|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,027.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$2,010.80 |
| Max. Negotiated Rate |
$3,991.65 |
| Rate for Payer: Aetna Commercial |
$3,714.45
|
| Rate for Payer: Aetna Medicare |
$2,882.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.45
|
| Rate for Payer: BCBS Complete |
$2,010.80
|
| Rate for Payer: BCBS MAPPO |
$2,771.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,771.98
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Cofinity Commercial |
$3,991.65
|
| Rate for Payer: Cofinity Commercial |
$3,714.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,771.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,910.58
|
| Rate for Payer: Nomi Health Commercial |
$3,326.38
|
| Rate for Payer: PACE SWMI |
$2,771.98
|
| Rate for Payer: PHP Commercial |
$3,880.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,771.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,267.55
|
| Rate for Payer: Priority Health Medicare |
$2,771.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,771.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,771.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,312.42
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,332.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,732.80 |
| Max. Negotiated Rate |
$3,457.18 |
| Rate for Payer: Aetna Commercial |
$3,217.10
|
| Rate for Payer: Aetna Medicare |
$2,496.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,457.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.10
|
| Rate for Payer: BCBS Complete |
$1,732.80
|
| Rate for Payer: BCBS MAPPO |
$2,400.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,400.82
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Cofinity Commercial |
$3,457.18
|
| Rate for Payer: Cofinity Commercial |
$3,217.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,400.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,520.86
|
| Rate for Payer: Nomi Health Commercial |
$2,880.98
|
| Rate for Payer: PACE SWMI |
$2,400.82
|
| Rate for Payer: PHP Commercial |
$3,361.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,400.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,815.80
|
| Rate for Payer: Priority Health Medicare |
$2,400.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,400.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,400.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,992.72
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,316.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$1,186.81 |
| Max. Negotiated Rate |
$2,155.40 |
| Rate for Payer: Aetna Commercial |
$1,590.33
|
| Rate for Payer: Aetna Medicare |
$1,234.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,590.33
|
| Rate for Payer: BCBS Complete |
$1,326.40
|
| Rate for Payer: BCBS MAPPO |
$1,186.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,186.81
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,709.01
|
| Rate for Payer: Cofinity Commercial |
$1,590.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,186.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,246.15
|
| Rate for Payer: Nomi Health Commercial |
$1,424.17
|
| Rate for Payer: PACE SWMI |
$1,186.81
|
| Rate for Payer: PHP Commercial |
$1,661.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,186.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,155.40
|
| Rate for Payer: Priority Health Medicare |
$1,186.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,186.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,186.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,525.36
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$455.96 |
| Rate for Payer: Aetna Commercial |
$424.30
|
| Rate for Payer: Aetna Medicare |
$329.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.30
|
| Rate for Payer: BCBS Complete |
$108.00
|
| Rate for Payer: BCBS MAPPO |
$316.64
|
| Rate for Payer: BCN Medicare Advantage |
$316.64
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cofinity Commercial |
$455.96
|
| Rate for Payer: Cofinity Commercial |
$424.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.47
|
| Rate for Payer: Nomi Health Commercial |
$379.97
|
| Rate for Payer: PACE SWMI |
$316.64
|
| Rate for Payer: PHP Commercial |
$443.30
|
| Rate for Payer: PHP Medicare Advantage |
$316.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
| Rate for Payer: Priority Health Medicare |
$316.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.64
|
| Rate for Payer: UHC Medicare Advantage |
$316.64
|
| Rate for Payer: UMR Bronson Commercial |
$124.20
|
|
|
PR EPDRM AGRFT T/A/L EA ADD 100 SQCM/EA 1%INFT/CHLD
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$98.85 |
| Max. Negotiated Rate |
$165.10 |
| Rate for Payer: Aetna Commercial |
$132.46
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.46
|
| Rate for Payer: BCBS Complete |
$101.60
|
| Rate for Payer: BCBS MAPPO |
$98.85
|
| Rate for Payer: BCN Medicare Advantage |
$98.85
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$142.34
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.79
|
| Rate for Payer: Nomi Health Commercial |
$118.62
|
| Rate for Payer: PACE SWMI |
$98.85
|
| Rate for Payer: PHP Commercial |
$138.39
|
| Rate for Payer: PHP Medicare Advantage |
$98.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health Medicare |
$98.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.85
|
| Rate for Payer: UHC Medicare Advantage |
$98.85
|
| Rate for Payer: UMR Bronson Commercial |
$116.84
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$349.05 |
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: BCBS Complete |
$214.80
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: UMR Bronson Commercial |
$247.02
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$309.44 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$414.65
|
| Rate for Payer: Aetna Medicare |
$321.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.59
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$309.44
|
| Rate for Payer: BCN Medicare Advantage |
$309.44
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$414.65
|
| Rate for Payer: Cofinity Commercial |
$445.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.91
|
| Rate for Payer: Nomi Health Commercial |
$371.33
|
| Rate for Payer: PACE SWMI |
$309.44
|
| Rate for Payer: PHP Commercial |
$433.22
|
| Rate for Payer: PHP Medicare Advantage |
$309.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$309.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.44
|
| Rate for Payer: UHC Medicare Advantage |
$309.44
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT 1ST 100 SQCM/<
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$587.20 |
| Max. Negotiated Rate |
$966.20 |
| Rate for Payer: Aetna Commercial |
$899.10
|
| Rate for Payer: Aetna Medicare |
$697.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.10
|
| Rate for Payer: BCBS Complete |
$587.20
|
| Rate for Payer: BCBS MAPPO |
$670.97
|
| Rate for Payer: BCN Medicare Advantage |
$670.97
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$966.20
|
| Rate for Payer: Cofinity Commercial |
$899.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.52
|
| Rate for Payer: Nomi Health Commercial |
$805.16
|
| Rate for Payer: PACE SWMI |
$670.97
|
| Rate for Payer: PHP Commercial |
$939.36
|
| Rate for Payer: PHP Medicare Advantage |
$670.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.20
|
| Rate for Payer: Priority Health Medicare |
$670.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.97
|
| Rate for Payer: UHC Medicare Advantage |
$670.97
|
| Rate for Payer: UMR Bronson Commercial |
$675.28
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT EA 100 SQCM
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$133.60 |
| Max. Negotiated Rate |
$217.10 |
| Rate for Payer: Aetna Commercial |
$179.08
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.08
|
| Rate for Payer: BCBS Complete |
$133.60
|
| Rate for Payer: BCBS MAPPO |
$133.64
|
| Rate for Payer: BCN Medicare Advantage |
$133.64
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$192.44
|
| Rate for Payer: Cofinity Commercial |
$179.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.32
|
| Rate for Payer: Nomi Health Commercial |
$160.37
|
| Rate for Payer: PACE SWMI |
$133.64
|
| Rate for Payer: PHP Commercial |
$187.10
|
| Rate for Payer: PHP Medicare Advantage |
$133.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Medicare |
$133.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.64
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
| Rate for Payer: UMR Bronson Commercial |
$153.64
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,072.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$428.80 |
| Max. Negotiated Rate |
$782.11 |
| Rate for Payer: Aetna Commercial |
$727.79
|
| Rate for Payer: Aetna Medicare |
$564.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.79
|
| Rate for Payer: BCBS Complete |
$428.80
|
| Rate for Payer: BCBS MAPPO |
$543.13
|
| Rate for Payer: BCN Medicare Advantage |
$543.13
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Cofinity Commercial |
$782.11
|
| Rate for Payer: Cofinity Commercial |
$727.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.29
|
| Rate for Payer: Nomi Health Commercial |
$651.76
|
| Rate for Payer: PACE SWMI |
$543.13
|
| Rate for Payer: PHP Commercial |
$760.38
|
| Rate for Payer: PHP Medicare Advantage |
$543.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.80
|
| Rate for Payer: Priority Health Medicare |
$543.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.13
|
| Rate for Payer: UHC Medicare Advantage |
$543.13
|
| Rate for Payer: UMR Bronson Commercial |
$493.12
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$577.43 |
| Rate for Payer: Aetna Commercial |
$537.33
|
| Rate for Payer: Aetna Medicare |
$417.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.33
|
| Rate for Payer: BCBS Complete |
$302.40
|
| Rate for Payer: BCBS MAPPO |
$400.99
|
| Rate for Payer: BCN Medicare Advantage |
$400.99
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$577.43
|
| Rate for Payer: Cofinity Commercial |
$537.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.04
|
| Rate for Payer: Nomi Health Commercial |
$481.19
|
| Rate for Payer: PACE SWMI |
$400.99
|
| Rate for Payer: PHP Commercial |
$561.39
|
| Rate for Payer: PHP Medicare Advantage |
$400.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health Medicare |
$400.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.99
|
| Rate for Payer: UHC Medicare Advantage |
$400.99
|
| Rate for Payer: UMR Bronson Commercial |
$347.76
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$688.80 |
| Max. Negotiated Rate |
$1,119.30 |
| Rate for Payer: Aetna Commercial |
$1,025.54
|
| Rate for Payer: Aetna Medicare |
$795.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.54
|
| Rate for Payer: BCBS Complete |
$688.80
|
| Rate for Payer: BCBS MAPPO |
$765.33
|
| Rate for Payer: BCN Medicare Advantage |
$765.33
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cofinity Commercial |
$1,102.08
|
| Rate for Payer: Cofinity Commercial |
$1,025.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.60
|
| Rate for Payer: Nomi Health Commercial |
$918.40
|
| Rate for Payer: PACE SWMI |
$765.33
|
| Rate for Payer: PHP Commercial |
$1,071.46
|
| Rate for Payer: PHP Medicare Advantage |
$765.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health Medicare |
$765.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.33
|
| Rate for Payer: UHC Medicare Advantage |
$765.33
|
| Rate for Payer: UMR Bronson Commercial |
$792.12
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 SQCM/</1% INFT/CHLD
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$643.20 |
| Max. Negotiated Rate |
$1,045.20 |
| Rate for Payer: Aetna Commercial |
$918.62
|
| Rate for Payer: Aetna Medicare |
$712.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.62
|
| Rate for Payer: BCBS Complete |
$643.20
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCN Medicare Advantage |
$685.54
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$987.18
|
| Rate for Payer: Cofinity Commercial |
$918.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.82
|
| Rate for Payer: Nomi Health Commercial |
$822.65
|
| Rate for Payer: PACE SWMI |
$685.54
|
| Rate for Payer: PHP Commercial |
$959.76
|
| Rate for Payer: PHP Medicare Advantage |
$685.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.20
|
| Rate for Payer: Priority Health Medicare |
$685.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.54
|
| Rate for Payer: UHC Medicare Advantage |
$685.54
|
| Rate for Payer: UMR Bronson Commercial |
$739.68
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/ULNA
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$504.00 |
| Max. Negotiated Rate |
$862.76 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$623.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.85
|
| Rate for Payer: BCBS Complete |
$504.00
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCN Medicare Advantage |
$599.14
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$862.76
|
| Rate for Payer: Cofinity Commercial |
$802.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.10
|
| Rate for Payer: Nomi Health Commercial |
$718.97
|
| Rate for Payer: PACE SWMI |
$599.14
|
| Rate for Payer: PHP Commercial |
$838.80
|
| Rate for Payer: PHP Medicare Advantage |
$599.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.14
|
| Rate for Payer: UHC Medicare Advantage |
$599.14
|
| Rate for Payer: UMR Bronson Commercial |
$579.60
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$470.00 |
| Max. Negotiated Rate |
$1,001.07 |
| Rate for Payer: Aetna Commercial |
$931.55
|
| Rate for Payer: Aetna Medicare |
$723.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.07
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: BCBS MAPPO |
$695.19
|
| Rate for Payer: BCN Medicare Advantage |
$695.19
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$931.55
|
| Rate for Payer: Cofinity Commercial |
$1,001.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.95
|
| Rate for Payer: Nomi Health Commercial |
$834.23
|
| Rate for Payer: PACE SWMI |
$695.19
|
| Rate for Payer: PHP Commercial |
$973.27
|
| Rate for Payer: PHP Medicare Advantage |
$695.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health Medicare |
$695.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.19
|
| Rate for Payer: UHC Medicare Advantage |
$695.19
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$143.88 |
| Max. Negotiated Rate |
$247.65 |
| Rate for Payer: Aetna Commercial |
$192.80
|
| Rate for Payer: Aetna Medicare |
$149.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.80
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$143.88
|
| Rate for Payer: BCN Medicare Advantage |
$143.88
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.07
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: PACE SWMI |
$143.88
|
| Rate for Payer: PHP Commercial |
$201.43
|
| Rate for Payer: PHP Medicare Advantage |
$143.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Medicare |
$143.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.88
|
| Rate for Payer: UHC Medicare Advantage |
$143.88
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$11.44
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.44
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Cofinity Commercial |
$11.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Nomi Health Commercial |
$10.25
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$662.00 |
| Max. Negotiated Rate |
$1,075.75 |
| Rate for Payer: Aetna Medicare |
$827.50
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: UMR Bronson Commercial |
$761.30
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$355.29 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$476.09
|
| Rate for Payer: Aetna Medicare |
$369.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.62
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$355.29
|
| Rate for Payer: BCN Medicare Advantage |
$355.29
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$476.09
|
| Rate for Payer: Cofinity Commercial |
$511.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.05
|
| Rate for Payer: Nomi Health Commercial |
$426.35
|
| Rate for Payer: PACE SWMI |
$355.29
|
| Rate for Payer: PHP Commercial |
$497.41
|
| Rate for Payer: PHP Medicare Advantage |
$355.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$355.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.29
|
| Rate for Payer: UHC Medicare Advantage |
$355.29
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$1,086.80 |
| Rate for Payer: Aetna Medicare |
$836.00
|
| Rate for Payer: BCBS Complete |
$668.80
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.80
|
| Rate for Payer: UMR Bronson Commercial |
$769.12
|
|
|
PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
HCPCS 43276
|
| Min. Negotiated Rate |
$451.73 |
| Max. Negotiated Rate |
$966.55 |
| Rate for Payer: Aetna Commercial |
$605.32
|
| Rate for Payer: Aetna Medicare |
$469.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.32
|
| Rate for Payer: BCBS Complete |
$594.80
|
| Rate for Payer: BCBS MAPPO |
$451.73
|
| Rate for Payer: BCN Medicare Advantage |
$451.73
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cofinity Commercial |
$650.49
|
| Rate for Payer: Cofinity Commercial |
$605.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.32
|
| Rate for Payer: Nomi Health Commercial |
$542.08
|
| Rate for Payer: PACE SWMI |
$451.73
|
| Rate for Payer: PHP Commercial |
$632.42
|
| Rate for Payer: PHP Medicare Advantage |
$451.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.55
|
| Rate for Payer: Priority Health Medicare |
$451.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$451.73
|
| Rate for Payer: UHC Medicare Advantage |
$451.73
|
| Rate for Payer: UMR Bronson Commercial |
$684.02
|
|
|
PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD
|
Professional
|
Both
|
$1,905.00
|
|
|
Service Code
|
HCPCS 43265
|
| Min. Negotiated Rate |
$405.66 |
| Max. Negotiated Rate |
$1,238.25 |
| Rate for Payer: Aetna Commercial |
$543.58
|
| Rate for Payer: Aetna Medicare |
$421.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.58
|
| Rate for Payer: BCBS Complete |
$762.00
|
| Rate for Payer: BCBS MAPPO |
$405.66
|
| Rate for Payer: BCN Medicare Advantage |
$405.66
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cash Price |
$1,524.00
|
| Rate for Payer: Cofinity Commercial |
$584.15
|
| Rate for Payer: Cofinity Commercial |
$543.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.94
|
| Rate for Payer: Nomi Health Commercial |
$486.79
|
| Rate for Payer: PACE SWMI |
$405.66
|
| Rate for Payer: PHP Commercial |
$567.92
|
| Rate for Payer: PHP Medicare Advantage |
$405.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,238.25
|
| Rate for Payer: Priority Health Medicare |
$405.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.66
|
| Rate for Payer: UHC Medicare Advantage |
$405.66
|
| Rate for Payer: UMR Bronson Commercial |
$876.30
|
|
|
PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43260
|
| Min. Negotiated Rate |
$302.93 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$405.93
|
| Rate for Payer: Aetna Medicare |
$315.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.93
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$302.93
|
| Rate for Payer: BCN Medicare Advantage |
$302.93
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$405.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.08
|
| Rate for Payer: Nomi Health Commercial |
$363.52
|
| Rate for Payer: PACE SWMI |
$302.93
|
| Rate for Payer: PHP Commercial |
$424.10
|
| Rate for Payer: PHP Medicare Advantage |
$302.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$302.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.93
|
| Rate for Payer: UHC Medicare Advantage |
$302.93
|
| Rate for Payer: UMR Bronson Commercial |
$507.84
|
|
|
PR ERCP,INSERT STENT,BILIARY/PANC
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 43268
|
| Min. Negotiated Rate |
$682.00 |
| Max. Negotiated Rate |
$1,108.25 |
| Rate for Payer: Aetna Medicare |
$852.50
|
| Rate for Payer: BCBS Complete |
$682.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.25
|
| Rate for Payer: UMR Bronson Commercial |
$784.30
|
|
|
PR ERCP,NASOBILIARY DRAIN TUBE
|
Professional
|
Both
|
$1,649.00
|
|
|
Service Code
|
HCPCS 43267
|
| Min. Negotiated Rate |
$659.60 |
| Max. Negotiated Rate |
$1,071.85 |
| Rate for Payer: Aetna Medicare |
$824.50
|
| Rate for Payer: BCBS Complete |
$659.60
|
| Rate for Payer: Cash Price |
$1,319.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.85
|
| Rate for Payer: UMR Bronson Commercial |
$758.54
|
|
