|
PR PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 43763
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$496.50 |
| Rate for Payer: Aetna Commercial |
$109.79
|
| Rate for Payer: Aetna Medicare |
$85.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.98
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$81.93
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: BCN Medicare Advantage |
$81.93
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cofinity Commercial |
$109.79
|
| Rate for Payer: Cofinity Commercial |
$117.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.03
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.12
|
| Rate for Payer: Nomi Health Commercial |
$98.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$496.50
|
| Rate for Payer: PACE SWMI |
$81.93
|
| Rate for Payer: PHP Commercial |
$114.70
|
| Rate for Payer: PHP Medicare Advantage |
$81.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.57
|
| Rate for Payer: Priority Health Medicare |
$81.93
|
| Rate for Payer: Priority Health SBD |
$159.57
|
| Rate for Payer: Priority Health Tiered Network |
$159.57
|
| Rate for Payer: Railroad Medicare Medicare |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.05
|
| Rate for Payer: UHC Core |
$149.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$81.93
|
| Rate for Payer: UHC Exchange |
$149.05
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$304.52
|
|
|
PR PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 0201T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,396.07
|
| Rate for Payer: Aetna Medicare |
$1,258.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,396.07
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,887.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,651.42
|
| Rate for Payer: UHC Core |
$3,651.42
|
| Rate for Payer: UHC Exchange |
$3,651.42
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.82
|
|
|
PR PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 0200T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,325.11
|
| Rate for Payer: Aetna Medicare |
$1,193.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,325.11
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,790.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,562.39
|
| Rate for Payer: UHC Core |
$2,562.39
|
| Rate for Payer: UHC Exchange |
$2,562.39
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.02
|
|
|
PR PERQ SKELETAL FIXATION METATARSAL FX W/MNPJ EACH
|
Professional
|
Both
|
$1,109.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$831.75 |
| Rate for Payer: Aetna Commercial |
$493.40
|
| Rate for Payer: Aetna Medicare |
$382.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.22
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS MAPPO |
$368.21
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$368.21
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cofinity Commercial |
$493.40
|
| Rate for Payer: Cofinity Commercial |
$530.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.62
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.03
|
| Rate for Payer: Nomi Health Commercial |
$441.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.75
|
| Rate for Payer: PACE SWMI |
$368.21
|
| Rate for Payer: PHP Commercial |
$515.49
|
| Rate for Payer: PHP Medicare Advantage |
$368.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$368.21
|
| Rate for Payer: Priority Health SBD |
$640.92
|
| Rate for Payer: Priority Health Tiered Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$368.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.98
|
| Rate for Payer: UHC Core |
$628.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$368.21
|
| Rate for Payer: UHC Exchange |
$628.98
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
| Rate for Payer: UMR Bronson Commercial |
$510.14
|
|
|
PR PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 27216
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,191.27
|
| Rate for Payer: Aetna Medicare |
$1,633.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.27
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,433.03
|
| Rate for Payer: Priority Health SBD |
$1,433.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,433.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,576.42
|
| Rate for Payer: UHC Core |
$1,576.42
|
| Rate for Payer: UHC Exchange |
$1,576.42
|
| Rate for Payer: UHC Medicaid |
$508.22
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,502.82
|
|
|
PR PERQ SKELETAL FIXATION TALUS FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 28436
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$882.00 |
| Rate for Payer: Aetna Commercial |
$636.62
|
| Rate for Payer: Aetna Medicare |
$494.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.13
|
| Rate for Payer: BCBS Complete |
$332.79
|
| Rate for Payer: BCBS MAPPO |
$475.09
|
| Rate for Payer: BCN Commercial |
$761.91
|
| Rate for Payer: BCN Medicare Advantage |
$475.09
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Cofinity Commercial |
$636.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.84
|
| Rate for Payer: Meridian Medicaid |
$332.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.60
|
| Rate for Payer: Nomi Health Commercial |
$570.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.00
|
| Rate for Payer: PACE SWMI |
$475.09
|
| Rate for Payer: PHP Commercial |
$665.13
|
| Rate for Payer: PHP Medicare Advantage |
$475.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$814.46
|
| Rate for Payer: Priority Health Medicare |
$475.09
|
| Rate for Payer: Priority Health SBD |
$814.46
|
| Rate for Payer: Priority Health Tiered Network |
$814.46
|
| Rate for Payer: Railroad Medicare Medicare |
$475.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.04
|
| Rate for Payer: UHC Core |
$804.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.09
|
| Rate for Payer: UHC Exchange |
$804.04
|
| Rate for Payer: UHC Medicaid |
$316.94
|
| Rate for Payer: UHCCP Medicaid |
$316.94
|
| Rate for Payer: UMR Bronson Commercial |
$540.96
|
|
|
PR PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 25651
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$844.11 |
| Rate for Payer: Aetna Commercial |
$612.45
|
| Rate for Payer: Aetna Medicare |
$475.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.15
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$457.05
|
| Rate for Payer: BCN Commercial |
$758.43
|
| Rate for Payer: BCN Medicare Advantage |
$457.05
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$612.45
|
| Rate for Payer: Cofinity Commercial |
$658.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.90
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.75
|
| Rate for Payer: Nomi Health Commercial |
$548.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.75
|
| Rate for Payer: PACE SWMI |
$457.05
|
| Rate for Payer: PHP Commercial |
$639.87
|
| Rate for Payer: PHP Medicare Advantage |
$457.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$810.74
|
| Rate for Payer: Priority Health Medicare |
$457.05
|
| Rate for Payer: Priority Health SBD |
$810.74
|
| Rate for Payer: Priority Health Tiered Network |
$810.74
|
| Rate for Payer: Railroad Medicare Medicare |
$457.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$844.11
|
| Rate for Payer: UHC Core |
$844.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.05
|
| Rate for Payer: UHC Exchange |
$844.11
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
| Rate for Payer: UMR Bronson Commercial |
$410.78
|
|
|
PR PERQ SKELETAL FIXJ CALCANEAL FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 28406
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$708.82
|
| Rate for Payer: Aetna Medicare |
$550.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$761.72
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$528.97
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$528.97
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$708.82
|
| Rate for Payer: Cofinity Commercial |
$761.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.42
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$581.87
|
| Rate for Payer: Nomi Health Commercial |
$634.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: PACE SWMI |
$528.97
|
| Rate for Payer: PHP Commercial |
$740.56
|
| Rate for Payer: PHP Medicare Advantage |
$528.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$528.97
|
| Rate for Payer: Priority Health SBD |
$967.25
|
| Rate for Payer: Priority Health Tiered Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$528.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.33
|
| Rate for Payer: UHC Core |
$936.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$528.97
|
| Rate for Payer: UHC Exchange |
$936.33
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
| Rate for Payer: UMR Bronson Commercial |
$744.28
|
|
|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$333.35 |
| Max. Negotiated Rate |
$1,103.25 |
| Rate for Payer: Aetna Commercial |
$676.90
|
| Rate for Payer: Aetna Medicare |
$525.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.42
|
| Rate for Payer: BCBS Complete |
$350.02
|
| Rate for Payer: BCBS MAPPO |
$505.15
|
| Rate for Payer: BCN Commercial |
$827.64
|
| Rate for Payer: BCN Medicare Advantage |
$505.15
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Cofinity Commercial |
$727.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.41
|
| Rate for Payer: Meridian Medicaid |
$350.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$555.66
|
| Rate for Payer: Nomi Health Commercial |
$606.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.25
|
| Rate for Payer: PACE SWMI |
$505.15
|
| Rate for Payer: PHP Commercial |
$707.21
|
| Rate for Payer: PHP Medicare Advantage |
$505.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$884.73
|
| Rate for Payer: Priority Health Medicare |
$505.15
|
| Rate for Payer: Priority Health SBD |
$884.73
|
| Rate for Payer: Priority Health Tiered Network |
$884.73
|
| Rate for Payer: Railroad Medicare Medicare |
$505.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.13
|
| Rate for Payer: UHC Core |
$920.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$505.15
|
| Rate for Payer: UHC Exchange |
$920.13
|
| Rate for Payer: UHC Medicaid |
$333.35
|
| Rate for Payer: UHCCP Medicaid |
$333.35
|
| Rate for Payer: UMR Bronson Commercial |
$676.66
|
|
|
PR PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 25606
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$832.86
|
| Rate for Payer: Aetna Medicare |
$646.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.02
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$621.54
|
| Rate for Payer: BCN Commercial |
$1,030.32
|
| Rate for Payer: BCN Medicare Advantage |
$621.54
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$832.86
|
| Rate for Payer: Cofinity Commercial |
$895.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.62
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.69
|
| Rate for Payer: Nomi Health Commercial |
$745.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.50
|
| Rate for Payer: PACE SWMI |
$621.54
|
| Rate for Payer: PHP Commercial |
$870.16
|
| Rate for Payer: PHP Medicare Advantage |
$621.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,101.39
|
| Rate for Payer: Priority Health Medicare |
$621.54
|
| Rate for Payer: Priority Health SBD |
$1,101.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,101.39
|
| Rate for Payer: Railroad Medicare Medicare |
$621.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,150.87
|
| Rate for Payer: UHC Core |
$1,150.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.54
|
| Rate for Payer: UHC Exchange |
$1,150.87
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
| Rate for Payer: UMR Bronson Commercial |
$920.92
|
|
|
PR PERQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MNPJ
|
Professional
|
Both
|
$2,446.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$499.27 |
| Max. Negotiated Rate |
$1,834.50 |
| Rate for Payer: Aetna Commercial |
$1,016.64
|
| Rate for Payer: Aetna Medicare |
$789.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,016.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.51
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCBS MAPPO |
$758.69
|
| Rate for Payer: BCN Commercial |
$1,253.41
|
| Rate for Payer: BCN Medicare Advantage |
$758.69
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Cofinity Commercial |
$1,016.64
|
| Rate for Payer: Cofinity Commercial |
$1,092.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.62
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$834.56
|
| Rate for Payer: Nomi Health Commercial |
$910.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,834.50
|
| Rate for Payer: PACE SWMI |
$758.69
|
| Rate for Payer: PHP Commercial |
$1,062.17
|
| Rate for Payer: PHP Medicare Advantage |
$758.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,339.87
|
| Rate for Payer: Priority Health Medicare |
$758.69
|
| Rate for Payer: Priority Health SBD |
$1,339.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,339.87
|
| Rate for Payer: Railroad Medicare Medicare |
$758.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,406.84
|
| Rate for Payer: UHC Core |
$1,406.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$758.69
|
| Rate for Payer: UHC Exchange |
$1,406.84
|
| Rate for Payer: UHC Medicaid |
$499.27
|
| Rate for Payer: UHCCP Medicaid |
$499.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,125.16
|
|
|
PR PERQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MNPJ
|
Professional
|
Both
|
$1,943.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$440.48 |
| Max. Negotiated Rate |
$1,457.25 |
| Rate for Payer: Aetna Commercial |
$897.61
|
| Rate for Payer: Aetna Medicare |
$696.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.60
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$669.86
|
| Rate for Payer: BCN Commercial |
$1,108.01
|
| Rate for Payer: BCN Medicare Advantage |
$669.86
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cofinity Commercial |
$897.61
|
| Rate for Payer: Cofinity Commercial |
$964.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.35
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$736.85
|
| Rate for Payer: Nomi Health Commercial |
$803.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,457.25
|
| Rate for Payer: PACE SWMI |
$669.86
|
| Rate for Payer: PHP Commercial |
$937.80
|
| Rate for Payer: PHP Medicare Advantage |
$669.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,184.43
|
| Rate for Payer: Priority Health Medicare |
$669.86
|
| Rate for Payer: Priority Health SBD |
$1,184.43
|
| Rate for Payer: Priority Health Tiered Network |
$1,184.43
|
| Rate for Payer: Railroad Medicare Medicare |
$669.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.81
|
| Rate for Payer: UHC Core |
$1,247.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$669.86
|
| Rate for Payer: UHC Exchange |
$1,247.81
|
| Rate for Payer: UHC Medicaid |
$440.48
|
| Rate for Payer: UHCCP Medicaid |
$440.48
|
| Rate for Payer: UMR Bronson Commercial |
$893.78
|
|
|
PR PERQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$479.46 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$976.66
|
| Rate for Payer: Aetna Medicare |
$758.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.66
|
| Rate for Payer: BCBS Complete |
$503.43
|
| Rate for Payer: BCBS MAPPO |
$728.85
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$728.85
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cofinity Commercial |
$1,049.54
|
| Rate for Payer: Cofinity Commercial |
$976.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.29
|
| Rate for Payer: Meridian Medicaid |
$503.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.74
|
| Rate for Payer: Nomi Health Commercial |
$874.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: PACE SWMI |
$728.85
|
| Rate for Payer: PHP Commercial |
$1,020.39
|
| Rate for Payer: PHP Medicare Advantage |
$728.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,286.10
|
| Rate for Payer: Priority Health Medicare |
$728.85
|
| Rate for Payer: Priority Health SBD |
$1,286.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,286.10
|
| Rate for Payer: Railroad Medicare Medicare |
$728.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,327.05
|
| Rate for Payer: UHC Core |
$1,327.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$728.85
|
| Rate for Payer: UHC Exchange |
$1,327.05
|
| Rate for Payer: UHC Medicaid |
$479.46
|
| Rate for Payer: UHCCP Medicaid |
$479.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,220.84
|
|
|
PR PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 92928
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$977.14 |
| Rate for Payer: Aetna Commercial |
$627.79
|
| Rate for Payer: Aetna Medicare |
$487.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.64
|
| Rate for Payer: BCBS Complete |
$310.65
|
| Rate for Payer: BCBS MAPPO |
$468.50
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: BCN Medicare Advantage |
$468.50
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$627.79
|
| Rate for Payer: Cofinity Commercial |
$674.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.93
|
| Rate for Payer: Meridian Medicaid |
$310.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.35
|
| Rate for Payer: Nomi Health Commercial |
$562.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$468.50
|
| Rate for Payer: PHP Commercial |
$655.90
|
| Rate for Payer: PHP Medicare Advantage |
$468.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$814.55
|
| Rate for Payer: Priority Health Medicare |
$468.50
|
| Rate for Payer: Priority Health SBD |
$814.55
|
| Rate for Payer: Priority Health Tiered Network |
$814.55
|
| Rate for Payer: Railroad Medicare Medicare |
$468.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$977.14
|
| Rate for Payer: UHC Core |
$977.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.50
|
| Rate for Payer: UHC Exchange |
$977.14
|
| Rate for Payer: UHC Medicaid |
$295.86
|
| Rate for Payer: UHCCP Medicaid |
$295.86
|
| Rate for Payer: UMR Bronson Commercial |
$589.26
|
|
|
PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 92930
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$867.85 |
| Rate for Payer: Aetna Commercial |
$673.30
|
| Rate for Payer: Aetna Medicare |
$522.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.54
|
| Rate for Payer: BCBS Complete |
$338.38
|
| Rate for Payer: BCBS MAPPO |
$502.46
|
| Rate for Payer: BCN Medicare Advantage |
$502.46
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cofinity Commercial |
$723.54
|
| Rate for Payer: Cofinity Commercial |
$673.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.58
|
| Rate for Payer: Meridian Medicaid |
$338.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$552.71
|
| Rate for Payer: Nomi Health Commercial |
$602.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$847.50
|
| Rate for Payer: PACE SWMI |
$502.46
|
| Rate for Payer: PHP Commercial |
$703.44
|
| Rate for Payer: PHP Medicare Advantage |
$502.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$745.13
|
| Rate for Payer: Priority Health Medicare |
$502.46
|
| Rate for Payer: Priority Health SBD |
$745.13
|
| Rate for Payer: Priority Health Tiered Network |
$745.13
|
| Rate for Payer: Railroad Medicare Medicare |
$502.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.85
|
| Rate for Payer: UHC Core |
$867.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$502.46
|
| Rate for Payer: UHC Exchange |
$867.85
|
| Rate for Payer: UHC Medicaid |
$322.27
|
| Rate for Payer: UHCCP Medicaid |
$322.27
|
| Rate for Payer: UMR Bronson Commercial |
$519.80
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 0913T
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$5,330.92 |
| Rate for Payer: Aetna Medicare |
$589.50
|
| Rate for Payer: BCBS Complete |
$471.60
|
| Rate for Payer: BCN Commercial |
$5,330.92
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$877.22
|
| Rate for Payer: UHC Core |
$877.22
|
| Rate for Payer: UHC Exchange |
$877.22
|
| Rate for Payer: UMR Bronson Commercial |
$542.34
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 0914T
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Medicare |
$295.00
|
| Rate for Payer: BCBS Complete |
$236.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: UMR Bronson Commercial |
$271.40
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 36906
|
| Min. Negotiated Rate |
$283.93 |
| Max. Negotiated Rate |
$1,191.00 |
| Rate for Payer: Aetna Commercial |
$598.77
|
| Rate for Payer: Aetna Medicare |
$464.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.45
|
| Rate for Payer: BCBS Complete |
$298.13
|
| Rate for Payer: BCBS MAPPO |
$446.84
|
| Rate for Payer: BCN Commercial |
$742.49
|
| Rate for Payer: BCN Medicare Advantage |
$446.84
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$598.77
|
| Rate for Payer: Cofinity Commercial |
$643.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.18
|
| Rate for Payer: Meridian Medicaid |
$298.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.52
|
| Rate for Payer: Nomi Health Commercial |
$536.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.00
|
| Rate for Payer: PACE SWMI |
$446.84
|
| Rate for Payer: PHP Commercial |
$625.58
|
| Rate for Payer: PHP Medicare Advantage |
$446.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$798.46
|
| Rate for Payer: Priority Health Medicare |
$446.84
|
| Rate for Payer: Priority Health SBD |
$798.46
|
| Rate for Payer: Priority Health Tiered Network |
$798.46
|
| Rate for Payer: Railroad Medicare Medicare |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.29
|
| Rate for Payer: UHC Core |
$917.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.84
|
| Rate for Payer: UHC Exchange |
$917.29
|
| Rate for Payer: UHC Medicaid |
$283.93
|
| Rate for Payer: UHCCP Medicaid |
$283.93
|
| Rate for Payer: UMR Bronson Commercial |
$730.48
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 36905
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$1,021.50 |
| Rate for Payer: Aetna Commercial |
$518.63
|
| Rate for Payer: Aetna Medicare |
$402.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.34
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$387.04
|
| Rate for Payer: BCN Commercial |
$644.89
|
| Rate for Payer: BCN Medicare Advantage |
$387.04
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$518.63
|
| Rate for Payer: Cofinity Commercial |
$557.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.39
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.74
|
| Rate for Payer: Nomi Health Commercial |
$464.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.50
|
| Rate for Payer: PACE SWMI |
$387.04
|
| Rate for Payer: PHP Commercial |
$541.86
|
| Rate for Payer: PHP Medicare Advantage |
$387.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$693.50
|
| Rate for Payer: Priority Health Medicare |
$387.04
|
| Rate for Payer: Priority Health SBD |
$693.50
|
| Rate for Payer: Priority Health Tiered Network |
$693.50
|
| Rate for Payer: Railroad Medicare Medicare |
$387.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$794.17
|
| Rate for Payer: UHC Core |
$794.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.04
|
| Rate for Payer: UHC Exchange |
$794.17
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
| Rate for Payer: UMR Bronson Commercial |
$626.52
|
|
|
PR PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 36904
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$685.50 |
| Rate for Payer: Aetna Commercial |
$431.68
|
| Rate for Payer: Aetna Medicare |
$335.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.90
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$322.15
|
| Rate for Payer: BCN Commercial |
$535.83
|
| Rate for Payer: BCN Medicare Advantage |
$322.15
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$431.68
|
| Rate for Payer: Cofinity Commercial |
$463.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.26
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$354.37
|
| Rate for Payer: Nomi Health Commercial |
$386.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$685.50
|
| Rate for Payer: PACE SWMI |
$322.15
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: PHP Medicare Advantage |
$322.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$576.22
|
| Rate for Payer: Priority Health Medicare |
$322.15
|
| Rate for Payer: Priority Health SBD |
$576.22
|
| Rate for Payer: Priority Health Tiered Network |
$576.22
|
| Rate for Payer: Railroad Medicare Medicare |
$322.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.47
|
| Rate for Payer: UHC Core |
$662.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.15
|
| Rate for Payer: UHC Exchange |
$662.47
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
| Rate for Payer: UMR Bronson Commercial |
$420.44
|
|
|
PR PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 33897
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$1,038.47 |
| Rate for Payer: Aetna Commercial |
$679.17
|
| Rate for Payer: Aetna Medicare |
$527.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.85
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS MAPPO |
$506.84
|
| Rate for Payer: BCN Commercial |
$846.57
|
| Rate for Payer: BCN Medicare Advantage |
$506.84
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$679.17
|
| Rate for Payer: Cofinity Commercial |
$729.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.18
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.52
|
| Rate for Payer: Nomi Health Commercial |
$608.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$506.84
|
| Rate for Payer: PHP Commercial |
$709.58
|
| Rate for Payer: PHP Medicare Advantage |
$506.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$910.38
|
| Rate for Payer: Priority Health Medicare |
$506.84
|
| Rate for Payer: Priority Health SBD |
$910.38
|
| Rate for Payer: Priority Health Tiered Network |
$910.38
|
| Rate for Payer: Railroad Medicare Medicare |
$506.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.47
|
| Rate for Payer: UHC Core |
$1,038.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.84
|
| Rate for Payer: UHC Exchange |
$1,038.47
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
| Rate for Payer: UMR Bronson Commercial |
$589.26
|
|
|
PR PERQ TRLUML C ANGIOPLASTY 1 MAJ C ART&/BRANCHES
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 92920
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$878.46 |
| Rate for Payer: Aetna Commercial |
$523.77
|
| Rate for Payer: Aetna Medicare |
$406.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.85
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$390.87
|
| Rate for Payer: BCN Commercial |
$771.38
|
| Rate for Payer: BCN Medicare Advantage |
$390.87
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Cofinity Commercial |
$562.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.41
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$429.96
|
| Rate for Payer: Nomi Health Commercial |
$469.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$864.75
|
| Rate for Payer: PACE SWMI |
$390.87
|
| Rate for Payer: PHP Commercial |
$547.22
|
| Rate for Payer: PHP Medicare Advantage |
$390.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$733.15
|
| Rate for Payer: Priority Health Medicare |
$390.87
|
| Rate for Payer: Priority Health SBD |
$733.15
|
| Rate for Payer: Priority Health Tiered Network |
$733.15
|
| Rate for Payer: Railroad Medicare Medicare |
$390.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$878.46
|
| Rate for Payer: UHC Core |
$878.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$390.87
|
| Rate for Payer: UHC Exchange |
$878.46
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
| Rate for Payer: UMR Bronson Commercial |
$530.38
|
|
|
PR PERQ TRLUML C ATHRC ANGIOP 1 MAJ C ART&/BRANCHES
|
Professional
|
Both
|
$2,627.00
|
|
|
Service Code
|
HCPCS 92924
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$1,970.25 |
| Rate for Payer: Aetna Commercial |
$634.93
|
| Rate for Payer: Aetna Medicare |
$492.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.32
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$473.83
|
| Rate for Payer: BCN Commercial |
$918.78
|
| Rate for Payer: BCN Medicare Advantage |
$473.83
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cofinity Commercial |
$634.93
|
| Rate for Payer: Cofinity Commercial |
$682.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.52
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.21
|
| Rate for Payer: Nomi Health Commercial |
$568.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,970.25
|
| Rate for Payer: PACE SWMI |
$473.83
|
| Rate for Payer: PHP Commercial |
$663.36
|
| Rate for Payer: PHP Medicare Advantage |
$473.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$873.25
|
| Rate for Payer: Priority Health Medicare |
$473.83
|
| Rate for Payer: Priority Health SBD |
$873.25
|
| Rate for Payer: Priority Health Tiered Network |
$873.25
|
| Rate for Payer: Railroad Medicare Medicare |
$473.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.27
|
| Rate for Payer: UHC Core |
$1,047.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$473.83
|
| Rate for Payer: UHC Exchange |
$1,047.27
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,208.42
|
|
|
PR PERQ TRLUML C ATHRC ST ANGIOP 1 MAJ C ART&/BRNCH
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 92933
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,110.00 |
| Rate for Payer: Aetna Commercial |
$748.82
|
| Rate for Payer: Aetna Medicare |
$581.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.70
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$558.82
|
| Rate for Payer: BCN Commercial |
$962.10
|
| Rate for Payer: BCN Medicare Advantage |
$558.82
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$748.82
|
| Rate for Payer: Cofinity Commercial |
$804.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$586.76
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$614.70
|
| Rate for Payer: Nomi Health Commercial |
$670.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.00
|
| Rate for Payer: PACE SWMI |
$558.82
|
| Rate for Payer: PHP Commercial |
$782.35
|
| Rate for Payer: PHP Medicare Advantage |
$558.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$914.42
|
| Rate for Payer: Priority Health Medicare |
$558.82
|
| Rate for Payer: Priority Health SBD |
$914.42
|
| Rate for Payer: Priority Health Tiered Network |
$914.42
|
| Rate for Payer: Railroad Medicare Medicare |
$558.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.93
|
| Rate for Payer: UHC Core |
$1,096.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.82
|
| Rate for Payer: UHC Exchange |
$1,096.93
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
| Rate for Payer: UMR Bronson Commercial |
$680.80
|
|
|
PR PERQ TRLUML CORONARY MCHNL ASPIR THROMBECTOMY
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 92973
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$807.75 |
| Rate for Payer: Aetna Commercial |
$110.23
|
| Rate for Payer: Aetna Medicare |
$85.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.45
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$82.26
|
| Rate for Payer: BCN Commercial |
$256.46
|
| Rate for Payer: BCN Medicare Advantage |
$82.26
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$110.23
|
| Rate for Payer: Cofinity Commercial |
$118.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.37
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.49
|
| Rate for Payer: Nomi Health Commercial |
$98.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$807.75
|
| Rate for Payer: PACE SWMI |
$82.26
|
| Rate for Payer: PHP Commercial |
$115.16
|
| Rate for Payer: PHP Medicare Advantage |
$82.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$243.75
|
| Rate for Payer: Priority Health Medicare |
$82.26
|
| Rate for Payer: Priority Health SBD |
$243.75
|
| Rate for Payer: Priority Health Tiered Network |
$243.75
|
| Rate for Payer: Railroad Medicare Medicare |
$82.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$291.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.26
|
| Rate for Payer: UHC Exchange |
$291.93
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
| Rate for Payer: UMR Bronson Commercial |
$495.42
|
|
