|
PR INSERTION VASCULAR PEDICLE CARPAL BONE
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 25430
|
| Min. Negotiated Rate |
$264.89 |
| Max. Negotiated Rate |
$1,135.78 |
| Rate for Payer: Aetna Commercial |
$949.58
|
| Rate for Payer: Aetna Medicare |
$736.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.58
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS MAPPO |
$708.64
|
| Rate for Payer: BCBS Trust/PPO |
$264.89
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$708.64
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cofinity Commercial |
$1,020.44
|
| Rate for Payer: Cofinity Commercial |
$949.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.07
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Nomi Health Commercial |
$850.37
|
| Rate for Payer: PACE SWMI |
$708.64
|
| Rate for Payer: PHP Commercial |
$992.10
|
| Rate for Payer: PHP Medicare Advantage |
$708.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,135.78
|
| Rate for Payer: Priority Health Medicare |
$708.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,135.78
|
| Rate for Payer: Priority Health SBD |
$1,135.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.64
|
| Rate for Payer: UHC Medicare Advantage |
$708.64
|
| Rate for Payer: UHCCP Medicaid |
$479.89
|
| Rate for Payer: UMR Bronson Commercial |
$568.10
|
|
|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$63.44 |
| Max. Negotiated Rate |
$332.30 |
| Rate for Payer: Aetna Commercial |
$216.08
|
| Rate for Payer: Aetna Medicare |
$167.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.20
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS MAPPO |
$161.25
|
| Rate for Payer: BCBS Trust/PPO |
$63.44
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: BCN Medicare Advantage |
$161.25
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$216.08
|
| Rate for Payer: Cofinity Commercial |
$232.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.31
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Nomi Health Commercial |
$193.50
|
| Rate for Payer: PACE SWMI |
$161.25
|
| Rate for Payer: PHP Commercial |
$225.75
|
| Rate for Payer: PHP Medicare Advantage |
$161.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.48
|
| Rate for Payer: Priority Health Medicare |
$161.25
|
| Rate for Payer: Priority Health Narrow Network |
$257.48
|
| Rate for Payer: Priority Health SBD |
$257.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.25
|
| Rate for Payer: UHC Medicare Advantage |
$161.25
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADD
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 0172T
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$343.85 |
| Rate for Payer: Aetna Medicare |
$264.50
|
| Rate for Payer: BCBS Complete |
$211.60
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.85
|
| Rate for Payer: UMR Bronson Commercial |
$243.34
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, SINGLE
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 0171T
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$1,777.10 |
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,257.64
|
|
|
PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 53855
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$2,298.11 |
| Rate for Payer: Aetna Commercial |
$104.55
|
| Rate for Payer: Aetna Medicare |
$81.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.35
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$78.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,298.11
|
| Rate for Payer: BCN Commercial |
$963.67
|
| Rate for Payer: BCN Medicare Advantage |
$78.02
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cofinity Commercial |
$104.55
|
| Rate for Payer: Cofinity Commercial |
$112.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.92
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$93.62
|
| Rate for Payer: PACE SWMI |
$78.02
|
| Rate for Payer: PHP Commercial |
$109.23
|
| Rate for Payer: PHP Medicare Advantage |
$78.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.90
|
| Rate for Payer: Priority Health Medicare |
$78.02
|
| Rate for Payer: Priority Health Narrow Network |
$128.90
|
| Rate for Payer: Priority Health SBD |
$128.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.02
|
| Rate for Payer: UHC Medicare Advantage |
$78.02
|
| Rate for Payer: UHCCP Medicaid |
$51.76
|
| Rate for Payer: UMR Bronson Commercial |
$537.28
|
|
|
PR INSERT TRAY W/O BAG/CATH
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4310
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$8.51 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$8.51
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR
|
Professional
|
Both
|
$2,147.00
|
|
|
Service Code
|
HCPCS 36557
|
| Min. Negotiated Rate |
$206.18 |
| Max. Negotiated Rate |
$1,711.35 |
| Rate for Payer: Aetna Commercial |
$415.40
|
| Rate for Payer: Aetna Medicare |
$322.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.40
|
| Rate for Payer: BCBS Complete |
$216.49
|
| Rate for Payer: BCBS MAPPO |
$310.00
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: BCN Commercial |
$1,711.35
|
| Rate for Payer: BCN Medicare Advantage |
$310.00
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cofinity Commercial |
$415.40
|
| Rate for Payer: Cofinity Commercial |
$446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.50
|
| Rate for Payer: Meridian Medicaid |
$216.49
|
| Rate for Payer: Nomi Health Commercial |
$372.00
|
| Rate for Payer: PACE SWMI |
$310.00
|
| Rate for Payer: PHP Commercial |
$434.00
|
| Rate for Payer: PHP Medicare Advantage |
$310.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.55
|
| Rate for Payer: Priority Health Medicare |
$310.00
|
| Rate for Payer: Priority Health Narrow Network |
$510.55
|
| Rate for Payer: Priority Health SBD |
$510.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.00
|
| Rate for Payer: UHC Medicare Advantage |
$310.00
|
| Rate for Payer: UHCCP Medicaid |
$206.18
|
| Rate for Payer: UMR Bronson Commercial |
$987.62
|
|
|
PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 37191
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$2,999.02 |
| Rate for Payer: Aetna Commercial |
$279.44
|
| Rate for Payer: Aetna Medicare |
$216.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.30
|
| Rate for Payer: BCBS Complete |
$144.48
|
| Rate for Payer: BCBS MAPPO |
$208.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.83
|
| Rate for Payer: BCN Commercial |
$2,999.02
|
| Rate for Payer: BCN Medicare Advantage |
$208.54
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cofinity Commercial |
$279.44
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.97
|
| Rate for Payer: Meridian Medicaid |
$144.48
|
| Rate for Payer: Nomi Health Commercial |
$250.25
|
| Rate for Payer: PACE SWMI |
$208.54
|
| Rate for Payer: PHP Commercial |
$291.96
|
| Rate for Payer: PHP Medicare Advantage |
$208.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.44
|
| Rate for Payer: Priority Health Medicare |
$208.54
|
| Rate for Payer: Priority Health Narrow Network |
$341.44
|
| Rate for Payer: Priority Health SBD |
$341.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.54
|
| Rate for Payer: UHC Medicare Advantage |
$208.54
|
| Rate for Payer: UHCCP Medicaid |
$137.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.04
|
|
|
PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART
|
Professional
|
Both
|
$3,309.00
|
|
|
Service Code
|
HCPCS 35585
|
| Min. Negotiated Rate |
$1,041.36 |
| Max. Negotiated Rate |
$2,597.43 |
| Rate for Payer: Aetna Commercial |
$2,145.92
|
| Rate for Payer: Aetna Medicare |
$1,665.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,145.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,306.06
|
| Rate for Payer: BCBS Complete |
$1,093.43
|
| Rate for Payer: BCBS MAPPO |
$1,601.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.96
|
| Rate for Payer: BCN Commercial |
$2,378.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,601.43
|
| Rate for Payer: Cash Price |
$2,647.20
|
| Rate for Payer: Cash Price |
$2,647.20
|
| Rate for Payer: Cofinity Commercial |
$2,145.92
|
| Rate for Payer: Cofinity Commercial |
$2,306.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,601.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,681.50
|
| Rate for Payer: Meridian Medicaid |
$1,093.43
|
| Rate for Payer: Nomi Health Commercial |
$1,921.72
|
| Rate for Payer: PACE SWMI |
$1,601.43
|
| Rate for Payer: PHP Commercial |
$2,242.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,601.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,041.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,150.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,597.43
|
| Rate for Payer: Priority Health Medicare |
$1,601.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.43
|
| Rate for Payer: Priority Health SBD |
$2,597.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,601.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,601.43
|
| Rate for Payer: UHCCP Medicaid |
$1,041.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,522.14
|
|
|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$4,664.00
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$899.50 |
| Max. Negotiated Rate |
$3,031.60 |
| Rate for Payer: Aetna Commercial |
$1,852.03
|
| Rate for Payer: Aetna Medicare |
$1,437.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,852.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.24
|
| Rate for Payer: BCBS Complete |
$944.48
|
| Rate for Payer: BCBS MAPPO |
$1,382.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.35
|
| Rate for Payer: BCN Commercial |
$2,057.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.11
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,852.03
|
| Rate for Payer: Cofinity Commercial |
$1,990.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,451.22
|
| Rate for Payer: Meridian Medicaid |
$944.48
|
| Rate for Payer: Nomi Health Commercial |
$1,658.53
|
| Rate for Payer: PACE SWMI |
$1,382.11
|
| Rate for Payer: PHP Commercial |
$1,934.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$899.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,031.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.24
|
| Rate for Payer: Priority Health Medicare |
$1,382.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,243.24
|
| Rate for Payer: Priority Health SBD |
$2,243.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,382.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,382.11
|
| Rate for Payer: UHCCP Medicaid |
$899.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,145.44
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$2,851.00
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$833.68 |
| Max. Negotiated Rate |
$2,076.78 |
| Rate for Payer: Aetna Commercial |
$1,719.98
|
| Rate for Payer: Aetna Medicare |
$1,334.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,848.34
|
| Rate for Payer: BCBS Complete |
$875.36
|
| Rate for Payer: BCBS MAPPO |
$1,283.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$1,945.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.57
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cofinity Commercial |
$1,719.98
|
| Rate for Payer: Cofinity Commercial |
$1,848.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,347.75
|
| Rate for Payer: Meridian Medicaid |
$875.36
|
| Rate for Payer: Nomi Health Commercial |
$1,540.28
|
| Rate for Payer: PACE SWMI |
$1,283.57
|
| Rate for Payer: PHP Commercial |
$1,797.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,853.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,076.78
|
| Rate for Payer: Priority Health Medicare |
$1,283.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.78
|
| Rate for Payer: Priority Health SBD |
$2,076.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.57
|
| Rate for Payer: UHCCP Medicaid |
$833.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,311.46
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$234.73 |
| Max. Negotiated Rate |
$1,885.50 |
| Rate for Payer: Aetna Commercial |
$471.13
|
| Rate for Payer: Aetna Medicare |
$365.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.29
|
| Rate for Payer: BCBS Complete |
$246.47
|
| Rate for Payer: BCBS MAPPO |
$351.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,885.50
|
| Rate for Payer: BCN Commercial |
$539.01
|
| Rate for Payer: BCN Medicare Advantage |
$351.59
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$471.13
|
| Rate for Payer: Cofinity Commercial |
$506.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.17
|
| Rate for Payer: Meridian Medicaid |
$246.47
|
| Rate for Payer: Nomi Health Commercial |
$421.91
|
| Rate for Payer: PACE SWMI |
$351.59
|
| Rate for Payer: PHP Commercial |
$492.23
|
| Rate for Payer: PHP Medicare Advantage |
$351.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.95
|
| Rate for Payer: Priority Health Medicare |
$351.59
|
| Rate for Payer: Priority Health Narrow Network |
$583.95
|
| Rate for Payer: Priority Health SBD |
$583.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.59
|
| Rate for Payer: UHC Medicare Advantage |
$351.59
|
| Rate for Payer: UHCCP Medicaid |
$234.73
|
| Rate for Payer: UMR Bronson Commercial |
$570.86
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$1,400.52 |
| Rate for Payer: Aetna Commercial |
$468.76
|
| Rate for Payer: Aetna Medicare |
$363.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.74
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS MAPPO |
$349.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,400.52
|
| Rate for Payer: BCN Commercial |
$533.63
|
| Rate for Payer: BCN Medicare Advantage |
$349.82
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$468.76
|
| Rate for Payer: Cofinity Commercial |
$503.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.31
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Nomi Health Commercial |
$419.78
|
| Rate for Payer: PACE SWMI |
$349.82
|
| Rate for Payer: PHP Commercial |
$489.75
|
| Rate for Payer: PHP Medicare Advantage |
$349.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$579.68
|
| Rate for Payer: Priority Health Medicare |
$349.82
|
| Rate for Payer: Priority Health Narrow Network |
$579.68
|
| Rate for Payer: Priority Health SBD |
$579.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.82
|
| Rate for Payer: UHC Medicare Advantage |
$349.82
|
| Rate for Payer: UHCCP Medicaid |
$233.45
|
| Rate for Payer: UMR Bronson Commercial |
$570.86
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$391.82 |
| Rate for Payer: Aetna Commercial |
$337.24
|
| Rate for Payer: Aetna Medicare |
$261.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.40
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$251.67
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$375.30
|
| Rate for Payer: BCN Medicare Advantage |
$251.67
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$337.24
|
| Rate for Payer: Cofinity Commercial |
$362.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.25
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Nomi Health Commercial |
$302.00
|
| Rate for Payer: PACE SWMI |
$251.67
|
| Rate for Payer: PHP Commercial |
$352.34
|
| Rate for Payer: PHP Medicare Advantage |
$251.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.82
|
| Rate for Payer: Priority Health Medicare |
$251.67
|
| Rate for Payer: Priority Health Narrow Network |
$391.82
|
| Rate for Payer: Priority Health SBD |
$391.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.67
|
| Rate for Payer: UHC Medicare Advantage |
$251.67
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
| Rate for Payer: UMR Bronson Commercial |
$251.16
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$439.29
|
| Rate for Payer: Aetna Medicare |
$340.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.08
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS MAPPO |
$327.83
|
| Rate for Payer: BCBS Trust/PPO |
$133.29
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: BCN Medicare Advantage |
$327.83
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$439.29
|
| Rate for Payer: Cofinity Commercial |
$472.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.22
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Nomi Health Commercial |
$393.40
|
| Rate for Payer: PACE SWMI |
$327.83
|
| Rate for Payer: PHP Commercial |
$458.96
|
| Rate for Payer: PHP Medicare Advantage |
$327.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.82
|
| Rate for Payer: Priority Health Medicare |
$327.83
|
| Rate for Payer: Priority Health Narrow Network |
$506.82
|
| Rate for Payer: Priority Health SBD |
$506.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.83
|
| Rate for Payer: UHC Medicare Advantage |
$327.83
|
| Rate for Payer: UHCCP Medicaid |
$214.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.02
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$573.95 |
| Rate for Payer: Aetna Commercial |
$439.80
|
| Rate for Payer: Aetna Medicare |
$341.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.62
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS MAPPO |
$328.21
|
| Rate for Payer: BCBS Trust/PPO |
$69.19
|
| Rate for Payer: BCN Commercial |
$488.19
|
| Rate for Payer: BCN Medicare Advantage |
$328.21
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$439.80
|
| Rate for Payer: Cofinity Commercial |
$472.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.62
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Nomi Health Commercial |
$393.85
|
| Rate for Payer: PACE SWMI |
$328.21
|
| Rate for Payer: PHP Commercial |
$459.49
|
| Rate for Payer: PHP Medicare Advantage |
$328.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.38
|
| Rate for Payer: Priority Health Medicare |
$328.21
|
| Rate for Payer: Priority Health Narrow Network |
$510.38
|
| Rate for Payer: Priority Health SBD |
$510.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.21
|
| Rate for Payer: UHC Medicare Advantage |
$328.21
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
| Rate for Payer: UMR Bronson Commercial |
$406.18
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$121.62 |
| Max. Negotiated Rate |
$1,011.69 |
| Rate for Payer: Aetna Commercial |
$244.04
|
| Rate for Payer: Aetna Medicare |
$189.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.25
|
| Rate for Payer: BCBS Complete |
$127.70
|
| Rate for Payer: BCBS MAPPO |
$182.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.69
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: BCN Medicare Advantage |
$182.12
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$244.04
|
| Rate for Payer: Cofinity Commercial |
$262.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.23
|
| Rate for Payer: Meridian Medicaid |
$127.70
|
| Rate for Payer: Nomi Health Commercial |
$218.54
|
| Rate for Payer: PACE SWMI |
$182.12
|
| Rate for Payer: PHP Commercial |
$254.97
|
| Rate for Payer: PHP Medicare Advantage |
$182.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.20
|
| Rate for Payer: Priority Health Medicare |
$182.12
|
| Rate for Payer: Priority Health Narrow Network |
$329.20
|
| Rate for Payer: Priority Health SBD |
$329.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.12
|
| Rate for Payer: UHC Medicare Advantage |
$182.12
|
| Rate for Payer: UHCCP Medicaid |
$121.62
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$720.07 |
| Rate for Payer: Aetna Commercial |
$153.12
|
| Rate for Payer: Aetna Medicare |
$118.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.55
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$114.27
|
| Rate for Payer: BCBS Trust/PPO |
$720.07
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: BCN Medicare Advantage |
$114.27
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$153.12
|
| Rate for Payer: Cofinity Commercial |
$164.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.98
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Nomi Health Commercial |
$137.12
|
| Rate for Payer: PACE SWMI |
$114.27
|
| Rate for Payer: PHP Commercial |
$159.98
|
| Rate for Payer: PHP Medicare Advantage |
$114.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.32
|
| Rate for Payer: Priority Health Medicare |
$114.27
|
| Rate for Payer: Priority Health Narrow Network |
$189.32
|
| Rate for Payer: Priority Health SBD |
$189.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.27
|
| Rate for Payer: UHC Medicare Advantage |
$114.27
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
| Rate for Payer: UMR Bronson Commercial |
$305.90
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$1,619.00
|
|
|
Service Code
|
HCPCS 33224
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$1,392.07 |
| Rate for Payer: Aetna Commercial |
$651.70
|
| Rate for Payer: Aetna Medicare |
$505.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.33
|
| Rate for Payer: BCBS Complete |
$336.37
|
| Rate for Payer: BCBS MAPPO |
$486.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.07
|
| Rate for Payer: BCN Commercial |
$738.39
|
| Rate for Payer: BCN Medicare Advantage |
$486.34
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Cofinity Commercial |
$651.70
|
| Rate for Payer: Cofinity Commercial |
$700.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.66
|
| Rate for Payer: Meridian Medicaid |
$336.37
|
| Rate for Payer: Nomi Health Commercial |
$583.61
|
| Rate for Payer: PACE SWMI |
$486.34
|
| Rate for Payer: PHP Commercial |
$680.88
|
| Rate for Payer: PHP Medicare Advantage |
$486.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.21
|
| Rate for Payer: Priority Health Medicare |
$486.34
|
| Rate for Payer: Priority Health Narrow Network |
$797.21
|
| Rate for Payer: Priority Health SBD |
$797.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.34
|
| Rate for Payer: UHC Medicare Advantage |
$486.34
|
| Rate for Payer: UHCCP Medicaid |
$320.35
|
| Rate for Payer: UMR Bronson Commercial |
$744.74
|
|
|
PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 33225
|
| Min. Negotiated Rate |
$288.83 |
| Max. Negotiated Rate |
$1,409.50 |
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Aetna Commercial |
$589.04
|
| Rate for Payer: Aetna Medicare |
$457.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.00
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$439.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.50
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$439.58
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$589.04
|
| Rate for Payer: Cofinity Commercial |
$633.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.56
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Nomi Health Commercial |
$527.50
|
| Rate for Payer: PACE SWMI |
$439.58
|
| Rate for Payer: PHP Commercial |
$615.41
|
| Rate for Payer: PHP Medicare Advantage |
$439.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$718.49
|
| Rate for Payer: Priority Health Medicare |
$439.58
|
| Rate for Payer: Priority Health Narrow Network |
$718.49
|
| Rate for Payer: Priority Health SBD |
$718.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.58
|
| Rate for Payer: UHC Medicare Advantage |
$439.58
|
| Rate for Payer: UHCCP Medicaid |
$288.83
|
| Rate for Payer: UMR Bronson Commercial |
$453.56
|
|
|
PR INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$8,205.00
|
|
|
Service Code
|
HCPCS 33335
|
| Min. Negotiated Rate |
$818.87 |
| Max. Negotiated Rate |
$5,333.25 |
| Rate for Payer: Aetna Commercial |
$2,392.29
|
| Rate for Payer: Aetna Medicare |
$1,856.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,392.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,570.82
|
| Rate for Payer: BCBS Complete |
$1,230.97
|
| Rate for Payer: BCBS MAPPO |
$1,785.29
|
| Rate for Payer: BCBS Trust/PPO |
$818.87
|
| Rate for Payer: BCN Commercial |
$2,673.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,785.29
|
| Rate for Payer: Cash Price |
$6,564.00
|
| Rate for Payer: Cash Price |
$6,564.00
|
| Rate for Payer: Cofinity Commercial |
$2,392.29
|
| Rate for Payer: Cofinity Commercial |
$2,570.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,785.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,874.55
|
| Rate for Payer: Meridian Medicaid |
$1,230.97
|
| Rate for Payer: Nomi Health Commercial |
$2,142.35
|
| Rate for Payer: PACE SWMI |
$1,785.29
|
| Rate for Payer: PHP Commercial |
$2,499.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,785.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,172.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,333.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,912.81
|
| Rate for Payer: Priority Health Medicare |
$1,785.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,912.81
|
| Rate for Payer: Priority Health SBD |
$2,912.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,785.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,785.29
|
| Rate for Payer: UHCCP Medicaid |
$1,172.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,774.30
|
|
|
PR INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 53445
|
| Min. Negotiated Rate |
$485.85 |
| Max. Negotiated Rate |
$3,567.61 |
| Rate for Payer: Aetna Commercial |
$968.67
|
| Rate for Payer: Aetna Medicare |
$751.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.67
|
| Rate for Payer: BCBS Complete |
$510.14
|
| Rate for Payer: BCBS MAPPO |
$722.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,567.61
|
| Rate for Payer: BCN Commercial |
$1,092.68
|
| Rate for Payer: BCN Medicare Advantage |
$722.89
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,040.96
|
| Rate for Payer: Cofinity Commercial |
$968.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.03
|
| Rate for Payer: Meridian Medicaid |
$510.14
|
| Rate for Payer: Nomi Health Commercial |
$867.47
|
| Rate for Payer: PACE SWMI |
$722.89
|
| Rate for Payer: PHP Commercial |
$1,012.05
|
| Rate for Payer: PHP Medicare Advantage |
$722.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.86
|
| Rate for Payer: Priority Health Medicare |
$722.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.86
|
| Rate for Payer: Priority Health SBD |
$1,206.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.89
|
| Rate for Payer: UHC Medicare Advantage |
$722.89
|
| Rate for Payer: UHCCP Medicaid |
$485.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.82
|
|
|
PR INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN
|
Professional
|
Both
|
$1,358.00
|
|
|
Service Code
|
HCPCS 33970
|
| Min. Negotiated Rate |
$220.46 |
| Max. Negotiated Rate |
$979.47 |
| Rate for Payer: Aetna Commercial |
$452.40
|
| Rate for Payer: Aetna Medicare |
$351.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.16
|
| Rate for Payer: BCBS Complete |
$231.48
|
| Rate for Payer: BCBS MAPPO |
$337.61
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$505.29
|
| Rate for Payer: BCN Medicare Advantage |
$337.61
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cofinity Commercial |
$452.40
|
| Rate for Payer: Cofinity Commercial |
$486.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.49
|
| Rate for Payer: Meridian Medicaid |
$231.48
|
| Rate for Payer: Nomi Health Commercial |
$405.13
|
| Rate for Payer: PACE SWMI |
$337.61
|
| Rate for Payer: PHP Commercial |
$472.65
|
| Rate for Payer: PHP Medicare Advantage |
$337.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.85
|
| Rate for Payer: Priority Health Medicare |
$337.61
|
| Rate for Payer: Priority Health Narrow Network |
$548.85
|
| Rate for Payer: Priority Health SBD |
$548.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.61
|
| Rate for Payer: UHC Medicare Advantage |
$337.61
|
| Rate for Payer: UHCCP Medicaid |
$220.46
|
| Rate for Payer: UMR Bronson Commercial |
$624.68
|
|
|
PR INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 57267
|
| Min. Negotiated Rate |
$159.11 |
| Max. Negotiated Rate |
$1,692.14 |
| Rate for Payer: Aetna Commercial |
$322.19
|
| Rate for Payer: Aetna Medicare |
$250.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.23
|
| Rate for Payer: BCBS Complete |
$167.07
|
| Rate for Payer: BCBS MAPPO |
$240.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,692.14
|
| Rate for Payer: BCN Commercial |
$363.58
|
| Rate for Payer: BCN Medicare Advantage |
$240.44
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cofinity Commercial |
$322.19
|
| Rate for Payer: Cofinity Commercial |
$346.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.46
|
| Rate for Payer: Meridian Medicaid |
$167.07
|
| Rate for Payer: Nomi Health Commercial |
$288.53
|
| Rate for Payer: PACE SWMI |
$240.44
|
| Rate for Payer: PHP Commercial |
$336.62
|
| Rate for Payer: PHP Medicare Advantage |
$240.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.04
|
| Rate for Payer: Priority Health Medicare |
$240.44
|
| Rate for Payer: Priority Health Narrow Network |
$370.04
|
| Rate for Payer: Priority Health SBD |
$370.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.44
|
| Rate for Payer: UHC Medicare Advantage |
$240.44
|
| Rate for Payer: UHCCP Medicaid |
$159.11
|
| Rate for Payer: UMR Bronson Commercial |
$376.74
|
|
|
PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH
|
Professional
|
Both
|
$1,466.00
|
|
|
Service Code
|
HCPCS 54405
|
| Min. Negotiated Rate |
$156.83 |
| Max. Negotiated Rate |
$1,284.62 |
| Rate for Payer: Aetna Commercial |
$1,035.65
|
| Rate for Payer: Aetna Medicare |
$803.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.93
|
| Rate for Payer: BCBS Complete |
$543.47
|
| Rate for Payer: BCBS MAPPO |
$772.87
|
| Rate for Payer: BCBS Trust/PPO |
$156.83
|
| Rate for Payer: BCN Commercial |
$1,165.50
|
| Rate for Payer: BCN Medicare Advantage |
$772.87
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cash Price |
$1,172.80
|
| Rate for Payer: Cofinity Commercial |
$1,035.65
|
| Rate for Payer: Cofinity Commercial |
$1,112.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.51
|
| Rate for Payer: Meridian Medicaid |
$543.47
|
| Rate for Payer: Nomi Health Commercial |
$927.44
|
| Rate for Payer: PACE SWMI |
$772.87
|
| Rate for Payer: PHP Commercial |
$1,082.02
|
| Rate for Payer: PHP Medicare Advantage |
$772.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.62
|
| Rate for Payer: Priority Health Medicare |
$772.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,284.62
|
| Rate for Payer: Priority Health SBD |
$1,284.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.87
|
| Rate for Payer: UHC Medicare Advantage |
$772.87
|
| Rate for Payer: UHCCP Medicaid |
$517.59
|
| Rate for Payer: UMR Bronson Commercial |
$674.36
|
|
