|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$274.71 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: Aetna Medicare |
$161.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.57
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCBS MAPPO |
$155.26
|
| Rate for Payer: BCN Commercial |
$255.97
|
| Rate for Payer: BCN Medicare Advantage |
$155.26
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cofinity Commercial |
$208.05
|
| Rate for Payer: Cofinity Commercial |
$223.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.02
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.79
|
| Rate for Payer: Nomi Health Commercial |
$186.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: PACE SWMI |
$155.26
|
| Rate for Payer: PHP Commercial |
$217.36
|
| Rate for Payer: PHP Medicare Advantage |
$155.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$273.61
|
| Rate for Payer: Priority Health Medicare |
$155.26
|
| Rate for Payer: Priority Health SBD |
$273.61
|
| Rate for Payer: Priority Health Tiered Network |
$273.61
|
| Rate for Payer: Railroad Medicare Medicare |
$155.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.71
|
| Rate for Payer: UHC Core |
$274.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.26
|
| Rate for Payer: UHC Exchange |
$274.71
|
| Rate for Payer: UHC Medicaid |
$102.03
|
| Rate for Payer: UHCCP Medicaid |
$102.03
|
| Rate for Payer: UMR Bronson Commercial |
$156.40
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADD
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 0172T
|
| Min. Negotiated Rate |
$218.00 |
| Max. Negotiated Rate |
$408.75 |
| Rate for Payer: Aetna Medicare |
$272.50
|
| Rate for Payer: BCBS Complete |
$218.00
|
| Rate for Payer: Cash Price |
$436.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.75
|
| Rate for Payer: UMR Bronson Commercial |
$250.70
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, SINGLE
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 0171T
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,112.00 |
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,112.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.36
|
|
|
PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 53855
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$902.25 |
| Rate for Payer: Aetna Commercial |
$96.12
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.12
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.73
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: BCN Medicare Advantage |
$71.73
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cofinity Commercial |
$103.29
|
| Rate for Payer: Cofinity Commercial |
$96.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.32
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.90
|
| Rate for Payer: Nomi Health Commercial |
$86.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$902.25
|
| Rate for Payer: PACE SWMI |
$71.73
|
| Rate for Payer: PHP Commercial |
$100.42
|
| Rate for Payer: PHP Medicare Advantage |
$71.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.82
|
| Rate for Payer: Priority Health Medicare |
$71.73
|
| Rate for Payer: Priority Health SBD |
$131.82
|
| Rate for Payer: Priority Health Tiered Network |
$131.82
|
| Rate for Payer: Railroad Medicare Medicare |
$71.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.08
|
| Rate for Payer: UHC Core |
$147.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.73
|
| Rate for Payer: UHC Exchange |
$147.08
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
| Rate for Payer: UMR Bronson Commercial |
$553.38
|
|
|
PR INSERT TRAY W/O BAG/CATH
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4310
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$15.85 |
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Medicare |
$11.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.85
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$11.01
|
| Rate for Payer: BCN Commercial |
$10.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.01
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.11
|
| Rate for Payer: Nomi Health Commercial |
$13.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$11.01
|
| Rate for Payer: PHP Commercial |
$15.41
|
| Rate for Payer: PHP Medicare Advantage |
$11.01
|
| Rate for Payer: Priority Health Medicare |
$11.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Core |
$3.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.01
|
| Rate for Payer: UHC Exchange |
$3.59
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR
|
Professional
|
Both
|
$2,211.00
|
|
|
Service Code
|
HCPCS 36557
|
| Min. Negotiated Rate |
$196.60 |
| Max. Negotiated Rate |
$1,658.25 |
| Rate for Payer: Aetna Commercial |
$408.11
|
| Rate for Payer: Aetna Medicare |
$316.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.11
|
| Rate for Payer: BCBS Complete |
$206.43
|
| Rate for Payer: BCBS MAPPO |
$304.56
|
| Rate for Payer: BCN Commercial |
$482.05
|
| Rate for Payer: BCN Medicare Advantage |
$304.56
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cash Price |
$1,768.80
|
| Rate for Payer: Cofinity Commercial |
$438.57
|
| Rate for Payer: Cofinity Commercial |
$408.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.79
|
| Rate for Payer: Meridian Medicaid |
$206.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.02
|
| Rate for Payer: Nomi Health Commercial |
$365.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.25
|
| Rate for Payer: PACE SWMI |
$304.56
|
| Rate for Payer: PHP Commercial |
$426.38
|
| Rate for Payer: PHP Medicare Advantage |
$304.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$518.37
|
| Rate for Payer: Priority Health Medicare |
$304.56
|
| Rate for Payer: Priority Health SBD |
$518.37
|
| Rate for Payer: Priority Health Tiered Network |
$518.37
|
| Rate for Payer: Railroad Medicare Medicare |
$304.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.86
|
| Rate for Payer: UHC Core |
$563.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.56
|
| Rate for Payer: UHC Exchange |
$563.86
|
| Rate for Payer: UHC Medicaid |
$196.60
|
| Rate for Payer: UHCCP Medicaid |
$196.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.06
|
|
|
PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 37191
|
| Min. Negotiated Rate |
$121.84 |
| Max. Negotiated Rate |
$2,142.75 |
| Rate for Payer: Aetna Commercial |
$256.86
|
| Rate for Payer: Aetna Medicare |
$199.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.03
|
| Rate for Payer: BCBS Complete |
$127.93
|
| Rate for Payer: BCBS MAPPO |
$191.69
|
| Rate for Payer: BCN Commercial |
$321.70
|
| Rate for Payer: BCN Medicare Advantage |
$191.69
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cofinity Commercial |
$256.86
|
| Rate for Payer: Cofinity Commercial |
$276.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.27
|
| Rate for Payer: Meridian Medicaid |
$127.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.86
|
| Rate for Payer: Nomi Health Commercial |
$230.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.75
|
| Rate for Payer: PACE SWMI |
$191.69
|
| Rate for Payer: PHP Commercial |
$268.37
|
| Rate for Payer: PHP Medicare Advantage |
$191.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$345.95
|
| Rate for Payer: Priority Health Medicare |
$191.69
|
| Rate for Payer: Priority Health SBD |
$345.95
|
| Rate for Payer: Priority Health Tiered Network |
$345.95
|
| Rate for Payer: Railroad Medicare Medicare |
$191.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.30
|
| Rate for Payer: UHC Core |
$399.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$191.69
|
| Rate for Payer: UHC Exchange |
$399.30
|
| Rate for Payer: UHC Medicaid |
$121.84
|
| Rate for Payer: UHCCP Medicaid |
$121.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,314.22
|
|
|
PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART
|
Professional
|
Both
|
$3,408.00
|
|
|
Service Code
|
HCPCS 35585
|
| Min. Negotiated Rate |
$961.70 |
| Max. Negotiated Rate |
$3,011.30 |
| Rate for Payer: Aetna Commercial |
$2,045.71
|
| Rate for Payer: Aetna Medicare |
$1,587.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,045.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,198.38
|
| Rate for Payer: BCBS Complete |
$1,009.78
|
| Rate for Payer: BCBS MAPPO |
$1,526.65
|
| Rate for Payer: BCN Commercial |
$2,434.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,526.65
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Cofinity Commercial |
$2,045.71
|
| Rate for Payer: Cofinity Commercial |
$2,198.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,526.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,602.98
|
| Rate for Payer: Meridian Medicaid |
$1,009.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,679.32
|
| Rate for Payer: Nomi Health Commercial |
$1,831.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,556.00
|
| Rate for Payer: PACE SWMI |
$1,526.65
|
| Rate for Payer: PHP Commercial |
$2,137.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,526.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$961.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,618.13
|
| Rate for Payer: Priority Health Medicare |
$1,526.65
|
| Rate for Payer: Priority Health SBD |
$2,618.13
|
| Rate for Payer: Priority Health Tiered Network |
$2,618.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,526.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,011.30
|
| Rate for Payer: UHC Core |
$3,011.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,526.65
|
| Rate for Payer: UHC Exchange |
$3,011.30
|
| Rate for Payer: UHC Medicaid |
$961.70
|
| Rate for Payer: UHCCP Medicaid |
$961.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,567.68
|
|
|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$4,804.00
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$830.27 |
| Max. Negotiated Rate |
$3,603.00 |
| Rate for Payer: Aetna Commercial |
$1,764.83
|
| Rate for Payer: Aetna Medicare |
$1,369.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,896.54
|
| Rate for Payer: BCBS Complete |
$871.78
|
| Rate for Payer: BCBS MAPPO |
$1,317.04
|
| Rate for Payer: BCN Commercial |
$2,102.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.04
|
| Rate for Payer: Cash Price |
$3,843.20
|
| Rate for Payer: Cash Price |
$3,843.20
|
| Rate for Payer: Cofinity Commercial |
$1,764.83
|
| Rate for Payer: Cofinity Commercial |
$1,896.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,382.89
|
| Rate for Payer: Meridian Medicaid |
$871.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,448.74
|
| Rate for Payer: Nomi Health Commercial |
$1,580.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,603.00
|
| Rate for Payer: PACE SWMI |
$1,317.04
|
| Rate for Payer: PHP Commercial |
$1,843.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$830.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,261.48
|
| Rate for Payer: Priority Health Medicare |
$1,317.04
|
| Rate for Payer: Priority Health SBD |
$2,261.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,261.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,317.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,596.39
|
| Rate for Payer: UHC Core |
$2,596.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,317.04
|
| Rate for Payer: UHC Exchange |
$2,596.39
|
| Rate for Payer: UHC Medicaid |
$830.27
|
| Rate for Payer: UHCCP Medicaid |
$830.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,209.84
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$2,937.00
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$773.19 |
| Max. Negotiated Rate |
$2,451.35 |
| Rate for Payer: Aetna Commercial |
$1,645.96
|
| Rate for Payer: Aetna Medicare |
$1,277.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,645.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,768.80
|
| Rate for Payer: BCBS Complete |
$811.85
|
| Rate for Payer: BCBS MAPPO |
$1,228.33
|
| Rate for Payer: BCN Commercial |
$1,949.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,228.33
|
| Rate for Payer: Cash Price |
$2,349.60
|
| Rate for Payer: Cash Price |
$2,349.60
|
| Rate for Payer: Cofinity Commercial |
$1,645.96
|
| Rate for Payer: Cofinity Commercial |
$1,768.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,228.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,289.75
|
| Rate for Payer: Meridian Medicaid |
$811.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,351.16
|
| Rate for Payer: Nomi Health Commercial |
$1,474.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,202.75
|
| Rate for Payer: PACE SWMI |
$1,228.33
|
| Rate for Payer: PHP Commercial |
$1,719.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,228.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$773.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,096.00
|
| Rate for Payer: Priority Health Medicare |
$1,228.33
|
| Rate for Payer: Priority Health SBD |
$2,096.00
|
| Rate for Payer: Priority Health Tiered Network |
$2,096.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,228.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,451.35
|
| Rate for Payer: UHC Core |
$2,451.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,228.33
|
| Rate for Payer: UHC Exchange |
$2,451.35
|
| Rate for Payer: UHC Medicaid |
$773.19
|
| Rate for Payer: UHCCP Medicaid |
$773.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,351.02
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,278.00
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Aetna Commercial |
$439.17
|
| Rate for Payer: Aetna Medicare |
$340.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.95
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCBS MAPPO |
$327.74
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$327.74
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cofinity Commercial |
$439.17
|
| Rate for Payer: Cofinity Commercial |
$471.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.13
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.51
|
| Rate for Payer: Nomi Health Commercial |
$393.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$958.50
|
| Rate for Payer: PACE SWMI |
$327.74
|
| Rate for Payer: PHP Commercial |
$458.84
|
| Rate for Payer: PHP Medicare Advantage |
$327.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$590.14
|
| Rate for Payer: Priority Health Medicare |
$327.74
|
| Rate for Payer: Priority Health SBD |
$590.14
|
| Rate for Payer: Priority Health Tiered Network |
$590.14
|
| Rate for Payer: Railroad Medicare Medicare |
$327.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.57
|
| Rate for Payer: UHC Core |
$656.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$327.74
|
| Rate for Payer: UHC Exchange |
$656.57
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
| Rate for Payer: UMR Bronson Commercial |
$587.88
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,278.00
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$958.50 |
| Rate for Payer: Aetna Commercial |
$437.83
|
| Rate for Payer: Aetna Medicare |
$339.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.51
|
| Rate for Payer: BCBS Complete |
$221.19
|
| Rate for Payer: BCBS MAPPO |
$326.74
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: BCN Medicare Advantage |
$326.74
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cash Price |
$1,022.40
|
| Rate for Payer: Cofinity Commercial |
$437.83
|
| Rate for Payer: Cofinity Commercial |
$470.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.08
|
| Rate for Payer: Meridian Medicaid |
$221.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.41
|
| Rate for Payer: Nomi Health Commercial |
$392.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$958.50
|
| Rate for Payer: PACE SWMI |
$326.74
|
| Rate for Payer: PHP Commercial |
$457.44
|
| Rate for Payer: PHP Medicare Advantage |
$326.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$586.93
|
| Rate for Payer: Priority Health Medicare |
$326.74
|
| Rate for Payer: Priority Health SBD |
$586.93
|
| Rate for Payer: Priority Health Tiered Network |
$586.93
|
| Rate for Payer: Railroad Medicare Medicare |
$326.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.16
|
| Rate for Payer: UHC Core |
$647.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.74
|
| Rate for Payer: UHC Exchange |
$647.16
|
| Rate for Payer: UHC Medicaid |
$210.66
|
| Rate for Payer: UHCCP Medicaid |
$210.66
|
| Rate for Payer: UMR Bronson Commercial |
$587.88
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$461.31 |
| Rate for Payer: Aetna Commercial |
$308.90
|
| Rate for Payer: Aetna Medicare |
$239.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.95
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$230.52
|
| Rate for Payer: BCN Commercial |
$385.44
|
| Rate for Payer: BCN Medicare Advantage |
$230.52
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$308.90
|
| Rate for Payer: Cofinity Commercial |
$331.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.05
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$253.57
|
| Rate for Payer: Nomi Health Commercial |
$276.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: PACE SWMI |
$230.52
|
| Rate for Payer: PHP Commercial |
$322.73
|
| Rate for Payer: PHP Medicare Advantage |
$230.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$412.02
|
| Rate for Payer: Priority Health Medicare |
$230.52
|
| Rate for Payer: Priority Health SBD |
$412.02
|
| Rate for Payer: Priority Health Tiered Network |
$412.02
|
| Rate for Payer: Railroad Medicare Medicare |
$230.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.31
|
| Rate for Payer: UHC Core |
$461.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$230.52
|
| Rate for Payer: UHC Exchange |
$461.31
|
| Rate for Payer: UHC Medicaid |
$145.91
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
| Rate for Payer: UMR Bronson Commercial |
$258.52
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$405.83
|
| Rate for Payer: Aetna Medicare |
$314.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.12
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS MAPPO |
$302.86
|
| Rate for Payer: BCN Commercial |
$501.47
|
| Rate for Payer: BCN Medicare Advantage |
$302.86
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$405.83
|
| Rate for Payer: Cofinity Commercial |
$436.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.00
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.15
|
| Rate for Payer: Nomi Health Commercial |
$363.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$302.86
|
| Rate for Payer: PHP Commercial |
$424.00
|
| Rate for Payer: PHP Medicare Advantage |
$302.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$536.06
|
| Rate for Payer: Priority Health Medicare |
$302.86
|
| Rate for Payer: Priority Health SBD |
$536.06
|
| Rate for Payer: Priority Health Tiered Network |
$536.06
|
| Rate for Payer: Railroad Medicare Medicare |
$302.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.50
|
| Rate for Payer: UHC Core |
$597.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.86
|
| Rate for Payer: UHC Exchange |
$597.50
|
| Rate for Payer: UHC Medicaid |
$191.49
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,083.76
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$681.75 |
| Rate for Payer: Aetna Commercial |
$406.44
|
| Rate for Payer: Aetna Medicare |
$315.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.77
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$303.31
|
| Rate for Payer: BCN Commercial |
$501.96
|
| Rate for Payer: BCN Medicare Advantage |
$303.31
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cofinity Commercial |
$406.44
|
| Rate for Payer: Cofinity Commercial |
$436.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.48
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.64
|
| Rate for Payer: Nomi Health Commercial |
$363.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.75
|
| Rate for Payer: PACE SWMI |
$303.31
|
| Rate for Payer: PHP Commercial |
$424.63
|
| Rate for Payer: PHP Medicare Advantage |
$303.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$536.58
|
| Rate for Payer: Priority Health Medicare |
$303.31
|
| Rate for Payer: Priority Health SBD |
$536.58
|
| Rate for Payer: Priority Health Tiered Network |
$536.58
|
| Rate for Payer: Railroad Medicare Medicare |
$303.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.50
|
| Rate for Payer: UHC Core |
$597.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.31
|
| Rate for Payer: UHC Exchange |
$597.50
|
| Rate for Payer: UHC Medicaid |
$191.70
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
| Rate for Payer: UMR Bronson Commercial |
$418.14
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$1,145.25 |
| Rate for Payer: Aetna Commercial |
$235.30
|
| Rate for Payer: Aetna Medicare |
$182.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.86
|
| Rate for Payer: BCBS Complete |
$118.75
|
| Rate for Payer: BCBS MAPPO |
$175.60
|
| Rate for Payer: BCN Commercial |
$284.34
|
| Rate for Payer: BCN Medicare Advantage |
$175.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cofinity Commercial |
$235.30
|
| Rate for Payer: Cofinity Commercial |
$252.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.38
|
| Rate for Payer: Meridian Medicaid |
$118.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.16
|
| Rate for Payer: Nomi Health Commercial |
$210.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,145.25
|
| Rate for Payer: PACE SWMI |
$175.60
|
| Rate for Payer: PHP Commercial |
$245.84
|
| Rate for Payer: PHP Medicare Advantage |
$175.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$305.78
|
| Rate for Payer: Priority Health Medicare |
$175.60
|
| Rate for Payer: Priority Health SBD |
$305.78
|
| Rate for Payer: Priority Health Tiered Network |
$305.78
|
| Rate for Payer: Railroad Medicare Medicare |
$175.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.90
|
| Rate for Payer: UHC Core |
$374.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.60
|
| Rate for Payer: UHC Exchange |
$374.90
|
| Rate for Payer: UHC Medicaid |
$113.10
|
| Rate for Payer: UHCCP Medicaid |
$113.10
|
| Rate for Payer: UMR Bronson Commercial |
$702.42
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$513.75 |
| Rate for Payer: Aetna Commercial |
$143.42
|
| Rate for Payer: Aetna Medicare |
$111.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.12
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$107.03
|
| Rate for Payer: BCN Commercial |
$177.29
|
| Rate for Payer: BCN Medicare Advantage |
$107.03
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cofinity Commercial |
$143.42
|
| Rate for Payer: Cofinity Commercial |
$154.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.38
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.73
|
| Rate for Payer: Nomi Health Commercial |
$128.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.75
|
| Rate for Payer: PACE SWMI |
$107.03
|
| Rate for Payer: PHP Commercial |
$149.84
|
| Rate for Payer: PHP Medicare Advantage |
$107.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.64
|
| Rate for Payer: Priority Health Medicare |
$107.03
|
| Rate for Payer: Priority Health SBD |
$190.64
|
| Rate for Payer: Priority Health Tiered Network |
$190.64
|
| Rate for Payer: Railroad Medicare Medicare |
$107.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.58
|
| Rate for Payer: UHC Core |
$218.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.03
|
| Rate for Payer: UHC Exchange |
$218.58
|
| Rate for Payer: UHC Medicaid |
$68.59
|
| Rate for Payer: UHCCP Medicaid |
$68.59
|
| Rate for Payer: UMR Bronson Commercial |
$315.10
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 33224
|
| Min. Negotiated Rate |
$281.59 |
| Max. Negotiated Rate |
$1,251.00 |
| Rate for Payer: Aetna Commercial |
$594.62
|
| Rate for Payer: Aetna Medicare |
$461.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.00
|
| Rate for Payer: BCBS Complete |
$295.67
|
| Rate for Payer: BCBS MAPPO |
$443.75
|
| Rate for Payer: BCN Commercial |
$748.96
|
| Rate for Payer: BCN Medicare Advantage |
$443.75
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$594.62
|
| Rate for Payer: Cofinity Commercial |
$639.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.94
|
| Rate for Payer: Meridian Medicaid |
$295.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$488.12
|
| Rate for Payer: Nomi Health Commercial |
$532.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,251.00
|
| Rate for Payer: PACE SWMI |
$443.75
|
| Rate for Payer: PHP Commercial |
$621.25
|
| Rate for Payer: PHP Medicare Advantage |
$443.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.41
|
| Rate for Payer: Priority Health Medicare |
$443.75
|
| Rate for Payer: Priority Health SBD |
$805.41
|
| Rate for Payer: Priority Health Tiered Network |
$805.41
|
| Rate for Payer: Railroad Medicare Medicare |
$443.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$919.42
|
| Rate for Payer: UHC Core |
$919.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$443.75
|
| Rate for Payer: UHC Exchange |
$919.42
|
| Rate for Payer: UHC Medicaid |
$281.59
|
| Rate for Payer: UHCCP Medicaid |
$281.59
|
| Rate for Payer: UMR Bronson Commercial |
$767.28
|
|
|
PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 33225
|
| Min. Negotiated Rate |
$251.55 |
| Max. Negotiated Rate |
$838.52 |
| Rate for Payer: Aetna Commercial |
$532.68
|
| Rate for Payer: Aetna Medicare |
$413.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.43
|
| Rate for Payer: BCBS Complete |
$264.13
|
| Rate for Payer: BCBS MAPPO |
$397.52
|
| Rate for Payer: BCN Commercial |
$675.27
|
| Rate for Payer: BCN Medicare Advantage |
$397.52
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$532.68
|
| Rate for Payer: Cofinity Commercial |
$572.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.40
|
| Rate for Payer: Meridian Medicaid |
$264.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.27
|
| Rate for Payer: Nomi Health Commercial |
$477.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$397.52
|
| Rate for Payer: PHP Commercial |
$556.53
|
| Rate for Payer: PHP Medicare Advantage |
$397.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$726.16
|
| Rate for Payer: Priority Health Medicare |
$397.52
|
| Rate for Payer: Priority Health SBD |
$726.16
|
| Rate for Payer: Priority Health Tiered Network |
$726.16
|
| Rate for Payer: Railroad Medicare Medicare |
$397.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.52
|
| Rate for Payer: UHC Core |
$838.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$397.52
|
| Rate for Payer: UHC Exchange |
$838.52
|
| Rate for Payer: UHC Medicaid |
$251.55
|
| Rate for Payer: UHCCP Medicaid |
$251.55
|
| Rate for Payer: UMR Bronson Commercial |
$467.36
|
|
|
PR INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$8,451.00
|
|
|
Service Code
|
HCPCS 33335
|
| Min. Negotiated Rate |
$1,128.05 |
| Max. Negotiated Rate |
$6,338.25 |
| Rate for Payer: Aetna Commercial |
$2,369.52
|
| Rate for Payer: Aetna Medicare |
$1,839.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,369.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,546.35
|
| Rate for Payer: BCBS Complete |
$1,184.45
|
| Rate for Payer: BCBS MAPPO |
$1,768.30
|
| Rate for Payer: BCN Commercial |
$2,740.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,768.30
|
| Rate for Payer: Cash Price |
$6,760.80
|
| Rate for Payer: Cash Price |
$6,760.80
|
| Rate for Payer: Cofinity Commercial |
$2,369.52
|
| Rate for Payer: Cofinity Commercial |
$2,546.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,768.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,856.71
|
| Rate for Payer: Meridian Medicaid |
$1,184.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,945.13
|
| Rate for Payer: Nomi Health Commercial |
$2,121.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,338.25
|
| Rate for Payer: PACE SWMI |
$1,768.30
|
| Rate for Payer: PHP Commercial |
$2,475.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,768.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,128.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,947.48
|
| Rate for Payer: Priority Health Medicare |
$1,768.30
|
| Rate for Payer: Priority Health SBD |
$2,947.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,947.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,768.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,332.08
|
| Rate for Payer: UHC Core |
$3,332.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,768.30
|
| Rate for Payer: UHC Exchange |
$3,332.08
|
| Rate for Payer: UHC Medicaid |
$1,128.05
|
| Rate for Payer: UHCCP Medicaid |
$1,128.05
|
| Rate for Payer: UMR Bronson Commercial |
$3,887.46
|
|
|
PR INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$3,211.00
|
|
|
Service Code
|
HCPCS 53445
|
| Min. Negotiated Rate |
$439.63 |
| Max. Negotiated Rate |
$2,408.25 |
| Rate for Payer: Aetna Commercial |
$908.55
|
| Rate for Payer: Aetna Medicare |
$705.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$908.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.35
|
| Rate for Payer: BCBS Complete |
$461.61
|
| Rate for Payer: BCBS MAPPO |
$678.02
|
| Rate for Payer: BCN Commercial |
$1,135.89
|
| Rate for Payer: BCN Medicare Advantage |
$678.02
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cofinity Commercial |
$908.55
|
| Rate for Payer: Cofinity Commercial |
$976.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$711.92
|
| Rate for Payer: Meridian Medicaid |
$461.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$745.82
|
| Rate for Payer: Nomi Health Commercial |
$813.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.25
|
| Rate for Payer: PACE SWMI |
$678.02
|
| Rate for Payer: PHP Commercial |
$949.23
|
| Rate for Payer: PHP Medicare Advantage |
$678.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,237.35
|
| Rate for Payer: Priority Health Medicare |
$678.02
|
| Rate for Payer: Priority Health SBD |
$1,237.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,237.35
|
| Rate for Payer: Railroad Medicare Medicare |
$678.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,328.06
|
| Rate for Payer: UHC Core |
$1,328.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.02
|
| Rate for Payer: UHC Exchange |
$1,328.06
|
| Rate for Payer: UHC Medicaid |
$439.63
|
| Rate for Payer: UHCCP Medicaid |
$439.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,477.06
|
|
|
PR INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 33970
|
| Min. Negotiated Rate |
$200.43 |
| Max. Negotiated Rate |
$1,049.25 |
| Rate for Payer: Aetna Commercial |
$425.29
|
| Rate for Payer: Aetna Medicare |
$330.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.03
|
| Rate for Payer: BCBS Complete |
$210.45
|
| Rate for Payer: BCBS MAPPO |
$317.38
|
| Rate for Payer: BCN Commercial |
$515.41
|
| Rate for Payer: BCN Medicare Advantage |
$317.38
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cofinity Commercial |
$425.29
|
| Rate for Payer: Cofinity Commercial |
$457.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.25
|
| Rate for Payer: Meridian Medicaid |
$210.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$349.12
|
| Rate for Payer: Nomi Health Commercial |
$380.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,049.25
|
| Rate for Payer: PACE SWMI |
$317.38
|
| Rate for Payer: PHP Commercial |
$444.33
|
| Rate for Payer: PHP Medicare Advantage |
$317.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$554.26
|
| Rate for Payer: Priority Health Medicare |
$317.38
|
| Rate for Payer: Priority Health SBD |
$554.26
|
| Rate for Payer: Priority Health Tiered Network |
$554.26
|
| Rate for Payer: Railroad Medicare Medicare |
$317.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.99
|
| Rate for Payer: UHC Core |
$633.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$317.38
|
| Rate for Payer: UHC Exchange |
$633.99
|
| Rate for Payer: UHC Medicaid |
$200.43
|
| Rate for Payer: UHCCP Medicaid |
$200.43
|
| Rate for Payer: UMR Bronson Commercial |
$643.54
|
|
|
PR INSJ INTRAPERITONEAL CATHETER W/IMG GUID
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 49418
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$361.05 |
| Rate for Payer: Aetna Commercial |
$233.00
|
| Rate for Payer: Aetna Medicare |
$180.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.39
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$173.88
|
| Rate for Payer: BCN Commercial |
$294.81
|
| Rate for Payer: BCN Medicare Advantage |
$173.88
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$233.00
|
| Rate for Payer: Cofinity Commercial |
$250.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.57
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.27
|
| Rate for Payer: Nomi Health Commercial |
$208.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PACE SWMI |
$173.88
|
| Rate for Payer: PHP Commercial |
$243.43
|
| Rate for Payer: PHP Medicare Advantage |
$173.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$359.20
|
| Rate for Payer: Priority Health Medicare |
$173.88
|
| Rate for Payer: Priority Health SBD |
$359.20
|
| Rate for Payer: Priority Health Tiered Network |
$359.20
|
| Rate for Payer: Railroad Medicare Medicare |
$173.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.05
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.88
|
| Rate for Payer: UHC Exchange |
$361.05
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
| Rate for Payer: UMR Bronson Commercial |
$191.82
|
|
|
PR INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 57267
|
| Min. Negotiated Rate |
$139.73 |
| Max. Negotiated Rate |
$633.00 |
| Rate for Payer: Aetna Commercial |
$294.14
|
| Rate for Payer: Aetna Medicare |
$228.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.09
|
| Rate for Payer: BCBS Complete |
$146.72
|
| Rate for Payer: BCBS MAPPO |
$219.51
|
| Rate for Payer: BCN Commercial |
$371.99
|
| Rate for Payer: BCN Medicare Advantage |
$219.51
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cofinity Commercial |
$294.14
|
| Rate for Payer: Cofinity Commercial |
$316.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.49
|
| Rate for Payer: Meridian Medicaid |
$146.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$241.46
|
| Rate for Payer: Nomi Health Commercial |
$263.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.00
|
| Rate for Payer: PACE SWMI |
$219.51
|
| Rate for Payer: PHP Commercial |
$307.31
|
| Rate for Payer: PHP Medicare Advantage |
$219.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$376.75
|
| Rate for Payer: Priority Health Medicare |
$219.51
|
| Rate for Payer: Priority Health SBD |
$376.75
|
| Rate for Payer: Priority Health Tiered Network |
$376.75
|
| Rate for Payer: Railroad Medicare Medicare |
$219.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.37
|
| Rate for Payer: UHC Core |
$451.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$219.51
|
| Rate for Payer: UHC Exchange |
$451.37
|
| Rate for Payer: UHC Medicaid |
$139.73
|
| Rate for Payer: UHCCP Medicaid |
$139.73
|
| Rate for Payer: UMR Bronson Commercial |
$388.24
|
|
|
PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 54405
|
| Min. Negotiated Rate |
$464.77 |
| Max. Negotiated Rate |
$1,429.11 |
| Rate for Payer: Aetna Commercial |
$964.37
|
| Rate for Payer: Aetna Medicare |
$748.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,036.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.37
|
| Rate for Payer: BCBS Complete |
$488.01
|
| Rate for Payer: BCBS MAPPO |
$719.68
|
| Rate for Payer: BCN Commercial |
$1,210.10
|
| Rate for Payer: BCN Medicare Advantage |
$719.68
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$1,036.34
|
| Rate for Payer: Cofinity Commercial |
$964.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.66
|
| Rate for Payer: Meridian Medicaid |
$488.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.65
|
| Rate for Payer: Nomi Health Commercial |
$863.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,132.50
|
| Rate for Payer: PACE SWMI |
$719.68
|
| Rate for Payer: PHP Commercial |
$1,007.55
|
| Rate for Payer: PHP Medicare Advantage |
$719.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,318.19
|
| Rate for Payer: Priority Health Medicare |
$719.68
|
| Rate for Payer: Priority Health SBD |
$1,318.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,318.19
|
| Rate for Payer: Railroad Medicare Medicare |
$719.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,429.11
|
| Rate for Payer: UHC Core |
$1,429.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.68
|
| Rate for Payer: UHC Exchange |
$1,429.11
|
| Rate for Payer: UHC Medicaid |
$464.77
|
| Rate for Payer: UHCCP Medicaid |
$464.77
|
| Rate for Payer: UMR Bronson Commercial |
$694.60
|
|
