|
PR PUNCTURE ASPIRATION CYST OF BREAST
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$147.75 |
| Rate for Payer: Aetna Commercial |
$48.80
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.44
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCN Commercial |
$63.24
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Nomi Health Commercial |
$43.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Commercial |
$50.99
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.88
|
| Rate for Payer: Priority Health Medicare |
$36.42
|
| Rate for Payer: Priority Health SBD |
$57.88
|
| Rate for Payer: Priority Health Tiered Network |
$57.88
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.46
|
| Rate for Payer: UHC Core |
$77.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.42
|
| Rate for Payer: UHC Exchange |
$77.46
|
| Rate for Payer: UHC Medicaid |
$23.22
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
|
|
PR PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 61070
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$67.76
|
| Rate for Payer: Aetna Medicare |
$52.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.82
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$50.57
|
| Rate for Payer: BCN Commercial |
$116.27
|
| Rate for Payer: BCN Medicare Advantage |
$50.57
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$72.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.10
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.63
|
| Rate for Payer: Nomi Health Commercial |
$60.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
| Rate for Payer: PACE SWMI |
$50.57
|
| Rate for Payer: PHP Commercial |
$70.80
|
| Rate for Payer: PHP Medicare Advantage |
$50.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$97.76
|
| Rate for Payer: Priority Health Medicare |
$50.57
|
| Rate for Payer: Priority Health SBD |
$97.76
|
| Rate for Payer: Priority Health Tiered Network |
$97.76
|
| Rate for Payer: Railroad Medicare Medicare |
$50.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.20
|
| Rate for Payer: UHC Core |
$99.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.57
|
| Rate for Payer: UHC Exchange |
$99.20
|
| Rate for Payer: UHC Medicaid |
$32.80
|
| Rate for Payer: UHCCP Medicaid |
$32.80
|
| Rate for Payer: UMR Bronson Commercial |
$189.98
|
|
|
PR PURE TONE AUDIOMETRY AIR & BONE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 92553
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$72.21 |
| Rate for Payer: Aetna Commercial |
$60.17
|
| Rate for Payer: Aetna Medicare |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.66
|
| Rate for Payer: BCBS MAPPO |
$44.90
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$44.90
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Cofinity Commercial |
$64.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.39
|
| Rate for Payer: Nomi Health Commercial |
$53.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: PACE SWMI |
$44.90
|
| Rate for Payer: PHP Commercial |
$62.86
|
| Rate for Payer: PHP Medicare Advantage |
$44.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$44.90
|
| Rate for Payer: Priority Health SBD |
$66.59
|
| Rate for Payer: Priority Health Tiered Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$44.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.46
|
| Rate for Payer: UHC Core |
$57.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.90
|
| Rate for Payer: UHC Exchange |
$57.46
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
|
|
PR PURE TONE AUDIOMETRY AIR ONLY
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 92552
|
| Min. Negotiated Rate |
$25.76 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna Commercial |
$49.54
|
| Rate for Payer: Aetna Medicare |
$38.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.24
|
| Rate for Payer: BCBS MAPPO |
$36.97
|
| Rate for Payer: BCN Commercial |
$59.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.97
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$53.24
|
| Rate for Payer: Cofinity Commercial |
$49.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$36.97
|
| Rate for Payer: PHP Commercial |
$51.76
|
| Rate for Payer: PHP Medicare Advantage |
$36.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55.12
|
| Rate for Payer: Priority Health Medicare |
$36.97
|
| Rate for Payer: Priority Health SBD |
$55.12
|
| Rate for Payer: Priority Health Tiered Network |
$55.12
|
| Rate for Payer: Railroad Medicare Medicare |
$36.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.37
|
| Rate for Payer: UHC Core |
$47.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.97
|
| Rate for Payer: UHC Exchange |
$47.37
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR PVB THORACIC CONT CATHETER INFUSION W/IMG GID
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64463
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$102.32
|
| Rate for Payer: Aetna Medicare |
$79.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.96
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$76.36
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$76.36
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$102.32
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.18
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.00
|
| Rate for Payer: Nomi Health Commercial |
$91.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$76.36
|
| Rate for Payer: PHP Commercial |
$106.90
|
| Rate for Payer: PHP Medicare Advantage |
$76.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.97
|
| Rate for Payer: Priority Health Medicare |
$76.36
|
| Rate for Payer: Priority Health SBD |
$139.97
|
| Rate for Payer: Priority Health Tiered Network |
$139.97
|
| Rate for Payer: Railroad Medicare Medicare |
$76.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.27
|
| Rate for Payer: UHC Core |
$148.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.36
|
| Rate for Payer: UHC Exchange |
$148.27
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
| Rate for Payer: UMR Bronson Commercial |
$150.42
|
|
|
PR PYELOPLASTY COMPLICATED
|
Professional
|
Both
|
$2,748.00
|
|
|
Service Code
|
HCPCS 50405
|
| Min. Negotiated Rate |
$793.00 |
| Max. Negotiated Rate |
$2,469.79 |
| Rate for Payer: Aetna Commercial |
$1,650.83
|
| Rate for Payer: Aetna Medicare |
$1,281.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,650.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.02
|
| Rate for Payer: BCBS Complete |
$832.65
|
| Rate for Payer: BCBS MAPPO |
$1,231.96
|
| Rate for Payer: BCN Commercial |
$2,076.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.96
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cofinity Commercial |
$1,650.83
|
| Rate for Payer: Cofinity Commercial |
$1,774.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.56
|
| Rate for Payer: Meridian Medicaid |
$832.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.16
|
| Rate for Payer: Nomi Health Commercial |
$1,478.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,061.00
|
| Rate for Payer: PACE SWMI |
$1,231.96
|
| Rate for Payer: PHP Commercial |
$1,724.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,261.54
|
| Rate for Payer: Priority Health Medicare |
$1,231.96
|
| Rate for Payer: Priority Health SBD |
$2,261.54
|
| Rate for Payer: Priority Health Tiered Network |
$2,261.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,469.79
|
| Rate for Payer: UHC Core |
$2,469.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,231.96
|
| Rate for Payer: UHC Exchange |
$2,469.79
|
| Rate for Payer: UHC Medicaid |
$793.00
|
| Rate for Payer: UHCCP Medicaid |
$793.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,264.08
|
|
|
PR PYELOPLASTY SIMPLE
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 50400
|
| Min. Negotiated Rate |
$658.81 |
| Max. Negotiated Rate |
$2,058.47 |
| Rate for Payer: Aetna Commercial |
$1,370.47
|
| Rate for Payer: Aetna Medicare |
$1,063.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,370.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.75
|
| Rate for Payer: BCBS Complete |
$691.75
|
| Rate for Payer: BCBS MAPPO |
$1,022.74
|
| Rate for Payer: BCN Commercial |
$1,721.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.74
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,370.47
|
| Rate for Payer: Cofinity Commercial |
$1,472.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,073.88
|
| Rate for Payer: Meridian Medicaid |
$691.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.01
|
| Rate for Payer: Nomi Health Commercial |
$1,227.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,386.75
|
| Rate for Payer: PACE SWMI |
$1,022.74
|
| Rate for Payer: PHP Commercial |
$1,431.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,874.76
|
| Rate for Payer: Priority Health Medicare |
$1,022.74
|
| Rate for Payer: Priority Health SBD |
$1,874.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,874.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,022.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,058.47
|
| Rate for Payer: UHC Core |
$2,058.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,022.74
|
| Rate for Payer: UHC Exchange |
$2,058.47
|
| Rate for Payer: UHC Medicaid |
$658.81
|
| Rate for Payer: UHCCP Medicaid |
$658.81
|
| Rate for Payer: UMR Bronson Commercial |
$850.54
|
|
|
PR PYLOROMYOTOMY CUTTING PYLORIC MUSC
|
Professional
|
Both
|
$2,324.00
|
|
|
Service Code
|
HCPCS 43520
|
| Min. Negotiated Rate |
$434.31 |
| Max. Negotiated Rate |
$1,743.00 |
| Rate for Payer: Aetna Commercial |
$904.50
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.00
|
| Rate for Payer: BCBS Complete |
$456.03
|
| Rate for Payer: BCBS MAPPO |
$675.00
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$675.00
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cash Price |
$1,859.20
|
| Rate for Payer: Cofinity Commercial |
$904.50
|
| Rate for Payer: Cofinity Commercial |
$972.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.75
|
| Rate for Payer: Meridian Medicaid |
$456.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$742.50
|
| Rate for Payer: Nomi Health Commercial |
$810.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,743.00
|
| Rate for Payer: PACE SWMI |
$675.00
|
| Rate for Payer: PHP Commercial |
$945.00
|
| Rate for Payer: PHP Medicare Advantage |
$675.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,312.41
|
| Rate for Payer: Priority Health Medicare |
$675.00
|
| Rate for Payer: Priority Health SBD |
$1,312.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,312.41
|
| Rate for Payer: Railroad Medicare Medicare |
$675.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.44
|
| Rate for Payer: UHC Core |
$1,218.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$675.00
|
| Rate for Payer: UHC Exchange |
$1,218.44
|
| Rate for Payer: UHC Medicaid |
$434.31
|
| Rate for Payer: UHCCP Medicaid |
$434.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.04
|
|
|
PR PYLOROPLASTY
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$555.50 |
| Max. Negotiated Rate |
$1,975.50 |
| Rate for Payer: Aetna Commercial |
$1,160.44
|
| Rate for Payer: Aetna Medicare |
$900.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.04
|
| Rate for Payer: BCBS Complete |
$583.27
|
| Rate for Payer: BCBS MAPPO |
$866.00
|
| Rate for Payer: BCN Commercial |
$1,398.83
|
| Rate for Payer: BCN Medicare Advantage |
$866.00
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cofinity Commercial |
$1,160.44
|
| Rate for Payer: Cofinity Commercial |
$1,247.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.30
|
| Rate for Payer: Meridian Medicaid |
$583.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$952.60
|
| Rate for Payer: Nomi Health Commercial |
$1,039.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,975.50
|
| Rate for Payer: PACE SWMI |
$866.00
|
| Rate for Payer: PHP Commercial |
$1,212.40
|
| Rate for Payer: PHP Medicare Advantage |
$866.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,704.38
|
| Rate for Payer: Priority Health Medicare |
$866.00
|
| Rate for Payer: Priority Health SBD |
$1,704.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,704.38
|
| Rate for Payer: Railroad Medicare Medicare |
$866.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,664.75
|
| Rate for Payer: UHC Core |
$1,664.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$866.00
|
| Rate for Payer: UHC Exchange |
$1,664.75
|
| Rate for Payer: UHC Medicaid |
$555.50
|
| Rate for Payer: UHCCP Medicaid |
$555.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,211.64
|
|
|
PR QUADRICEPSPLASTY
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 27430
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,582.50 |
| Rate for Payer: Aetna Commercial |
$914.16
|
| Rate for Payer: Aetna Medicare |
$709.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.38
|
| Rate for Payer: BCBS Complete |
$468.10
|
| Rate for Payer: BCBS MAPPO |
$682.21
|
| Rate for Payer: BCN Commercial |
$1,132.41
|
| Rate for Payer: BCN Medicare Advantage |
$682.21
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$914.16
|
| Rate for Payer: Cofinity Commercial |
$982.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.32
|
| Rate for Payer: Meridian Medicaid |
$468.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$750.43
|
| Rate for Payer: Nomi Health Commercial |
$818.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.50
|
| Rate for Payer: PACE SWMI |
$682.21
|
| Rate for Payer: PHP Commercial |
$955.09
|
| Rate for Payer: PHP Medicare Advantage |
$682.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,210.51
|
| Rate for Payer: Priority Health Medicare |
$682.21
|
| Rate for Payer: Priority Health SBD |
$1,210.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,210.51
|
| Rate for Payer: Railroad Medicare Medicare |
$682.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,294.86
|
| Rate for Payer: UHC Core |
$1,294.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$682.21
|
| Rate for Payer: UHC Exchange |
$1,294.86
|
| Rate for Payer: UHC Medicaid |
$445.81
|
| Rate for Payer: UHCCP Medicaid |
$445.81
|
| Rate for Payer: UMR Bronson Commercial |
$970.60
|
|
|
PR QUAL NONMD EST PT 11-20M
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2062
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR QUAL NONMD EST PT 21>MIN
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2063
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR QUAL NONMD EST PT 5-10M
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2061
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 90375
|
| Min. Negotiated Rate |
$104.42 |
| Max. Negotiated Rate |
$396.26 |
| Rate for Payer: Aetna Commercial |
$368.74
|
| Rate for Payer: Aetna Medicare |
$286.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.26
|
| Rate for Payer: BCBS MAPPO |
$275.18
|
| Rate for Payer: BCBS Trust/PPO |
$347.06
|
| Rate for Payer: BCN Commercial |
$334.80
|
| Rate for Payer: BCN Medicare Advantage |
$275.18
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$396.26
|
| Rate for Payer: Cofinity Commercial |
$368.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.70
|
| Rate for Payer: Nomi Health Commercial |
$330.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: PACE SWMI |
$275.18
|
| Rate for Payer: PHP Commercial |
$385.25
|
| Rate for Payer: PHP Medicare Advantage |
$275.18
|
| Rate for Payer: Priority Health Medicare |
$275.18
|
| Rate for Payer: Railroad Medicare Medicare |
$275.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.95
|
| Rate for Payer: UHC Core |
$279.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.18
|
| Rate for Payer: UHC Exchange |
$279.95
|
| Rate for Payer: UMR Bronson Commercial |
$104.42
|
|
|
PR RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 90675
|
| Min. Negotiated Rate |
$98.44 |
| Max. Negotiated Rate |
$453.92 |
| Rate for Payer: Aetna Commercial |
$422.39
|
| Rate for Payer: Aetna Medicare |
$327.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.39
|
| Rate for Payer: BCBS MAPPO |
$315.22
|
| Rate for Payer: BCBS Trust/PPO |
$434.61
|
| Rate for Payer: BCN Commercial |
$443.93
|
| Rate for Payer: BCN Medicare Advantage |
$315.22
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$422.39
|
| Rate for Payer: Cofinity Commercial |
$453.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.74
|
| Rate for Payer: Nomi Health Commercial |
$378.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.50
|
| Rate for Payer: PACE SWMI |
$315.22
|
| Rate for Payer: PHP Commercial |
$441.31
|
| Rate for Payer: PHP Medicare Advantage |
$315.22
|
| Rate for Payer: Priority Health Medicare |
$315.22
|
| Rate for Payer: Railroad Medicare Medicare |
$315.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$332.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.22
|
| Rate for Payer: UHC Exchange |
$332.54
|
| Rate for Payer: UMR Bronson Commercial |
$98.44
|
|
|
PR RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY
|
Professional
|
Both
|
$6,209.00
|
|
|
Service Code
|
HCPCS 58210
|
| Min. Negotiated Rate |
$1,069.90 |
| Max. Negotiated Rate |
$4,656.75 |
| Rate for Payer: Aetna Commercial |
$2,233.06
|
| Rate for Payer: Aetna Medicare |
$1,733.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.06
|
| Rate for Payer: BCBS Complete |
$1,123.39
|
| Rate for Payer: BCBS MAPPO |
$1,666.46
|
| Rate for Payer: BCN Commercial |
$2,732.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.46
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cofinity Commercial |
$2,399.70
|
| Rate for Payer: Cofinity Commercial |
$2,233.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,749.78
|
| Rate for Payer: Meridian Medicaid |
$1,123.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,833.11
|
| Rate for Payer: Nomi Health Commercial |
$1,999.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,656.75
|
| Rate for Payer: PACE SWMI |
$1,666.46
|
| Rate for Payer: PHP Commercial |
$2,333.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,069.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.86
|
| Rate for Payer: Priority Health Medicare |
$1,666.46
|
| Rate for Payer: Priority Health SBD |
$2,767.86
|
| Rate for Payer: Priority Health Tiered Network |
$2,767.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,666.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,200.03
|
| Rate for Payer: UHC Core |
$3,200.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,666.46
|
| Rate for Payer: UHC Exchange |
$3,200.03
|
| Rate for Payer: UHC Medicaid |
$1,069.90
|
| Rate for Payer: UHCCP Medicaid |
$1,069.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,856.14
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS
|
Professional
|
Both
|
$2,801.00
|
|
|
Service Code
|
HCPCS 25115
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$2,100.75 |
| Rate for Payer: Aetna Commercial |
$917.07
|
| Rate for Payer: Aetna Medicare |
$711.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.51
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$684.38
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: BCN Medicare Advantage |
$684.38
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cofinity Commercial |
$917.07
|
| Rate for Payer: Cofinity Commercial |
$985.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.60
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.82
|
| Rate for Payer: Nomi Health Commercial |
$821.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,100.75
|
| Rate for Payer: PACE SWMI |
$684.38
|
| Rate for Payer: PHP Commercial |
$958.13
|
| Rate for Payer: PHP Medicare Advantage |
$684.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,242.46
|
| Rate for Payer: Priority Health Medicare |
$684.38
|
| Rate for Payer: Priority Health SBD |
$1,242.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,242.46
|
| Rate for Payer: Railroad Medicare Medicare |
$684.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,316.52
|
| Rate for Payer: UHC Core |
$1,316.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$684.38
|
| Rate for Payer: UHC Exchange |
$1,316.52
|
| Rate for Payer: UHC Medicaid |
$448.58
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,288.46
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 25116
|
| Min. Negotiated Rate |
$364.23 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$741.09
|
| Rate for Payer: Aetna Medicare |
$575.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$741.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.39
|
| Rate for Payer: BCBS Complete |
$382.44
|
| Rate for Payer: BCBS MAPPO |
$553.05
|
| Rate for Payer: BCN Commercial |
$931.72
|
| Rate for Payer: BCN Medicare Advantage |
$553.05
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$741.09
|
| Rate for Payer: Cofinity Commercial |
$796.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.70
|
| Rate for Payer: Meridian Medicaid |
$382.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$608.36
|
| Rate for Payer: Nomi Health Commercial |
$663.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.00
|
| Rate for Payer: PACE SWMI |
$553.05
|
| Rate for Payer: PHP Commercial |
$774.27
|
| Rate for Payer: PHP Medicare Advantage |
$553.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$995.98
|
| Rate for Payer: Priority Health Medicare |
$553.05
|
| Rate for Payer: Priority Health SBD |
$995.98
|
| Rate for Payer: Priority Health Tiered Network |
$995.98
|
| Rate for Payer: Railroad Medicare Medicare |
$553.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.44
|
| Rate for Payer: UHC Core |
$1,041.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$553.05
|
| Rate for Payer: UHC Exchange |
$1,041.44
|
| Rate for Payer: UHC Medicaid |
$364.23
|
| Rate for Payer: UHCCP Medicaid |
$364.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,104.00
|
|
|
PR RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ
|
Professional
|
Both
|
$1,959.00
|
|
|
Service Code
|
HCPCS 69150
|
| Min. Negotiated Rate |
$574.04 |
| Max. Negotiated Rate |
$1,763.80 |
| Rate for Payer: Aetna Commercial |
$1,172.85
|
| Rate for Payer: Aetna Medicare |
$910.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,172.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.37
|
| Rate for Payer: BCBS Complete |
$602.74
|
| Rate for Payer: BCBS MAPPO |
$875.26
|
| Rate for Payer: BCN Commercial |
$1,501.91
|
| Rate for Payer: BCN Medicare Advantage |
$875.26
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cofinity Commercial |
$1,172.85
|
| Rate for Payer: Cofinity Commercial |
$1,260.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$919.02
|
| Rate for Payer: Meridian Medicaid |
$602.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$962.79
|
| Rate for Payer: Nomi Health Commercial |
$1,050.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,469.25
|
| Rate for Payer: PACE SWMI |
$875.26
|
| Rate for Payer: PHP Commercial |
$1,225.36
|
| Rate for Payer: PHP Medicare Advantage |
$875.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,484.04
|
| Rate for Payer: Priority Health Medicare |
$875.26
|
| Rate for Payer: Priority Health SBD |
$1,484.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,484.04
|
| Rate for Payer: Railroad Medicare Medicare |
$875.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.80
|
| Rate for Payer: UHC Core |
$1,763.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$875.26
|
| Rate for Payer: UHC Exchange |
$1,763.80
|
| Rate for Payer: UHC Medicaid |
$574.04
|
| Rate for Payer: UHCCP Medicaid |
$574.04
|
| Rate for Payer: UMR Bronson Commercial |
$901.14
|
|
|
PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP
|
Professional
|
Both
|
$3,131.00
|
|
|
Service Code
|
HCPCS 42844
|
| Min. Negotiated Rate |
$783.41 |
| Max. Negotiated Rate |
$2,501.67 |
| Rate for Payer: Aetna Commercial |
$1,595.70
|
| Rate for Payer: Aetna Medicare |
$1,238.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,595.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,714.78
|
| Rate for Payer: BCBS Complete |
$822.58
|
| Rate for Payer: BCBS MAPPO |
$1,190.82
|
| Rate for Payer: BCN Commercial |
$2,053.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,190.82
|
| Rate for Payer: Cash Price |
$2,504.80
|
| Rate for Payer: Cash Price |
$2,504.80
|
| Rate for Payer: Cofinity Commercial |
$1,595.70
|
| Rate for Payer: Cofinity Commercial |
$1,714.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,190.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,250.36
|
| Rate for Payer: Meridian Medicaid |
$822.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,309.90
|
| Rate for Payer: Nomi Health Commercial |
$1,428.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,348.25
|
| Rate for Payer: PACE SWMI |
$1,190.82
|
| Rate for Payer: PHP Commercial |
$1,667.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,190.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,501.67
|
| Rate for Payer: Priority Health Medicare |
$1,190.82
|
| Rate for Payer: Priority Health SBD |
$2,501.67
|
| Rate for Payer: Priority Health Tiered Network |
$2,501.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,190.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,387.25
|
| Rate for Payer: UHC Core |
$2,387.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,190.82
|
| Rate for Payer: UHC Exchange |
$2,387.25
|
| Rate for Payer: UHC Medicaid |
$783.41
|
| Rate for Payer: UHCCP Medicaid |
$783.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,440.26
|
|
|
PR RADICAL RESECTION STERNUM
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21630
|
| Min. Negotiated Rate |
$746.57 |
| Max. Negotiated Rate |
$2,141.82 |
| Rate for Payer: Aetna Commercial |
$1,538.63
|
| Rate for Payer: Aetna Medicare |
$1,194.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,538.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.45
|
| Rate for Payer: BCBS Complete |
$783.90
|
| Rate for Payer: BCBS MAPPO |
$1,148.23
|
| Rate for Payer: BCN Commercial |
$1,980.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.23
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,538.63
|
| Rate for Payer: Cofinity Commercial |
$1,653.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,205.64
|
| Rate for Payer: Meridian Medicaid |
$783.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,263.05
|
| Rate for Payer: Nomi Health Commercial |
$1,377.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,065.50
|
| Rate for Payer: PACE SWMI |
$1,148.23
|
| Rate for Payer: PHP Commercial |
$1,607.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$746.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,117.59
|
| Rate for Payer: Priority Health Medicare |
$1,148.23
|
| Rate for Payer: Priority Health SBD |
$2,117.59
|
| Rate for Payer: Priority Health Tiered Network |
$2,117.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,148.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,141.82
|
| Rate for Payer: UHC Core |
$2,141.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,148.23
|
| Rate for Payer: UHC Exchange |
$2,141.82
|
| Rate for Payer: UHC Medicaid |
$746.57
|
| Rate for Payer: UHCCP Medicaid |
$746.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,266.84
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$580.85 |
| Max. Negotiated Rate |
$1,838.48 |
| Rate for Payer: Aetna Commercial |
$1,177.87
|
| Rate for Payer: Aetna Medicare |
$914.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.77
|
| Rate for Payer: BCBS Complete |
$609.89
|
| Rate for Payer: BCBS MAPPO |
$879.01
|
| Rate for Payer: BCN Commercial |
$1,508.88
|
| Rate for Payer: BCN Medicare Advantage |
$879.01
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cofinity Commercial |
$1,177.87
|
| Rate for Payer: Cofinity Commercial |
$1,265.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$879.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.96
|
| Rate for Payer: Meridian Medicaid |
$609.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.91
|
| Rate for Payer: Nomi Health Commercial |
$1,054.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,392.00
|
| Rate for Payer: PACE SWMI |
$879.01
|
| Rate for Payer: PHP Commercial |
$1,230.61
|
| Rate for Payer: PHP Medicare Advantage |
$879.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,838.48
|
| Rate for Payer: Priority Health Medicare |
$879.01
|
| Rate for Payer: Priority Health SBD |
$1,838.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,838.48
|
| Rate for Payer: Railroad Medicare Medicare |
$879.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.84
|
| Rate for Payer: UHC Core |
$1,727.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$879.01
|
| Rate for Payer: UHC Exchange |
$1,727.84
|
| Rate for Payer: UHC Medicaid |
$580.85
|
| Rate for Payer: UHCCP Medicaid |
$580.85
|
| Rate for Payer: UMR Bronson Commercial |
$853.76
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$870.74 |
| Max. Negotiated Rate |
$2,653.01 |
| Rate for Payer: Aetna Commercial |
$1,802.43
|
| Rate for Payer: Aetna Medicare |
$1,398.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,802.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,936.94
|
| Rate for Payer: BCBS Complete |
$914.28
|
| Rate for Payer: BCBS MAPPO |
$1,345.10
|
| Rate for Payer: BCN Commercial |
$2,272.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,345.10
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cofinity Commercial |
$1,802.43
|
| Rate for Payer: Cofinity Commercial |
$1,936.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,345.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,412.36
|
| Rate for Payer: Meridian Medicaid |
$914.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,479.61
|
| Rate for Payer: Nomi Health Commercial |
$1,614.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,031.75
|
| Rate for Payer: PACE SWMI |
$1,345.10
|
| Rate for Payer: PHP Commercial |
$1,883.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,345.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$870.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,429.01
|
| Rate for Payer: Priority Health Medicare |
$1,345.10
|
| Rate for Payer: Priority Health SBD |
$2,429.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,429.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,345.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,653.01
|
| Rate for Payer: UHC Core |
$2,653.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,345.10
|
| Rate for Payer: UHC Exchange |
$2,653.01
|
| Rate for Payer: UHC Medicaid |
$870.74
|
| Rate for Payer: UHCCP Medicaid |
$870.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.14
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$5,676.00
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,171.50 |
| Max. Negotiated Rate |
$4,257.00 |
| Rate for Payer: Aetna Commercial |
$2,434.62
|
| Rate for Payer: Aetna Medicare |
$1,889.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,434.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,616.31
|
| Rate for Payer: BCBS Complete |
$1,230.08
|
| Rate for Payer: BCBS MAPPO |
$1,816.88
|
| Rate for Payer: BCN Commercial |
$3,088.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,816.88
|
| Rate for Payer: Cash Price |
$4,540.80
|
| Rate for Payer: Cash Price |
$4,540.80
|
| Rate for Payer: Cofinity Commercial |
$2,434.62
|
| Rate for Payer: Cofinity Commercial |
$2,616.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,816.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,907.72
|
| Rate for Payer: Meridian Medicaid |
$1,230.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,998.57
|
| Rate for Payer: Nomi Health Commercial |
$2,180.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,257.00
|
| Rate for Payer: PACE SWMI |
$1,816.88
|
| Rate for Payer: PHP Commercial |
$2,543.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,816.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,301.50
|
| Rate for Payer: Priority Health Medicare |
$1,816.88
|
| Rate for Payer: Priority Health SBD |
$3,301.50
|
| Rate for Payer: Priority Health Tiered Network |
$3,301.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,816.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,633.59
|
| Rate for Payer: UHC Core |
$3,633.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,816.88
|
| Rate for Payer: UHC Exchange |
$3,633.59
|
| Rate for Payer: UHC Medicaid |
$1,171.50
|
| Rate for Payer: UHCCP Medicaid |
$1,171.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,610.96
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$3,120.00
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$628.78 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Aetna Commercial |
$1,294.59
|
| Rate for Payer: Aetna Medicare |
$1,004.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,294.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,391.20
|
| Rate for Payer: BCBS Complete |
$660.22
|
| Rate for Payer: BCBS MAPPO |
$966.11
|
| Rate for Payer: BCN Commercial |
$1,618.44
|
| Rate for Payer: BCN Medicare Advantage |
$966.11
|
| Rate for Payer: Cash Price |
$2,496.00
|
| Rate for Payer: Cash Price |
$2,496.00
|
| Rate for Payer: Cofinity Commercial |
$1,294.59
|
| Rate for Payer: Cofinity Commercial |
$1,391.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,014.42
|
| Rate for Payer: Meridian Medicaid |
$660.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,062.72
|
| Rate for Payer: Nomi Health Commercial |
$1,159.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,340.00
|
| Rate for Payer: PACE SWMI |
$966.11
|
| Rate for Payer: PHP Commercial |
$1,352.55
|
| Rate for Payer: PHP Medicare Advantage |
$966.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,730.06
|
| Rate for Payer: Priority Health Medicare |
$966.11
|
| Rate for Payer: Priority Health SBD |
$1,730.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,730.06
|
| Rate for Payer: Railroad Medicare Medicare |
$966.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,866.83
|
| Rate for Payer: UHC Core |
$1,866.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$966.11
|
| Rate for Payer: UHC Exchange |
$1,866.83
|
| Rate for Payer: UHC Medicaid |
$628.78
|
| Rate for Payer: UHCCP Medicaid |
$628.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,435.20
|
|
