|
PR INSJ NON-NDWELLG BLADDER CATHETER
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 51701
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$661.43 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare |
$25.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$24.05
|
| Rate for Payer: BCBS Trust/PPO |
$661.43
|
| Rate for Payer: BCN Commercial |
$52.23
|
| Rate for Payer: BCN Medicare Advantage |
$24.05
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$32.23
|
| Rate for Payer: Cofinity Commercial |
$34.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.25
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$28.86
|
| Rate for Payer: PACE SWMI |
$24.05
|
| Rate for Payer: PHP Commercial |
$33.67
|
| Rate for Payer: PHP Medicare Advantage |
$24.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.48
|
| Rate for Payer: Priority Health Medicare |
$24.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.48
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.05
|
| Rate for Payer: UHC Medicare Advantage |
$24.05
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 36555
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$898.64 |
| Rate for Payer: Aetna Commercial |
$107.59
|
| Rate for Payer: Aetna Medicare |
$83.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.62
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.29
|
| Rate for Payer: BCBS Trust/PPO |
$898.64
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: BCN Medicare Advantage |
$80.29
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$107.59
|
| Rate for Payer: Cofinity Commercial |
$115.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.30
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$96.35
|
| Rate for Payer: PACE SWMI |
$80.29
|
| Rate for Payer: PHP Commercial |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$80.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.89
|
| Rate for Payer: Priority Health Medicare |
$80.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.89
|
| Rate for Payer: Priority Health SBD |
$131.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.29
|
| Rate for Payer: UHC Medicare Advantage |
$80.29
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$461.38
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 36556
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$558.35 |
| Rate for Payer: Aetna Commercial |
$107.58
|
| Rate for Payer: Aetna Medicare |
$83.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.60
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.28
|
| Rate for Payer: BCBS Trust/PPO |
$253.58
|
| Rate for Payer: BCN Commercial |
$313.24
|
| Rate for Payer: BCN Medicare Advantage |
$80.28
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cofinity Commercial |
$107.58
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.29
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$96.34
|
| Rate for Payer: PACE SWMI |
$80.28
|
| Rate for Payer: PHP Commercial |
$112.39
|
| Rate for Payer: PHP Medicare Advantage |
$80.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.43
|
| Rate for Payer: Priority Health Medicare |
$80.28
|
| Rate for Payer: Priority Health Narrow Network |
$132.43
|
| Rate for Payer: Priority Health SBD |
$132.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.28
|
| Rate for Payer: UHC Medicare Advantage |
$80.28
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$395.14
|
|
|
PR INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 54400
|
| Min. Negotiated Rate |
$199.17 |
| Max. Negotiated Rate |
$1,037.40 |
| Rate for Payer: Aetna Commercial |
$682.25
|
| Rate for Payer: Aetna Medicare |
$529.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.16
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$509.14
|
| Rate for Payer: BCBS Trust/PPO |
$199.17
|
| Rate for Payer: BCN Commercial |
$769.17
|
| Rate for Payer: BCN Medicare Advantage |
$509.14
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cofinity Commercial |
$682.25
|
| Rate for Payer: Cofinity Commercial |
$733.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.60
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Nomi Health Commercial |
$610.97
|
| Rate for Payer: PACE SWMI |
$509.14
|
| Rate for Payer: PHP Commercial |
$712.80
|
| Rate for Payer: PHP Medicare Advantage |
$509.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,037.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.03
|
| Rate for Payer: Priority Health Medicare |
$509.14
|
| Rate for Payer: Priority Health Narrow Network |
$850.03
|
| Rate for Payer: Priority Health SBD |
$850.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.14
|
| Rate for Payer: UHC Medicare Advantage |
$509.14
|
| Rate for Payer: UHCCP Medicaid |
$342.08
|
| Rate for Payer: UMR Bronson Commercial |
$734.16
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 33990
|
| Min. Negotiated Rate |
$224.93 |
| Max. Negotiated Rate |
$1,090.41 |
| Rate for Payer: Aetna Commercial |
$460.40
|
| Rate for Payer: Aetna Medicare |
$357.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.76
|
| Rate for Payer: BCBS Complete |
$236.18
|
| Rate for Payer: BCBS MAPPO |
$343.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.41
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$343.58
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cofinity Commercial |
$460.40
|
| Rate for Payer: Cofinity Commercial |
$494.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.76
|
| Rate for Payer: Meridian Medicaid |
$236.18
|
| Rate for Payer: Nomi Health Commercial |
$412.30
|
| Rate for Payer: PACE SWMI |
$343.58
|
| Rate for Payer: PHP Commercial |
$481.01
|
| Rate for Payer: PHP Medicare Advantage |
$343.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.07
|
| Rate for Payer: Priority Health Medicare |
$343.58
|
| Rate for Payer: Priority Health Narrow Network |
$561.07
|
| Rate for Payer: Priority Health SBD |
$561.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.58
|
| Rate for Payer: UHC Medicare Advantage |
$343.58
|
| Rate for Payer: UHCCP Medicaid |
$224.93
|
| Rate for Payer: UMR Bronson Commercial |
$412.62
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS
|
Professional
|
Both
|
$3,380.00
|
|
|
Service Code
|
HCPCS 33991
|
| Min. Negotiated Rate |
$282.86 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna Commercial |
$581.43
|
| Rate for Payer: Aetna Medicare |
$451.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.82
|
| Rate for Payer: BCBS Complete |
$297.00
|
| Rate for Payer: BCBS MAPPO |
$433.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$433.90
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cofinity Commercial |
$581.43
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.60
|
| Rate for Payer: Meridian Medicaid |
$297.00
|
| Rate for Payer: Nomi Health Commercial |
$520.68
|
| Rate for Payer: PACE SWMI |
$433.90
|
| Rate for Payer: PHP Commercial |
$607.46
|
| Rate for Payer: PHP Medicare Advantage |
$433.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,197.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.14
|
| Rate for Payer: Priority Health Medicare |
$433.90
|
| Rate for Payer: Priority Health Narrow Network |
$704.14
|
| Rate for Payer: Priority Health SBD |
$704.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.90
|
| Rate for Payer: UHC Medicare Advantage |
$433.90
|
| Rate for Payer: UHCCP Medicaid |
$282.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,554.80
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
36571
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$399.47
|
| Rate for Payer: Aetna Medicare |
$310.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.28
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$298.11
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$298.11
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$429.28
|
| Rate for Payer: Cofinity Commercial |
$399.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.02
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Nomi Health Commercial |
$357.73
|
| Rate for Payer: PACE SWMI |
$298.11
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: PHP Medicare Advantage |
$298.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.06
|
| Rate for Payer: Priority Health Medicare |
$298.11
|
| Rate for Payer: Priority Health Narrow Network |
$494.06
|
| Rate for Payer: Priority Health SBD |
$494.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.11
|
| Rate for Payer: UHC Medicare Advantage |
$298.11
|
| Rate for Payer: UHCCP Medicaid |
$198.52
|
| Rate for Payer: UMR Bronson Commercial |
$797.18
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$1,733.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$762.52 |
| Max. Negotiated Rate |
$1,559.70 |
| Rate for Payer: Aetna American Axle |
$1,126.45
|
| Rate for Payer: Aetna Commercial |
$1,473.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.45
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,213.10
|
| Rate for Payer: Cofinity Commercial |
$1,490.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,386.40
|
| Rate for Payer: Healthscope Commercial |
$1,559.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,299.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.05
|
| Rate for Payer: PHP Commercial |
$1,473.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health SBD |
$1,091.79
|
| Rate for Payer: UMR Bronson Commercial |
$762.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,299.75
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 36571
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$399.47
|
| Rate for Payer: Aetna Medicare |
$310.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.28
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$298.11
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$298.11
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$429.28
|
| Rate for Payer: Cofinity Commercial |
$399.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.02
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Nomi Health Commercial |
$357.73
|
| Rate for Payer: PACE SWMI |
$298.11
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: PHP Medicare Advantage |
$298.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.06
|
| Rate for Payer: Priority Health Medicare |
$298.11
|
| Rate for Payer: Priority Health Narrow Network |
$494.06
|
| Rate for Payer: Priority Health SBD |
$494.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.11
|
| Rate for Payer: UHC Medicare Advantage |
$298.11
|
| Rate for Payer: UHCCP Medicaid |
$198.52
|
| Rate for Payer: UMR Bronson Commercial |
$797.18
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$1,733.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.05 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$1,126.45
|
| Rate for Payer: Aetna Commercial |
$1,473.05
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,951.95
|
| Rate for Payer: BCN Commercial |
$2,951.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,213.10
|
| Rate for Payer: Cofinity Commercial |
$1,490.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,386.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,559.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,299.75
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.05
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$1,473.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,091.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.16
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$301.05
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$641.21
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,299.75
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,086.00
|
|
|
Service Code
|
HCPCS 36570
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$2,152.62 |
| Rate for Payer: Aetna Commercial |
$430.13
|
| Rate for Payer: Aetna Medicare |
$333.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.23
|
| Rate for Payer: BCBS Complete |
$224.10
|
| Rate for Payer: BCBS MAPPO |
$320.99
|
| Rate for Payer: BCN Commercial |
$2,152.62
|
| Rate for Payer: BCN Medicare Advantage |
$320.99
|
| Rate for Payer: Cash Price |
$2,468.80
|
| Rate for Payer: Cash Price |
$2,468.80
|
| Rate for Payer: Cofinity Commercial |
$430.13
|
| Rate for Payer: Cofinity Commercial |
$462.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.04
|
| Rate for Payer: Meridian Medicaid |
$224.10
|
| Rate for Payer: Nomi Health Commercial |
$385.19
|
| Rate for Payer: PACE SWMI |
$320.99
|
| Rate for Payer: PHP Commercial |
$449.39
|
| Rate for Payer: PHP Medicare Advantage |
$320.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,005.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.69
|
| Rate for Payer: Priority Health Medicare |
$320.99
|
| Rate for Payer: Priority Health Narrow Network |
$529.69
|
| Rate for Payer: Priority Health SBD |
$529.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.99
|
| Rate for Payer: UHC Medicare Advantage |
$320.99
|
| Rate for Payer: UHCCP Medicaid |
$213.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,419.56
|
|
|
PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 19342
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$1,594.65 |
| Rate for Payer: Aetna Commercial |
$976.35
|
| Rate for Payer: Aetna Medicare |
$757.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.35
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS MAPPO |
$728.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.65
|
| Rate for Payer: BCN Commercial |
$1,114.67
|
| Rate for Payer: BCN Medicare Advantage |
$728.62
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,049.21
|
| Rate for Payer: Cofinity Commercial |
$976.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.05
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Nomi Health Commercial |
$874.34
|
| Rate for Payer: PACE SWMI |
$728.62
|
| Rate for Payer: PHP Commercial |
$1,020.07
|
| Rate for Payer: PHP Medicare Advantage |
$728.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,035.32
|
| Rate for Payer: Priority Health Medicare |
$728.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,035.32
|
| Rate for Payer: Priority Health SBD |
$1,035.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.62
|
| Rate for Payer: UHC Medicare Advantage |
$728.62
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
| Rate for Payer: UMR Bronson Commercial |
$771.42
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS
|
Professional
|
Both
|
$1,890.00
|
|
|
Service Code
|
HCPCS 61886
|
| Min. Negotiated Rate |
$579.36 |
| Max. Negotiated Rate |
$1,804.66 |
| Rate for Payer: Aetna Commercial |
$1,158.44
|
| Rate for Payer: Aetna Medicare |
$899.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.89
|
| Rate for Payer: BCBS Complete |
$608.33
|
| Rate for Payer: BCBS MAPPO |
$864.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.41
|
| Rate for Payer: BCN Commercial |
$1,804.66
|
| Rate for Payer: BCN Medicare Advantage |
$864.51
|
| Rate for Payer: Cash Price |
$1,512.00
|
| Rate for Payer: Cash Price |
$1,512.00
|
| Rate for Payer: Cofinity Commercial |
$1,158.44
|
| Rate for Payer: Cofinity Commercial |
$1,244.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.74
|
| Rate for Payer: Meridian Medicaid |
$608.33
|
| Rate for Payer: Nomi Health Commercial |
$1,037.41
|
| Rate for Payer: PACE SWMI |
$864.51
|
| Rate for Payer: PHP Commercial |
$1,210.31
|
| Rate for Payer: PHP Medicare Advantage |
$864.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,228.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.24
|
| Rate for Payer: Priority Health Medicare |
$864.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.24
|
| Rate for Payer: Priority Health SBD |
$1,537.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.51
|
| Rate for Payer: UHC Medicare Advantage |
$864.51
|
| Rate for Payer: UHCCP Medicaid |
$579.36
|
| Rate for Payer: UMR Bronson Commercial |
$869.40
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 61885
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$1,084.02 |
| Rate for Payer: Aetna Commercial |
$694.28
|
| Rate for Payer: Aetna Medicare |
$538.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.09
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$518.12
|
| Rate for Payer: BCBS Trust/PPO |
$810.94
|
| Rate for Payer: BCN Commercial |
$1,084.02
|
| Rate for Payer: BCN Medicare Advantage |
$518.12
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cofinity Commercial |
$694.28
|
| Rate for Payer: Cofinity Commercial |
$746.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.03
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Nomi Health Commercial |
$621.74
|
| Rate for Payer: PACE SWMI |
$518.12
|
| Rate for Payer: PHP Commercial |
$725.37
|
| Rate for Payer: PHP Medicare Advantage |
$518.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.32
|
| Rate for Payer: Priority Health Medicare |
$518.12
|
| Rate for Payer: Priority Health Narrow Network |
$921.32
|
| Rate for Payer: Priority Health SBD |
$921.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.12
|
| Rate for Payer: UHC Medicare Advantage |
$518.12
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
| Rate for Payer: UMR Bronson Commercial |
$760.84
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,897.00
|
|
|
Service Code
|
HCPCS 33249
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$1,427.95 |
| Rate for Payer: Aetna Commercial |
$1,158.70
|
| Rate for Payer: Aetna Medicare |
$899.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,158.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,245.17
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$864.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$1,319.43
|
| Rate for Payer: BCN Medicare Advantage |
$864.70
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,158.70
|
| Rate for Payer: Cofinity Commercial |
$1,245.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.94
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Nomi Health Commercial |
$1,037.64
|
| Rate for Payer: PACE SWMI |
$864.70
|
| Rate for Payer: PHP Commercial |
$1,210.58
|
| Rate for Payer: PHP Medicare Advantage |
$864.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,427.95
|
| Rate for Payer: Priority Health Medicare |
$864.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,427.95
|
| Rate for Payer: Priority Health SBD |
$1,427.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.70
|
| Rate for Payer: UHC Medicare Advantage |
$864.70
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
| Rate for Payer: UMR Bronson Commercial |
$872.62
|
|
|
PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 63685
|
| Min. Negotiated Rate |
$218.96 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$437.87
|
| Rate for Payer: Aetna Medicare |
$339.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.55
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS MAPPO |
$326.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$529.73
|
| Rate for Payer: BCN Medicare Advantage |
$326.77
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$437.87
|
| Rate for Payer: Cofinity Commercial |
$470.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.11
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Nomi Health Commercial |
$392.12
|
| Rate for Payer: PACE SWMI |
$326.77
|
| Rate for Payer: PHP Commercial |
$457.48
|
| Rate for Payer: PHP Medicare Advantage |
$326.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.65
|
| Rate for Payer: Priority Health Medicare |
$326.77
|
| Rate for Payer: Priority Health Narrow Network |
$584.65
|
| Rate for Payer: Priority Health SBD |
$584.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.77
|
| Rate for Payer: UHC Medicare Advantage |
$326.77
|
| Rate for Payer: UHCCP Medicaid |
$218.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.02
|
|
|
PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 33210
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$1,347.69 |
| Rate for Payer: Aetna Commercial |
$206.09
|
| Rate for Payer: Aetna Medicare |
$159.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.47
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$153.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.69
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$206.09
|
| Rate for Payer: Cofinity Commercial |
$221.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.49
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Nomi Health Commercial |
$184.56
|
| Rate for Payer: PACE SWMI |
$153.80
|
| Rate for Payer: PHP Commercial |
$215.32
|
| Rate for Payer: PHP Medicare Advantage |
$153.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.03
|
| Rate for Payer: Priority Health Medicare |
$153.80
|
| Rate for Payer: Priority Health Narrow Network |
$251.03
|
| Rate for Payer: Priority Health SBD |
$251.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.80
|
| Rate for Payer: UHC Medicare Advantage |
$153.80
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
| Rate for Payer: UMR Bronson Commercial |
$476.56
|
|
|
PR INSJ SUBQ RSVR PUMP/CONT INFUSION SYS VENTR CATH
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 61215
|
| Min. Negotiated Rate |
$341.44 |
| Max. Negotiated Rate |
$1,771.25 |
| Rate for Payer: Aetna Commercial |
$682.80
|
| Rate for Payer: Aetna Medicare |
$529.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.75
|
| Rate for Payer: BCBS Complete |
$358.51
|
| Rate for Payer: BCBS MAPPO |
$509.55
|
| Rate for Payer: BCBS Trust/PPO |
$682.56
|
| Rate for Payer: BCN Commercial |
$1,063.68
|
| Rate for Payer: BCN Medicare Advantage |
$509.55
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cofinity Commercial |
$682.80
|
| Rate for Payer: Cofinity Commercial |
$733.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.03
|
| Rate for Payer: Meridian Medicaid |
$358.51
|
| Rate for Payer: Nomi Health Commercial |
$611.46
|
| Rate for Payer: PACE SWMI |
$509.55
|
| Rate for Payer: PHP Commercial |
$713.37
|
| Rate for Payer: PHP Medicare Advantage |
$509.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$904.26
|
| Rate for Payer: Priority Health Medicare |
$509.55
|
| Rate for Payer: Priority Health Narrow Network |
$904.26
|
| Rate for Payer: Priority Health SBD |
$904.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.55
|
| Rate for Payer: UHC Medicare Advantage |
$509.55
|
| Rate for Payer: UHCCP Medicaid |
$341.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,253.50
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 51703
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$2,051.39 |
| Rate for Payer: Aetna Commercial |
$97.23
|
| Rate for Payer: Aetna Medicare |
$75.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.23
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$72.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,051.39
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: BCN Medicare Advantage |
$72.56
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$104.49
|
| Rate for Payer: Cofinity Commercial |
$97.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.19
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Nomi Health Commercial |
$87.07
|
| Rate for Payer: PACE SWMI |
$72.56
|
| Rate for Payer: PHP Commercial |
$101.58
|
| Rate for Payer: PHP Medicare Advantage |
$72.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.37
|
| Rate for Payer: Priority Health Medicare |
$72.56
|
| Rate for Payer: Priority Health Narrow Network |
$120.37
|
| Rate for Payer: Priority Health SBD |
$120.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.56
|
| Rate for Payer: UHC Medicare Advantage |
$72.56
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$137.54
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 51702
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$1,962.63 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.63
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Commercial |
$33.14
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.95
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Narrow Network |
$39.95
|
| Rate for Payer: Priority Health SBD |
$39.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
| Rate for Payer: UMR Bronson Commercial |
$80.50
|
|
|
PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 54660
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$2,434.41 |
| Rate for Payer: Aetna Commercial |
$461.00
|
| Rate for Payer: Aetna Medicare |
$357.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.40
|
| Rate for Payer: BCBS Complete |
$244.00
|
| Rate for Payer: BCBS MAPPO |
$344.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,434.41
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$344.03
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$495.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.23
|
| Rate for Payer: Meridian Medicaid |
$244.00
|
| Rate for Payer: Nomi Health Commercial |
$412.84
|
| Rate for Payer: PACE SWMI |
$344.03
|
| Rate for Payer: PHP Commercial |
$481.64
|
| Rate for Payer: PHP Medicare Advantage |
$344.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.74
|
| Rate for Payer: Priority Health Medicare |
$344.03
|
| Rate for Payer: Priority Health Narrow Network |
$575.74
|
| Rate for Payer: Priority Health SBD |
$575.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.03
|
| Rate for Payer: UHC Medicare Advantage |
$344.03
|
| Rate for Payer: UHCCP Medicaid |
$232.38
|
| Rate for Payer: UMR Bronson Commercial |
$335.34
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,446.00
|
|
|
Service Code
|
HCPCS 36561
|
| Hospital Charge Code |
36561
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$2,239.90 |
| Rate for Payer: Aetna Commercial |
$421.34
|
| Rate for Payer: Aetna Medicare |
$327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.78
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$314.43
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$314.43
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$452.78
|
| Rate for Payer: Cofinity Commercial |
$421.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.15
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Nomi Health Commercial |
$377.32
|
| Rate for Payer: PACE SWMI |
$314.43
|
| Rate for Payer: PHP Commercial |
$440.20
|
| Rate for Payer: PHP Medicare Advantage |
$314.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.72
|
| Rate for Payer: Priority Health Medicare |
$314.43
|
| Rate for Payer: Priority Health Narrow Network |
$521.72
|
| Rate for Payer: Priority Health SBD |
$521.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.43
|
| Rate for Payer: UHC Medicare Advantage |
$314.43
|
| Rate for Payer: UHCCP Medicaid |
$209.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,585.16
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$3,446.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$317.74 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: BCN Commercial |
$2,560.84
|
| Rate for Payer: Aetna American Axle |
$2,239.90
|
| Rate for Payer: Aetna Commercial |
$2,929.10
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,560.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$2,963.56
|
| Rate for Payer: Cofinity Commercial |
$2,412.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,412.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,101.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,412.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,584.50
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,929.10
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,929.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,170.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.51
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$317.74
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,275.02
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,584.50
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$3,446.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,516.24 |
| Max. Negotiated Rate |
$3,101.40 |
| Rate for Payer: Aetna American Axle |
$2,239.90
|
| Rate for Payer: Aetna Commercial |
$2,929.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.90
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$2,412.20
|
| Rate for Payer: Cofinity Commercial |
$2,963.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,412.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.80
|
| Rate for Payer: Healthscope Commercial |
$3,101.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,412.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,584.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,929.10
|
| Rate for Payer: PHP Commercial |
$2,929.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health SBD |
$2,170.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,516.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,584.50
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,446.00
|
|
|
Service Code
|
HCPCS 36561
|
| Min. Negotiated Rate |
$209.59 |
| Max. Negotiated Rate |
$2,239.90 |
| Rate for Payer: Aetna Commercial |
$421.34
|
| Rate for Payer: Aetna Medicare |
$327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.78
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$314.43
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$314.43
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cash Price |
$2,756.80
|
| Rate for Payer: Cofinity Commercial |
$421.34
|
| Rate for Payer: Cofinity Commercial |
$452.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.15
|
| Rate for Payer: Meridian Medicaid |
$220.07
|
| Rate for Payer: Nomi Health Commercial |
$377.32
|
| Rate for Payer: PACE SWMI |
$314.43
|
| Rate for Payer: PHP Commercial |
$440.20
|
| Rate for Payer: PHP Medicare Advantage |
$314.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.72
|
| Rate for Payer: Priority Health Medicare |
$314.43
|
| Rate for Payer: Priority Health Narrow Network |
$521.72
|
| Rate for Payer: Priority Health SBD |
$521.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.43
|
| Rate for Payer: UHC Medicare Advantage |
$314.43
|
| Rate for Payer: UHCCP Medicaid |
$209.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,585.16
|
|
