|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$1,321.60 |
| Max. Negotiated Rate |
$2,581.02 |
| Rate for Payer: Aetna Commercial |
$2,348.49
|
| Rate for Payer: Aetna Medicare |
$1,652.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,348.49
|
| Rate for Payer: BCBS Complete |
$1,321.60
|
| Rate for Payer: BCN Commercial |
$2,581.02
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,478.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,519.84
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,083.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$349.75 |
| Max. Negotiated Rate |
$1,073.95 |
| Rate for Payer: Aetna Commercial |
$699.56
|
| Rate for Payer: Aetna Medicare |
$542.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.77
|
| Rate for Payer: BCBS Complete |
$367.24
|
| Rate for Payer: BCBS MAPPO |
$522.06
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: BCN Medicare Advantage |
$522.06
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cofinity Commercial |
$751.77
|
| Rate for Payer: Cofinity Commercial |
$699.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.16
|
| Rate for Payer: Meridian Medicaid |
$367.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$574.27
|
| Rate for Payer: Nomi Health Commercial |
$626.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$812.25
|
| Rate for Payer: PACE SWMI |
$522.06
|
| Rate for Payer: PHP Commercial |
$730.88
|
| Rate for Payer: PHP Medicare Advantage |
$522.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,073.95
|
| Rate for Payer: Priority Health Medicare |
$522.06
|
| Rate for Payer: Priority Health SBD |
$1,073.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,073.95
|
| Rate for Payer: Railroad Medicare Medicare |
$522.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.68
|
| Rate for Payer: UHC Core |
$997.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$522.06
|
| Rate for Payer: UHC Exchange |
$997.68
|
| Rate for Payer: UHC Medicaid |
$349.75
|
| Rate for Payer: UHCCP Medicaid |
$349.75
|
| Rate for Payer: UMR Bronson Commercial |
$498.18
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$680.54 |
| Max. Negotiated Rate |
$2,060.91 |
| Rate for Payer: Aetna Commercial |
$1,402.91
|
| Rate for Payer: Aetna Medicare |
$1,088.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,402.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,507.61
|
| Rate for Payer: BCBS Complete |
$714.57
|
| Rate for Payer: BCBS MAPPO |
$1,046.95
|
| Rate for Payer: BCN Commercial |
$1,772.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,046.95
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,402.91
|
| Rate for Payer: Cofinity Commercial |
$1,507.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,046.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,099.30
|
| Rate for Payer: Meridian Medicaid |
$714.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,151.64
|
| Rate for Payer: Nomi Health Commercial |
$1,256.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: PACE SWMI |
$1,046.95
|
| Rate for Payer: PHP Commercial |
$1,465.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,046.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,622.12
|
| Rate for Payer: Priority Health Medicare |
$1,046.95
|
| Rate for Payer: Priority Health SBD |
$1,622.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,622.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,046.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,060.91
|
| Rate for Payer: UHC Core |
$2,060.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,046.95
|
| Rate for Payer: UHC Exchange |
$2,060.91
|
| Rate for Payer: UHC Medicaid |
$680.54
|
| Rate for Payer: UHCCP Medicaid |
$680.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,256.72
|
|
|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,731.00
|
|
|
Service Code
|
HCPCS 26390
|
| Min. Negotiated Rate |
$542.94 |
| Max. Negotiated Rate |
$2,048.25 |
| Rate for Payer: Aetna Commercial |
$1,096.33
|
| Rate for Payer: Aetna Medicare |
$850.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,178.15
|
| Rate for Payer: BCBS Complete |
$570.09
|
| Rate for Payer: BCBS MAPPO |
$818.16
|
| Rate for Payer: BCN Commercial |
$1,322.64
|
| Rate for Payer: BCN Medicare Advantage |
$818.16
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,096.33
|
| Rate for Payer: Cofinity Commercial |
$1,178.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$818.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$859.07
|
| Rate for Payer: Meridian Medicaid |
$570.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$899.98
|
| Rate for Payer: Nomi Health Commercial |
$981.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,048.25
|
| Rate for Payer: PACE SWMI |
$818.16
|
| Rate for Payer: PHP Commercial |
$1,145.42
|
| Rate for Payer: PHP Medicare Advantage |
$818.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,413.86
|
| Rate for Payer: Priority Health Medicare |
$818.16
|
| Rate for Payer: Priority Health SBD |
$1,413.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,413.86
|
| Rate for Payer: Railroad Medicare Medicare |
$818.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,466.84
|
| Rate for Payer: UHC Core |
$1,466.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$818.16
|
| Rate for Payer: UHC Exchange |
$1,466.84
|
| Rate for Payer: UHC Medicaid |
$542.94
|
| Rate for Payer: UHCCP Medicaid |
$542.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,256.26
|
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$243.02
|
| Rate for Payer: Aetna Medicare |
$188.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.16
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$181.36
|
| Rate for Payer: BCN Commercial |
$305.26
|
| Rate for Payer: BCN Medicare Advantage |
$181.36
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$243.02
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.43
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.50
|
| Rate for Payer: Nomi Health Commercial |
$217.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: PACE SWMI |
$181.36
|
| Rate for Payer: PHP Commercial |
$253.90
|
| Rate for Payer: PHP Medicare Advantage |
$181.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.93
|
| Rate for Payer: Priority Health Medicare |
$181.36
|
| Rate for Payer: Priority Health SBD |
$371.93
|
| Rate for Payer: Priority Health Tiered Network |
$371.93
|
| Rate for Payer: Railroad Medicare Medicare |
$181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.33
|
| Rate for Payer: UHC Core |
$363.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.36
|
| Rate for Payer: UHC Exchange |
$363.33
|
| Rate for Payer: UHC Medicaid |
$120.35
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
| Rate for Payer: UMR Bronson Commercial |
$241.50
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$330.51 |
| Rate for Payer: Aetna Commercial |
$224.88
|
| Rate for Payer: Aetna Medicare |
$174.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.66
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$167.82
|
| Rate for Payer: BCN Commercial |
$285.34
|
| Rate for Payer: BCN Medicare Advantage |
$167.82
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$224.88
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.21
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.60
|
| Rate for Payer: Nomi Health Commercial |
$201.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$167.82
|
| Rate for Payer: PHP Commercial |
$234.95
|
| Rate for Payer: PHP Medicare Advantage |
$167.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$310.84
|
| Rate for Payer: Priority Health Medicare |
$167.82
|
| Rate for Payer: Priority Health SBD |
$310.84
|
| Rate for Payer: Priority Health Tiered Network |
$310.84
|
| Rate for Payer: Railroad Medicare Medicare |
$167.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Core |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.82
|
| Rate for Payer: UHC Exchange |
$330.51
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$195.04
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$318.16 |
| Rate for Payer: Aetna Commercial |
$218.33
|
| Rate for Payer: Aetna Medicare |
$169.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.62
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$162.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$162.93
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$218.33
|
| Rate for Payer: Cofinity Commercial |
$234.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.08
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.22
|
| Rate for Payer: Nomi Health Commercial |
$195.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.25
|
| Rate for Payer: PACE SWMI |
$162.93
|
| Rate for Payer: PHP Commercial |
$228.10
|
| Rate for Payer: PHP Medicare Advantage |
$162.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$297.81
|
| Rate for Payer: Priority Health Medicare |
$162.93
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$297.81
|
| Rate for Payer: Railroad Medicare Medicare |
$162.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.16
|
| Rate for Payer: UHC Core |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.93
|
| Rate for Payer: UHC Exchange |
$318.16
|
| Rate for Payer: UHC Medicaid |
$105.65
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: UMR Bronson Commercial |
$130.18
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$116.30
|
| Rate for Payer: Aetna Medicare |
$90.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.98
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$86.79
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: BCN Medicare Advantage |
$86.79
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$116.30
|
| Rate for Payer: Cofinity Commercial |
$124.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.13
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.47
|
| Rate for Payer: Nomi Health Commercial |
$104.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$86.79
|
| Rate for Payer: PHP Commercial |
$121.51
|
| Rate for Payer: PHP Medicare Advantage |
$86.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.49
|
| Rate for Payer: Priority Health Medicare |
$86.79
|
| Rate for Payer: Priority Health SBD |
$159.49
|
| Rate for Payer: Priority Health Tiered Network |
$159.49
|
| Rate for Payer: Railroad Medicare Medicare |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.98
|
| Rate for Payer: UHC Core |
$175.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.79
|
| Rate for Payer: UHC Exchange |
$175.98
|
| Rate for Payer: UHC Medicaid |
$56.02
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
| Rate for Payer: UMR Bronson Commercial |
$603.52
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$81.45
|
| Rate for Payer: Aetna Medicare |
$63.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.52
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$60.78
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$60.78
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$81.45
|
| Rate for Payer: Cofinity Commercial |
$87.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.82
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.86
|
| Rate for Payer: Nomi Health Commercial |
$72.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$60.78
|
| Rate for Payer: PHP Commercial |
$85.09
|
| Rate for Payer: PHP Medicare Advantage |
$60.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$125.60
|
| Rate for Payer: Priority Health Medicare |
$60.78
|
| Rate for Payer: Priority Health SBD |
$125.60
|
| Rate for Payer: Priority Health Tiered Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$60.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.22
|
| Rate for Payer: UHC Core |
$126.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.78
|
| Rate for Payer: UHC Exchange |
$126.22
|
| Rate for Payer: UHC Medicaid |
$38.77
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
| Rate for Payer: UMR Bronson Commercial |
$603.52
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$690.10 |
| Rate for Payer: Aetna Commercial |
$482.49
|
| Rate for Payer: Aetna Medicare |
$374.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.50
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$360.07
|
| Rate for Payer: BCN Commercial |
$591.11
|
| Rate for Payer: BCN Medicare Advantage |
$360.07
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$482.49
|
| Rate for Payer: Cofinity Commercial |
$518.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.07
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.08
|
| Rate for Payer: Nomi Health Commercial |
$432.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$560.25
|
| Rate for Payer: PACE SWMI |
$360.07
|
| Rate for Payer: PHP Commercial |
$504.10
|
| Rate for Payer: PHP Medicare Advantage |
$360.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$643.90
|
| Rate for Payer: Priority Health Medicare |
$360.07
|
| Rate for Payer: Priority Health SBD |
$643.90
|
| Rate for Payer: Priority Health Tiered Network |
$643.90
|
| Rate for Payer: Railroad Medicare Medicare |
$360.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$690.10
|
| Rate for Payer: UHC Core |
$690.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.07
|
| Rate for Payer: UHC Exchange |
$690.10
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
| Rate for Payer: UMR Bronson Commercial |
$343.62
|
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$3,224.30 |
| Rate for Payer: Aetna Commercial |
$2,159.03
|
| Rate for Payer: Aetna Medicare |
$1,675.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,159.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.16
|
| Rate for Payer: BCBS Complete |
$1,094.77
|
| Rate for Payer: BCBS MAPPO |
$1,611.22
|
| Rate for Payer: BCN Commercial |
$2,646.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,611.22
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,159.03
|
| Rate for Payer: Cofinity Commercial |
$2,320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,611.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,691.78
|
| Rate for Payer: Meridian Medicaid |
$1,094.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,772.34
|
| Rate for Payer: Nomi Health Commercial |
$1,933.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,514.00
|
| Rate for Payer: PACE SWMI |
$1,611.22
|
| Rate for Payer: PHP Commercial |
$2,255.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,611.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,042.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,224.30
|
| Rate for Payer: Priority Health Medicare |
$1,611.22
|
| Rate for Payer: Priority Health SBD |
$3,224.30
|
| Rate for Payer: Priority Health Tiered Network |
$3,224.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,611.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,162.57
|
| Rate for Payer: UHC Core |
$3,162.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,611.22
|
| Rate for Payer: UHC Exchange |
$3,162.57
|
| Rate for Payer: UHC Medicaid |
$1,042.64
|
| Rate for Payer: UHCCP Medicaid |
$1,042.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,541.92
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,524.00
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,244.56 |
| Max. Negotiated Rate |
$3,737.69 |
| Rate for Payer: Aetna Commercial |
$2,622.96
|
| Rate for Payer: Aetna Medicare |
$2,035.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,622.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,818.70
|
| Rate for Payer: BCBS Complete |
$1,306.79
|
| Rate for Payer: BCBS MAPPO |
$1,957.43
|
| Rate for Payer: BCN Commercial |
$3,072.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,957.43
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cofinity Commercial |
$2,622.96
|
| Rate for Payer: Cofinity Commercial |
$2,818.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,957.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,055.30
|
| Rate for Payer: Meridian Medicaid |
$1,306.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,153.17
|
| Rate for Payer: Nomi Health Commercial |
$2,348.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: PACE SWMI |
$1,957.43
|
| Rate for Payer: PHP Commercial |
$2,740.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,957.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,244.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,303.60
|
| Rate for Payer: Priority Health Medicare |
$1,957.43
|
| Rate for Payer: Priority Health SBD |
$3,303.60
|
| Rate for Payer: Priority Health Tiered Network |
$3,303.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,957.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,737.69
|
| Rate for Payer: UHC Core |
$3,737.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,957.43
|
| Rate for Payer: UHC Exchange |
$3,737.69
|
| Rate for Payer: UHC Medicaid |
$1,244.56
|
| Rate for Payer: UHCCP Medicaid |
$1,244.56
|
| Rate for Payer: UMR Bronson Commercial |
$2,081.04
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,749.75 |
| Rate for Payer: Aetna Medicare |
$1,166.50
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.18
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,231.66 |
| Rate for Payer: Aetna Commercial |
$873.47
|
| Rate for Payer: Aetna Medicare |
$677.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.65
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$651.84
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: BCN Medicare Advantage |
$651.84
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$938.65
|
| Rate for Payer: Cofinity Commercial |
$873.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.43
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.02
|
| Rate for Payer: Nomi Health Commercial |
$782.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.75
|
| Rate for Payer: PACE SWMI |
$651.84
|
| Rate for Payer: PHP Commercial |
$912.58
|
| Rate for Payer: PHP Medicare Advantage |
$651.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$983.58
|
| Rate for Payer: Priority Health Medicare |
$651.84
|
| Rate for Payer: Priority Health SBD |
$983.58
|
| Rate for Payer: Priority Health Tiered Network |
$983.58
|
| Rate for Payer: Railroad Medicare Medicare |
$651.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,231.66
|
| Rate for Payer: UHC Core |
$1,231.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.84
|
| Rate for Payer: UHC Exchange |
$1,231.66
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
| Rate for Payer: UMR Bronson Commercial |
$591.10
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$542.72 |
| Max. Negotiated Rate |
$1,588.22 |
| Rate for Payer: Aetna Commercial |
$1,110.18
|
| Rate for Payer: Aetna Medicare |
$861.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.03
|
| Rate for Payer: BCBS Complete |
$569.86
|
| Rate for Payer: BCBS MAPPO |
$828.49
|
| Rate for Payer: BCN Commercial |
$1,412.78
|
| Rate for Payer: BCN Medicare Advantage |
$828.49
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$1,110.18
|
| Rate for Payer: Cofinity Commercial |
$1,193.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$869.91
|
| Rate for Payer: Meridian Medicaid |
$569.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$911.34
|
| Rate for Payer: Nomi Health Commercial |
$994.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,249.50
|
| Rate for Payer: PACE SWMI |
$828.49
|
| Rate for Payer: PHP Commercial |
$1,159.89
|
| Rate for Payer: PHP Medicare Advantage |
$828.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,293.05
|
| Rate for Payer: Priority Health Medicare |
$828.49
|
| Rate for Payer: Priority Health SBD |
$1,293.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,293.05
|
| Rate for Payer: Railroad Medicare Medicare |
$828.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.22
|
| Rate for Payer: UHC Core |
$1,588.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$828.49
|
| Rate for Payer: UHC Exchange |
$1,588.22
|
| Rate for Payer: UHC Medicaid |
$542.72
|
| Rate for Payer: UHCCP Medicaid |
$542.72
|
| Rate for Payer: UMR Bronson Commercial |
$766.36
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,453.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$931.45 |
| Max. Negotiated Rate |
$2,858.61 |
| Rate for Payer: Aetna Commercial |
$1,925.71
|
| Rate for Payer: Aetna Medicare |
$1,494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,925.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.42
|
| Rate for Payer: BCBS Complete |
$978.02
|
| Rate for Payer: BCBS MAPPO |
$1,437.10
|
| Rate for Payer: BCN Commercial |
$2,410.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,437.10
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,925.71
|
| Rate for Payer: Cofinity Commercial |
$2,069.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,437.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,508.95
|
| Rate for Payer: Meridian Medicaid |
$978.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,580.81
|
| Rate for Payer: Nomi Health Commercial |
$1,724.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,589.75
|
| Rate for Payer: PACE SWMI |
$1,437.10
|
| Rate for Payer: PHP Commercial |
$2,011.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,437.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,205.98
|
| Rate for Payer: Priority Health Medicare |
$1,437.10
|
| Rate for Payer: Priority Health SBD |
$2,205.98
|
| Rate for Payer: Priority Health Tiered Network |
$2,205.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,437.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,858.61
|
| Rate for Payer: UHC Core |
$2,858.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,437.10
|
| Rate for Payer: UHC Exchange |
$2,858.61
|
| Rate for Payer: UHC Medicaid |
$931.45
|
| Rate for Payer: UHCCP Medicaid |
$931.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.38
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$552.31 |
| Max. Negotiated Rate |
$1,597.58 |
| Rate for Payer: Aetna Commercial |
$1,128.45
|
| Rate for Payer: Aetna Medicare |
$875.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,128.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.67
|
| Rate for Payer: BCBS Complete |
$579.93
|
| Rate for Payer: BCBS MAPPO |
$842.13
|
| Rate for Payer: BCN Commercial |
$1,432.20
|
| Rate for Payer: BCN Medicare Advantage |
$842.13
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,128.45
|
| Rate for Payer: Cofinity Commercial |
$1,212.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.24
|
| Rate for Payer: Meridian Medicaid |
$579.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$926.34
|
| Rate for Payer: Nomi Health Commercial |
$1,010.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,248.00
|
| Rate for Payer: PACE SWMI |
$842.13
|
| Rate for Payer: PHP Commercial |
$1,178.98
|
| Rate for Payer: PHP Medicare Advantage |
$842.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,310.83
|
| Rate for Payer: Priority Health Medicare |
$842.13
|
| Rate for Payer: Priority Health SBD |
$1,310.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,310.83
|
| Rate for Payer: Railroad Medicare Medicare |
$842.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,597.58
|
| Rate for Payer: UHC Core |
$1,597.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$842.13
|
| Rate for Payer: UHC Exchange |
$1,597.58
|
| Rate for Payer: UHC Medicaid |
$552.31
|
| Rate for Payer: UHCCP Medicaid |
$552.31
|
| Rate for Payer: UMR Bronson Commercial |
$765.44
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$371.47 |
| Max. Negotiated Rate |
$1,095.54 |
| Rate for Payer: Aetna Commercial |
$776.89
|
| Rate for Payer: Aetna Medicare |
$602.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.87
|
| Rate for Payer: BCBS Complete |
$390.04
|
| Rate for Payer: BCBS MAPPO |
$579.77
|
| Rate for Payer: BCN Commercial |
$935.71
|
| Rate for Payer: BCN Medicare Advantage |
$579.77
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$776.89
|
| Rate for Payer: Cofinity Commercial |
$834.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.76
|
| Rate for Payer: Meridian Medicaid |
$390.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.75
|
| Rate for Payer: Nomi Health Commercial |
$695.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.50
|
| Rate for Payer: PACE SWMI |
$579.77
|
| Rate for Payer: PHP Commercial |
$811.68
|
| Rate for Payer: PHP Medicare Advantage |
$579.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,000.24
|
| Rate for Payer: Priority Health Medicare |
$579.77
|
| Rate for Payer: Priority Health SBD |
$1,000.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,000.24
|
| Rate for Payer: Railroad Medicare Medicare |
$579.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.54
|
| Rate for Payer: UHC Core |
$1,095.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.77
|
| Rate for Payer: UHC Exchange |
$1,095.54
|
| Rate for Payer: UHC Medicaid |
$371.47
|
| Rate for Payer: UHCCP Medicaid |
$371.47
|
| Rate for Payer: UMR Bronson Commercial |
$569.48
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$751.25 |
| Max. Negotiated Rate |
$2,291.11 |
| Rate for Payer: Aetna Commercial |
$1,569.90
|
| Rate for Payer: Aetna Medicare |
$1,218.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,569.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.06
|
| Rate for Payer: BCBS Complete |
$788.81
|
| Rate for Payer: BCBS MAPPO |
$1,171.57
|
| Rate for Payer: BCN Commercial |
$1,880.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.57
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,569.90
|
| Rate for Payer: Cofinity Commercial |
$1,687.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.15
|
| Rate for Payer: Meridian Medicaid |
$788.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.73
|
| Rate for Payer: Nomi Health Commercial |
$1,405.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,426.50
|
| Rate for Payer: PACE SWMI |
$1,171.57
|
| Rate for Payer: PHP Commercial |
$1,640.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,291.11
|
| Rate for Payer: Priority Health Medicare |
$1,171.57
|
| Rate for Payer: Priority Health SBD |
$2,291.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,291.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.83
|
| Rate for Payer: UHC Core |
$2,229.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,171.57
|
| Rate for Payer: UHC Exchange |
$2,229.83
|
| Rate for Payer: UHC Medicaid |
$751.25
|
| Rate for Payer: UHCCP Medicaid |
$751.25
|
| Rate for Payer: UMR Bronson Commercial |
$874.92
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$153.60
|
| Rate for Payer: Aetna Medicare |
$119.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.07
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$114.63
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$114.63
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cofinity Commercial |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$165.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.36
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.09
|
| Rate for Payer: Nomi Health Commercial |
$137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: PACE SWMI |
$114.63
|
| Rate for Payer: PHP Commercial |
$160.48
|
| Rate for Payer: PHP Medicare Advantage |
$114.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.39
|
| Rate for Payer: Priority Health Medicare |
$114.63
|
| Rate for Payer: Priority Health SBD |
$192.39
|
| Rate for Payer: Priority Health Tiered Network |
$192.39
|
| Rate for Payer: Railroad Medicare Medicare |
$114.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.32
|
| Rate for Payer: UHC Core |
$213.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.63
|
| Rate for Payer: UHC Exchange |
$213.32
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
| Rate for Payer: UMR Bronson Commercial |
$178.02
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$717.75 |
| Rate for Payer: Aetna Commercial |
$373.06
|
| Rate for Payer: Aetna Medicare |
$289.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.90
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$278.40
|
| Rate for Payer: BCN Commercial |
$471.59
|
| Rate for Payer: BCN Medicare Advantage |
$278.40
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$373.06
|
| Rate for Payer: Cofinity Commercial |
$400.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.32
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.24
|
| Rate for Payer: Nomi Health Commercial |
$334.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.75
|
| Rate for Payer: PACE SWMI |
$278.40
|
| Rate for Payer: PHP Commercial |
$389.76
|
| Rate for Payer: PHP Medicare Advantage |
$278.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$477.61
|
| Rate for Payer: Priority Health Medicare |
$278.40
|
| Rate for Payer: Priority Health SBD |
$477.61
|
| Rate for Payer: Priority Health Tiered Network |
$477.61
|
| Rate for Payer: Railroad Medicare Medicare |
$278.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.74
|
| Rate for Payer: UHC Core |
$542.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.40
|
| Rate for Payer: UHC Exchange |
$542.74
|
| Rate for Payer: UHC Medicaid |
$180.41
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
| Rate for Payer: UMR Bronson Commercial |
$440.22
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$1,005.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$753.75 |
| Rate for Payer: Aetna Commercial |
$437.48
|
| Rate for Payer: Aetna Medicare |
$339.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.13
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$326.48
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$326.48
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cofinity Commercial |
$437.48
|
| Rate for Payer: Cofinity Commercial |
$470.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.80
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.13
|
| Rate for Payer: Nomi Health Commercial |
$391.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.75
|
| Rate for Payer: PACE SWMI |
$326.48
|
| Rate for Payer: PHP Commercial |
$457.07
|
| Rate for Payer: PHP Medicare Advantage |
$326.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$326.48
|
| Rate for Payer: Priority Health SBD |
$588.75
|
| Rate for Payer: Priority Health Tiered Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$326.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.29
|
| Rate for Payer: UHC Core |
$669.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.48
|
| Rate for Payer: UHC Exchange |
$669.29
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
| Rate for Payer: UMR Bronson Commercial |
$462.30
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$1,415.18 |
| Rate for Payer: Aetna Commercial |
$992.38
|
| Rate for Payer: Aetna Medicare |
$770.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.38
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$740.58
|
| Rate for Payer: BCN Commercial |
$1,248.94
|
| Rate for Payer: BCN Medicare Advantage |
$740.58
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$1,066.44
|
| Rate for Payer: Cofinity Commercial |
$992.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.61
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.64
|
| Rate for Payer: Nomi Health Commercial |
$888.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,156.50
|
| Rate for Payer: PACE SWMI |
$740.58
|
| Rate for Payer: PHP Commercial |
$1,036.81
|
| Rate for Payer: PHP Medicare Advantage |
$740.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,335.08
|
| Rate for Payer: Priority Health Medicare |
$740.58
|
| Rate for Payer: Priority Health SBD |
$1,335.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,335.08
|
| Rate for Payer: Railroad Medicare Medicare |
$740.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,415.18
|
| Rate for Payer: UHC Core |
$1,415.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.58
|
| Rate for Payer: UHC Exchange |
$1,415.18
|
| Rate for Payer: UHC Medicaid |
$483.72
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
| Rate for Payer: UMR Bronson Commercial |
$709.32
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$932.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$903.58 |
| Rate for Payer: Aetna Commercial |
$659.87
|
| Rate for Payer: Aetna Medicare |
$512.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.11
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$492.44
|
| Rate for Payer: BCN Commercial |
$804.24
|
| Rate for Payer: BCN Medicare Advantage |
$492.44
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cofinity Commercial |
$659.87
|
| Rate for Payer: Cofinity Commercial |
$709.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.06
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.68
|
| Rate for Payer: Nomi Health Commercial |
$590.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$699.00
|
| Rate for Payer: PACE SWMI |
$492.44
|
| Rate for Payer: PHP Commercial |
$689.42
|
| Rate for Payer: PHP Medicare Advantage |
$492.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$859.72
|
| Rate for Payer: Priority Health Medicare |
$492.44
|
| Rate for Payer: Priority Health SBD |
$859.72
|
| Rate for Payer: Priority Health Tiered Network |
$859.72
|
| Rate for Payer: Railroad Medicare Medicare |
$492.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.58
|
| Rate for Payer: UHC Core |
$903.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.44
|
| Rate for Payer: UHC Exchange |
$903.58
|
| Rate for Payer: UHC Medicaid |
$324.19
|
| Rate for Payer: UHCCP Medicaid |
$324.19
|
| Rate for Payer: UMR Bronson Commercial |
$428.72
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$391.28 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$801.40
|
| Rate for Payer: Aetna Medicare |
$621.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.21
|
| Rate for Payer: BCBS Complete |
$410.84
|
| Rate for Payer: BCBS MAPPO |
$598.06
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: BCN Medicare Advantage |
$598.06
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$801.40
|
| Rate for Payer: Cofinity Commercial |
$861.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.96
|
| Rate for Payer: Meridian Medicaid |
$410.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.87
|
| Rate for Payer: Nomi Health Commercial |
$717.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.00
|
| Rate for Payer: PACE SWMI |
$598.06
|
| Rate for Payer: PHP Commercial |
$837.28
|
| Rate for Payer: PHP Medicare Advantage |
$598.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,079.57
|
| Rate for Payer: Priority Health Medicare |
$598.06
|
| Rate for Payer: Priority Health SBD |
$1,079.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,079.57
|
| Rate for Payer: Railroad Medicare Medicare |
$598.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.12
|
| Rate for Payer: UHC Core |
$1,203.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$598.06
|
| Rate for Payer: UHC Exchange |
$1,203.12
|
| Rate for Payer: UHC Medicaid |
$391.28
|
| Rate for Payer: UHCCP Medicaid |
$391.28
|
| Rate for Payer: UMR Bronson Commercial |
$756.24
|
|
