
$240.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.00
|
| Rate for Payer: PACE SWMI |
$200.62
|
| Rate for Payer: PHP Commercial |
$280.87
|
| Rate for Payer: PHP Medicare Advantage |
$200.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$350.52
|
| Rate for Payer: Priority Health Medicare |
$200.62
|
| Rate for Payer: Priority Health SBD |
$350.52
|
| Rate for Payer: Priority Health Tiered Network |
$350.52
|
| Rate for Payer: Railroad Medicare Medicare |
$200.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.94
|
| Rate for Payer: UHC Core |
$397.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.62
|
| Rate for Payer: UHC Exchange |
$397.94
|
| Rate for Payer: UHC Medicaid |
$129.93
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
| Rate for Payer: UMR Bronson Commercial |
$967.84
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$47.58
|
| Rate for Payer: Aetna Medicare |
$36.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.13
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$35.51
|
| Rate for Payer: BCN Commercial |
$60.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.51
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$47.58
|
| Rate for Payer: Cofinity Commercial |
$51.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.29
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.06
|
| Rate for Payer: Nomi Health Commercial |
$42.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$35.51
|
| Rate for Payer: PHP Commercial |
$49.71
|
| Rate for Payer: PHP Medicare Advantage |
$35.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.03
|
| Rate for Payer: Priority Health Medicare |
$35.51
|
| Rate for Payer: Priority Health SBD |
$61.03
|
| Rate for Payer: Priority Health Tiered Network |
$61.03
|
| Rate for Payer: Railroad Medicare Medicare |
$35.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.11
|
| Rate for Payer: UHC Core |
$73.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.51
|
| Rate for Payer: UHC Exchange |
$73.11
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
| Rate for Payer: UMR Bronson Commercial |
$63.02
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.24 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna American Axle |
$143.65
|
| Rate for Payer: Aetna Commercial |
$187.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.65
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Advantage |
$154.70
|
| Rate for Payer: Cofinity Commercial |
$190.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PHP Commercial |
$187.85
|
| Rate for Payer: Priority Health SBD |
$139.23
|
| Rate for Payer: UMR Bronson Commercial |
$97.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.75
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$81.77 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna American Axle |
$143.65
|
| Rate for Payer: Aetna Commercial |
$187.85
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$159.75
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$159.75
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Advantage |
$154.70
|
| Rate for Payer: Cofinity Commercial |
$190.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.75
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$187.85
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$139.23
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: UMR Bronson Commercial |
$81.77
|
| Rate for Payer: VA VA |
$201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.75
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
58100
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.05
|
| Rate for Payer: Aetna Medicare |
$57.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.57
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$55.26
|
| Rate for Payer: BCN Commercial |
$74.22
|
| Rate for Payer: BCN Medicare Advantage |
$55.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Cofinity Commercial |
$79.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.02
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.79
|
| Rate for Payer: Nomi Health Commercial |
$66.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$55.26
|
| Rate for Payer: PHP Commercial |
$77.36
|
| Rate for Payer: PHP Medicare Advantage |
$55.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.31
|
| Rate for Payer: Priority Health Medicare |
$55.26
|
| Rate for Payer: Priority Health SBD |
$95.31
|
| Rate for Payer: Priority Health Tiered Network |
$95.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.34
|
| Rate for Payer: UHC Core |
$114.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.26
|
| Rate for Payer: UHC Exchange |
$114.34
|
| Rate for Payer: UHC Medicaid |
$35.15
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.05
|
| Rate for Payer: Aetna Medicare |
$57.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.57
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$55.26
|
| Rate for Payer: BCN Commercial |
$74.22
|
| Rate for Payer: BCN Medicare Advantage |
$55.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Cofinity Commercial |
$79.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.02
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.79
|
| Rate for Payer: Nomi Health Commercial |
$66.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$55.26
|
| Rate for Payer: PHP Commercial |
$77.36
|
| Rate for Payer: PHP Medicare Advantage |
$55.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.31
|
| Rate for Payer: Priority Health Medicare |
$55.26
|
| Rate for Payer: Priority Health SBD |
$95.31
|
| Rate for Payer: Priority Health Tiered Network |
$95.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.34
|
| Rate for Payer: UHC Core |
$114.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.26
|
| Rate for Payer: UHC Exchange |
$114.34
|
| Rate for Payer: UHC Medicaid |
$35.15
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,897.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$194.90 |
| Max. Negotiated Rate |
$2,172.75 |
| Rate for Payer: Aetna Commercial |
$408.87
|
| Rate for Payer: Aetna Medicare |
$317.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.39
|
| Rate for Payer: BCBS Complete |
$204.65
|
| Rate for Payer: BCBS MAPPO |
$305.13
|
| Rate for Payer: BCN Commercial |
$526.37
|
| Rate for Payer: BCN Medicare Advantage |
$305.13
|
| Rate for Payer: Cash Price |
$2,317.60
|
| Rate for Payer: Cash Price |
$2,317.60
|
| Rate for Payer: Cofinity Commercial |
$408.87
|
| Rate for Payer: Cofinity Commercial |
$439.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.39
|
| Rate for Payer: Meridian Medicaid |
$204.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.64
|
| Rate for Payer: Nomi Health Commercial |
$366.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,172.75
|
| Rate for Payer: PACE SWMI |
$305.13
|
| Rate for Payer: PHP Commercial |
$427.18
|
| Rate for Payer: PHP Medicare Advantage |
$305.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$533.09
|
| Rate for Payer: Priority Health Medicare |
$305.13
|
| Rate for Payer: Priority Health SBD |
$533.09
|
| Rate for Payer: Priority Health Tiered Network |
$533.09
|
| Rate for Payer: Railroad Medicare Medicare |
$305.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.49
|
| Rate for Payer: UHC Core |
$628.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.13
|
| Rate for Payer: UHC Exchange |
$628.49
|
| Rate for Payer: UHC Medicaid |
$194.90
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,332.62
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$361.50 |
| Rate for Payer: Aetna Commercial |
$135.34
|
| Rate for Payer: Aetna Medicare |
$105.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.44
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$101.00
|
| Rate for Payer: BCN Commercial |
$174.79
|
| Rate for Payer: BCN Medicare Advantage |
$101.00
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$135.34
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.05
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.10
|
| Rate for Payer: Nomi Health Commercial |
$121.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.50
|
| Rate for Payer: PACE SWMI |
$101.00
|
| Rate for Payer: PHP Commercial |
$141.40
|
| Rate for Payer: PHP Medicare Advantage |
$101.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$212.98
|
| Rate for Payer: Priority Health Medicare |
$101.00
|
| Rate for Payer: Priority Health SBD |
$212.98
|
| Rate for Payer: Priority Health Tiered Network |
$212.98
|
| Rate for Payer: Railroad Medicare Medicare |
$101.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.66
|
| Rate for Payer: UHC Core |
$212.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.00
|
| Rate for Payer: UHC Exchange |
$212.66
|
| Rate for Payer: UHC Medicaid |
$64.97
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| Rate for Payer: UMR Bronson Commercial |
$221.72
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$722.25 |
| Rate for Payer: Aetna Commercial |
$168.08
|
| Rate for Payer: Aetna Medicare |
$130.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.62
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$125.43
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$125.43
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$168.08
|
| Rate for Payer: Cofinity Commercial |
$180.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.70
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.97
|
| Rate for Payer: Nomi Health Commercial |
$150.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.25
|
| Rate for Payer: PACE SWMI |
$125.43
|
| Rate for Payer: PHP Commercial |
$175.60
|
| Rate for Payer: PHP Medicare Advantage |
$125.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.87
|
| Rate for Payer: Priority Health Medicare |
$125.43
|
| Rate for Payer: Priority Health SBD |
$257.87
|
| Rate for Payer: Priority Health Tiered Network |
$257.87
|
| Rate for Payer: Railroad Medicare Medicare |
$125.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.60
|
| Rate for Payer: UHC Core |
$252.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$125.43
|
| Rate for Payer: UHC Exchange |
$252.60
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
| Rate for Payer: UMR Bronson Commercial |
$442.98
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 44361
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$763.50 |
| Rate for Payer: Aetna Commercial |
$185.35
|
| Rate for Payer: Aetna Medicare |
$143.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$138.32
|
| Rate for Payer: BCN Commercial |
$234.05
|
| Rate for Payer: BCN Medicare Advantage |
$138.32
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$185.35
|
| Rate for Payer: Cofinity Commercial |
$199.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.24
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.15
|
| Rate for Payer: Nomi Health Commercial |
$165.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.50
|
| Rate for Payer: PACE SWMI |
$138.32
|
| Rate for Payer: PHP Commercial |
$193.65
|
| Rate for Payer: PHP Medicare Advantage |
$138.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$285.18
|
| Rate for Payer: Priority Health Medicare |
$138.32
|
| Rate for Payer: Priority Health SBD |
$285.18
|
| Rate for Payer: Priority Health Tiered Network |
$285.18
|
| Rate for Payer: Railroad Medicare Medicare |
$138.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.96
|
| Rate for Payer: UHC Core |
$278.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.32
|
| Rate for Payer: UHC Exchange |
$278.96
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
| Rate for Payer: UMR Bronson Commercial |
$468.28
|
|
|
PR ENDOVASC ABDO REPAIR W/PROS
|
Professional
|
Both
|
$5,493.00
|
|
|
Service Code
|
HCPCS 34805
|
| Min. Negotiated Rate |
$2,197.20 |
| Max. Negotiated Rate |
$4,119.75 |
| Rate for Payer: Aetna Medicare |
$2,746.50
|
| Rate for Payer: BCBS Complete |
$2,197.20
|
| Rate for Payer: Cash Price |
$4,394.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,119.75
|
| Rate for Payer: UMR Bronson Commercial |
$2,526.78
|
|
|
PR ENDOVASCULAR REPAIR ILIAC ARTERY W ILIO-ILIAC PROSTHESIS
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 34900
|
| Min. Negotiated Rate |
$727.60 |
| Max. Negotiated Rate |
$1,364.25 |
| Rate for Payer: Aetna Medicare |
$909.50
|
| Rate for Payer: BCBS Complete |
$727.60
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,364.25
|
| Rate for Payer: UMR Bronson Commercial |
$836.74
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,823.00
|
|
|
Service Code
|
HCPCS 36478
|
| Min. Negotiated Rate |
$157.41 |
| Max. Negotiated Rate |
$2,117.25 |
| Rate for Payer: Aetna Commercial |
$332.65
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.48
|
| Rate for Payer: BCBS Complete |
$165.28
|
| Rate for Payer: BCBS MAPPO |
$248.25
|
| Rate for Payer: BCN Commercial |
$407.35
|
| Rate for Payer: BCN Medicare Advantage |
$248.25
|
| Rate for Payer: Cash Price |
$2,258.40
|
| Rate for Payer: Cash Price |
$2,258.40
|
| Rate for Payer: Cofinity Commercial |
$332.65
|
| Rate for Payer: Cofinity Commercial |
$357.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.66
|
| Rate for Payer: Meridian Medicaid |
$165.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.07
|
| Rate for Payer: Nomi Health Commercial |
$297.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,117.25
|
| Rate for Payer: PACE SWMI |
$248.25
|
| Rate for Payer: PHP Commercial |
$347.55
|
| Rate for Payer: PHP Medicare Advantage |
$248.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$438.04
|
| Rate for Payer: Priority Health Medicare |
$248.25
|
| Rate for Payer: Priority Health SBD |
$438.04
|
| Rate for Payer: Priority Health Tiered Network |
$438.04
|
| Rate for Payer: Railroad Medicare Medicare |
$248.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.74
|
| Rate for Payer: UHC Core |
$496.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.25
|
| Rate for Payer: UHC Exchange |
$496.74
|
| Rate for Payer: UHC Medicaid |
$157.41
|
| Rate for Payer: UHCCP Medicaid |
$157.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,298.58
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,243.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$2,432.25 |
| Rate for Payer: Aetna Commercial |
$332.82
|
| Rate for Payer: Aetna Medicare |
$258.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.65
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$248.37
|
| Rate for Payer: BCN Commercial |
$406.35
|
| Rate for Payer: BCN Medicare Advantage |
$248.37
|
| Rate for Payer: Cash Price |
$2,594.40
|
| Rate for Payer: Cash Price |
$2,594.40
|
| Rate for Payer: Cofinity Commercial |
$332.82
|
| Rate for Payer: Cofinity Commercial |
$357.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.79
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.21
|
| Rate for Payer: Nomi Health Commercial |
$298.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,432.25
|
| Rate for Payer: PACE SWMI |
$248.37
|
| Rate for Payer: PHP Commercial |
$347.72
|
| Rate for Payer: PHP Medicare Advantage |
$248.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$436.98
|
| Rate for Payer: Priority Health Medicare |
$248.37
|
| Rate for Payer: Priority Health SBD |
$436.98
|
| Rate for Payer: Priority Health Tiered Network |
$436.98
|
| Rate for Payer: Railroad Medicare Medicare |
$248.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.77
|
| Rate for Payer: UHC Core |
$498.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.37
|
| Rate for Payer: UHC Exchange |
$498.77
|
| Rate for Payer: UHC Medicaid |
$157.19
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,491.78
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$159.39
|
| Rate for Payer: Aetna Medicare |
$123.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.29
|
| Rate for Payer: BCBS Complete |
$78.73
|
| Rate for Payer: BCBS MAPPO |
$118.95
|
| Rate for Payer: BCN Commercial |
$195.70
|
| Rate for Payer: BCN Medicare Advantage |
$118.95
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$159.39
|
| Rate for Payer: Cofinity Commercial |
$171.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.90
|
| Rate for Payer: Meridian Medicaid |
$78.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.84
|
| Rate for Payer: Nomi Health Commercial |
$142.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.00
|
| Rate for Payer: PACE SWMI |
$118.95
|
| Rate for Payer: PHP Commercial |
$166.53
|
| Rate for Payer: PHP Medicare Advantage |
$118.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$210.45
|
| Rate for Payer: Priority Health Medicare |
$118.95
|
| Rate for Payer: Priority Health SBD |
$210.45
|
| Rate for Payer: Priority Health Tiered Network |
$210.45
|
| Rate for Payer: Railroad Medicare Medicare |
$118.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.23
|
| Rate for Payer: UHC Core |
$242.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.95
|
| Rate for Payer: UHC Exchange |
$242.23
|
| Rate for Payer: UHC Medicaid |
$74.98
|
| Rate for Payer: UHCCP Medicaid |
$74.98
|
| Rate for Payer: UMR Bronson Commercial |
$154.56
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$1,281.75 |
| Rate for Payer: Aetna Commercial |
$292.00
|
| Rate for Payer: Aetna Medicare |
$226.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.79
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS MAPPO |
$217.91
|
| Rate for Payer: BCN Commercial |
$357.05
|
| Rate for Payer: BCN Medicare Advantage |
$217.91
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cofinity Commercial |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.81
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$261.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.75
|
| Rate for Payer: PACE SWMI |
$217.91
|
| Rate for Payer: PHP Commercial |
$305.07
|
| Rate for Payer: PHP Medicare Advantage |
$217.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$435.04
|
| Rate for Payer: Priority Health Medicare |
$217.91
|
| Rate for Payer: Priority Health SBD |
$435.04
|
| Rate for Payer: Priority Health Tiered Network |
$435.04
|
| Rate for Payer: Railroad Medicare Medicare |
$217.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.49
|
| Rate for Payer: UHC Core |
$433.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.91
|
| Rate for Payer: UHC Exchange |
$433.49
|
| Rate for Payer: UHC Medicaid |
$138.02
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
| Rate for Payer: UMR Bronson Commercial |
$786.14
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,602.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$699.92 |
| Max. Negotiated Rate |
$2,701.50 |
| Rate for Payer: Aetna Commercial |
$1,464.26
|
| Rate for Payer: Aetna Medicare |
$1,136.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,573.53
|
| Rate for Payer: BCBS Complete |
$734.92
|
| Rate for Payer: BCBS MAPPO |
$1,092.73
|
| Rate for Payer: BCN Commercial |
$1,762.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,092.73
|
| Rate for Payer: Cash Price |
$2,881.60
|
| Rate for Payer: Cash Price |
$2,881.60
|
| Rate for Payer: Cofinity Commercial |
$1,464.26
|
| Rate for Payer: Cofinity Commercial |
$1,573.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,092.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,147.37
|
| Rate for Payer: Meridian Medicaid |
$734.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,202.00
|
| Rate for Payer: Nomi Health Commercial |
$1,311.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,701.50
|
| Rate for Payer: PACE SWMI |
$1,092.73
|
| Rate for Payer: PHP Commercial |
$1,529.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,092.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$699.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,147.93
|
| Rate for Payer: Priority Health Medicare |
$1,092.73
|
| Rate for Payer: Priority Health SBD |
$2,147.93
|
| Rate for Payer: Priority Health Tiered Network |
$2,147.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,092.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,102.72
|
| Rate for Payer: UHC Core |
$2,102.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,092.73
|
| Rate for Payer: UHC Exchange |
$2,102.72
|
| Rate for Payer: UHC Medicaid |
$699.92
|
| Rate for Payer: UHCCP Medicaid |
$699.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,656.92
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,963.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$788.74 |
| Max. Negotiated Rate |
$2,449.31 |
| Rate for Payer: Aetna Commercial |
$1,640.36
|
| Rate for Payer: Aetna Medicare |
$1,273.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,640.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,762.78
|
| Rate for Payer: BCBS Complete |
$828.18
|
| Rate for Payer: BCBS MAPPO |
$1,224.15
|
| Rate for Payer: BCN Commercial |
$2,061.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.15
|
| Rate for Payer: Cash Price |
$2,370.40
|
| Rate for Payer: Cash Price |
$2,370.40
|
| Rate for Payer: Cofinity Commercial |
$1,640.36
|
| Rate for Payer: Cofinity Commercial |
$1,762.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,285.36
|
| Rate for Payer: Meridian Medicaid |
$828.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,346.57
|
| Rate for Payer: Nomi Health Commercial |
$1,468.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,222.25
|
| Rate for Payer: PACE SWMI |
$1,224.15
|
| Rate for Payer: PHP Commercial |
$1,713.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,245.25
|
| Rate for Payer: Priority Health Medicare |
$1,224.15
|
| Rate for Payer: Priority Health SBD |
$2,245.25
|
| Rate for Payer: Priority Health Tiered Network |
$2,245.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,224.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,449.31
|
| Rate for Payer: UHC Core |
$2,449.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,224.15
|
| Rate for Payer: UHC Exchange |
$2,449.31
|
| Rate for Payer: UHC Medicaid |
$788.74
|
| Rate for Payer: UHCCP Medicaid |
$788.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,362.98
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$784.91 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,641.39
|
| Rate for Payer: Aetna Medicare |
$1,273.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,763.88
|
| Rate for Payer: BCBS Complete |
$824.16
|
| Rate for Payer: BCBS MAPPO |
$1,224.92
|
| Rate for Payer: BCN Commercial |
$1,975.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.92
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,641.39
|
| Rate for Payer: Cofinity Commercial |
$1,763.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,286.17
|
| Rate for Payer: Meridian Medicaid |
$824.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,347.41
|
| Rate for Payer: Nomi Health Commercial |
$1,469.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: PACE SWMI |
$1,224.92
|
| Rate for Payer: PHP Commercial |
$1,714.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$784.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,407.62
|
| Rate for Payer: Priority Health Medicare |
$1,224.92
|
| Rate for Payer: Priority Health SBD |
$2,407.62
|
| Rate for Payer: Priority Health Tiered Network |
$2,407.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,224.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,343.88
|
| Rate for Payer: UHC Core |
$2,343.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,224.92
|
| Rate for Payer: UHC Exchange |
$2,343.88
|
| Rate for Payer: UHC Medicaid |
$784.91
|
| Rate for Payer: UHCCP Medicaid |
$784.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,502.82
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,073.00 |
| Max. Negotiated Rate |
$4,843.26 |
| Rate for Payer: Aetna American Axle |
$1,885.00
|
| Rate for Payer: Aetna Commercial |
$2,465.00
|
| Rate for Payer: Aetna Medicare |
$1,450.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,885.00
|
| Rate for Payer: BCBS Complete |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,843.26
|
| Rate for Payer: BCN Commercial |
$4,843.26
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Advantage |
$2,030.00
|
| Rate for Payer: Cofinity Commercial |
$2,494.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,320.00
|
| Rate for Payer: Healthscope Commercial |
$2,610.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,175.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,320.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,465.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PHP Commercial |
$2,465.00
|
| Rate for Payer: Priority Health SBD |
$1,827.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,175.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,900.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$650.72 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Aetna Commercial |
$1,362.35
|
| Rate for Payer: Aetna Medicare |
$1,057.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.02
|
| Rate for Payer: BCBS Complete |
$683.26
|
| Rate for Payer: BCBS MAPPO |
$1,016.68
|
| Rate for Payer: BCN Commercial |
$1,637.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.68
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Commercial |
$1,362.35
|
| Rate for Payer: Cofinity Commercial |
$1,464.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,067.51
|
| Rate for Payer: Meridian Medicaid |
$683.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,118.35
|
| Rate for Payer: Nomi Health Commercial |
$1,220.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PACE SWMI |
$1,016.68
|
| Rate for Payer: PHP Commercial |
$1,423.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,995.63
|
| Rate for Payer: Priority Health Medicare |
$1,016.68
|
| Rate for Payer: Priority Health SBD |
$1,995.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,995.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,016.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.99
|
| Rate for Payer: UHC Core |
$1,950.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,016.68
|
| Rate for Payer: UHC Exchange |
$1,950.99
|
| Rate for Payer: UHC Medicaid |
$650.72
|
| Rate for Payer: UHCCP Medicaid |
$650.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,334.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,900.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$650.72 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Aetna Commercial |
$1,362.35
|
| Rate for Payer: Aetna Medicare |
$1,057.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.02
|
| Rate for Payer: BCBS Complete |
$683.26
|
| Rate for Payer: BCBS MAPPO |
$1,016.68
|
| Rate for Payer: BCN Commercial |
$1,637.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,016.68
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Commercial |
$1,362.35
|
| Rate for Payer: Cofinity Commercial |
$1,464.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,016.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,067.51
|
| Rate for Payer: Meridian Medicaid |
$683.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,118.35
|
| Rate for Payer: Nomi Health Commercial |
$1,220.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PACE SWMI |
$1,016.68
|
| Rate for Payer: PHP Commercial |
$1,423.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,016.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,995.63
|
| Rate for Payer: Priority Health Medicare |
$1,016.68
|
| Rate for Payer: Priority Health SBD |
$1,995.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,995.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,016.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.99
|
| Rate for Payer: UHC Core |
$1,950.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,016.68
|
| Rate for Payer: UHC Exchange |
$1,950.99
|
| Rate for Payer: UHC Medicaid |
$650.72
|
| Rate for Payer: UHCCP Medicaid |
$650.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,334.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,276.00 |
| Max. Negotiated Rate |
$2,610.00 |
| Rate for Payer: Aetna American Axle |
$1,885.00
|
| Rate for Payer: Aetna Commercial |
$2,465.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,885.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Advantage |
$2,030.00
|
| Rate for Payer: Cofinity Commercial |
$2,494.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,320.00
|
| Rate for Payer: Healthscope Commercial |
$2,610.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,175.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,465.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PHP Commercial |
$2,465.00
|
| Rate for Payer: Priority Health SBD |
$1,827.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,175.00
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,173.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$946.57 |
| Max. Negotiated Rate |
$2,943.98 |
| Rate for Payer: Aetna Commercial |
$1,987.27
|
| Rate for Payer: Aetna Medicare |
$1,542.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,987.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,135.58
|
| Rate for Payer: BCBS Complete |
$993.90
|
| Rate for Payer: BCBS MAPPO |
$1,483.04
|
| Rate for Payer: BCN Commercial |
$2,416.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,483.04
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$1,987.27
|
| Rate for Payer: Cofinity Commercial |
$2,135.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,483.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,557.19
|
| Rate for Payer: Meridian Medicaid |
$993.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,631.34
|
| Rate for Payer: Nomi Health Commercial |
$1,779.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.75
|
| Rate for Payer: PACE SWMI |
$1,483.04
|
| Rate for Payer: PHP Commercial |
$2,076.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,483.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$946.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,943.98
|
| Rate for Payer: Priority Health Medicare |
$1,483.04
|
| Rate for Payer: Priority Health SBD |
$2,943.98
|
| Rate for Payer: Priority Health Tiered Network |
$2,943.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,483.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,892.18
|
| Rate for Payer: UHC Core |
$2,892.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,483.04
|
| Rate for Payer: UHC Exchange |
$2,892.18
|
| Rate for Payer: UHC Medicaid |
$946.57
|
| Rate for Payer: UHCCP Medicaid |
$946.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,459.58
|
|
