|
PR KO IMMOB CANVAS LONG PRE OTS
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS L1830
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$96.31 |
| Rate for Payer: Aetna Commercial |
$89.62
|
| Rate for Payer: Aetna Medicare |
$69.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.31
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$66.88
|
| Rate for Payer: BCN Commercial |
$64.89
|
| Rate for Payer: BCN Medicare Advantage |
$66.88
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$89.62
|
| Rate for Payer: Cofinity Commercial |
$96.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.22
|
| Rate for Payer: Nomi Health Commercial |
$80.26
|
| Rate for Payer: PACE SWMI |
$66.88
|
| Rate for Payer: PHP Commercial |
$93.63
|
| Rate for Payer: PHP Medicare Advantage |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$66.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.88
|
| Rate for Payer: UHC Medicare Advantage |
$66.88
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR KYBELLA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 00086
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$244.80 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR KYLEENA, 19.5 MG
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS Q9984
|
| Min. Negotiated Rate |
$350.80 |
| Max. Negotiated Rate |
$570.05 |
| Rate for Payer: Aetna Medicare |
$438.50
|
| Rate for Payer: BCBS Complete |
$350.80
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR KYLEENA, 19.5 MG
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS J7296
|
| Min. Negotiated Rate |
$677.12 |
| Max. Negotiated Rate |
$1,351.89 |
| Rate for Payer: Aetna Commercial |
$1,101.70
|
| Rate for Payer: Aetna Medicare |
$736.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.70
|
| Rate for Payer: BCBS Complete |
$1,351.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.44
|
| Rate for Payer: BCN Commercial |
$1,121.75
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Meridian Medicaid |
$1,351.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,287.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.80
|
| Rate for Payer: UHCCP Medicaid |
$1,287.51
|
| Rate for Payer: UMR Bronson Commercial |
$677.12
|
|
|
PR KYPHECTOMY SINGLE OR TWO SEGMENTS
|
Professional
|
Both
|
$12,926.00
|
|
|
Service Code
|
HCPCS 22818
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$8,401.90 |
| Rate for Payer: Aetna Commercial |
$2,774.05
|
| Rate for Payer: Aetna Medicare |
$2,153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,981.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,774.05
|
| Rate for Payer: BCBS Complete |
$1,451.04
|
| Rate for Payer: BCBS MAPPO |
$2,070.19
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$3,130.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,070.19
|
| Rate for Payer: Cash Price |
$10,340.80
|
| Rate for Payer: Cash Price |
$10,340.80
|
| Rate for Payer: Cofinity Commercial |
$2,774.05
|
| Rate for Payer: Cofinity Commercial |
$2,981.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,070.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,173.70
|
| Rate for Payer: Meridian Medicaid |
$1,451.04
|
| Rate for Payer: Nomi Health Commercial |
$2,484.23
|
| Rate for Payer: PACE SWMI |
$2,070.19
|
| Rate for Payer: PHP Commercial |
$2,898.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,070.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,401.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,277.58
|
| Rate for Payer: Priority Health Medicare |
$2,070.19
|
| Rate for Payer: Priority Health Narrow Network |
$3,277.58
|
| Rate for Payer: Priority Health SBD |
$3,277.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,070.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,070.19
|
| Rate for Payer: UHCCP Medicaid |
$1,381.94
|
| Rate for Payer: UMR Bronson Commercial |
$5,945.96
|
|
|
PR LABYRINTHOTOMY TRANSCANAL
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 69801
|
| Min. Negotiated Rate |
$79.88 |
| Max. Negotiated Rate |
$2,908.82 |
| Rate for Payer: Aetna Commercial |
$159.31
|
| Rate for Payer: Aetna Medicare |
$123.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.20
|
| Rate for Payer: BCBS Complete |
$83.87
|
| Rate for Payer: BCBS MAPPO |
$118.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,908.82
|
| Rate for Payer: BCN Commercial |
$336.70
|
| Rate for Payer: BCN Medicare Advantage |
$118.89
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cofinity Commercial |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.83
|
| Rate for Payer: Meridian Medicaid |
$83.87
|
| Rate for Payer: Nomi Health Commercial |
$142.67
|
| Rate for Payer: PACE SWMI |
$118.89
|
| Rate for Payer: PHP Commercial |
$166.45
|
| Rate for Payer: PHP Medicare Advantage |
$118.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.41
|
| Rate for Payer: Priority Health Medicare |
$118.89
|
| Rate for Payer: Priority Health Narrow Network |
$181.41
|
| Rate for Payer: Priority Health SBD |
$181.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.89
|
| Rate for Payer: UHC Medicare Advantage |
$118.89
|
| Rate for Payer: UHCCP Medicaid |
$79.88
|
| Rate for Payer: UMR Bronson Commercial |
$187.68
|
|
|
PR LAIV3 VACCINE LIVE FOR INTRANASAL USE
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 90660
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$44.85 |
| Rate for Payer: Aetna Commercial |
$38.69
|
| Rate for Payer: Aetna Medicare |
$30.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.57
|
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: BCBS MAPPO |
$28.87
|
| Rate for Payer: BCN Medicare Advantage |
$28.87
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$38.69
|
| Rate for Payer: Cofinity Commercial |
$41.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.31
|
| Rate for Payer: Nomi Health Commercial |
$34.65
|
| Rate for Payer: PACE SWMI |
$28.87
|
| Rate for Payer: PHP Commercial |
$40.42
|
| Rate for Payer: PHP Medicare Advantage |
$28.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.85
|
| Rate for Payer: Priority Health Medicare |
$28.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.87
|
| Rate for Payer: UHC Medicare Advantage |
$28.87
|
| Rate for Payer: UMR Bronson Commercial |
$31.74
|
|
|
PR LAIV4 VACCINE FOR INTRANASAL USE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 90672
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$27.79 |
| Rate for Payer: Aetna Commercial |
$27.79
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.79
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$27.54
|
| Rate for Payer: BCN Commercial |
$27.54
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED CERVICAL
|
Professional
|
Both
|
$8,260.00
|
|
|
Service Code
|
HCPCS 63285
|
| Min. Negotiated Rate |
$381.43 |
| Max. Negotiated Rate |
$5,369.00 |
| Rate for Payer: Aetna Commercial |
$3,477.64
|
| Rate for Payer: Aetna Medicare |
$2,699.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,477.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,737.16
|
| Rate for Payer: BCBS Complete |
$1,785.85
|
| Rate for Payer: BCBS MAPPO |
$2,595.25
|
| Rate for Payer: BCBS Trust/PPO |
$381.43
|
| Rate for Payer: BCN Commercial |
$4,242.16
|
| Rate for Payer: BCN Medicare Advantage |
$2,595.25
|
| Rate for Payer: Cash Price |
$6,608.00
|
| Rate for Payer: Cash Price |
$6,608.00
|
| Rate for Payer: Cofinity Commercial |
$3,477.64
|
| Rate for Payer: Cofinity Commercial |
$3,737.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,595.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,725.01
|
| Rate for Payer: Meridian Medicaid |
$1,785.85
|
| Rate for Payer: Nomi Health Commercial |
$3,114.30
|
| Rate for Payer: PACE SWMI |
$2,595.25
|
| Rate for Payer: PHP Commercial |
$3,633.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,595.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,700.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,369.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,521.86
|
| Rate for Payer: Priority Health Medicare |
$2,595.25
|
| Rate for Payer: Priority Health Narrow Network |
$4,521.86
|
| Rate for Payer: Priority Health SBD |
$4,521.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,595.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,595.25
|
| Rate for Payer: UHCCP Medicaid |
$1,700.81
|
| Rate for Payer: UMR Bronson Commercial |
$3,799.60
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACIC
|
Professional
|
Both
|
$8,278.00
|
|
|
Service Code
|
HCPCS 63286
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$5,380.70 |
| Rate for Payer: Aetna Commercial |
$3,436.98
|
| Rate for Payer: Aetna Medicare |
$2,667.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,436.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,693.47
|
| Rate for Payer: BCBS Complete |
$1,765.49
|
| Rate for Payer: BCBS MAPPO |
$2,564.91
|
| Rate for Payer: BCBS Trust/PPO |
$172.75
|
| Rate for Payer: BCN Commercial |
$4,200.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,564.91
|
| Rate for Payer: Cash Price |
$6,622.40
|
| Rate for Payer: Cash Price |
$6,622.40
|
| Rate for Payer: Cofinity Commercial |
$3,436.98
|
| Rate for Payer: Cofinity Commercial |
$3,693.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,564.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,693.16
|
| Rate for Payer: Meridian Medicaid |
$1,765.49
|
| Rate for Payer: Nomi Health Commercial |
$3,077.89
|
| Rate for Payer: PACE SWMI |
$2,564.91
|
| Rate for Payer: PHP Commercial |
$3,590.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,564.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,380.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,447.93
|
| Rate for Payer: Priority Health Medicare |
$2,564.91
|
| Rate for Payer: Priority Health Narrow Network |
$4,447.93
|
| Rate for Payer: Priority Health SBD |
$4,447.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,564.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,564.91
|
| Rate for Payer: UHCCP Medicaid |
$1,681.42
|
| Rate for Payer: UMR Bronson Commercial |
$3,807.88
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR
|
Professional
|
Both
|
$8,749.00
|
|
|
Service Code
|
HCPCS 63287
|
| Min. Negotiated Rate |
$174.34 |
| Max. Negotiated Rate |
$5,686.85 |
| Rate for Payer: Aetna Commercial |
$3,646.41
|
| Rate for Payer: Aetna Medicare |
$2,830.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,646.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,918.53
|
| Rate for Payer: BCBS Complete |
$1,871.73
|
| Rate for Payer: BCBS MAPPO |
$2,721.20
|
| Rate for Payer: BCBS Trust/PPO |
$174.34
|
| Rate for Payer: BCN Commercial |
$4,448.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,721.20
|
| Rate for Payer: Cash Price |
$6,999.20
|
| Rate for Payer: Cash Price |
$6,999.20
|
| Rate for Payer: Cofinity Commercial |
$3,646.41
|
| Rate for Payer: Cofinity Commercial |
$3,918.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,721.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,857.26
|
| Rate for Payer: Meridian Medicaid |
$1,871.73
|
| Rate for Payer: Nomi Health Commercial |
$3,265.44
|
| Rate for Payer: PACE SWMI |
$2,721.20
|
| Rate for Payer: PHP Commercial |
$3,809.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,721.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,782.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,686.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,740.24
|
| Rate for Payer: Priority Health Medicare |
$2,721.20
|
| Rate for Payer: Priority Health Narrow Network |
$4,740.24
|
| Rate for Payer: Priority Health SBD |
$4,740.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,721.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,721.20
|
| Rate for Payer: UHCCP Medicaid |
$1,782.60
|
| Rate for Payer: UMR Bronson Commercial |
$4,024.54
|
|
|
PR LAM BX/EXC ISPI NEO IDRL SACRAL
|
Professional
|
Both
|
$6,285.00
|
|
|
Service Code
|
HCPCS 63283
|
| Min. Negotiated Rate |
$481.28 |
| Max. Negotiated Rate |
$4,085.25 |
| Rate for Payer: Aetna Commercial |
$2,533.10
|
| Rate for Payer: Aetna Medicare |
$1,965.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,533.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,722.13
|
| Rate for Payer: BCBS Complete |
$1,305.44
|
| Rate for Payer: BCBS MAPPO |
$1,890.37
|
| Rate for Payer: BCBS Trust/PPO |
$481.28
|
| Rate for Payer: BCN Commercial |
$2,812.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,890.37
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cofinity Commercial |
$2,533.10
|
| Rate for Payer: Cofinity Commercial |
$2,722.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,890.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,984.89
|
| Rate for Payer: Meridian Medicaid |
$1,305.44
|
| Rate for Payer: Nomi Health Commercial |
$2,268.44
|
| Rate for Payer: PACE SWMI |
$1,890.37
|
| Rate for Payer: PHP Commercial |
$2,646.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,890.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,243.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,085.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,304.23
|
| Rate for Payer: Priority Health Medicare |
$1,890.37
|
| Rate for Payer: Priority Health Narrow Network |
$3,304.23
|
| Rate for Payer: Priority Health SBD |
$3,304.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,890.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,890.37
|
| Rate for Payer: UHCCP Medicaid |
$1,243.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,891.10
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED CERVICAL
|
Professional
|
Both
|
$7,589.00
|
|
|
Service Code
|
HCPCS 63280
|
| Min. Negotiated Rate |
$499.24 |
| Max. Negotiated Rate |
$4,932.85 |
| Rate for Payer: Aetna Commercial |
$2,808.65
|
| Rate for Payer: Aetna Medicare |
$2,179.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,808.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.25
|
| Rate for Payer: BCBS Complete |
$1,446.34
|
| Rate for Payer: BCBS MAPPO |
$2,096.01
|
| Rate for Payer: BCBS Trust/PPO |
$499.24
|
| Rate for Payer: BCN Commercial |
$3,442.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,096.01
|
| Rate for Payer: Cash Price |
$6,071.20
|
| Rate for Payer: Cash Price |
$6,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,808.65
|
| Rate for Payer: Cofinity Commercial |
$3,018.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,096.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,200.81
|
| Rate for Payer: Meridian Medicaid |
$1,446.34
|
| Rate for Payer: Nomi Health Commercial |
$2,515.21
|
| Rate for Payer: PACE SWMI |
$2,096.01
|
| Rate for Payer: PHP Commercial |
$2,934.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,096.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,932.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,672.19
|
| Rate for Payer: Priority Health Medicare |
$2,096.01
|
| Rate for Payer: Priority Health Narrow Network |
$3,672.19
|
| Rate for Payer: Priority Health SBD |
$3,672.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,096.01
|
| Rate for Payer: UHC Medicare Advantage |
$2,096.01
|
| Rate for Payer: UHCCP Medicaid |
$1,377.47
|
| Rate for Payer: UMR Bronson Commercial |
$3,490.94
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED LUMBAR
|
Professional
|
Both
|
$8,001.00
|
|
|
Service Code
|
HCPCS 63282
|
| Min. Negotiated Rate |
$1,293.98 |
| Max. Negotiated Rate |
$5,200.65 |
| Rate for Payer: Aetna Commercial |
$2,637.21
|
| Rate for Payer: Aetna Medicare |
$2,046.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,834.02
|
| Rate for Payer: BCBS Complete |
$1,358.68
|
| Rate for Payer: BCBS MAPPO |
$1,968.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,220.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,968.07
|
| Rate for Payer: Cash Price |
$6,400.80
|
| Rate for Payer: Cash Price |
$6,400.80
|
| Rate for Payer: Cofinity Commercial |
$2,637.21
|
| Rate for Payer: Cofinity Commercial |
$2,834.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,968.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,066.47
|
| Rate for Payer: Meridian Medicaid |
$1,358.68
|
| Rate for Payer: Nomi Health Commercial |
$2,361.68
|
| Rate for Payer: PACE SWMI |
$1,968.07
|
| Rate for Payer: PHP Commercial |
$2,755.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,968.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,293.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,200.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,432.76
|
| Rate for Payer: Priority Health Medicare |
$1,968.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,432.76
|
| Rate for Payer: Priority Health SBD |
$3,432.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,968.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,968.07
|
| Rate for Payer: UHCCP Medicaid |
$1,293.98
|
| Rate for Payer: UMR Bronson Commercial |
$3,680.46
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED THORACIC
|
Professional
|
Both
|
$7,432.00
|
|
|
Service Code
|
HCPCS 63281
|
| Min. Negotiated Rate |
$1,367.46 |
| Max. Negotiated Rate |
$4,830.80 |
| Rate for Payer: Aetna Commercial |
$2,788.71
|
| Rate for Payer: Aetna Medicare |
$2,164.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,788.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,996.83
|
| Rate for Payer: BCBS Complete |
$1,435.83
|
| Rate for Payer: BCBS MAPPO |
$2,081.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,409.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,081.13
|
| Rate for Payer: Cash Price |
$5,945.60
|
| Rate for Payer: Cash Price |
$5,945.60
|
| Rate for Payer: Cofinity Commercial |
$2,788.71
|
| Rate for Payer: Cofinity Commercial |
$2,996.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,081.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,185.19
|
| Rate for Payer: Meridian Medicaid |
$1,435.83
|
| Rate for Payer: Nomi Health Commercial |
$2,497.36
|
| Rate for Payer: PACE SWMI |
$2,081.13
|
| Rate for Payer: PHP Commercial |
$2,913.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,081.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,367.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,642.05
|
| Rate for Payer: Priority Health Medicare |
$2,081.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,642.05
|
| Rate for Payer: Priority Health SBD |
$3,642.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,081.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,081.13
|
| Rate for Payer: UHCCP Medicaid |
$1,367.46
|
| Rate for Payer: UMR Bronson Commercial |
$3,418.72
|
|
|
PR LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL
|
Professional
|
Both
|
$9,383.00
|
|
|
Service Code
|
HCPCS 63290
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$6,098.95 |
| Rate for Payer: Aetna Commercial |
$3,708.45
|
| Rate for Payer: Aetna Medicare |
$2,878.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,708.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,985.20
|
| Rate for Payer: BCBS Complete |
$1,903.26
|
| Rate for Payer: BCBS MAPPO |
$2,767.50
|
| Rate for Payer: BCBS Trust/PPO |
$213.43
|
| Rate for Payer: BCN Commercial |
$4,523.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,767.50
|
| Rate for Payer: Cash Price |
$7,506.40
|
| Rate for Payer: Cash Price |
$7,506.40
|
| Rate for Payer: Cofinity Commercial |
$3,708.45
|
| Rate for Payer: Cofinity Commercial |
$3,985.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,767.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,905.88
|
| Rate for Payer: Meridian Medicaid |
$1,903.26
|
| Rate for Payer: Nomi Health Commercial |
$3,321.00
|
| Rate for Payer: PACE SWMI |
$2,767.50
|
| Rate for Payer: PHP Commercial |
$3,874.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,767.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,812.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,098.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,819.87
|
| Rate for Payer: Priority Health Medicare |
$2,767.50
|
| Rate for Payer: Priority Health Narrow Network |
$4,819.87
|
| Rate for Payer: Priority Health SBD |
$4,819.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,767.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,767.50
|
| Rate for Payer: UHCCP Medicaid |
$1,812.63
|
| Rate for Payer: UMR Bronson Commercial |
$4,316.18
|
|
|
PR LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR
|
Professional
|
Both
|
$5,418.00
|
|
|
Service Code
|
HCPCS 63267
|
| Min. Negotiated Rate |
$244.07 |
| Max. Negotiated Rate |
$3,521.70 |
| Rate for Payer: Aetna Commercial |
$1,808.65
|
| Rate for Payer: Aetna Medicare |
$1,403.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,943.63
|
| Rate for Payer: BCBS Complete |
$938.88
|
| Rate for Payer: BCBS MAPPO |
$1,349.74
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: BCN Commercial |
$2,226.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.74
|
| Rate for Payer: Cash Price |
$4,334.40
|
| Rate for Payer: Cash Price |
$4,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,808.65
|
| Rate for Payer: Cofinity Commercial |
$1,943.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,417.23
|
| Rate for Payer: Meridian Medicaid |
$938.88
|
| Rate for Payer: Nomi Health Commercial |
$1,619.69
|
| Rate for Payer: PACE SWMI |
$1,349.74
|
| Rate for Payer: PHP Commercial |
$1,889.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,373.82
|
| Rate for Payer: Priority Health Medicare |
$1,349.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,373.82
|
| Rate for Payer: Priority Health SBD |
$2,373.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,349.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,349.74
|
| Rate for Payer: UHCCP Medicaid |
$894.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,492.28
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL
|
Professional
|
Both
|
$5,819.00
|
|
|
Service Code
|
HCPCS 63265
|
| Min. Negotiated Rate |
$399.92 |
| Max. Negotiated Rate |
$3,782.35 |
| Rate for Payer: Aetna Commercial |
$2,202.60
|
| Rate for Payer: Aetna Medicare |
$1,709.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,202.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.97
|
| Rate for Payer: BCBS Complete |
$1,138.38
|
| Rate for Payer: BCBS MAPPO |
$1,643.73
|
| Rate for Payer: BCBS Trust/PPO |
$399.92
|
| Rate for Payer: BCN Commercial |
$2,712.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,643.73
|
| Rate for Payer: Cash Price |
$4,655.20
|
| Rate for Payer: Cash Price |
$4,655.20
|
| Rate for Payer: Cofinity Commercial |
$2,202.60
|
| Rate for Payer: Cofinity Commercial |
$2,366.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,643.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,725.92
|
| Rate for Payer: Meridian Medicaid |
$1,138.38
|
| Rate for Payer: Nomi Health Commercial |
$1,972.48
|
| Rate for Payer: PACE SWMI |
$1,643.73
|
| Rate for Payer: PHP Commercial |
$2,301.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,643.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,084.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,892.48
|
| Rate for Payer: Priority Health Medicare |
$1,643.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,892.48
|
| Rate for Payer: Priority Health SBD |
$2,892.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,643.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,643.73
|
| Rate for Payer: UHCCP Medicaid |
$1,084.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,676.74
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL
|
Professional
|
Both
|
$4,597.00
|
|
|
Service Code
|
HCPCS 63268
|
| Min. Negotiated Rate |
$312.75 |
| Max. Negotiated Rate |
$2,988.05 |
| Rate for Payer: Aetna Commercial |
$1,946.40
|
| Rate for Payer: Aetna Medicare |
$1,510.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,946.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,091.66
|
| Rate for Payer: BCBS Complete |
$1,005.75
|
| Rate for Payer: BCBS MAPPO |
$1,452.54
|
| Rate for Payer: BCBS Trust/PPO |
$312.75
|
| Rate for Payer: BCN Commercial |
$2,272.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,452.54
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cash Price |
$3,677.60
|
| Rate for Payer: Cofinity Commercial |
$1,946.40
|
| Rate for Payer: Cofinity Commercial |
$2,091.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,452.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,525.17
|
| Rate for Payer: Meridian Medicaid |
$1,005.75
|
| Rate for Payer: Nomi Health Commercial |
$1,743.05
|
| Rate for Payer: PACE SWMI |
$1,452.54
|
| Rate for Payer: PHP Commercial |
$2,033.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,452.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$957.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,988.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,544.43
|
| Rate for Payer: Priority Health Medicare |
$1,452.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,544.43
|
| Rate for Payer: Priority Health SBD |
$2,544.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,452.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,452.54
|
| Rate for Payer: UHCCP Medicaid |
$957.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,114.62
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC
|
Professional
|
Both
|
$5,916.00
|
|
|
Service Code
|
HCPCS 63266
|
| Min. Negotiated Rate |
$600.15 |
| Max. Negotiated Rate |
$3,845.40 |
| Rate for Payer: Aetna Commercial |
$2,271.55
|
| Rate for Payer: Aetna Medicare |
$1,763.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,271.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.07
|
| Rate for Payer: BCBS Complete |
$1,173.49
|
| Rate for Payer: BCBS MAPPO |
$1,695.19
|
| Rate for Payer: BCBS Trust/PPO |
$600.15
|
| Rate for Payer: BCN Commercial |
$2,788.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,695.19
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cofinity Commercial |
$2,271.55
|
| Rate for Payer: Cofinity Commercial |
$2,441.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,695.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.95
|
| Rate for Payer: Meridian Medicaid |
$1,173.49
|
| Rate for Payer: Nomi Health Commercial |
$2,034.23
|
| Rate for Payer: PACE SWMI |
$1,695.19
|
| Rate for Payer: PHP Commercial |
$2,373.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,695.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,845.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,968.70
|
| Rate for Payer: Priority Health Medicare |
$1,695.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,968.70
|
| Rate for Payer: Priority Health SBD |
$2,968.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,695.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,695.19
|
| Rate for Payer: UHCCP Medicaid |
$1,117.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,721.36
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL
|
Professional
|
Both
|
$6,211.00
|
|
|
Service Code
|
HCPCS 63270
|
| Min. Negotiated Rate |
$440.60 |
| Max. Negotiated Rate |
$4,037.15 |
| Rate for Payer: Aetna Commercial |
$2,764.35
|
| Rate for Payer: Aetna Medicare |
$2,145.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,764.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,970.65
|
| Rate for Payer: BCBS Complete |
$1,421.74
|
| Rate for Payer: BCBS MAPPO |
$2,062.95
|
| Rate for Payer: BCBS Trust/PPO |
$440.60
|
| Rate for Payer: BCN Commercial |
$3,067.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,062.95
|
| Rate for Payer: Cash Price |
$4,968.80
|
| Rate for Payer: Cash Price |
$4,968.80
|
| Rate for Payer: Cofinity Commercial |
$2,764.35
|
| Rate for Payer: Cofinity Commercial |
$2,970.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,062.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,166.10
|
| Rate for Payer: Meridian Medicaid |
$1,421.74
|
| Rate for Payer: Nomi Health Commercial |
$2,475.54
|
| Rate for Payer: PACE SWMI |
$2,062.95
|
| Rate for Payer: PHP Commercial |
$2,888.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,062.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,037.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,599.97
|
| Rate for Payer: Priority Health Medicare |
$2,062.95
|
| Rate for Payer: Priority Health Narrow Network |
$3,599.97
|
| Rate for Payer: Priority Health SBD |
$3,599.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,062.95
|
| Rate for Payer: UHC Medicare Advantage |
$2,062.95
|
| Rate for Payer: UHCCP Medicaid |
$1,354.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,857.06
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR
|
Professional
|
Both
|
$6,546.00
|
|
|
Service Code
|
HCPCS 63272
|
| Min. Negotiated Rate |
$318.56 |
| Max. Negotiated Rate |
$4,254.90 |
| Rate for Payer: Aetna Commercial |
$2,495.60
|
| Rate for Payer: Aetna Medicare |
$1,936.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,495.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,681.84
|
| Rate for Payer: BCBS Complete |
$1,288.90
|
| Rate for Payer: BCBS MAPPO |
$1,862.39
|
| Rate for Payer: BCBS Trust/PPO |
$318.56
|
| Rate for Payer: BCN Commercial |
$3,028.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,862.39
|
| Rate for Payer: Cash Price |
$5,236.80
|
| Rate for Payer: Cash Price |
$5,236.80
|
| Rate for Payer: Cofinity Commercial |
$2,495.60
|
| Rate for Payer: Cofinity Commercial |
$2,681.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,862.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,955.51
|
| Rate for Payer: Meridian Medicaid |
$1,288.90
|
| Rate for Payer: Nomi Health Commercial |
$2,234.87
|
| Rate for Payer: PACE SWMI |
$1,862.39
|
| Rate for Payer: PHP Commercial |
$2,607.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,862.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,227.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,254.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,236.56
|
| Rate for Payer: Priority Health Medicare |
$1,862.39
|
| Rate for Payer: Priority Health Narrow Network |
$3,236.56
|
| Rate for Payer: Priority Health SBD |
$3,236.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,862.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,862.39
|
| Rate for Payer: UHCCP Medicaid |
$1,227.52
|
| Rate for Payer: UMR Bronson Commercial |
$3,011.16
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL
|
Professional
|
Both
|
$5,744.00
|
|
|
Service Code
|
HCPCS 63273
|
| Min. Negotiated Rate |
$580.07 |
| Max. Negotiated Rate |
$3,733.60 |
| Rate for Payer: Aetna Commercial |
$2,485.89
|
| Rate for Payer: Aetna Medicare |
$1,929.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,485.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,671.40
|
| Rate for Payer: BCBS Complete |
$1,280.17
|
| Rate for Payer: BCBS MAPPO |
$1,855.14
|
| Rate for Payer: BCBS Trust/PPO |
$580.07
|
| Rate for Payer: BCN Commercial |
$3,039.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,855.14
|
| Rate for Payer: Cash Price |
$4,595.20
|
| Rate for Payer: Cash Price |
$4,595.20
|
| Rate for Payer: Cofinity Commercial |
$2,485.89
|
| Rate for Payer: Cofinity Commercial |
$2,671.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,855.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,947.90
|
| Rate for Payer: Meridian Medicaid |
$1,280.17
|
| Rate for Payer: Nomi Health Commercial |
$2,226.17
|
| Rate for Payer: PACE SWMI |
$1,855.14
|
| Rate for Payer: PHP Commercial |
$2,597.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,855.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,733.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,241.68
|
| Rate for Payer: Priority Health Medicare |
$1,855.14
|
| Rate for Payer: Priority Health Narrow Network |
$3,241.68
|
| Rate for Payer: Priority Health SBD |
$3,241.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,855.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,855.14
|
| Rate for Payer: UHCCP Medicaid |
$1,219.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,642.24
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC
|
Professional
|
Both
|
$6,110.00
|
|
|
Service Code
|
HCPCS 63271
|
| Min. Negotiated Rate |
$1,352.34 |
| Max. Negotiated Rate |
$3,971.50 |
| Rate for Payer: Aetna Commercial |
$2,759.50
|
| Rate for Payer: Aetna Medicare |
$2,141.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,965.44
|
| Rate for Payer: BCBS Complete |
$1,419.96
|
| Rate for Payer: BCBS MAPPO |
$2,059.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$3,374.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,059.33
|
| Rate for Payer: Cash Price |
$4,888.00
|
| Rate for Payer: Cash Price |
$4,888.00
|
| Rate for Payer: Cofinity Commercial |
$2,759.50
|
| Rate for Payer: Cofinity Commercial |
$2,965.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,059.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,162.30
|
| Rate for Payer: Meridian Medicaid |
$1,419.96
|
| Rate for Payer: Nomi Health Commercial |
$2,471.20
|
| Rate for Payer: PACE SWMI |
$2,059.33
|
| Rate for Payer: PHP Commercial |
$2,883.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,059.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,352.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,971.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,589.16
|
| Rate for Payer: Priority Health Medicare |
$2,059.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,589.16
|
| Rate for Payer: Priority Health SBD |
$3,589.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,059.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,059.33
|
| Rate for Payer: UHCCP Medicaid |
$1,352.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,810.60
|
|
|
PR LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR
|
Professional
|
Both
|
$6,468.00
|
|
|
Service Code
|
HCPCS 63252
|
| Min. Negotiated Rate |
$1,061.35 |
| Max. Negotiated Rate |
$5,230.47 |
| Rate for Payer: Aetna Commercial |
$4,027.14
|
| Rate for Payer: Aetna Medicare |
$3,125.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,027.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,327.68
|
| Rate for Payer: BCBS Complete |
$2,065.41
|
| Rate for Payer: BCBS MAPPO |
$3,005.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.35
|
| Rate for Payer: BCN Commercial |
$4,459.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,005.33
|
| Rate for Payer: Cash Price |
$5,174.40
|
| Rate for Payer: Cash Price |
$5,174.40
|
| Rate for Payer: Cofinity Commercial |
$4,027.14
|
| Rate for Payer: Cofinity Commercial |
$4,327.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,005.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,155.60
|
| Rate for Payer: Meridian Medicaid |
$2,065.41
|
| Rate for Payer: Nomi Health Commercial |
$3,606.40
|
| Rate for Payer: PACE SWMI |
$3,005.33
|
| Rate for Payer: PHP Commercial |
$4,207.46
|
| Rate for Payer: PHP Medicare Advantage |
$3,005.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,967.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,204.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,230.47
|
| Rate for Payer: Priority Health Medicare |
$3,005.33
|
| Rate for Payer: Priority Health Narrow Network |
$5,230.47
|
| Rate for Payer: Priority Health SBD |
$5,230.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,005.33
|
| Rate for Payer: UHC Medicare Advantage |
$3,005.33
|
| Rate for Payer: UHCCP Medicaid |
$1,967.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,975.28
|
|
