|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$167.84 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$335.50
|
| Rate for Payer: Aetna Medicare |
$260.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.53
|
| Rate for Payer: BCBS Complete |
$176.23
|
| Rate for Payer: BCBS MAPPO |
$250.37
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: BCN Medicare Advantage |
$250.37
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$335.50
|
| Rate for Payer: Cofinity Commercial |
$360.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.89
|
| Rate for Payer: Meridian Medicaid |
$176.23
|
| Rate for Payer: Nomi Health Commercial |
$300.44
|
| Rate for Payer: PACE SWMI |
$250.37
|
| Rate for Payer: PHP Commercial |
$350.52
|
| Rate for Payer: PHP Medicare Advantage |
$250.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.51
|
| Rate for Payer: Priority Health Medicare |
$250.37
|
| Rate for Payer: Priority Health Narrow Network |
$469.51
|
| Rate for Payer: Priority Health SBD |
$469.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.37
|
| Rate for Payer: UHC Medicare Advantage |
$250.37
|
| Rate for Payer: UHCCP Medicaid |
$167.84
|
| Rate for Payer: UMR Bronson Commercial |
$636.64
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,318.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$856.70 |
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Aetna Commercial |
$301.84
|
| Rate for Payer: Aetna Medicare |
$234.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.36
|
| Rate for Payer: BCBS Complete |
$158.34
|
| Rate for Payer: BCBS MAPPO |
$225.25
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$225.25
|
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Cofinity Commercial |
$301.84
|
| Rate for Payer: Cofinity Commercial |
$324.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.51
|
| Rate for Payer: Meridian Medicaid |
$158.34
|
| Rate for Payer: Nomi Health Commercial |
$270.30
|
| Rate for Payer: PACE SWMI |
$225.25
|
| Rate for Payer: PHP Commercial |
$315.35
|
| Rate for Payer: PHP Medicare Advantage |
$225.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.20
|
| Rate for Payer: Priority Health Medicare |
$225.25
|
| Rate for Payer: Priority Health Narrow Network |
$421.20
|
| Rate for Payer: Priority Health SBD |
$421.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.25
|
| Rate for Payer: UHC Medicare Advantage |
$225.25
|
| Rate for Payer: UHCCP Medicaid |
$150.80
|
| Rate for Payer: UMR Bronson Commercial |
$606.28
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,532.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$1,943.09 |
| Rate for Payer: Aetna Commercial |
$514.37
|
| Rate for Payer: Aetna Medicare |
$399.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.76
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$383.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.09
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: BCN Medicare Advantage |
$383.86
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cofinity Commercial |
$514.37
|
| Rate for Payer: Cofinity Commercial |
$552.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.05
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: PACE SWMI |
$383.86
|
| Rate for Payer: PHP Commercial |
$537.40
|
| Rate for Payer: PHP Medicare Advantage |
$383.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.50
|
| Rate for Payer: Priority Health Medicare |
$383.86
|
| Rate for Payer: Priority Health Narrow Network |
$719.50
|
| Rate for Payer: Priority Health SBD |
$719.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.86
|
| Rate for Payer: UHC Medicare Advantage |
$383.86
|
| Rate for Payer: UHCCP Medicaid |
$256.88
|
| Rate for Payer: UMR Bronson Commercial |
$704.72
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$151.23 |
| Max. Negotiated Rate |
$611.00 |
| Rate for Payer: Aetna Commercial |
$303.52
|
| Rate for Payer: Aetna Medicare |
$235.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.17
|
| Rate for Payer: BCBS Complete |
$158.79
|
| Rate for Payer: BCBS MAPPO |
$226.51
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$343.05
|
| Rate for Payer: BCN Medicare Advantage |
$226.51
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cofinity Commercial |
$303.52
|
| Rate for Payer: Cofinity Commercial |
$326.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.84
|
| Rate for Payer: Meridian Medicaid |
$158.79
|
| Rate for Payer: Nomi Health Commercial |
$271.81
|
| Rate for Payer: PACE SWMI |
$226.51
|
| Rate for Payer: PHP Commercial |
$317.11
|
| Rate for Payer: PHP Medicare Advantage |
$226.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.20
|
| Rate for Payer: Priority Health Medicare |
$226.51
|
| Rate for Payer: Priority Health Narrow Network |
$421.20
|
| Rate for Payer: Priority Health SBD |
$421.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.51
|
| Rate for Payer: UHC Medicare Advantage |
$226.51
|
| Rate for Payer: UHCCP Medicaid |
$151.23
|
| Rate for Payer: UMR Bronson Commercial |
$432.40
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$633.10 |
| Rate for Payer: Aetna Commercial |
$241.12
|
| Rate for Payer: Aetna Medicare |
$187.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.11
|
| Rate for Payer: BCBS Complete |
$126.59
|
| Rate for Payer: BCBS MAPPO |
$179.94
|
| Rate for Payer: BCBS Trust/PPO |
$283.17
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$179.94
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cofinity Commercial |
$241.12
|
| Rate for Payer: Cofinity Commercial |
$259.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.94
|
| Rate for Payer: Meridian Medicaid |
$126.59
|
| Rate for Payer: Nomi Health Commercial |
$215.93
|
| Rate for Payer: PACE SWMI |
$179.94
|
| Rate for Payer: PHP Commercial |
$251.92
|
| Rate for Payer: PHP Medicare Advantage |
$179.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.07
|
| Rate for Payer: Priority Health Medicare |
$179.94
|
| Rate for Payer: Priority Health Narrow Network |
$337.07
|
| Rate for Payer: Priority Health SBD |
$337.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.94
|
| Rate for Payer: UHC Medicare Advantage |
$179.94
|
| Rate for Payer: UHCCP Medicaid |
$120.56
|
| Rate for Payer: UMR Bronson Commercial |
$448.04
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$740.68 |
| Rate for Payer: Aetna Commercial |
$229.65
|
| Rate for Payer: Aetna Medicare |
$178.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.79
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$171.38
|
| Rate for Payer: BCBS Trust/PPO |
$740.68
|
| Rate for Payer: BCN Commercial |
$260.46
|
| Rate for Payer: BCN Medicare Advantage |
$171.38
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$229.65
|
| Rate for Payer: Cofinity Commercial |
$246.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.95
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Nomi Health Commercial |
$205.66
|
| Rate for Payer: PACE SWMI |
$171.38
|
| Rate for Payer: PHP Commercial |
$239.93
|
| Rate for Payer: PHP Medicare Advantage |
$171.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.97
|
| Rate for Payer: Priority Health Medicare |
$171.38
|
| Rate for Payer: Priority Health Narrow Network |
$320.97
|
| Rate for Payer: Priority Health SBD |
$320.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.38
|
| Rate for Payer: UHC Medicare Advantage |
$171.38
|
| Rate for Payer: UHCCP Medicaid |
$114.81
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$128.65 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$257.39
|
| Rate for Payer: Aetna Medicare |
$199.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.60
|
| Rate for Payer: BCBS Complete |
$135.08
|
| Rate for Payer: BCBS MAPPO |
$192.08
|
| Rate for Payer: BCBS Trust/PPO |
$700.00
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: BCN Medicare Advantage |
$192.08
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$257.39
|
| Rate for Payer: Cofinity Commercial |
$276.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.68
|
| Rate for Payer: Meridian Medicaid |
$135.08
|
| Rate for Payer: Nomi Health Commercial |
$230.50
|
| Rate for Payer: PACE SWMI |
$192.08
|
| Rate for Payer: PHP Commercial |
$268.91
|
| Rate for Payer: PHP Medicare Advantage |
$192.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.15
|
| Rate for Payer: Priority Health Medicare |
$192.08
|
| Rate for Payer: Priority Health Narrow Network |
$359.15
|
| Rate for Payer: Priority Health SBD |
$359.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.08
|
| Rate for Payer: UHC Medicare Advantage |
$192.08
|
| Rate for Payer: UHCCP Medicaid |
$128.65
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$626.43 |
| Max. Negotiated Rate |
$1,796.60 |
| Rate for Payer: Aetna Commercial |
$1,269.42
|
| Rate for Payer: Aetna Medicare |
$985.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.16
|
| Rate for Payer: BCBS Complete |
$657.75
|
| Rate for Payer: BCBS MAPPO |
$947.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.90
|
| Rate for Payer: BCN Commercial |
$1,418.63
|
| Rate for Payer: BCN Medicare Advantage |
$947.33
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cofinity Commercial |
$1,269.42
|
| Rate for Payer: Cofinity Commercial |
$1,364.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$994.70
|
| Rate for Payer: Meridian Medicaid |
$657.75
|
| Rate for Payer: Nomi Health Commercial |
$1,136.80
|
| Rate for Payer: PACE SWMI |
$947.33
|
| Rate for Payer: PHP Commercial |
$1,326.26
|
| Rate for Payer: PHP Medicare Advantage |
$947.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,737.28
|
| Rate for Payer: Priority Health Medicare |
$947.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,737.28
|
| Rate for Payer: Priority Health SBD |
$1,737.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.33
|
| Rate for Payer: UHC Medicare Advantage |
$947.33
|
| Rate for Payer: UHCCP Medicaid |
$626.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.44
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$627.07 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$1,270.25
|
| Rate for Payer: Aetna Medicare |
$985.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: BCBS Complete |
$658.42
|
| Rate for Payer: BCBS MAPPO |
$947.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$1,420.10
|
| Rate for Payer: BCN Medicare Advantage |
$947.95
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,270.25
|
| Rate for Payer: Cofinity Commercial |
$1,365.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$995.35
|
| Rate for Payer: Meridian Medicaid |
$658.42
|
| Rate for Payer: Nomi Health Commercial |
$1,137.54
|
| Rate for Payer: PACE SWMI |
$947.95
|
| Rate for Payer: PHP Commercial |
$1,327.13
|
| Rate for Payer: PHP Medicare Advantage |
$947.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,914.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,742.06
|
| Rate for Payer: Priority Health Medicare |
$947.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,742.06
|
| Rate for Payer: Priority Health SBD |
$1,742.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.95
|
| Rate for Payer: UHC Medicare Advantage |
$947.95
|
| Rate for Payer: UHCCP Medicaid |
$627.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,355.16
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,992.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$1,294.80 |
| Rate for Payer: Aetna Commercial |
$316.47
|
| Rate for Payer: Aetna Medicare |
$245.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.08
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$236.17
|
| Rate for Payer: BCBS Trust/PPO |
$726.94
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$236.17
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cofinity Commercial |
$316.47
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.98
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Nomi Health Commercial |
$283.40
|
| Rate for Payer: PACE SWMI |
$236.17
|
| Rate for Payer: PHP Commercial |
$330.64
|
| Rate for Payer: PHP Medicare Advantage |
$236.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.75
|
| Rate for Payer: Priority Health Medicare |
$236.17
|
| Rate for Payer: Priority Health Narrow Network |
$430.75
|
| Rate for Payer: Priority Health SBD |
$430.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.17
|
| Rate for Payer: UHC Medicare Advantage |
$236.17
|
| Rate for Payer: UHCCP Medicaid |
$154.43
|
| Rate for Payer: UMR Bronson Commercial |
$916.32
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,027.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$5,085.96 |
| Rate for Payer: Aetna Commercial |
$3,714.45
|
| Rate for Payer: Aetna Medicare |
$2,882.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,714.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.65
|
| Rate for Payer: BCBS Complete |
$1,915.34
|
| Rate for Payer: BCBS MAPPO |
$2,771.98
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$4,149.37
|
| 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 |
$3,714.45
|
| Rate for Payer: Cofinity Commercial |
$3,991.65
|
| 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: Meridian Medicaid |
$1,915.34
|
| 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 Choice Medicaid |
$1,824.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,267.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,085.96
|
| Rate for Payer: Priority Health Medicare |
$2,771.98
|
| Rate for Payer: Priority Health Narrow Network |
$5,085.96
|
| Rate for Payer: Priority Health SBD |
$5,085.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,771.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,771.98
|
| Rate for Payer: UHCCP Medicaid |
$1,824.13
|
| 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 |
$1,581.53 |
| Max. Negotiated Rate |
$4,406.43 |
| Rate for Payer: Aetna Commercial |
$3,217.10
|
| Rate for Payer: Aetna Medicare |
$2,496.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,457.18
|
| Rate for Payer: BCBS Complete |
$1,660.61
|
| Rate for Payer: BCBS MAPPO |
$2,400.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.09
|
| Rate for Payer: BCN Commercial |
$3,594.23
|
| 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 |
$3,217.10
|
| Rate for Payer: Cofinity Commercial |
$3,457.18
|
| 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: Meridian Medicaid |
$1,660.61
|
| 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 Choice Medicaid |
$1,581.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,815.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,406.43
|
| Rate for Payer: Priority Health Medicare |
$2,400.82
|
| Rate for Payer: Priority Health Narrow Network |
$4,406.43
|
| Rate for Payer: Priority Health SBD |
$4,406.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,400.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,400.82
|
| Rate for Payer: UHCCP Medicaid |
$1,581.53
|
| 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 |
$236.68 |
| Max. Negotiated Rate |
$2,182.94 |
| Rate for Payer: Aetna Commercial |
$1,590.33
|
| Rate for Payer: Aetna Medicare |
$1,234.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,590.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.01
|
| Rate for Payer: BCBS Complete |
$823.03
|
| Rate for Payer: BCBS MAPPO |
$1,186.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.68
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| 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: Meridian Medicaid |
$823.03
|
| 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 Choice Medicaid |
$783.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,182.94
|
| Rate for Payer: Priority Health Medicare |
$1,186.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,182.94
|
| Rate for Payer: Priority Health SBD |
$2,182.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,186.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,186.81
|
| Rate for Payer: UHCCP Medicaid |
$783.84
|
| 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 |
$249.53 |
| Rate for Payer: BCBS Complete |
$108.00
|
| Rate for Payer: BCN Commercial |
$249.53
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
| 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 |
$64.97 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$132.46
|
| Rate for Payer: Aetna Medicare |
$102.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.34
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$98.85
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$164.20
|
| 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: Meridian Medicaid |
$68.22
|
| 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 Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.36
|
| Rate for Payer: Priority Health Medicare |
$98.85
|
| Rate for Payer: Priority Health Narrow Network |
$136.36
|
| Rate for Payer: Priority Health SBD |
$136.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.85
|
| Rate for Payer: UHC Medicare Advantage |
$98.85
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| 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 |
$190.64 |
| Max. Negotiated Rate |
$2,001.73 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.30
|
| Rate for Payer: BCBS Complete |
$200.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.73
|
| Rate for Payer: BCN Commercial |
$835.64
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Meridian Medicaid |
$200.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.65
|
| Rate for Payer: Priority Health Narrow Network |
$796.65
|
| Rate for Payer: Priority Health SBD |
$422.34
|
| Rate for Payer: UHCCP Medicaid |
$190.64
|
| 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 |
$156.34 |
| Max. Negotiated Rate |
$2,287.54 |
| 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 |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$309.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.54
|
| Rate for Payer: BCN Commercial |
$481.35
|
| 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: Meridian Medicaid |
$164.16
|
| 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 Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.01
|
| Rate for Payer: Priority Health Medicare |
$309.44
|
| Rate for Payer: Priority Health Narrow Network |
$460.01
|
| Rate for Payer: Priority Health SBD |
$344.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.44
|
| Rate for Payer: UHC Medicare Advantage |
$309.44
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
| 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 |
$138.90 |
| Max. Negotiated Rate |
$1,172.34 |
| Rate for Payer: Aetna Commercial |
$899.10
|
| Rate for Payer: Aetna Medicare |
$697.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.20
|
| Rate for Payer: BCBS Complete |
$473.47
|
| Rate for Payer: BCBS MAPPO |
$670.97
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| 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 |
$899.10
|
| Rate for Payer: Cofinity Commercial |
$966.20
|
| 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: Meridian Medicaid |
$473.47
|
| 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 Choice Medicaid |
$450.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.67
|
| Rate for Payer: Priority Health Medicare |
$670.97
|
| Rate for Payer: Priority Health Narrow Network |
$943.67
|
| Rate for Payer: Priority Health SBD |
$943.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.97
|
| Rate for Payer: UHC Medicare Advantage |
$670.97
|
| Rate for Payer: UHCCP Medicaid |
$450.92
|
| 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 |
$87.97 |
| Max. Negotiated Rate |
$281.44 |
| Rate for Payer: Aetna Commercial |
$179.08
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.44
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$133.64
|
| Rate for Payer: BCBS Trust/PPO |
$281.44
|
| Rate for Payer: BCN Commercial |
$225.28
|
| 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 |
$179.08
|
| Rate for Payer: Cofinity Commercial |
$192.44
|
| 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: Meridian Medicaid |
$92.37
|
| 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 Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.57
|
| Rate for Payer: Priority Health Medicare |
$133.64
|
| Rate for Payer: Priority Health Narrow Network |
$185.57
|
| Rate for Payer: Priority Health SBD |
$185.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.64
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
| Rate for Payer: UMR Bronson Commercial |
$153.64
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,072.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$365.30 |
| Max. Negotiated Rate |
$2,782.03 |
| Rate for Payer: Aetna Commercial |
$727.79
|
| Rate for Payer: Aetna Medicare |
$564.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.11
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$543.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.03
|
| Rate for Payer: BCN Commercial |
$821.46
|
| 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 |
$727.79
|
| Rate for Payer: Cofinity Commercial |
$782.11
|
| 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: Meridian Medicaid |
$383.56
|
| 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 Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.15
|
| Rate for Payer: Priority Health Medicare |
$543.13
|
| Rate for Payer: Priority Health Narrow Network |
$909.15
|
| Rate for Payer: Priority Health SBD |
$909.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.13
|
| Rate for Payer: UHC Medicare Advantage |
$543.13
|
| Rate for Payer: UHCCP Medicaid |
$365.30
|
| Rate for Payer: UMR Bronson Commercial |
$493.12
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$1,211.92 |
| Rate for Payer: Aetna Commercial |
$537.33
|
| Rate for Payer: Aetna Medicare |
$417.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.43
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS MAPPO |
$400.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.92
|
| Rate for Payer: BCN Commercial |
$606.94
|
| 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 |
$537.33
|
| Rate for Payer: Cofinity Commercial |
$577.43
|
| 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: Meridian Medicaid |
$283.82
|
| 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 Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.62
|
| Rate for Payer: Priority Health Medicare |
$400.99
|
| Rate for Payer: Priority Health Narrow Network |
$671.62
|
| Rate for Payer: Priority Health SBD |
$671.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.99
|
| Rate for Payer: UHC Medicare Advantage |
$400.99
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
| 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 |
$513.12 |
| Max. Negotiated Rate |
$2,046.63 |
| Rate for Payer: Aetna Commercial |
$1,025.54
|
| Rate for Payer: Aetna Medicare |
$795.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.08
|
| Rate for Payer: BCBS Complete |
$538.78
|
| Rate for Payer: BCBS MAPPO |
$765.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.63
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| 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 |
$1,025.54
|
| Rate for Payer: Cofinity Commercial |
$1,102.08
|
| 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: Meridian Medicaid |
$538.78
|
| 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 Choice Medicaid |
$513.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.44
|
| Rate for Payer: Priority Health Medicare |
$765.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.44
|
| Rate for Payer: Priority Health SBD |
$1,273.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.33
|
| Rate for Payer: UHC Medicare Advantage |
$765.33
|
| Rate for Payer: UHCCP Medicaid |
$513.12
|
| 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 |
$206.12 |
| Max. Negotiated Rate |
$1,219.74 |
| Rate for Payer: Aetna Commercial |
$918.62
|
| Rate for Payer: Aetna Medicare |
$712.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.18
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,219.74
|
| 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 |
$918.62
|
| Rate for Payer: Cofinity Commercial |
$987.18
|
| 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: Meridian Medicaid |
$482.63
|
| 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 Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$969.86
|
| Rate for Payer: Priority Health Medicare |
$685.54
|
| Rate for Payer: Priority Health Narrow Network |
$969.86
|
| Rate for Payer: Priority Health SBD |
$969.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.54
|
| Rate for Payer: UHC Medicare Advantage |
$685.54
|
| Rate for Payer: UHCCP Medicaid |
$459.65
|
| 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 |
$406.19 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$623.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.76
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$913.83
|
| 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 |
$802.85
|
| Rate for Payer: Cofinity Commercial |
$862.76
|
| 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: Meridian Medicaid |
$426.50
|
| 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 Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: Priority Health SBD |
$961.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.14
|
| Rate for Payer: UHC Medicare Advantage |
$599.14
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
| 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 |
$469.88 |
| Max. Negotiated Rate |
$1,112.88 |
| Rate for Payer: Aetna Commercial |
$931.55
|
| Rate for Payer: Aetna Medicare |
$723.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.55
|
| Rate for Payer: BCBS Complete |
$493.37
|
| Rate for Payer: BCBS MAPPO |
$695.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.37
|
| Rate for Payer: BCN Commercial |
$1,059.45
|
| 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 |
$1,001.07
|
| Rate for Payer: Cofinity Commercial |
$931.55
|
| 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: Meridian Medicaid |
$493.37
|
| 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 Choice Medicaid |
$469.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,112.88
|
| Rate for Payer: Priority Health Medicare |
$695.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.88
|
| Rate for Payer: Priority Health SBD |
$1,112.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.19
|
| Rate for Payer: UHC Medicare Advantage |
$695.19
|
| Rate for Payer: UHCCP Medicaid |
$469.88
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
