|
PR LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 58571
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$1,801.80 |
| Rate for Payer: Aetna Commercial |
$1,167.29
|
| Rate for Payer: Aetna Medicare |
$905.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.40
|
| Rate for Payer: BCBS Complete |
$612.35
|
| Rate for Payer: BCBS MAPPO |
$871.11
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$1,329.21
|
| Rate for Payer: BCN Medicare Advantage |
$871.11
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cofinity Commercial |
$1,167.29
|
| Rate for Payer: Cofinity Commercial |
$1,254.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.67
|
| Rate for Payer: Meridian Medicaid |
$612.35
|
| Rate for Payer: Nomi Health Commercial |
$1,045.33
|
| Rate for Payer: PACE SWMI |
$871.11
|
| Rate for Payer: PHP Commercial |
$1,219.55
|
| Rate for Payer: PHP Medicare Advantage |
$871.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,360.66
|
| Rate for Payer: Priority Health Medicare |
$871.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.66
|
| Rate for Payer: Priority Health SBD |
$1,360.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$871.11
|
| Rate for Payer: UHC Medicare Advantage |
$871.11
|
| Rate for Payer: UHCCP Medicaid |
$583.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,275.12
|
|
|
PR LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 59150
|
| Min. Negotiated Rate |
$284.23 |
| Max. Negotiated Rate |
$1,167.45 |
| Rate for Payer: Aetna Commercial |
$1,035.47
|
| Rate for Payer: Aetna Medicare |
$803.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.75
|
| Rate for Payer: BCBS Complete |
$535.65
|
| Rate for Payer: BCBS MAPPO |
$772.74
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$772.74
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,035.47
|
| Rate for Payer: Cofinity Commercial |
$1,112.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.38
|
| Rate for Payer: Meridian Medicaid |
$535.65
|
| Rate for Payer: Nomi Health Commercial |
$927.29
|
| Rate for Payer: PACE SWMI |
$772.74
|
| Rate for Payer: PHP Commercial |
$1,081.84
|
| Rate for Payer: PHP Medicare Advantage |
$772.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.76
|
| Rate for Payer: Priority Health Medicare |
$772.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.76
|
| Rate for Payer: Priority Health SBD |
$1,118.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.74
|
| Rate for Payer: UHC Medicare Advantage |
$772.74
|
| Rate for Payer: UHCCP Medicaid |
$510.14
|
| Rate for Payer: UMR Bronson Commercial |
$678.50
|
|
|
PR LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 59151
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$1,142.04 |
| Rate for Payer: Aetna Commercial |
$1,012.77
|
| Rate for Payer: Aetna Medicare |
$786.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.35
|
| Rate for Payer: BCBS Complete |
$523.56
|
| Rate for Payer: BCBS MAPPO |
$755.80
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$1,142.04
|
| Rate for Payer: BCN Medicare Advantage |
$755.80
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,012.77
|
| Rate for Payer: Cofinity Commercial |
$1,088.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.59
|
| Rate for Payer: Meridian Medicaid |
$523.56
|
| Rate for Payer: Nomi Health Commercial |
$906.96
|
| Rate for Payer: PACE SWMI |
$755.80
|
| Rate for Payer: PHP Commercial |
$1,058.12
|
| Rate for Payer: PHP Medicare Advantage |
$755.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,094.54
|
| Rate for Payer: Priority Health Medicare |
$755.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.54
|
| Rate for Payer: Priority Health SBD |
$1,094.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$755.80
|
| Rate for Payer: UHC Medicare Advantage |
$755.80
|
| Rate for Payer: UHCCP Medicaid |
$498.63
|
| Rate for Payer: UMR Bronson Commercial |
$639.40
|
|
|
PR LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,890.00
|
|
|
Service Code
|
HCPCS 50947
|
| Min. Negotiated Rate |
$879.26 |
| Max. Negotiated Rate |
$5,304.13 |
| Rate for Payer: Aetna Commercial |
$1,765.12
|
| Rate for Payer: Aetna Medicare |
$1,369.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,765.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,896.84
|
| Rate for Payer: BCBS Complete |
$923.22
|
| Rate for Payer: BCBS MAPPO |
$1,317.25
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.13
|
| Rate for Payer: BCN Commercial |
$1,985.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.25
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cash Price |
$2,312.00
|
| Rate for Payer: Cofinity Commercial |
$1,765.12
|
| Rate for Payer: Cofinity Commercial |
$1,896.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.11
|
| Rate for Payer: Meridian Medicaid |
$923.22
|
| Rate for Payer: Nomi Health Commercial |
$1,580.70
|
| Rate for Payer: PACE SWMI |
$1,317.25
|
| Rate for Payer: PHP Commercial |
$1,844.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$879.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,878.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,188.99
|
| Rate for Payer: Priority Health Medicare |
$1,317.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,188.99
|
| Rate for Payer: Priority Health SBD |
$2,188.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,317.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,317.25
|
| Rate for Payer: UHCCP Medicaid |
$879.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,329.40
|
|
|
PR LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT
|
Professional
|
Both
|
$2,617.00
|
|
|
Service Code
|
HCPCS 50948
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$1,632.60
|
| Rate for Payer: Aetna Medicare |
$1,267.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.44
|
| Rate for Payer: BCBS Complete |
$853.23
|
| Rate for Payer: BCBS MAPPO |
$1,218.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.36
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$1,632.60
|
| Rate for Payer: Cofinity Commercial |
$1,754.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.28
|
| Rate for Payer: Meridian Medicaid |
$853.23
|
| Rate for Payer: Nomi Health Commercial |
$1,462.03
|
| Rate for Payer: PACE SWMI |
$1,218.36
|
| Rate for Payer: PHP Commercial |
$1,705.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,007.38
|
| Rate for Payer: Priority Health Medicare |
$1,218.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,007.38
|
| Rate for Payer: Priority Health SBD |
$2,007.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.36
|
| Rate for Payer: UHCCP Medicaid |
$812.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,203.82
|
|
|
PR LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR
|
Professional
|
Both
|
$3,230.00
|
|
|
Service Code
|
HCPCS 58554
|
| Min. Negotiated Rate |
$639.24 |
| Max. Negotiated Rate |
$2,099.50 |
| Rate for Payer: Aetna Commercial |
$1,679.90
|
| Rate for Payer: Aetna Medicare |
$1,303.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.27
|
| Rate for Payer: BCBS Complete |
$876.49
|
| Rate for Payer: BCBS MAPPO |
$1,253.66
|
| Rate for Payer: BCBS Trust/PPO |
$639.24
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.66
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cash Price |
$2,584.00
|
| Rate for Payer: Cofinity Commercial |
$1,679.90
|
| Rate for Payer: Cofinity Commercial |
$1,805.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,316.34
|
| Rate for Payer: Meridian Medicaid |
$876.49
|
| Rate for Payer: Nomi Health Commercial |
$1,504.39
|
| Rate for Payer: PACE SWMI |
$1,253.66
|
| Rate for Payer: PHP Commercial |
$1,755.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,099.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,947.48
|
| Rate for Payer: Priority Health Medicare |
$1,253.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,947.48
|
| Rate for Payer: Priority Health SBD |
$1,947.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,253.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.66
|
| Rate for Payer: UHCCP Medicaid |
$834.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.80
|
|
|
PR LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 58550
|
| Min. Negotiated Rate |
$395.17 |
| Max. Negotiated Rate |
$1,636.05 |
| Rate for Payer: Aetna Commercial |
$1,136.99
|
| Rate for Payer: Aetna Medicare |
$882.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.84
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$848.50
|
| Rate for Payer: BCBS Trust/PPO |
$395.17
|
| Rate for Payer: BCN Commercial |
$1,292.55
|
| Rate for Payer: BCN Medicare Advantage |
$848.50
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,136.99
|
| Rate for Payer: Cofinity Commercial |
$1,221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.92
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Nomi Health Commercial |
$1,018.20
|
| Rate for Payer: PACE SWMI |
$848.50
|
| Rate for Payer: PHP Commercial |
$1,187.90
|
| Rate for Payer: PHP Medicare Advantage |
$848.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,319.49
|
| Rate for Payer: Priority Health Medicare |
$848.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,319.49
|
| Rate for Payer: Priority Health SBD |
$1,319.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$848.50
|
| Rate for Payer: UHC Medicare Advantage |
$848.50
|
| Rate for Payer: UHCCP Medicaid |
$566.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.82
|
|
|
PR LAPS W/REVISION INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 49325
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$1,351.92 |
| Rate for Payer: Aetna Commercial |
$537.34
|
| Rate for Payer: Aetna Medicare |
$417.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.44
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$401.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.92
|
| Rate for Payer: BCN Commercial |
$603.52
|
| Rate for Payer: BCN Medicare Advantage |
$401.00
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Cofinity Commercial |
$577.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.05
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Nomi Health Commercial |
$481.20
|
| Rate for Payer: PACE SWMI |
$401.00
|
| Rate for Payer: PHP Commercial |
$561.40
|
| Rate for Payer: PHP Medicare Advantage |
$401.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.79
|
| Rate for Payer: Priority Health Medicare |
$401.00
|
| Rate for Payer: Priority Health Narrow Network |
$739.79
|
| Rate for Payer: Priority Health SBD |
$739.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.00
|
| Rate for Payer: UHC Medicare Advantage |
$401.00
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
| Rate for Payer: UMR Bronson Commercial |
$440.22
|
|
|
PR LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 58552
|
| Min. Negotiated Rate |
$549.43 |
| Max. Negotiated Rate |
$1,630.85 |
| Rate for Payer: Aetna Commercial |
$1,264.65
|
| Rate for Payer: Aetna Medicare |
$981.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.03
|
| Rate for Payer: BCBS Complete |
$661.33
|
| Rate for Payer: BCBS MAPPO |
$943.77
|
| Rate for Payer: BCBS Trust/PPO |
$549.43
|
| Rate for Payer: BCN Commercial |
$1,437.69
|
| Rate for Payer: BCN Medicare Advantage |
$943.77
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,264.65
|
| Rate for Payer: Cofinity Commercial |
$1,359.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.96
|
| Rate for Payer: Meridian Medicaid |
$661.33
|
| Rate for Payer: Nomi Health Commercial |
$1,132.52
|
| Rate for Payer: PACE SWMI |
$943.77
|
| Rate for Payer: PHP Commercial |
$1,321.28
|
| Rate for Payer: PHP Medicare Advantage |
$943.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,465.32
|
| Rate for Payer: Priority Health Medicare |
$943.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,465.32
|
| Rate for Payer: Priority Health SBD |
$1,465.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.77
|
| Rate for Payer: UHC Medicare Advantage |
$943.77
|
| Rate for Payer: UHCCP Medicaid |
$629.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.14
|
|
|
PR LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS
|
Professional
|
Both
|
$3,016.00
|
|
|
Service Code
|
HCPCS 58553
|
| Min. Negotiated Rate |
$543.62 |
| Max. Negotiated Rate |
$1,960.40 |
| Rate for Payer: Aetna Commercial |
$1,444.27
|
| Rate for Payer: Aetna Medicare |
$1,120.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.05
|
| Rate for Payer: BCBS Complete |
$752.59
|
| Rate for Payer: BCBS MAPPO |
$1,077.81
|
| Rate for Payer: BCBS Trust/PPO |
$543.62
|
| Rate for Payer: BCN Commercial |
$1,640.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.81
|
| Rate for Payer: Cash Price |
$2,412.80
|
| Rate for Payer: Cash Price |
$2,412.80
|
| Rate for Payer: Cofinity Commercial |
$1,444.27
|
| Rate for Payer: Cofinity Commercial |
$1,552.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.70
|
| Rate for Payer: Meridian Medicaid |
$752.59
|
| Rate for Payer: Nomi Health Commercial |
$1,293.37
|
| Rate for Payer: PACE SWMI |
$1,077.81
|
| Rate for Payer: PHP Commercial |
$1,508.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,960.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.19
|
| Rate for Payer: Priority Health Medicare |
$1,077.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,671.19
|
| Rate for Payer: Priority Health SBD |
$1,671.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.81
|
| Rate for Payer: UHCCP Medicaid |
$716.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,387.36
|
|
|
PR LAPT RPR PARAESOPH HIATAL HERNIA W/MESH
|
Professional
|
Both
|
$2,625.00
|
|
|
Service Code
|
HCPCS 43333
|
| Min. Negotiated Rate |
$806.84 |
| Max. Negotiated Rate |
$2,246.17 |
| Rate for Payer: Aetna Commercial |
$1,638.62
|
| Rate for Payer: Aetna Medicare |
$1,271.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,638.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,760.90
|
| Rate for Payer: BCBS Complete |
$847.18
|
| Rate for Payer: BCBS MAPPO |
$1,222.85
|
| Rate for Payer: BCBS Trust/PPO |
$856.37
|
| Rate for Payer: BCN Commercial |
$1,827.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.85
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cash Price |
$2,100.00
|
| Rate for Payer: Cofinity Commercial |
$1,638.62
|
| Rate for Payer: Cofinity Commercial |
$1,760.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.99
|
| Rate for Payer: Meridian Medicaid |
$847.18
|
| Rate for Payer: Nomi Health Commercial |
$1,467.42
|
| Rate for Payer: PACE SWMI |
$1,222.85
|
| Rate for Payer: PHP Commercial |
$1,711.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$806.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,706.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,246.17
|
| Rate for Payer: Priority Health Medicare |
$1,222.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.17
|
| Rate for Payer: Priority Health SBD |
$2,246.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.85
|
| Rate for Payer: UHCCP Medicaid |
$806.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,207.50
|
|
|
PR LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 58960
|
| Min. Negotiated Rate |
$603.32 |
| Max. Negotiated Rate |
$1,494.09 |
| Rate for Payer: Aetna Commercial |
$1,281.54
|
| Rate for Payer: Aetna Medicare |
$994.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.17
|
| Rate for Payer: BCBS Complete |
$674.31
|
| Rate for Payer: BCBS MAPPO |
$956.37
|
| Rate for Payer: BCBS Trust/PPO |
$603.32
|
| Rate for Payer: BCN Commercial |
$1,456.26
|
| Rate for Payer: BCN Medicare Advantage |
$956.37
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,281.54
|
| Rate for Payer: Cofinity Commercial |
$1,377.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.19
|
| Rate for Payer: Meridian Medicaid |
$674.31
|
| Rate for Payer: Nomi Health Commercial |
$1,147.64
|
| Rate for Payer: PACE SWMI |
$956.37
|
| Rate for Payer: PHP Commercial |
$1,338.92
|
| Rate for Payer: PHP Medicare Advantage |
$956.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,494.09
|
| Rate for Payer: Priority Health Medicare |
$956.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,494.09
|
| Rate for Payer: Priority Health SBD |
$1,494.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.37
|
| Rate for Payer: UHC Medicare Advantage |
$956.37
|
| Rate for Payer: UHCCP Medicaid |
$642.20
|
| Rate for Payer: UMR Bronson Commercial |
$989.00
|
|
|
PR LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS
|
Professional
|
Both
|
$2,415.00
|
|
|
Service Code
|
HCPCS 47015
|
| Min. Negotiated Rate |
$241.96 |
| Max. Negotiated Rate |
$2,087.48 |
| Rate for Payer: Aetna Commercial |
$1,515.12
|
| Rate for Payer: Aetna Medicare |
$1,175.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.19
|
| Rate for Payer: BCBS Complete |
$787.25
|
| Rate for Payer: BCBS MAPPO |
$1,130.69
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$1,703.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,130.69
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cofinity Commercial |
$1,515.12
|
| Rate for Payer: Cofinity Commercial |
$1,628.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,130.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.22
|
| Rate for Payer: Meridian Medicaid |
$787.25
|
| Rate for Payer: Nomi Health Commercial |
$1,356.83
|
| Rate for Payer: PACE SWMI |
$1,130.69
|
| Rate for Payer: PHP Commercial |
$1,582.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,130.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,087.48
|
| Rate for Payer: Priority Health Medicare |
$1,130.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,087.48
|
| Rate for Payer: Priority Health SBD |
$2,087.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,130.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,130.69
|
| Rate for Payer: UHCCP Medicaid |
$749.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.90
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,BIOPSY
|
Professional
|
Both
|
$2,159.00
|
|
|
Service Code
|
HCPCS 47561
|
| Min. Negotiated Rate |
$863.60 |
| Max. Negotiated Rate |
$1,403.35 |
| Rate for Payer: Aetna Medicare |
$1,079.50
|
| Rate for Payer: BCBS Complete |
$863.60
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,403.35
|
| Rate for Payer: UMR Bronson Commercial |
$993.14
|
|
|
PR LAP,W/CHOLANGIOGRAPHY,W/O BX
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 47560
|
| Min. Negotiated Rate |
$194.80 |
| Max. Negotiated Rate |
$316.55 |
| Rate for Payer: Aetna Medicare |
$243.50
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.55
|
| Rate for Payer: UMR Bronson Commercial |
$224.02
|
|
|
PR LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 31561
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$1,441.20 |
| Rate for Payer: Aetna Commercial |
$434.45
|
| Rate for Payer: Aetna Medicare |
$337.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.88
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$324.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.20
|
| Rate for Payer: BCN Commercial |
$494.54
|
| Rate for Payer: BCN Medicare Advantage |
$324.22
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$466.88
|
| Rate for Payer: Cofinity Commercial |
$434.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.43
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Nomi Health Commercial |
$389.06
|
| Rate for Payer: PACE SWMI |
$324.22
|
| Rate for Payer: PHP Commercial |
$453.91
|
| Rate for Payer: PHP Medicare Advantage |
$324.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.42
|
| Rate for Payer: Priority Health Medicare |
$324.22
|
| Rate for Payer: Priority Health Narrow Network |
$470.42
|
| Rate for Payer: Priority Health SBD |
$470.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.22
|
| Rate for Payer: UHC Medicare Advantage |
$324.22
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
| Rate for Payer: UMR Bronson Commercial |
$364.78
|
|
|
PR LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 31541
|
| Min. Negotiated Rate |
$167.42 |
| Max. Negotiated Rate |
$1,146.94 |
| Rate for Payer: Aetna Commercial |
$335.19
|
| Rate for Payer: Aetna Medicare |
$260.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.20
|
| Rate for Payer: BCBS Complete |
$175.79
|
| Rate for Payer: BCBS MAPPO |
$250.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,146.94
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: BCN Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$335.19
|
| Rate for Payer: Cofinity Commercial |
$360.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.65
|
| Rate for Payer: Meridian Medicaid |
$175.79
|
| Rate for Payer: Nomi Health Commercial |
$300.17
|
| Rate for Payer: PACE SWMI |
$250.14
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: PHP Medicare Advantage |
$250.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.89
|
| Rate for Payer: Priority Health Medicare |
$250.14
|
| Rate for Payer: Priority Health Narrow Network |
$362.89
|
| Rate for Payer: Priority Health SBD |
$362.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.14
|
| Rate for Payer: UHC Medicare Advantage |
$250.14
|
| Rate for Payer: UHCCP Medicaid |
$167.42
|
| Rate for Payer: UMR Bronson Commercial |
$556.60
|
|
|
PR LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP
|
Professional
|
Both
|
$1,331.00
|
|
|
Service Code
|
HCPCS 31545
|
| Min. Negotiated Rate |
$229.61 |
| Max. Negotiated Rate |
$1,178.11 |
| Rate for Payer: Aetna Commercial |
$460.20
|
| Rate for Payer: Aetna Medicare |
$357.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.54
|
| Rate for Payer: BCBS Complete |
$241.09
|
| Rate for Payer: BCBS MAPPO |
$343.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,178.11
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$343.43
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cofinity Commercial |
$460.20
|
| Rate for Payer: Cofinity Commercial |
$494.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.60
|
| Rate for Payer: Meridian Medicaid |
$241.09
|
| Rate for Payer: Nomi Health Commercial |
$412.12
|
| Rate for Payer: PACE SWMI |
$343.43
|
| Rate for Payer: PHP Commercial |
$480.80
|
| Rate for Payer: PHP Medicare Advantage |
$343.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.68
|
| Rate for Payer: Priority Health Medicare |
$343.43
|
| Rate for Payer: Priority Health Narrow Network |
$498.68
|
| Rate for Payer: Priority Health SBD |
$498.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.43
|
| Rate for Payer: UHC Medicare Advantage |
$343.43
|
| Rate for Payer: UHCCP Medicaid |
$229.61
|
| Rate for Payer: UMR Bronson Commercial |
$612.26
|
|
|
PR LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Professional
|
Both
|
$1,108.00
|
|
|
Service Code
|
HCPCS 31571
|
| Min. Negotiated Rate |
$158.69 |
| Max. Negotiated Rate |
$745.43 |
| Rate for Payer: Aetna Commercial |
$317.77
|
| Rate for Payer: Aetna Medicare |
$246.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.48
|
| Rate for Payer: BCBS Complete |
$166.62
|
| Rate for Payer: BCBS MAPPO |
$237.14
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Medicare Advantage |
$237.14
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cofinity Commercial |
$317.77
|
| Rate for Payer: Cofinity Commercial |
$341.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.00
|
| Rate for Payer: Meridian Medicaid |
$166.62
|
| Rate for Payer: Nomi Health Commercial |
$284.57
|
| Rate for Payer: PACE SWMI |
$237.14
|
| Rate for Payer: PHP Commercial |
$332.00
|
| Rate for Payer: PHP Medicare Advantage |
$237.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$720.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$343.43
|
| Rate for Payer: Priority Health Medicare |
$237.14
|
| Rate for Payer: Priority Health Narrow Network |
$343.43
|
| Rate for Payer: Priority Health SBD |
$343.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.14
|
| Rate for Payer: UHC Medicare Advantage |
$237.14
|
| Rate for Payer: UHCCP Medicaid |
$158.69
|
| Rate for Payer: UMR Bronson Commercial |
$509.68
|
|
|
PR LARYNGOPLASTY MEDIALIZATION UNLIATERAL
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 31591
|
| Min. Negotiated Rate |
$709.08 |
| Max. Negotiated Rate |
$1,621.92 |
| Rate for Payer: Aetna Commercial |
$1,389.19
|
| Rate for Payer: Aetna Medicare |
$1,078.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,492.86
|
| Rate for Payer: BCBS Complete |
$744.53
|
| Rate for Payer: BCBS MAPPO |
$1,036.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.07
|
| Rate for Payer: BCN Commercial |
$1,621.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,036.71
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$1,389.19
|
| Rate for Payer: Cofinity Commercial |
$1,492.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,036.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,088.55
|
| Rate for Payer: Meridian Medicaid |
$744.53
|
| Rate for Payer: Nomi Health Commercial |
$1,244.05
|
| Rate for Payer: PACE SWMI |
$1,036.71
|
| Rate for Payer: PHP Commercial |
$1,451.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,036.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,538.24
|
| Rate for Payer: Priority Health Medicare |
$1,036.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,538.24
|
| Rate for Payer: Priority Health SBD |
$1,538.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,036.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,036.71
|
| Rate for Payer: UHCCP Medicaid |
$709.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,014.76
|
|
|
PR LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 31570
|
| Min. Negotiated Rate |
$146.33 |
| Max. Negotiated Rate |
$503.83 |
| Rate for Payer: Aetna Commercial |
$293.08
|
| Rate for Payer: Aetna Medicare |
$227.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.96
|
| Rate for Payer: BCBS Complete |
$153.65
|
| Rate for Payer: BCBS MAPPO |
$218.72
|
| Rate for Payer: BCBS Trust/PPO |
$419.47
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: BCN Medicare Advantage |
$218.72
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$293.08
|
| Rate for Payer: Cofinity Commercial |
$314.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.66
|
| Rate for Payer: Meridian Medicaid |
$153.65
|
| Rate for Payer: Nomi Health Commercial |
$262.46
|
| Rate for Payer: PACE SWMI |
$218.72
|
| Rate for Payer: PHP Commercial |
$306.21
|
| Rate for Payer: PHP Medicare Advantage |
$218.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.54
|
| Rate for Payer: Priority Health Medicare |
$218.72
|
| Rate for Payer: Priority Health Narrow Network |
$316.54
|
| Rate for Payer: Priority Health SBD |
$316.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.72
|
| Rate for Payer: UHC Medicare Advantage |
$218.72
|
| Rate for Payer: UHCCP Medicaid |
$146.33
|
| Rate for Payer: UMR Bronson Commercial |
$272.32
|
|
|
PR LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 31535
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$1,639.31 |
| Rate for Payer: Aetna Commercial |
$242.33
|
| Rate for Payer: Aetna Medicare |
$188.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.41
|
| Rate for Payer: BCBS Complete |
$127.26
|
| Rate for Payer: BCBS MAPPO |
$180.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.31
|
| Rate for Payer: BCN Commercial |
$273.66
|
| Rate for Payer: BCN Medicare Advantage |
$180.84
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cofinity Commercial |
$242.33
|
| Rate for Payer: Cofinity Commercial |
$260.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.88
|
| Rate for Payer: Meridian Medicaid |
$127.26
|
| Rate for Payer: Nomi Health Commercial |
$217.01
|
| Rate for Payer: PACE SWMI |
$180.84
|
| Rate for Payer: PHP Commercial |
$253.18
|
| Rate for Payer: PHP Medicare Advantage |
$180.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.39
|
| Rate for Payer: Priority Health Medicare |
$180.84
|
| Rate for Payer: Priority Health Narrow Network |
$261.39
|
| Rate for Payer: Priority Health SBD |
$261.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.84
|
| Rate for Payer: UHC Medicare Advantage |
$180.84
|
| Rate for Payer: UHCCP Medicaid |
$121.20
|
| Rate for Payer: UMR Bronson Commercial |
$178.94
|
|
|
PR LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 31540
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$1,165.96 |
| Rate for Payer: Aetna Commercial |
$307.80
|
| Rate for Payer: Aetna Medicare |
$238.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.77
|
| Rate for Payer: BCBS Complete |
$161.48
|
| Rate for Payer: BCBS MAPPO |
$229.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,165.96
|
| Rate for Payer: BCN Commercial |
$350.38
|
| Rate for Payer: BCN Medicare Advantage |
$229.70
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$307.80
|
| Rate for Payer: Cofinity Commercial |
$330.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.18
|
| Rate for Payer: Meridian Medicaid |
$161.48
|
| Rate for Payer: Nomi Health Commercial |
$275.64
|
| Rate for Payer: PACE SWMI |
$229.70
|
| Rate for Payer: PHP Commercial |
$321.58
|
| Rate for Payer: PHP Medicare Advantage |
$229.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.76
|
| Rate for Payer: Priority Health Medicare |
$229.70
|
| Rate for Payer: Priority Health Narrow Network |
$332.76
|
| Rate for Payer: Priority Health SBD |
$332.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.70
|
| Rate for Payer: UHC Medicare Advantage |
$229.70
|
| Rate for Payer: UHCCP Medicaid |
$153.79
|
| Rate for Payer: UMR Bronson Commercial |
$205.16
|
|
|
PR LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 31572
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$1,069.81 |
| Rate for Payer: Aetna Commercial |
$231.02
|
| Rate for Payer: Aetna Medicare |
$179.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.26
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$172.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.81
|
| Rate for Payer: BCN Commercial |
$777.97
|
| Rate for Payer: BCN Medicare Advantage |
$172.40
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$231.02
|
| Rate for Payer: Cofinity Commercial |
$248.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.02
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Nomi Health Commercial |
$206.88
|
| Rate for Payer: PACE SWMI |
$172.40
|
| Rate for Payer: PHP Commercial |
$241.36
|
| Rate for Payer: PHP Medicare Advantage |
$172.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.81
|
| Rate for Payer: Priority Health Medicare |
$172.40
|
| Rate for Payer: Priority Health Narrow Network |
$249.81
|
| Rate for Payer: Priority Health SBD |
$249.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$172.40
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
| Rate for Payer: UMR Bronson Commercial |
$347.30
|
|
|
PR LARYNGOSCOPY FLEXIBLE DIAGNOSTIC
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 31575
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$1,261.05 |
| Rate for Payer: Aetna Commercial |
$87.85
|
| Rate for Payer: Aetna Medicare |
$68.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.41
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$65.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$65.56
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$87.85
|
| Rate for Payer: Cofinity Commercial |
$94.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.84
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Nomi Health Commercial |
$78.67
|
| Rate for Payer: PACE SWMI |
$65.56
|
| Rate for Payer: PHP Commercial |
$91.78
|
| Rate for Payer: PHP Medicare Advantage |
$65.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.47
|
| Rate for Payer: Priority Health Medicare |
$65.56
|
| Rate for Payer: Priority Health Narrow Network |
$95.47
|
| Rate for Payer: Priority Health SBD |
$95.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.56
|
| Rate for Payer: UHC Medicare Advantage |
$65.56
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
| Rate for Payer: UMR Bronson Commercial |
$135.70
|
|
