|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 20670
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$710.25 |
| Rate for Payer: Aetna Commercial |
$180.65
|
| Rate for Payer: Aetna Medicare |
$140.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.13
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS MAPPO |
$134.81
|
| Rate for Payer: BCN Commercial |
$173.57
|
| Rate for Payer: BCN Medicare Advantage |
$134.81
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$180.65
|
| Rate for Payer: Cofinity Commercial |
$194.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.55
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.29
|
| Rate for Payer: Nomi Health Commercial |
$161.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$710.25
|
| Rate for Payer: PACE SWMI |
$134.81
|
| Rate for Payer: PHP Commercial |
$188.73
|
| Rate for Payer: PHP Medicare Advantage |
$134.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$235.29
|
| Rate for Payer: Priority Health Medicare |
$134.81
|
| Rate for Payer: Priority Health SBD |
$235.29
|
| Rate for Payer: Priority Health Tiered Network |
$235.29
|
| Rate for Payer: Railroad Medicare Medicare |
$134.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.20
|
| Rate for Payer: UHC Core |
$251.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.81
|
| Rate for Payer: UHC Exchange |
$251.20
|
| Rate for Payer: UHC Medicaid |
$89.25
|
| Rate for Payer: UHCCP Medicaid |
$89.25
|
| Rate for Payer: UMR Bronson Commercial |
$435.62
|
|
|
PR REMOVAL INDWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$1,746.00
|
|
|
Service Code
|
HCPCS 50384
|
| Min. Negotiated Rate |
$125.24 |
| Max. Negotiated Rate |
$1,309.50 |
| Rate for Payer: Aetna Commercial |
$263.43
|
| Rate for Payer: Aetna Medicare |
$204.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.09
|
| Rate for Payer: BCBS Complete |
$131.50
|
| Rate for Payer: BCBS MAPPO |
$196.59
|
| Rate for Payer: BCN Commercial |
$332.15
|
| Rate for Payer: BCN Medicare Advantage |
$196.59
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Cash Price |
$1,396.80
|
| Rate for Payer: Cofinity Commercial |
$263.43
|
| Rate for Payer: Cofinity Commercial |
$283.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.42
|
| Rate for Payer: Meridian Medicaid |
$131.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.25
|
| Rate for Payer: Nomi Health Commercial |
$235.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,309.50
|
| Rate for Payer: PACE SWMI |
$196.59
|
| Rate for Payer: PHP Commercial |
$275.23
|
| Rate for Payer: PHP Medicare Advantage |
$196.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$361.82
|
| Rate for Payer: Priority Health Medicare |
$196.59
|
| Rate for Payer: Priority Health SBD |
$361.82
|
| Rate for Payer: Priority Health Tiered Network |
$361.82
|
| Rate for Payer: Railroad Medicare Medicare |
$196.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.77
|
| Rate for Payer: UHC Core |
$409.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$196.59
|
| Rate for Payer: UHC Exchange |
$409.77
|
| Rate for Payer: UHC Medicaid |
$125.24
|
| Rate for Payer: UHCCP Medicaid |
$125.24
|
| Rate for Payer: UMR Bronson Commercial |
$803.16
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 19328
|
| Min. Negotiated Rate |
$327.38 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: Aetna Commercial |
$669.84
|
| Rate for Payer: Aetna Medicare |
$519.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.83
|
| Rate for Payer: BCBS Complete |
$343.75
|
| Rate for Payer: BCBS MAPPO |
$499.88
|
| Rate for Payer: BCN Commercial |
$841.58
|
| Rate for Payer: BCN Medicare Advantage |
$499.88
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cofinity Commercial |
$669.84
|
| Rate for Payer: Cofinity Commercial |
$719.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.87
|
| Rate for Payer: Meridian Medicaid |
$343.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.87
|
| Rate for Payer: Nomi Health Commercial |
$599.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,182.00
|
| Rate for Payer: PACE SWMI |
$499.88
|
| Rate for Payer: PHP Commercial |
$699.83
|
| Rate for Payer: PHP Medicare Advantage |
$499.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$770.28
|
| Rate for Payer: Priority Health Medicare |
$499.88
|
| Rate for Payer: Priority Health SBD |
$770.28
|
| Rate for Payer: Priority Health Tiered Network |
$770.28
|
| Rate for Payer: Railroad Medicare Medicare |
$499.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.93
|
| Rate for Payer: UHC Core |
$869.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$499.88
|
| Rate for Payer: UHC Exchange |
$869.93
|
| Rate for Payer: UHC Medicaid |
$327.38
|
| Rate for Payer: UHCCP Medicaid |
$327.38
|
| Rate for Payer: UMR Bronson Commercial |
$724.96
|
|
|
PR REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 33968
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$74.25 |
| Rate for Payer: Aetna Commercial |
$40.13
|
| Rate for Payer: Aetna Medicare |
$31.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.13
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$29.95
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Medicare Advantage |
$29.95
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$40.13
|
| Rate for Payer: Cofinity Commercial |
$43.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.45
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.95
|
| Rate for Payer: Nomi Health Commercial |
$35.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.25
|
| Rate for Payer: PACE SWMI |
$29.95
|
| Rate for Payer: PHP Commercial |
$41.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.56
|
| Rate for Payer: Priority Health Medicare |
$29.95
|
| Rate for Payer: Priority Health SBD |
$53.56
|
| Rate for Payer: Priority Health Tiered Network |
$53.56
|
| Rate for Payer: Railroad Medicare Medicare |
$29.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.41
|
| Rate for Payer: UHC Core |
$60.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.95
|
| Rate for Payer: UHC Exchange |
$60.41
|
| Rate for Payer: UHC Medicaid |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
| Rate for Payer: UMR Bronson Commercial |
$45.54
|
|
|
PR REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 20705
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$213.43 |
| Rate for Payer: Aetna Commercial |
$142.28
|
| Rate for Payer: Aetna Medicare |
$110.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.90
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$106.18
|
| Rate for Payer: BCN Commercial |
$185.25
|
| Rate for Payer: BCN Medicare Advantage |
$106.18
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$142.28
|
| Rate for Payer: Cofinity Commercial |
$152.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.49
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.80
|
| Rate for Payer: Nomi Health Commercial |
$127.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.00
|
| Rate for Payer: PACE SWMI |
$106.18
|
| Rate for Payer: PHP Commercial |
$148.65
|
| Rate for Payer: PHP Medicare Advantage |
$106.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.03
|
| Rate for Payer: Priority Health Medicare |
$106.18
|
| Rate for Payer: Priority Health SBD |
$198.03
|
| Rate for Payer: Priority Health Tiered Network |
$198.03
|
| Rate for Payer: Railroad Medicare Medicare |
$106.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.43
|
| Rate for Payer: UHC Core |
$213.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.18
|
| Rate for Payer: UHC Exchange |
$213.43
|
| Rate for Payer: UHC Medicaid |
$67.73
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
| Rate for Payer: UMR Bronson Commercial |
$121.44
|
|
|
PR REMOVAL INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 58301
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$77.55
|
| Rate for Payer: Aetna Medicare |
$60.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.33
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$57.87
|
| Rate for Payer: BCN Commercial |
$77.75
|
| Rate for Payer: BCN Medicare Advantage |
$57.87
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$77.55
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.76
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.66
|
| Rate for Payer: Nomi Health Commercial |
$69.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$57.87
|
| Rate for Payer: PHP Commercial |
$81.02
|
| Rate for Payer: PHP Medicare Advantage |
$57.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.87
|
| Rate for Payer: Priority Health Medicare |
$57.87
|
| Rate for Payer: Priority Health SBD |
$99.87
|
| Rate for Payer: Priority Health Tiered Network |
$99.87
|
| Rate for Payer: Railroad Medicare Medicare |
$57.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.82
|
| Rate for Payer: UHC Core |
$119.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.87
|
| Rate for Payer: UHC Exchange |
$119.82
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA
|
Professional
|
Both
|
$6,285.00
|
|
|
Service Code
|
HCPCS 32442
|
| Min. Negotiated Rate |
$1,802.41 |
| Max. Negotiated Rate |
$5,461.79 |
| Rate for Payer: Aetna Commercial |
$3,806.54
|
| Rate for Payer: Aetna Medicare |
$2,954.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,806.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,090.61
|
| Rate for Payer: BCBS Complete |
$1,892.53
|
| Rate for Payer: BCBS MAPPO |
$2,840.70
|
| Rate for Payer: BCN Commercial |
$4,482.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,840.70
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cash Price |
$5,028.00
|
| Rate for Payer: Cofinity Commercial |
$3,806.54
|
| Rate for Payer: Cofinity Commercial |
$4,090.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,840.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,982.74
|
| Rate for Payer: Meridian Medicaid |
$1,892.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,124.77
|
| Rate for Payer: Nomi Health Commercial |
$3,408.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,713.75
|
| Rate for Payer: PACE SWMI |
$2,840.70
|
| Rate for Payer: PHP Commercial |
$3,976.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,840.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,221.49
|
| Rate for Payer: Priority Health Medicare |
$2,840.70
|
| Rate for Payer: Priority Health SBD |
$4,221.49
|
| Rate for Payer: Priority Health Tiered Network |
$4,221.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,840.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,461.79
|
| Rate for Payer: UHC Core |
$5,461.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,840.70
|
| Rate for Payer: UHC Exchange |
$5,461.79
|
| Rate for Payer: UHC Medicaid |
$1,802.41
|
| Rate for Payer: UHCCP Medicaid |
$1,802.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,891.10
|
|
|
PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 11982
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Aetna Commercial |
$84.55
|
| Rate for Payer: Aetna Medicare |
$65.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.86
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$63.10
|
| Rate for Payer: BCN Commercial |
$108.56
|
| Rate for Payer: BCN Medicare Advantage |
$63.10
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$84.55
|
| Rate for Payer: Cofinity Commercial |
$90.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.25
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.41
|
| Rate for Payer: Nomi Health Commercial |
$75.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.50
|
| Rate for Payer: PACE SWMI |
$63.10
|
| Rate for Payer: PHP Commercial |
$88.34
|
| Rate for Payer: PHP Medicare Advantage |
$63.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.37
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health SBD |
$99.37
|
| Rate for Payer: Priority Health Tiered Network |
$99.37
|
| Rate for Payer: Railroad Medicare Medicare |
$63.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.31
|
| Rate for Payer: UHC Core |
$134.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.10
|
| Rate for Payer: UHC Exchange |
$134.31
|
| Rate for Payer: UHC Medicaid |
$40.26
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
| Rate for Payer: UMR Bronson Commercial |
$120.52
|
|
|
PR REMOVAL OF LUNG PNEUMONECTOMY
|
Professional
|
Both
|
$5,668.00
|
|
|
Service Code
|
HCPCS 32440
|
| Min. Negotiated Rate |
$949.98 |
| Max. Negotiated Rate |
$4,251.00 |
| Rate for Payer: Aetna Commercial |
$1,990.76
|
| Rate for Payer: Aetna Medicare |
$1,545.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,139.32
|
| Rate for Payer: BCBS Complete |
$997.48
|
| Rate for Payer: BCBS MAPPO |
$1,485.64
|
| Rate for Payer: BCN Commercial |
$2,320.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,485.64
|
| Rate for Payer: Cash Price |
$4,534.40
|
| Rate for Payer: Cash Price |
$4,534.40
|
| Rate for Payer: Cofinity Commercial |
$1,990.76
|
| Rate for Payer: Cofinity Commercial |
$2,139.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,485.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.92
|
| Rate for Payer: Meridian Medicaid |
$997.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,634.20
|
| Rate for Payer: Nomi Health Commercial |
$1,782.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,251.00
|
| Rate for Payer: PACE SWMI |
$1,485.64
|
| Rate for Payer: PHP Commercial |
$2,079.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,485.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$949.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,185.31
|
| Rate for Payer: Priority Health Medicare |
$1,485.64
|
| Rate for Payer: Priority Health SBD |
$2,185.31
|
| Rate for Payer: Priority Health Tiered Network |
$2,185.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,485.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,778.24
|
| Rate for Payer: UHC Core |
$2,778.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,485.64
|
| Rate for Payer: UHC Exchange |
$2,778.24
|
| Rate for Payer: UHC Medicaid |
$949.98
|
| Rate for Payer: UHCCP Medicaid |
$949.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,607.28
|
|
|
PR REMOVAL OF SUTURES
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS S0630
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$38.34 |
| Rate for Payer: Aetna Commercial |
$27.32
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.32
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCN Commercial |
$38.34
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: UMR Bronson Commercial |
$19.32
|
|
|
PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY
|
Professional
|
Both
|
$2,325.00
|
|
|
Service Code
|
HCPCS 49402
|
| Min. Negotiated Rate |
$509.92 |
| Max. Negotiated Rate |
$1,743.75 |
| Rate for Payer: Aetna Commercial |
$1,063.87
|
| Rate for Payer: Aetna Medicare |
$825.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.26
|
| Rate for Payer: BCBS Complete |
$535.42
|
| Rate for Payer: BCBS MAPPO |
$793.93
|
| Rate for Payer: BCN Commercial |
$1,289.27
|
| Rate for Payer: BCN Medicare Advantage |
$793.93
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cash Price |
$1,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,143.26
|
| Rate for Payer: Cofinity Commercial |
$1,063.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$833.63
|
| Rate for Payer: Meridian Medicaid |
$535.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$873.32
|
| Rate for Payer: Nomi Health Commercial |
$952.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,743.75
|
| Rate for Payer: PACE SWMI |
$793.93
|
| Rate for Payer: PHP Commercial |
$1,111.50
|
| Rate for Payer: PHP Medicare Advantage |
$793.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,570.89
|
| Rate for Payer: Priority Health Medicare |
$793.93
|
| Rate for Payer: Priority Health SBD |
$1,570.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,570.89
|
| Rate for Payer: Railroad Medicare Medicare |
$793.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,524.62
|
| Rate for Payer: UHC Core |
$1,524.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$793.93
|
| Rate for Payer: UHC Exchange |
$1,524.62
|
| Rate for Payer: UHC Medicaid |
$509.92
|
| Rate for Payer: UHCCP Medicaid |
$509.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.50
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 33233
|
| Min. Negotiated Rate |
$135.47 |
| Max. Negotiated Rate |
$490.50 |
| Rate for Payer: Aetna Commercial |
$278.76
|
| Rate for Payer: Aetna Medicare |
$216.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.56
|
| Rate for Payer: BCBS Complete |
$142.24
|
| Rate for Payer: BCBS MAPPO |
$208.03
|
| Rate for Payer: BCN Commercial |
$345.59
|
| Rate for Payer: BCN Medicare Advantage |
$208.03
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$278.76
|
| Rate for Payer: Cofinity Commercial |
$299.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.43
|
| Rate for Payer: Meridian Medicaid |
$142.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$228.83
|
| Rate for Payer: Nomi Health Commercial |
$249.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.50
|
| Rate for Payer: PACE SWMI |
$208.03
|
| Rate for Payer: PHP Commercial |
$291.24
|
| Rate for Payer: PHP Medicare Advantage |
$208.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.64
|
| Rate for Payer: Priority Health Medicare |
$208.03
|
| Rate for Payer: Priority Health SBD |
$371.64
|
| Rate for Payer: Priority Health Tiered Network |
$371.64
|
| Rate for Payer: Railroad Medicare Medicare |
$208.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.17
|
| Rate for Payer: UHC Core |
$404.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.03
|
| Rate for Payer: UHC Exchange |
$404.17
|
| Rate for Payer: UHC Medicaid |
$135.47
|
| Rate for Payer: UHCCP Medicaid |
$135.47
|
| Rate for Payer: UMR Bronson Commercial |
$300.84
|
|
|
PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 33992
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$223.27
|
| Rate for Payer: Aetna Medicare |
$173.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.93
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$166.62
|
| Rate for Payer: BCN Commercial |
$274.39
|
| Rate for Payer: BCN Medicare Advantage |
$166.62
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$223.27
|
| Rate for Payer: Cofinity Commercial |
$239.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.95
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.28
|
| Rate for Payer: Nomi Health Commercial |
$199.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$166.62
|
| Rate for Payer: PHP Commercial |
$233.27
|
| Rate for Payer: PHP Medicare Advantage |
$166.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$295.07
|
| Rate for Payer: Priority Health Medicare |
$166.62
|
| Rate for Payer: Priority Health SBD |
$295.07
|
| Rate for Payer: Priority Health Tiered Network |
$295.07
|
| Rate for Payer: Railroad Medicare Medicare |
$166.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.46
|
| Rate for Payer: UHC Core |
$356.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.62
|
| Rate for Payer: UHC Exchange |
$356.46
|
| Rate for Payer: UHC Medicaid |
$105.22
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
| Rate for Payer: UMR Bronson Commercial |
$266.80
|
|
|
PR REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 33997
|
| Min. Negotiated Rate |
$89.03 |
| Max. Negotiated Rate |
$292.95 |
| Rate for Payer: Aetna Commercial |
$188.70
|
| Rate for Payer: Aetna Medicare |
$146.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.78
|
| Rate for Payer: BCBS Complete |
$93.48
|
| Rate for Payer: BCBS MAPPO |
$140.82
|
| Rate for Payer: BCN Commercial |
$235.55
|
| Rate for Payer: BCN Medicare Advantage |
$140.82
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$188.70
|
| Rate for Payer: Cofinity Commercial |
$202.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.86
|
| Rate for Payer: Meridian Medicaid |
$93.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.90
|
| Rate for Payer: Nomi Health Commercial |
$168.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$140.82
|
| Rate for Payer: PHP Commercial |
$197.15
|
| Rate for Payer: PHP Medicare Advantage |
$140.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$253.30
|
| Rate for Payer: Priority Health Medicare |
$140.82
|
| Rate for Payer: Priority Health SBD |
$253.30
|
| Rate for Payer: Priority Health Tiered Network |
$253.30
|
| Rate for Payer: Railroad Medicare Medicare |
$140.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.95
|
| Rate for Payer: UHC Core |
$292.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.82
|
| Rate for Payer: UHC Exchange |
$292.95
|
| Rate for Payer: UHC Medicaid |
$89.03
|
| Rate for Payer: UHCCP Medicaid |
$89.03
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,165.00
|
|
|
Service Code
|
HCPCS 22850
|
| Min. Negotiated Rate |
$457.10 |
| Max. Negotiated Rate |
$1,623.75 |
| Rate for Payer: Aetna Commercial |
$943.29
|
| Rate for Payer: Aetna Medicare |
$732.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.29
|
| Rate for Payer: BCBS Complete |
$479.95
|
| Rate for Payer: BCBS MAPPO |
$703.95
|
| Rate for Payer: BCN Commercial |
$1,125.44
|
| Rate for Payer: BCN Medicare Advantage |
$703.95
|
| Rate for Payer: Cash Price |
$1,732.00
|
| Rate for Payer: Cash Price |
$1,732.00
|
| Rate for Payer: Cofinity Commercial |
$1,013.69
|
| Rate for Payer: Cofinity Commercial |
$943.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.15
|
| Rate for Payer: Meridian Medicaid |
$479.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.35
|
| Rate for Payer: Nomi Health Commercial |
$844.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,623.75
|
| Rate for Payer: PACE SWMI |
$703.95
|
| Rate for Payer: PHP Commercial |
$985.53
|
| Rate for Payer: PHP Medicare Advantage |
$703.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,203.06
|
| Rate for Payer: Priority Health Medicare |
$703.95
|
| Rate for Payer: Priority Health SBD |
$1,203.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,203.06
|
| Rate for Payer: Railroad Medicare Medicare |
$703.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,278.55
|
| Rate for Payer: UHC Core |
$1,278.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.95
|
| Rate for Payer: UHC Exchange |
$1,278.55
|
| Rate for Payer: UHC Medicaid |
$457.10
|
| Rate for Payer: UHCCP Medicaid |
$457.10
|
| Rate for Payer: UMR Bronson Commercial |
$995.90
|
|
|
PR REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 22852
|
| Min. Negotiated Rate |
$441.34 |
| Max. Negotiated Rate |
$1,724.25 |
| Rate for Payer: Aetna Commercial |
$909.83
|
| Rate for Payer: Aetna Medicare |
$706.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.73
|
| Rate for Payer: BCBS Complete |
$463.41
|
| Rate for Payer: BCBS MAPPO |
$678.98
|
| Rate for Payer: BCN Commercial |
$1,083.11
|
| Rate for Payer: BCN Medicare Advantage |
$678.98
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cofinity Commercial |
$909.83
|
| Rate for Payer: Cofinity Commercial |
$977.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.93
|
| Rate for Payer: Meridian Medicaid |
$463.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.88
|
| Rate for Payer: Nomi Health Commercial |
$814.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.25
|
| Rate for Payer: PACE SWMI |
$678.98
|
| Rate for Payer: PHP Commercial |
$950.57
|
| Rate for Payer: PHP Medicare Advantage |
$678.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,157.82
|
| Rate for Payer: Priority Health Medicare |
$678.98
|
| Rate for Payer: Priority Health SBD |
$1,157.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,157.82
|
| Rate for Payer: Railroad Medicare Medicare |
$678.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,227.05
|
| Rate for Payer: UHC Core |
$1,227.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.98
|
| Rate for Payer: UHC Exchange |
$1,227.05
|
| Rate for Payer: UHC Medicaid |
$441.34
|
| Rate for Payer: UHCCP Medicaid |
$441.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,057.54
|
|
|
PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 23333
|
| Min. Negotiated Rate |
$293.09 |
| Max. Negotiated Rate |
$806.63 |
| Rate for Payer: Aetna Commercial |
$597.14
|
| Rate for Payer: Aetna Medicare |
$463.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.71
|
| Rate for Payer: BCBS Complete |
$307.74
|
| Rate for Payer: BCBS MAPPO |
$445.63
|
| Rate for Payer: BCN Commercial |
$730.53
|
| Rate for Payer: BCN Medicare Advantage |
$445.63
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cofinity Commercial |
$597.14
|
| Rate for Payer: Cofinity Commercial |
$641.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.91
|
| Rate for Payer: Meridian Medicaid |
$307.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.19
|
| Rate for Payer: Nomi Health Commercial |
$534.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.00
|
| Rate for Payer: PACE SWMI |
$445.63
|
| Rate for Payer: PHP Commercial |
$623.88
|
| Rate for Payer: PHP Medicare Advantage |
$445.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$780.92
|
| Rate for Payer: Priority Health Medicare |
$445.63
|
| Rate for Payer: Priority Health SBD |
$780.92
|
| Rate for Payer: Priority Health Tiered Network |
$780.92
|
| Rate for Payer: Railroad Medicare Medicare |
$445.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.63
|
| Rate for Payer: UHC Core |
$806.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.63
|
| Rate for Payer: UHC Exchange |
$806.63
|
| Rate for Payer: UHC Medicaid |
$293.09
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
| Rate for Payer: UMR Bronson Commercial |
$448.96
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 33286
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Medicare |
$78.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.22
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$75.15
|
| Rate for Payer: BCN Commercial |
$125.99
|
| Rate for Payer: BCN Medicare Advantage |
$75.15
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$108.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.91
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.67
|
| Rate for Payer: Nomi Health Commercial |
$90.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.00
|
| Rate for Payer: PACE SWMI |
$75.15
|
| Rate for Payer: PHP Commercial |
$105.21
|
| Rate for Payer: PHP Medicare Advantage |
$75.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$135.49
|
| Rate for Payer: Priority Health Medicare |
$75.15
|
| Rate for Payer: Priority Health SBD |
$135.49
|
| Rate for Payer: Priority Health Tiered Network |
$135.49
|
| Rate for Payer: Railroad Medicare Medicare |
$75.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.17
|
| Rate for Payer: UHC Core |
$155.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.15
|
| Rate for Payer: UHC Exchange |
$155.17
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: UMR Bronson Commercial |
$126.96
|
|
|
PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 15854
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$21.75
|
| Rate for Payer: Aetna Medicare |
$16.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.37
|
| Rate for Payer: BCBS MAPPO |
$16.23
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$16.23
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Cofinity Commercial |
$23.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.85
|
| Rate for Payer: Nomi Health Commercial |
$19.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$16.23
|
| Rate for Payer: PHP Commercial |
$22.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.60
|
| Rate for Payer: Priority Health Medicare |
$16.23
|
| Rate for Payer: Priority Health SBD |
$19.60
|
| Rate for Payer: Priority Health Tiered Network |
$19.60
|
| Rate for Payer: Railroad Medicare Medicare |
$16.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.68
|
| Rate for Payer: UHC Core |
$27.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.23
|
| Rate for Payer: UHC Exchange |
$27.68
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$24.75 |
| Rate for Payer: Aetna Commercial |
$16.44
|
| Rate for Payer: Aetna Medicare |
$12.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.27
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$17.67
|
| Rate for Payer: Cofinity Commercial |
$16.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.50
|
| Rate for Payer: Nomi Health Commercial |
$14.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$12.27
|
| Rate for Payer: PHP Commercial |
$17.18
|
| Rate for Payer: PHP Medicare Advantage |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.50
|
| Rate for Payer: Priority Health Medicare |
$12.27
|
| Rate for Payer: Priority Health SBD |
$15.50
|
| Rate for Payer: Priority Health Tiered Network |
$15.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.59
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.27
|
| Rate for Payer: UHC Exchange |
$19.59
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$59.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.67
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCBS MAPPO |
$57.41
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Medicare Advantage |
$57.41
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$76.93
|
| Rate for Payer: Cofinity Commercial |
$82.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.28
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$68.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.75
|
| Rate for Payer: PACE SWMI |
$57.41
|
| Rate for Payer: PHP Commercial |
$80.37
|
| Rate for Payer: PHP Medicare Advantage |
$57.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.79
|
| Rate for Payer: Priority Health Medicare |
$57.41
|
| Rate for Payer: Priority Health SBD |
$89.79
|
| Rate for Payer: Priority Health Tiered Network |
$89.79
|
| Rate for Payer: Railroad Medicare Medicare |
$57.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.34
|
| Rate for Payer: UHC Core |
$80.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.41
|
| Rate for Payer: UHC Exchange |
$80.34
|
| Rate for Payer: UHC Medicaid |
$37.28
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
| Rate for Payer: UMR Bronson Commercial |
$75.90
|
|
|
PR REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 15850
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$174.75 |
| Rate for Payer: Aetna Medicare |
$116.50
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.75
|
| Rate for Payer: UMR Bronson Commercial |
$107.18
|
|
|
PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 11971
|
| Min. Negotiated Rate |
$328.87 |
| Max. Negotiated Rate |
$839.59 |
| Rate for Payer: Aetna Commercial |
$669.93
|
| Rate for Payer: Aetna Medicare |
$519.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.93
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$499.95
|
| Rate for Payer: BCN Commercial |
$839.59
|
| Rate for Payer: BCN Medicare Advantage |
$499.95
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cofinity Commercial |
$719.93
|
| Rate for Payer: Cofinity Commercial |
$669.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.95
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.95
|
| Rate for Payer: Nomi Health Commercial |
$599.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: PACE SWMI |
$499.95
|
| Rate for Payer: PHP Commercial |
$699.93
|
| Rate for Payer: PHP Medicare Advantage |
$499.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.44
|
| Rate for Payer: Priority Health Medicare |
$499.95
|
| Rate for Payer: Priority Health SBD |
$768.44
|
| Rate for Payer: Priority Health Tiered Network |
$768.44
|
| Rate for Payer: Railroad Medicare Medicare |
$499.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.30
|
| Rate for Payer: UHC Core |
$556.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$499.95
|
| Rate for Payer: UHC Exchange |
$556.30
|
| Rate for Payer: UHC Medicaid |
$328.87
|
| Rate for Payer: UHCCP Medicaid |
$328.87
|
| Rate for Payer: UMR Bronson Commercial |
$440.68
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$128.65 |
| Max. Negotiated Rate |
$757.50 |
| Rate for Payer: Aetna Commercial |
$271.28
|
| Rate for Payer: Aetna Medicare |
$210.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.53
|
| Rate for Payer: BCBS Complete |
$135.08
|
| Rate for Payer: BCBS MAPPO |
$202.45
|
| Rate for Payer: BCN Commercial |
$328.17
|
| Rate for Payer: BCN Medicare Advantage |
$202.45
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Cofinity Commercial |
$271.28
|
| Rate for Payer: Cofinity Commercial |
$291.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.57
|
| Rate for Payer: Meridian Medicaid |
$135.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$222.69
|
| Rate for Payer: Nomi Health Commercial |
$242.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$757.50
|
| Rate for Payer: PACE SWMI |
$202.45
|
| Rate for Payer: PHP Commercial |
$283.43
|
| Rate for Payer: PHP Medicare Advantage |
$202.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$399.85
|
| Rate for Payer: Priority Health Medicare |
$202.45
|
| Rate for Payer: Priority Health SBD |
$399.85
|
| Rate for Payer: Priority Health Tiered Network |
$399.85
|
| Rate for Payer: Railroad Medicare Medicare |
$202.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.22
|
| Rate for Payer: UHC Core |
$397.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$202.45
|
| Rate for Payer: UHC Exchange |
$397.22
|
| Rate for Payer: UHC Medicaid |
$128.65
|
| Rate for Payer: UHCCP Medicaid |
$128.65
|
| Rate for Payer: UMR Bronson Commercial |
$464.60
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,481.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$660.30 |
| Max. Negotiated Rate |
$2,610.75 |
| Rate for Payer: Aetna Commercial |
$1,393.81
|
| Rate for Payer: Aetna Medicare |
$1,081.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,497.83
|
| Rate for Payer: BCBS Complete |
$693.32
|
| Rate for Payer: BCBS MAPPO |
$1,040.16
|
| Rate for Payer: BCN Commercial |
$1,648.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.16
|
| Rate for Payer: Cash Price |
$2,784.80
|
| Rate for Payer: Cash Price |
$2,784.80
|
| Rate for Payer: Cofinity Commercial |
$1,393.81
|
| Rate for Payer: Cofinity Commercial |
$1,497.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,092.17
|
| Rate for Payer: Meridian Medicaid |
$693.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,144.18
|
| Rate for Payer: Nomi Health Commercial |
$1,248.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,610.75
|
| Rate for Payer: PACE SWMI |
$1,040.16
|
| Rate for Payer: PHP Commercial |
$1,456.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,772.56
|
| Rate for Payer: Priority Health Medicare |
$1,040.16
|
| Rate for Payer: Priority Health SBD |
$1,772.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,772.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,010.59
|
| Rate for Payer: UHC Core |
$2,010.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,040.16
|
| Rate for Payer: UHC Exchange |
$2,010.59
|
| Rate for Payer: UHC Medicaid |
$660.30
|
| Rate for Payer: UHCCP Medicaid |
$660.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,601.26
|
|
