|
PR INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 64727
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$225.71
|
| Rate for Payer: Aetna Medicare |
$175.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.71
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$168.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$168.44
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$225.71
|
| Rate for Payer: Cofinity Commercial |
$242.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.86
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Nomi Health Commercial |
$202.13
|
| Rate for Payer: PACE SWMI |
$168.44
|
| Rate for Payer: PHP Commercial |
$235.82
|
| Rate for Payer: PHP Medicare Advantage |
$168.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.56
|
| Rate for Payer: Priority Health Medicare |
$168.44
|
| Rate for Payer: Priority Health Narrow Network |
$302.56
|
| Rate for Payer: Priority Health SBD |
$302.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.44
|
| Rate for Payer: UHC Medicare Advantage |
$168.44
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
| Rate for Payer: UMR Bronson Commercial |
$345.00
|
|
|
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 22841
|
| Min. Negotiated Rate |
$123.16 |
| Max. Negotiated Rate |
$791.70 |
| Rate for Payer: Aetna Commercial |
$519.10
|
| Rate for Payer: Aetna Medicare |
$609.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.10
|
| Rate for Payer: BCBS Complete |
$487.20
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$123.16
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$597.41
|
| Rate for Payer: Priority Health Narrow Network |
$597.41
|
| Rate for Payer: Priority Health SBD |
$597.41
|
| Rate for Payer: UMR Bronson Commercial |
$560.28
|
|
|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$5,330.00
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$1,047.75 |
| Max. Negotiated Rate |
$3,464.50 |
| Rate for Payer: Aetna Commercial |
$2,094.18
|
| Rate for Payer: Aetna Medicare |
$1,625.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,094.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,250.46
|
| Rate for Payer: BCBS Complete |
$1,100.14
|
| Rate for Payer: BCBS MAPPO |
$1,562.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.41
|
| Rate for Payer: BCN Commercial |
$2,371.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,562.82
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cofinity Commercial |
$2,250.46
|
| Rate for Payer: Cofinity Commercial |
$2,094.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,562.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,640.96
|
| Rate for Payer: Meridian Medicaid |
$1,100.14
|
| Rate for Payer: Nomi Health Commercial |
$1,875.38
|
| Rate for Payer: PACE SWMI |
$1,562.82
|
| Rate for Payer: PHP Commercial |
$2,187.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,562.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,047.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,464.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,484.26
|
| Rate for Payer: Priority Health Medicare |
$1,562.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,484.26
|
| Rate for Payer: Priority Health SBD |
$2,484.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,562.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,562.82
|
| Rate for Payer: UHCCP Medicaid |
$1,047.75
|
| Rate for Payer: UMR Bronson Commercial |
$2,451.80
|
|
|
PR INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$99.35 |
| Rate for Payer: Aetna Commercial |
$83.11
|
| Rate for Payer: Aetna Medicare |
$76.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.11
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$60.75
|
| Rate for Payer: BCN Commercial |
$99.35
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.40
|
| Rate for Payer: Priority Health Narrow Network |
$98.40
|
| Rate for Payer: Priority Health SBD |
$98.40
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
| Rate for Payer: UMR Bronson Commercial |
$69.92
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$85.33
|
| Rate for Payer: Aetna Medicare |
$66.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.70
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$63.68
|
| Rate for Payer: BCBS Trust/PPO |
$756.00
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: BCN Medicare Advantage |
$63.68
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$91.70
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.86
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Nomi Health Commercial |
$76.42
|
| Rate for Payer: PACE SWMI |
$63.68
|
| Rate for Payer: PHP Commercial |
$89.15
|
| Rate for Payer: PHP Medicare Advantage |
$63.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.94
|
| Rate for Payer: Priority Health Medicare |
$63.68
|
| Rate for Payer: Priority Health Narrow Network |
$97.94
|
| Rate for Payer: Priority Health SBD |
$48.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.68
|
| Rate for Payer: UHC Medicare Advantage |
$63.68
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
| Rate for Payer: UMR Bronson Commercial |
$62.56
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$410.49 |
| Rate for Payer: Aetna Commercial |
$61.63
|
| Rate for Payer: Aetna Medicare |
$47.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.23
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$45.99
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$74.77
|
| Rate for Payer: BCN Medicare Advantage |
$45.99
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$61.63
|
| Rate for Payer: Cofinity Commercial |
$66.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.29
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$55.19
|
| Rate for Payer: PACE SWMI |
$45.99
|
| Rate for Payer: PHP Commercial |
$64.39
|
| Rate for Payer: PHP Medicare Advantage |
$45.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.04
|
| Rate for Payer: Priority Health Medicare |
$45.99
|
| Rate for Payer: Priority Health Narrow Network |
$72.04
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.99
|
| Rate for Payer: UHC Medicare Advantage |
$45.99
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$274.19 |
| Rate for Payer: Aetna Commercial |
$45.56
|
| Rate for Payer: Aetna Medicare |
$35.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.96
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Medicare Advantage |
$34.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$45.56
|
| Rate for Payer: Cofinity Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.70
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Nomi Health Commercial |
$40.80
|
| Rate for Payer: PACE SWMI |
$34.00
|
| Rate for Payer: PHP Commercial |
$47.60
|
| Rate for Payer: PHP Medicare Advantage |
$34.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.85
|
| Rate for Payer: Priority Health Medicare |
$34.00
|
| Rate for Payer: Priority Health Narrow Network |
$50.85
|
| Rate for Payer: Priority Health SBD |
$50.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.00
|
| Rate for Payer: UHC Medicare Advantage |
$34.00
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$108.83 |
| Rate for Payer: Aetna Commercial |
$63.60
|
| Rate for Payer: Aetna Medicare |
$49.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.34
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$47.46
|
| Rate for Payer: BCBS Trust/PPO |
$108.83
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$47.46
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$63.60
|
| Rate for Payer: Cofinity Commercial |
$68.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.83
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$56.95
|
| Rate for Payer: PACE SWMI |
$47.46
|
| Rate for Payer: PHP Commercial |
$66.44
|
| Rate for Payer: PHP Medicare Advantage |
$47.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.87
|
| Rate for Payer: Priority Health Medicare |
$47.46
|
| Rate for Payer: Priority Health Narrow Network |
$74.87
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.46
|
| Rate for Payer: UHC Medicare Advantage |
$47.46
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Commercial |
$67.43
|
| Rate for Payer: Aetna Commercial |
$67.43
|
| Rate for Payer: Aetna Medicare |
$52.33
|
| Rate for Payer: Aetna Medicare |
$52.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.46
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$50.32
|
| Rate for Payer: BCBS MAPPO |
$50.32
|
| Rate for Payer: BCBS Trust/PPO |
$79.25
|
| Rate for Payer: BCBS Trust/PPO |
$79.25
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Medicare Advantage |
$50.32
|
| Rate for Payer: BCN Medicare Advantage |
$50.32
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$67.43
|
| Rate for Payer: Cofinity Commercial |
$72.46
|
| Rate for Payer: Cofinity Commercial |
$72.46
|
| Rate for Payer: Cofinity Commercial |
$67.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.84
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Nomi Health Commercial |
$60.38
|
| Rate for Payer: Nomi Health Commercial |
$60.38
|
| Rate for Payer: PACE SWMI |
$50.32
|
| Rate for Payer: PACE SWMI |
$50.32
|
| Rate for Payer: PHP Commercial |
$70.45
|
| Rate for Payer: PHP Commercial |
$70.45
|
| Rate for Payer: PHP Medicare Advantage |
$50.32
|
| Rate for Payer: PHP Medicare Advantage |
$50.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.10
|
| Rate for Payer: Priority Health Medicare |
$50.32
|
| Rate for Payer: Priority Health Medicare |
$50.32
|
| Rate for Payer: Priority Health Narrow Network |
$79.10
|
| Rate for Payer: Priority Health Narrow Network |
$79.10
|
| Rate for Payer: Priority Health SBD |
$28.25
|
| Rate for Payer: Priority Health SBD |
$28.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.32
|
| Rate for Payer: UHC Medicare Advantage |
$50.32
|
| Rate for Payer: UHC Medicare Advantage |
$50.32
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$313.28 |
| Rate for Payer: Aetna Commercial |
$58.52
|
| Rate for Payer: Aetna Medicare |
$45.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.88
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$43.67
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$72.82
|
| Rate for Payer: BCN Medicare Advantage |
$43.67
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$58.52
|
| Rate for Payer: Cofinity Commercial |
$62.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.85
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Nomi Health Commercial |
$52.40
|
| Rate for Payer: PACE SWMI |
$43.67
|
| Rate for Payer: PHP Commercial |
$61.14
|
| Rate for Payer: PHP Medicare Advantage |
$43.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.74
|
| Rate for Payer: Priority Health Medicare |
$43.67
|
| Rate for Payer: Priority Health Narrow Network |
$68.74
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.67
|
| Rate for Payer: UHC Medicare Advantage |
$43.67
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 93289
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$133.90 |
| Rate for Payer: Aetna Commercial |
$87.06
|
| Rate for Payer: Aetna Medicare |
$67.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.56
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$64.97
|
| Rate for Payer: BCBS Trust/PPO |
$120.45
|
| Rate for Payer: BCN Commercial |
$106.53
|
| Rate for Payer: BCN Medicare Advantage |
$64.97
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$87.06
|
| Rate for Payer: Cofinity Commercial |
$93.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.22
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Nomi Health Commercial |
$77.96
|
| Rate for Payer: PACE SWMI |
$64.97
|
| Rate for Payer: PHP Commercial |
$90.96
|
| Rate for Payer: PHP Medicare Advantage |
$64.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.23
|
| Rate for Payer: Priority Health Medicare |
$64.97
|
| Rate for Payer: Priority Health Narrow Network |
$101.23
|
| Rate for Payer: Priority Health SBD |
$49.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.97
|
| Rate for Payer: UHC Medicare Advantage |
$64.97
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
| Rate for Payer: UMR Bronson Commercial |
$94.76
|
|
|
PR INTERTHORACOSCAPULAR AMPUTATION
|
Professional
|
Both
|
$5,989.00
|
|
|
Service Code
|
HCPCS 23900
|
| Min. Negotiated Rate |
$354.88 |
| Max. Negotiated Rate |
$3,892.85 |
| Rate for Payer: Aetna Commercial |
$1,787.43
|
| Rate for Payer: Aetna Medicare |
$1,387.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,787.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,920.82
|
| Rate for Payer: BCBS Complete |
$939.78
|
| Rate for Payer: BCBS MAPPO |
$1,333.90
|
| Rate for Payer: BCBS Trust/PPO |
$354.88
|
| Rate for Payer: BCN Commercial |
$2,024.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.90
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,787.43
|
| Rate for Payer: Cofinity Commercial |
$1,920.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,400.60
|
| Rate for Payer: Meridian Medicaid |
$939.78
|
| Rate for Payer: Nomi Health Commercial |
$1,600.68
|
| Rate for Payer: PACE SWMI |
$1,333.90
|
| Rate for Payer: PHP Commercial |
$1,867.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,892.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.45
|
| Rate for Payer: Priority Health Medicare |
$1,333.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,121.45
|
| Rate for Payer: Priority Health SBD |
$2,121.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.90
|
| Rate for Payer: UHCCP Medicaid |
$895.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,754.94
|
|
|
PR INTESTINAL PLICATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44680
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$1,928.55 |
| Rate for Payer: Aetna Commercial |
$1,405.00
|
| Rate for Payer: Aetna Medicare |
$1,090.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.85
|
| Rate for Payer: BCBS Complete |
$727.08
|
| Rate for Payer: BCBS MAPPO |
$1,048.51
|
| Rate for Payer: BCBS Trust/PPO |
$305.89
|
| Rate for Payer: BCN Commercial |
$1,572.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.51
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,405.00
|
| Rate for Payer: Cofinity Commercial |
$1,509.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.94
|
| Rate for Payer: Meridian Medicaid |
$727.08
|
| Rate for Payer: Nomi Health Commercial |
$1,258.21
|
| Rate for Payer: PACE SWMI |
$1,048.51
|
| Rate for Payer: PHP Commercial |
$1,467.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,927.60
|
| Rate for Payer: Priority Health Medicare |
$1,048.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,927.60
|
| Rate for Payer: Priority Health SBD |
$1,927.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.51
|
| Rate for Payer: UHCCP Medicaid |
$692.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,364.82
|
|
|
PR INT HRHC BY LIGATION 2+ HROID W/O IMG GDN
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 46946
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$1,392.60 |
| Rate for Payer: Aetna Commercial |
$482.28
|
| Rate for Payer: Aetna Medicare |
$374.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.27
|
| Rate for Payer: BCBS Complete |
$258.76
|
| Rate for Payer: BCBS MAPPO |
$359.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.60
|
| Rate for Payer: BCN Commercial |
$558.56
|
| Rate for Payer: BCN Medicare Advantage |
$359.91
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$482.28
|
| Rate for Payer: Cofinity Commercial |
$518.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.91
|
| Rate for Payer: Meridian Medicaid |
$258.76
|
| Rate for Payer: Nomi Health Commercial |
$431.89
|
| Rate for Payer: PACE SWMI |
$359.91
|
| Rate for Payer: PHP Commercial |
$503.87
|
| Rate for Payer: PHP Medicare Advantage |
$359.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.89
|
| Rate for Payer: Priority Health Medicare |
$359.91
|
| Rate for Payer: Priority Health Narrow Network |
$684.89
|
| Rate for Payer: Priority Health SBD |
$684.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$359.91
|
| Rate for Payer: UHC Medicare Advantage |
$359.91
|
| Rate for Payer: UHCCP Medicaid |
$246.44
|
| Rate for Payer: UMR Bronson Commercial |
$225.40
|
|
|
PR INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 46945
|
| Min. Negotiated Rate |
$212.06 |
| Max. Negotiated Rate |
$1,245.20 |
| Rate for Payer: Aetna Commercial |
$432.06
|
| Rate for Payer: Aetna Medicare |
$335.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.30
|
| Rate for Payer: BCBS Complete |
$232.60
|
| Rate for Payer: BCBS MAPPO |
$322.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.20
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: BCN Medicare Advantage |
$322.43
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$432.06
|
| Rate for Payer: Cofinity Commercial |
$464.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.55
|
| Rate for Payer: Meridian Medicaid |
$232.60
|
| Rate for Payer: Nomi Health Commercial |
$386.92
|
| Rate for Payer: PACE SWMI |
$322.43
|
| Rate for Payer: PHP Commercial |
$451.40
|
| Rate for Payer: PHP Medicare Advantage |
$322.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.31
|
| Rate for Payer: Priority Health Medicare |
$322.43
|
| Rate for Payer: Priority Health Narrow Network |
$613.31
|
| Rate for Payer: Priority Health SBD |
$613.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.43
|
| Rate for Payer: UHC Medicare Advantage |
$322.43
|
| Rate for Payer: UHCCP Medicaid |
$221.52
|
| Rate for Payer: UMR Bronson Commercial |
$212.06
|
|
|
PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 93662
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$211.11 |
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Medicare |
$146.50
|
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.64
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS Trust/PPO |
$68.15
|
| Rate for Payer: BCBS Trust/PPO |
$68.15
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.53
|
| Rate for Payer: Priority Health Narrow Network |
$128.53
|
| Rate for Payer: Priority Health Narrow Network |
$128.53
|
| Rate for Payer: Priority Health SBD |
$96.52
|
| Rate for Payer: Priority Health SBD |
$96.52
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
| Rate for Payer: UMR Bronson Commercial |
$134.78
|
| Rate for Payer: UMR Bronson Commercial |
$257.14
|
|
|
PR INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING
|
Professional
|
Both
|
$1,201.00
|
|
|
Service Code
|
HCPCS 93613
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$1,339.77 |
| Rate for Payer: Aetna Commercial |
$369.49
|
| Rate for Payer: Aetna Medicare |
$286.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.07
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS MAPPO |
$275.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$420.26
|
| Rate for Payer: BCN Medicare Advantage |
$275.74
|
| Rate for Payer: Cash Price |
$960.80
|
| Rate for Payer: Cash Price |
$960.80
|
| Rate for Payer: Cofinity Commercial |
$369.49
|
| Rate for Payer: Cofinity Commercial |
$397.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.53
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$330.89
|
| Rate for Payer: PACE SWMI |
$275.74
|
| Rate for Payer: PHP Commercial |
$386.04
|
| Rate for Payer: PHP Medicare Advantage |
$275.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$780.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.15
|
| Rate for Payer: Priority Health Medicare |
$275.74
|
| Rate for Payer: Priority Health Narrow Network |
$401.15
|
| Rate for Payer: Priority Health SBD |
$288.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.74
|
| Rate for Payer: UHC Medicare Advantage |
$275.74
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
| Rate for Payer: UMR Bronson Commercial |
$552.46
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL CMPL
|
Professional
|
Both
|
$9,212.00
|
|
|
Service Code
|
HCPCS 61692
|
| Min. Negotiated Rate |
$784.00 |
| Max. Negotiated Rate |
$6,284.31 |
| Rate for Payer: Aetna Commercial |
$4,845.68
|
| Rate for Payer: Aetna Medicare |
$3,760.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,845.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,207.30
|
| Rate for Payer: BCBS Complete |
$2,480.95
|
| Rate for Payer: BCBS MAPPO |
$3,616.18
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$5,360.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,616.18
|
| Rate for Payer: Cash Price |
$7,369.60
|
| Rate for Payer: Cash Price |
$7,369.60
|
| Rate for Payer: Cofinity Commercial |
$4,845.68
|
| Rate for Payer: Cofinity Commercial |
$5,207.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,616.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,796.99
|
| Rate for Payer: Meridian Medicaid |
$2,480.95
|
| Rate for Payer: Nomi Health Commercial |
$4,339.42
|
| Rate for Payer: PACE SWMI |
$3,616.18
|
| Rate for Payer: PHP Commercial |
$5,062.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,616.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,362.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,987.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,284.31
|
| Rate for Payer: Priority Health Medicare |
$3,616.18
|
| Rate for Payer: Priority Health Narrow Network |
$6,284.31
|
| Rate for Payer: Priority Health SBD |
$6,284.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,616.18
|
| Rate for Payer: UHC Medicare Advantage |
$3,616.18
|
| Rate for Payer: UHCCP Medicaid |
$2,362.81
|
| Rate for Payer: UMR Bronson Commercial |
$4,237.52
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL SMPL
|
Professional
|
Both
|
$7,820.00
|
|
|
Service Code
|
HCPCS 61690
|
| Min. Negotiated Rate |
$331.77 |
| Max. Negotiated Rate |
$5,083.00 |
| Rate for Payer: Aetna Commercial |
$2,902.84
|
| Rate for Payer: Aetna Medicare |
$2,252.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,902.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,119.47
|
| Rate for Payer: BCBS Complete |
$1,492.64
|
| Rate for Payer: BCBS MAPPO |
$2,166.30
|
| Rate for Payer: BCBS Trust/PPO |
$331.77
|
| Rate for Payer: BCN Commercial |
$3,215.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,166.30
|
| Rate for Payer: Cash Price |
$6,256.00
|
| Rate for Payer: Cash Price |
$6,256.00
|
| Rate for Payer: Cofinity Commercial |
$2,902.84
|
| Rate for Payer: Cofinity Commercial |
$3,119.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,166.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,274.62
|
| Rate for Payer: Meridian Medicaid |
$1,492.64
|
| Rate for Payer: Nomi Health Commercial |
$2,599.56
|
| Rate for Payer: PACE SWMI |
$2,166.30
|
| Rate for Payer: PHP Commercial |
$3,032.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,166.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,421.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,083.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,777.98
|
| Rate for Payer: Priority Health Medicare |
$2,166.30
|
| Rate for Payer: Priority Health Narrow Network |
$3,777.98
|
| Rate for Payer: Priority Health SBD |
$3,777.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,166.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,166.30
|
| Rate for Payer: UHCCP Medicaid |
$1,421.56
|
| Rate for Payer: UMR Bronson Commercial |
$3,597.20
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL
|
Professional
|
Both
|
$12,123.00
|
|
|
Service Code
|
HCPCS 61686
|
| Min. Negotiated Rate |
$191.24 |
| Max. Negotiated Rate |
$9,146.67 |
| Rate for Payer: Aetna Commercial |
$5,961.74
|
| Rate for Payer: Aetna Medicare |
$4,627.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,961.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,406.65
|
| Rate for Payer: BCBS Complete |
$3,050.59
|
| Rate for Payer: BCBS MAPPO |
$4,449.06
|
| Rate for Payer: BCBS Trust/PPO |
$191.24
|
| Rate for Payer: BCN Commercial |
$9,146.67
|
| Rate for Payer: BCN Medicare Advantage |
$4,449.06
|
| Rate for Payer: Cash Price |
$9,698.40
|
| Rate for Payer: Cash Price |
$9,698.40
|
| Rate for Payer: Cofinity Commercial |
$5,961.74
|
| Rate for Payer: Cofinity Commercial |
$6,406.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,449.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,671.51
|
| Rate for Payer: Meridian Medicaid |
$3,050.59
|
| Rate for Payer: Nomi Health Commercial |
$5,338.87
|
| Rate for Payer: PACE SWMI |
$4,449.06
|
| Rate for Payer: PHP Commercial |
$6,228.68
|
| Rate for Payer: PHP Medicare Advantage |
$4,449.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,905.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,879.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,727.71
|
| Rate for Payer: Priority Health Medicare |
$4,449.06
|
| Rate for Payer: Priority Health Narrow Network |
$7,727.71
|
| Rate for Payer: Priority Health SBD |
$7,727.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,449.06
|
| Rate for Payer: UHC Medicare Advantage |
$4,449.06
|
| Rate for Payer: UHCCP Medicaid |
$2,905.32
|
| Rate for Payer: UMR Bronson Commercial |
$5,576.58
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL
|
Professional
|
Both
|
$5,987.00
|
|
|
Service Code
|
HCPCS 61684
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$5,805.13 |
| Rate for Payer: Aetna Commercial |
$3,777.47
|
| Rate for Payer: Aetna Medicare |
$2,931.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,777.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,059.37
|
| Rate for Payer: BCBS Complete |
$1,938.37
|
| Rate for Payer: BCBS MAPPO |
$2,819.01
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: BCN Commercial |
$5,805.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,819.01
|
| Rate for Payer: Cash Price |
$4,789.60
|
| Rate for Payer: Cash Price |
$4,789.60
|
| Rate for Payer: Cofinity Commercial |
$3,777.47
|
| Rate for Payer: Cofinity Commercial |
$4,059.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,819.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,959.96
|
| Rate for Payer: Meridian Medicaid |
$1,938.37
|
| Rate for Payer: Nomi Health Commercial |
$3,382.81
|
| Rate for Payer: PACE SWMI |
$2,819.01
|
| Rate for Payer: PHP Commercial |
$3,946.61
|
| Rate for Payer: PHP Medicare Advantage |
$2,819.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,846.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,891.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,908.58
|
| Rate for Payer: Priority Health Medicare |
$2,819.01
|
| Rate for Payer: Priority Health Narrow Network |
$4,908.58
|
| Rate for Payer: Priority Health SBD |
$4,908.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,819.01
|
| Rate for Payer: UHC Medicare Advantage |
$2,819.01
|
| Rate for Payer: UHCCP Medicaid |
$1,846.07
|
| Rate for Payer: UMR Bronson Commercial |
$2,754.02
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL
|
Professional
|
Both
|
$8,916.00
|
|
|
Service Code
|
HCPCS 61682
|
| Min. Negotiated Rate |
$275.77 |
| Max. Negotiated Rate |
$8,459.92 |
| Rate for Payer: Aetna Commercial |
$5,499.37
|
| Rate for Payer: Aetna Medicare |
$4,268.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,499.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,909.77
|
| Rate for Payer: BCBS Complete |
$2,811.73
|
| Rate for Payer: BCBS MAPPO |
$4,104.01
|
| Rate for Payer: BCBS Trust/PPO |
$275.77
|
| Rate for Payer: BCN Commercial |
$8,459.92
|
| Rate for Payer: BCN Medicare Advantage |
$4,104.01
|
| Rate for Payer: Cash Price |
$7,132.80
|
| Rate for Payer: Cash Price |
$7,132.80
|
| Rate for Payer: Cofinity Commercial |
$5,499.37
|
| Rate for Payer: Cofinity Commercial |
$5,909.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,104.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,309.21
|
| Rate for Payer: Meridian Medicaid |
$2,811.73
|
| Rate for Payer: Nomi Health Commercial |
$4,924.81
|
| Rate for Payer: PACE SWMI |
$4,104.01
|
| Rate for Payer: PHP Commercial |
$5,745.61
|
| Rate for Payer: PHP Medicare Advantage |
$4,104.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,677.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,795.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,176.62
|
| Rate for Payer: Priority Health Medicare |
$4,104.01
|
| Rate for Payer: Priority Health Narrow Network |
$7,176.62
|
| Rate for Payer: Priority Health SBD |
$7,176.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,104.01
|
| Rate for Payer: UHC Medicare Advantage |
$4,104.01
|
| Rate for Payer: UHCCP Medicaid |
$2,677.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,101.36
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL
|
Professional
|
Both
|
$4,754.00
|
|
|
Service Code
|
HCPCS 61680
|
| Min. Negotiated Rate |
$373.51 |
| Max. Negotiated Rate |
$4,568.58 |
| Rate for Payer: Aetna Commercial |
$2,996.27
|
| Rate for Payer: Aetna Medicare |
$2,325.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,996.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,219.87
|
| Rate for Payer: BCBS Complete |
$1,541.62
|
| Rate for Payer: BCBS MAPPO |
$2,236.02
|
| Rate for Payer: BCBS Trust/PPO |
$373.51
|
| Rate for Payer: BCN Commercial |
$4,568.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,236.02
|
| Rate for Payer: Cash Price |
$3,803.20
|
| Rate for Payer: Cash Price |
$3,803.20
|
| Rate for Payer: Cofinity Commercial |
$3,219.87
|
| Rate for Payer: Cofinity Commercial |
$2,996.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,236.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,347.82
|
| Rate for Payer: Meridian Medicaid |
$1,541.62
|
| Rate for Payer: Nomi Health Commercial |
$2,683.22
|
| Rate for Payer: PACE SWMI |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$3,130.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,236.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,468.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,090.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,928.68
|
| Rate for Payer: Priority Health Medicare |
$2,236.02
|
| Rate for Payer: Priority Health Narrow Network |
$3,928.68
|
| Rate for Payer: Priority Health SBD |
$3,928.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,236.02
|
| Rate for Payer: UHC Medicare Advantage |
$2,236.02
|
| Rate for Payer: UHCCP Medicaid |
$1,468.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,186.84
|
|
|
PR INTRAFRACTION TRACK MOTION
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS G6017
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$1,256.83 |
| Rate for Payer: Aetna Commercial |
$94.22
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.22
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.83
|
| Rate for Payer: BCN Commercial |
$104.62
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.52
|
| Rate for Payer: Priority Health Narrow Network |
$136.52
|
| Rate for Payer: Priority Health SBD |
$136.52
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
|
|
PR INTRAOPERATIVE COLONIC LAVAGE
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 44701
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$300.09 |
| Rate for Payer: Aetna Commercial |
$221.25
|
| Rate for Payer: Aetna Medicare |
$171.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.76
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$165.11
|
| Rate for Payer: BCBS Trust/PPO |
$226.64
|
| Rate for Payer: BCN Commercial |
$245.32
|
| Rate for Payer: BCN Medicare Advantage |
$165.11
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$221.25
|
| Rate for Payer: Cofinity Commercial |
$237.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.37
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Nomi Health Commercial |
$198.13
|
| Rate for Payer: PACE SWMI |
$165.11
|
| Rate for Payer: PHP Commercial |
$231.15
|
| Rate for Payer: PHP Medicare Advantage |
$165.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.09
|
| Rate for Payer: Priority Health Medicare |
$165.11
|
| Rate for Payer: Priority Health Narrow Network |
$300.09
|
| Rate for Payer: Priority Health SBD |
$300.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.11
|
| Rate for Payer: UHC Medicare Advantage |
$165.11
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
| Rate for Payer: UMR Bronson Commercial |
$189.52
|
|
