|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,393.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$432.18 |
| Max. Negotiated Rate |
$1,256.11 |
| Rate for Payer: Aetna Commercial |
$886.20
|
| Rate for Payer: Aetna Medicare |
$687.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.33
|
| Rate for Payer: BCBS Complete |
$453.79
|
| Rate for Payer: BCBS MAPPO |
$661.34
|
| Rate for Payer: BCN Commercial |
$1,100.54
|
| Rate for Payer: BCN Medicare Advantage |
$661.34
|
| Rate for Payer: Cash Price |
$1,114.40
|
| Rate for Payer: Cash Price |
$1,114.40
|
| Rate for Payer: Cofinity Commercial |
$886.20
|
| Rate for Payer: Cofinity Commercial |
$952.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.41
|
| Rate for Payer: Meridian Medicaid |
$453.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$727.47
|
| Rate for Payer: Nomi Health Commercial |
$793.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,044.75
|
| Rate for Payer: PACE SWMI |
$661.34
|
| Rate for Payer: PHP Commercial |
$925.88
|
| Rate for Payer: PHP Medicare Advantage |
$661.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,176.45
|
| Rate for Payer: Priority Health Medicare |
$661.34
|
| Rate for Payer: Priority Health SBD |
$1,176.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,176.45
|
| Rate for Payer: Railroad Medicare Medicare |
$661.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,256.11
|
| Rate for Payer: UHC Core |
$1,256.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$661.34
|
| Rate for Payer: UHC Exchange |
$1,256.11
|
| Rate for Payer: UHC Medicaid |
$432.18
|
| Rate for Payer: UHCCP Medicaid |
$432.18
|
| Rate for Payer: UMR Bronson Commercial |
$640.78
|
|
|
PR REMOVE BILE DUCT STONE, PERCUT
|
Professional
|
Both
|
$931.00
|
|
|
Service Code
|
HCPCS 47630
|
| Min. Negotiated Rate |
$372.40 |
| Max. Negotiated Rate |
$698.25 |
| Rate for Payer: Aetna Medicare |
$465.50
|
| Rate for Payer: BCBS Complete |
$372.40
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.25
|
| Rate for Payer: UMR Bronson Commercial |
$428.26
|
|
|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$428.00 |
| Max. Negotiated Rate |
$802.50 |
| Rate for Payer: Aetna Medicare |
$535.00
|
| Rate for Payer: BCBS Complete |
$428.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$802.50
|
| Rate for Payer: UMR Bronson Commercial |
$492.20
|
|
|
PR REMOVE INT DWELL URETERAL STENT TRANSURETHRAL
|
Professional
|
Both
|
$1,629.00
|
|
|
Service Code
|
HCPCS 50386
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$1,221.75 |
| Rate for Payer: Aetna Commercial |
$191.37
|
| Rate for Payer: Aetna Medicare |
$148.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.65
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCBS MAPPO |
$142.81
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: BCN Medicare Advantage |
$142.81
|
| Rate for Payer: Cash Price |
$1,303.20
|
| Rate for Payer: Cash Price |
$1,303.20
|
| Rate for Payer: Cofinity Commercial |
$191.37
|
| Rate for Payer: Cofinity Commercial |
$205.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.95
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.09
|
| Rate for Payer: Nomi Health Commercial |
$171.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.75
|
| Rate for Payer: PACE SWMI |
$142.81
|
| Rate for Payer: PHP Commercial |
$199.93
|
| Rate for Payer: PHP Medicare Advantage |
$142.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$262.56
|
| Rate for Payer: Priority Health Medicare |
$142.81
|
| Rate for Payer: Priority Health SBD |
$262.56
|
| Rate for Payer: Priority Health Tiered Network |
$262.56
|
| Rate for Payer: Railroad Medicare Medicare |
$142.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.98
|
| Rate for Payer: UHC Core |
$286.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.81
|
| Rate for Payer: UHC Exchange |
$286.98
|
| Rate for Payer: UHC Medicaid |
$91.80
|
| Rate for Payer: UHCCP Medicaid |
$91.80
|
| Rate for Payer: UMR Bronson Commercial |
$749.34
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$218.40
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.50
|
| Rate for Payer: UMR Bronson Commercial |
$251.16
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,156.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$1,617.00 |
| Rate for Payer: Aetna Commercial |
$252.46
|
| Rate for Payer: Aetna Medicare |
$195.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.30
|
| Rate for Payer: BCBS Complete |
$126.81
|
| Rate for Payer: BCBS MAPPO |
$188.40
|
| Rate for Payer: BCN Commercial |
$318.21
|
| Rate for Payer: BCN Medicare Advantage |
$188.40
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cofinity Commercial |
$271.30
|
| Rate for Payer: Cofinity Commercial |
$252.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.82
|
| Rate for Payer: Meridian Medicaid |
$126.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.24
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,617.00
|
| Rate for Payer: PACE SWMI |
$188.40
|
| Rate for Payer: PHP Commercial |
$263.76
|
| Rate for Payer: PHP Medicare Advantage |
$188.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$346.63
|
| Rate for Payer: Priority Health Medicare |
$188.40
|
| Rate for Payer: Priority Health SBD |
$346.63
|
| Rate for Payer: Priority Health Tiered Network |
$346.63
|
| Rate for Payer: Railroad Medicare Medicare |
$188.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.78
|
| Rate for Payer: UHC Core |
$387.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.40
|
| Rate for Payer: UHC Exchange |
$387.78
|
| Rate for Payer: UHC Medicaid |
$120.77
|
| Rate for Payer: UHCCP Medicaid |
$120.77
|
| Rate for Payer: UMR Bronson Commercial |
$991.76
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,982.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$374.45 |
| Max. Negotiated Rate |
$1,486.50 |
| Rate for Payer: Aetna Commercial |
$773.45
|
| Rate for Payer: Aetna Medicare |
$600.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.17
|
| Rate for Payer: BCBS Complete |
$393.17
|
| Rate for Payer: BCBS MAPPO |
$577.20
|
| Rate for Payer: BCN Commercial |
$965.58
|
| Rate for Payer: BCN Medicare Advantage |
$577.20
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cofinity Commercial |
$773.45
|
| Rate for Payer: Cofinity Commercial |
$831.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.06
|
| Rate for Payer: Meridian Medicaid |
$393.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.92
|
| Rate for Payer: Nomi Health Commercial |
$692.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,486.50
|
| Rate for Payer: PACE SWMI |
$577.20
|
| Rate for Payer: PHP Commercial |
$808.08
|
| Rate for Payer: PHP Medicare Advantage |
$577.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,051.84
|
| Rate for Payer: Priority Health Medicare |
$577.20
|
| Rate for Payer: Priority Health SBD |
$1,051.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,051.84
|
| Rate for Payer: Railroad Medicare Medicare |
$577.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.16
|
| Rate for Payer: UHC Core |
$1,130.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.20
|
| Rate for Payer: UHC Exchange |
$1,130.16
|
| Rate for Payer: UHC Medicaid |
$374.45
|
| Rate for Payer: UHCCP Medicaid |
$374.45
|
| Rate for Payer: UMR Bronson Commercial |
$911.72
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$192.55 |
| Max. Negotiated Rate |
$598.44 |
| Rate for Payer: Aetna Commercial |
$401.04
|
| Rate for Payer: Aetna Medicare |
$311.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.96
|
| Rate for Payer: BCBS Complete |
$202.18
|
| Rate for Payer: BCBS MAPPO |
$299.28
|
| Rate for Payer: BCN Commercial |
$500.47
|
| Rate for Payer: BCN Medicare Advantage |
$299.28
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$401.04
|
| Rate for Payer: Cofinity Commercial |
$430.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.24
|
| Rate for Payer: Meridian Medicaid |
$202.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.21
|
| Rate for Payer: Nomi Health Commercial |
$359.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.25
|
| Rate for Payer: PACE SWMI |
$299.28
|
| Rate for Payer: PHP Commercial |
$418.99
|
| Rate for Payer: PHP Medicare Advantage |
$299.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$538.19
|
| Rate for Payer: Priority Health Medicare |
$299.28
|
| Rate for Payer: Priority Health SBD |
$538.19
|
| Rate for Payer: Priority Health Tiered Network |
$538.19
|
| Rate for Payer: Railroad Medicare Medicare |
$299.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.44
|
| Rate for Payer: UHC Core |
$598.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.28
|
| Rate for Payer: UHC Exchange |
$598.44
|
| Rate for Payer: UHC Medicaid |
$192.55
|
| Rate for Payer: UHCCP Medicaid |
$192.55
|
| Rate for Payer: UMR Bronson Commercial |
$332.58
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$626.68 |
| Rate for Payer: Aetna Commercial |
$419.07
|
| Rate for Payer: Aetna Medicare |
$325.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.35
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$312.74
|
| Rate for Payer: BCN Commercial |
$523.88
|
| Rate for Payer: BCN Medicare Advantage |
$312.74
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$419.07
|
| Rate for Payer: Cofinity Commercial |
$450.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.38
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.01
|
| Rate for Payer: Nomi Health Commercial |
$375.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.75
|
| Rate for Payer: PACE SWMI |
$312.74
|
| Rate for Payer: PHP Commercial |
$437.84
|
| Rate for Payer: PHP Medicare Advantage |
$312.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$563.37
|
| Rate for Payer: Priority Health Medicare |
$312.74
|
| Rate for Payer: Priority Health SBD |
$563.37
|
| Rate for Payer: Priority Health Tiered Network |
$563.37
|
| Rate for Payer: Railroad Medicare Medicare |
$312.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.68
|
| Rate for Payer: UHC Core |
$626.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.74
|
| Rate for Payer: UHC Exchange |
$626.68
|
| Rate for Payer: UHC Medicaid |
$201.07
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
| Rate for Payer: UMR Bronson Commercial |
$344.54
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$662.23 |
| Rate for Payer: Aetna Commercial |
$438.18
|
| Rate for Payer: Aetna Medicare |
$340.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.88
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$327.00
|
| Rate for Payer: BCN Commercial |
$549.28
|
| Rate for Payer: BCN Medicare Advantage |
$327.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$438.18
|
| Rate for Payer: Cofinity Commercial |
$470.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.35
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.70
|
| Rate for Payer: Nomi Health Commercial |
$392.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.25
|
| Rate for Payer: PACE SWMI |
$327.00
|
| Rate for Payer: PHP Commercial |
$457.80
|
| Rate for Payer: PHP Medicare Advantage |
$327.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$590.67
|
| Rate for Payer: Priority Health Medicare |
$327.00
|
| Rate for Payer: Priority Health SBD |
$590.67
|
| Rate for Payer: Priority Health Tiered Network |
$590.67
|
| Rate for Payer: Railroad Medicare Medicare |
$327.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.23
|
| Rate for Payer: UHC Core |
$662.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$327.00
|
| Rate for Payer: UHC Exchange |
$662.23
|
| Rate for Payer: UHC Medicaid |
$210.23
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
| Rate for Payer: UMR Bronson Commercial |
$273.70
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$337.60 |
| Max. Negotiated Rate |
$633.00 |
| Rate for Payer: Aetna Medicare |
$422.00
|
| Rate for Payer: BCBS Complete |
$337.60
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.00
|
| Rate for Payer: UMR Bronson Commercial |
$388.24
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0275
|
| 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 RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$146.21
|
| Rate for Payer: Aetna Medicare |
$113.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.12
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$109.11
|
| Rate for Payer: BCN Commercial |
$186.24
|
| Rate for Payer: BCN Medicare Advantage |
$109.11
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$146.21
|
| Rate for Payer: Cofinity Commercial |
$157.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.57
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.02
|
| Rate for Payer: Nomi Health Commercial |
$130.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.75
|
| Rate for Payer: PACE SWMI |
$109.11
|
| Rate for Payer: PHP Commercial |
$152.75
|
| Rate for Payer: PHP Medicare Advantage |
$109.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.89
|
| Rate for Payer: Priority Health Medicare |
$109.11
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: Priority Health Tiered Network |
$202.89
|
| Rate for Payer: Railroad Medicare Medicare |
$109.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.46
|
| Rate for Payer: UHC Core |
$226.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.11
|
| Rate for Payer: UHC Exchange |
$226.46
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
| Rate for Payer: UMR Bronson Commercial |
$499.10
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,750.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$454.76 |
| Max. Negotiated Rate |
$1,340.74 |
| Rate for Payer: Aetna Commercial |
$947.89
|
| Rate for Payer: Aetna Medicare |
$735.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.89
|
| Rate for Payer: BCBS Complete |
$477.50
|
| Rate for Payer: BCBS MAPPO |
$707.38
|
| Rate for Payer: BCN Commercial |
$1,137.89
|
| Rate for Payer: BCN Medicare Advantage |
$707.38
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cofinity Commercial |
$1,018.63
|
| Rate for Payer: Cofinity Commercial |
$947.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.75
|
| Rate for Payer: Meridian Medicaid |
$477.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.12
|
| Rate for Payer: Nomi Health Commercial |
$848.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,312.50
|
| Rate for Payer: PACE SWMI |
$707.38
|
| Rate for Payer: PHP Commercial |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$707.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,239.53
|
| Rate for Payer: Priority Health Medicare |
$707.38
|
| Rate for Payer: Priority Health SBD |
$1,239.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,239.53
|
| Rate for Payer: Railroad Medicare Medicare |
$707.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.74
|
| Rate for Payer: UHC Core |
$1,340.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.38
|
| Rate for Payer: UHC Exchange |
$1,340.74
|
| Rate for Payer: UHC Medicaid |
$454.76
|
| Rate for Payer: UHCCP Medicaid |
$454.76
|
| Rate for Payer: UMR Bronson Commercial |
$805.00
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$165.50 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Aetna Commercial |
$345.49
|
| Rate for Payer: Aetna Medicare |
$268.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.28
|
| Rate for Payer: BCBS Complete |
$173.78
|
| Rate for Payer: BCBS MAPPO |
$257.83
|
| Rate for Payer: BCN Commercial |
$434.24
|
| Rate for Payer: BCN Medicare Advantage |
$257.83
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cofinity Commercial |
$345.49
|
| Rate for Payer: Cofinity Commercial |
$371.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.72
|
| Rate for Payer: Meridian Medicaid |
$173.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.61
|
| Rate for Payer: Nomi Health Commercial |
$309.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.00
|
| Rate for Payer: PACE SWMI |
$257.83
|
| Rate for Payer: PHP Commercial |
$360.96
|
| Rate for Payer: PHP Medicare Advantage |
$257.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$473.03
|
| Rate for Payer: Priority Health Medicare |
$257.83
|
| Rate for Payer: Priority Health SBD |
$473.03
|
| Rate for Payer: Priority Health Tiered Network |
$473.03
|
| Rate for Payer: Railroad Medicare Medicare |
$257.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.40
|
| Rate for Payer: UHC Core |
$520.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.83
|
| Rate for Payer: UHC Exchange |
$520.40
|
| Rate for Payer: UHC Medicaid |
$165.50
|
| Rate for Payer: UHCCP Medicaid |
$165.50
|
| Rate for Payer: UMR Bronson Commercial |
$344.08
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$408.96 |
| Max. Negotiated Rate |
$1,941.75 |
| Rate for Payer: Aetna Commercial |
$845.98
|
| Rate for Payer: Aetna Medicare |
$656.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.12
|
| Rate for Payer: BCBS Complete |
$429.41
|
| Rate for Payer: BCBS MAPPO |
$631.33
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: BCN Medicare Advantage |
$631.33
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$845.98
|
| Rate for Payer: Cofinity Commercial |
$909.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.90
|
| Rate for Payer: Meridian Medicaid |
$429.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.46
|
| Rate for Payer: Nomi Health Commercial |
$757.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,941.75
|
| Rate for Payer: PACE SWMI |
$631.33
|
| Rate for Payer: PHP Commercial |
$883.86
|
| Rate for Payer: PHP Medicare Advantage |
$631.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,151.66
|
| Rate for Payer: Priority Health Medicare |
$631.33
|
| Rate for Payer: Priority Health SBD |
$1,151.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.66
|
| Rate for Payer: Railroad Medicare Medicare |
$631.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.40
|
| Rate for Payer: UHC Core |
$1,296.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.33
|
| Rate for Payer: UHC Exchange |
$1,296.40
|
| Rate for Payer: UHC Medicaid |
$408.96
|
| Rate for Payer: UHCCP Medicaid |
$408.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,190.94
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$399.64
|
| Rate for Payer: Aetna Medicare |
$310.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.47
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$298.24
|
| Rate for Payer: BCN Commercial |
$504.45
|
| Rate for Payer: BCN Medicare Advantage |
$298.24
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$399.64
|
| Rate for Payer: Cofinity Commercial |
$429.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.15
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.06
|
| Rate for Payer: Nomi Health Commercial |
$357.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.00
|
| Rate for Payer: PACE SWMI |
$298.24
|
| Rate for Payer: PHP Commercial |
$417.54
|
| Rate for Payer: PHP Medicare Advantage |
$298.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$549.52
|
| Rate for Payer: Priority Health Medicare |
$298.24
|
| Rate for Payer: Priority Health SBD |
$549.52
|
| Rate for Payer: Priority Health Tiered Network |
$549.52
|
| Rate for Payer: Railroad Medicare Medicare |
$298.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.35
|
| Rate for Payer: UHC Core |
$605.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$298.24
|
| Rate for Payer: UHC Exchange |
$605.35
|
| Rate for Payer: UHC Medicaid |
$191.27
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
| Rate for Payer: UMR Bronson Commercial |
$371.68
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$193.62 |
| Max. Negotiated Rate |
$642.00 |
| Rate for Payer: Aetna Commercial |
$404.55
|
| Rate for Payer: Aetna Medicare |
$313.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.74
|
| Rate for Payer: BCBS Complete |
$203.30
|
| Rate for Payer: BCBS MAPPO |
$301.90
|
| Rate for Payer: BCN Commercial |
$510.44
|
| Rate for Payer: BCN Medicare Advantage |
$301.90
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$404.55
|
| Rate for Payer: Cofinity Commercial |
$434.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.00
|
| Rate for Payer: Meridian Medicaid |
$203.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$362.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.00
|
| Rate for Payer: PACE SWMI |
$301.90
|
| Rate for Payer: PHP Commercial |
$422.66
|
| Rate for Payer: PHP Medicare Advantage |
$301.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$556.02
|
| Rate for Payer: Priority Health Medicare |
$301.90
|
| Rate for Payer: Priority Health SBD |
$556.02
|
| Rate for Payer: Priority Health Tiered Network |
$556.02
|
| Rate for Payer: Railroad Medicare Medicare |
$301.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.35
|
| Rate for Payer: UHC Core |
$613.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.90
|
| Rate for Payer: UHC Exchange |
$613.35
|
| Rate for Payer: UHC Medicaid |
$193.62
|
| Rate for Payer: UHCCP Medicaid |
$193.62
|
| Rate for Payer: UMR Bronson Commercial |
$393.76
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$220.88 |
| Max. Negotiated Rate |
$701.25 |
| Rate for Payer: Aetna Commercial |
$461.80
|
| Rate for Payer: Aetna Medicare |
$358.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.27
|
| Rate for Payer: BCBS Complete |
$231.92
|
| Rate for Payer: BCBS MAPPO |
$344.63
|
| Rate for Payer: BCN Commercial |
$581.64
|
| Rate for Payer: BCN Medicare Advantage |
$344.63
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$461.80
|
| Rate for Payer: Cofinity Commercial |
$496.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.86
|
| Rate for Payer: Meridian Medicaid |
$231.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.09
|
| Rate for Payer: Nomi Health Commercial |
$413.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.25
|
| Rate for Payer: PACE SWMI |
$344.63
|
| Rate for Payer: PHP Commercial |
$482.48
|
| Rate for Payer: PHP Medicare Advantage |
$344.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$633.60
|
| Rate for Payer: Priority Health Medicare |
$344.63
|
| Rate for Payer: Priority Health SBD |
$633.60
|
| Rate for Payer: Priority Health Tiered Network |
$633.60
|
| Rate for Payer: Railroad Medicare Medicare |
$344.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.72
|
| Rate for Payer: UHC Core |
$697.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.63
|
| Rate for Payer: UHC Exchange |
$697.72
|
| Rate for Payer: UHC Medicaid |
$220.88
|
| Rate for Payer: UHCCP Medicaid |
$220.88
|
| Rate for Payer: UMR Bronson Commercial |
$430.10
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$176.36 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Aetna Commercial |
$368.30
|
| Rate for Payer: Aetna Medicare |
$285.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.78
|
| Rate for Payer: BCBS Complete |
$185.18
|
| Rate for Payer: BCBS MAPPO |
$274.85
|
| Rate for Payer: BCN Commercial |
$463.62
|
| Rate for Payer: BCN Medicare Advantage |
$274.85
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cofinity Commercial |
$368.30
|
| Rate for Payer: Cofinity Commercial |
$395.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.59
|
| Rate for Payer: Meridian Medicaid |
$185.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.33
|
| Rate for Payer: Nomi Health Commercial |
$329.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.00
|
| Rate for Payer: PACE SWMI |
$274.85
|
| Rate for Payer: PHP Commercial |
$384.79
|
| Rate for Payer: PHP Medicare Advantage |
$274.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$505.04
|
| Rate for Payer: Priority Health Medicare |
$274.85
|
| Rate for Payer: Priority Health SBD |
$505.04
|
| Rate for Payer: Priority Health Tiered Network |
$505.04
|
| Rate for Payer: Railroad Medicare Medicare |
$274.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.82
|
| Rate for Payer: UHC Core |
$554.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$274.85
|
| Rate for Payer: UHC Exchange |
$554.82
|
| Rate for Payer: UHC Medicaid |
$176.36
|
| Rate for Payer: UHCCP Medicaid |
$176.36
|
| Rate for Payer: UMR Bronson Commercial |
$344.08
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$274.34 |
| Max. Negotiated Rate |
$871.37 |
| Rate for Payer: Aetna Commercial |
$574.19
|
| Rate for Payer: Aetna Medicare |
$445.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.04
|
| Rate for Payer: BCBS Complete |
$288.06
|
| Rate for Payer: BCBS MAPPO |
$428.50
|
| Rate for Payer: BCN Commercial |
$724.06
|
| Rate for Payer: BCN Medicare Advantage |
$428.50
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cofinity Commercial |
$574.19
|
| Rate for Payer: Cofinity Commercial |
$617.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.93
|
| Rate for Payer: Meridian Medicaid |
$288.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$471.35
|
| Rate for Payer: Nomi Health Commercial |
$514.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.25
|
| Rate for Payer: PACE SWMI |
$428.50
|
| Rate for Payer: PHP Commercial |
$599.90
|
| Rate for Payer: PHP Medicare Advantage |
$428.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$788.74
|
| Rate for Payer: Priority Health Medicare |
$428.50
|
| Rate for Payer: Priority Health SBD |
$788.74
|
| Rate for Payer: Priority Health Tiered Network |
$788.74
|
| Rate for Payer: Railroad Medicare Medicare |
$428.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.37
|
| Rate for Payer: UHC Core |
$871.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$428.50
|
| Rate for Payer: UHC Exchange |
$871.37
|
| Rate for Payer: UHC Medicaid |
$274.34
|
| Rate for Payer: UHCCP Medicaid |
$274.34
|
| Rate for Payer: UMR Bronson Commercial |
$452.18
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$621.32 |
| Max. Negotiated Rate |
$1,906.44 |
| Rate for Payer: Aetna Commercial |
$1,300.20
|
| Rate for Payer: Aetna Medicare |
$1,009.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.23
|
| Rate for Payer: BCBS Complete |
$652.39
|
| Rate for Payer: BCBS MAPPO |
$970.30
|
| Rate for Payer: BCN Commercial |
$1,564.66
|
| Rate for Payer: BCN Medicare Advantage |
$970.30
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cofinity Commercial |
$1,300.20
|
| Rate for Payer: Cofinity Commercial |
$1,397.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.82
|
| Rate for Payer: Meridian Medicaid |
$652.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,067.33
|
| Rate for Payer: Nomi Health Commercial |
$1,164.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.25
|
| Rate for Payer: PACE SWMI |
$970.30
|
| Rate for Payer: PHP Commercial |
$1,358.42
|
| Rate for Payer: PHP Medicare Advantage |
$970.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,906.44
|
| Rate for Payer: Priority Health Medicare |
$970.30
|
| Rate for Payer: Priority Health SBD |
$1,906.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,906.44
|
| Rate for Payer: Railroad Medicare Medicare |
$970.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,864.24
|
| Rate for Payer: UHC Core |
$1,864.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$970.30
|
| Rate for Payer: UHC Exchange |
$1,864.24
|
| Rate for Payer: UHC Medicaid |
$621.32
|
| Rate for Payer: UHCCP Medicaid |
$621.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,007.86
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$334.93 |
| Rate for Payer: Aetna Commercial |
$233.07
|
| Rate for Payer: Aetna Medicare |
$180.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.46
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$173.93
|
| Rate for Payer: BCN Commercial |
$274.89
|
| Rate for Payer: BCN Medicare Advantage |
$173.93
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$233.07
|
| Rate for Payer: Cofinity Commercial |
$250.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.63
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.32
|
| Rate for Payer: Nomi Health Commercial |
$208.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.25
|
| Rate for Payer: PACE SWMI |
$173.93
|
| Rate for Payer: PHP Commercial |
$243.50
|
| Rate for Payer: PHP Medicare Advantage |
$173.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$334.93
|
| Rate for Payer: Priority Health Medicare |
$173.93
|
| Rate for Payer: Priority Health SBD |
$334.93
|
| Rate for Payer: Priority Health Tiered Network |
$334.93
|
| Rate for Payer: Railroad Medicare Medicare |
$173.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.53
|
| Rate for Payer: UHC Core |
$311.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.93
|
| Rate for Payer: UHC Exchange |
$311.53
|
| Rate for Payer: UHC Medicaid |
$113.53
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
| Rate for Payer: UMR Bronson Commercial |
$161.46
|
|
|
PR REPAIR ANORECTAL FISTULA PLUG
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 46707
|
| Min. Negotiated Rate |
$327.38 |
| Max. Negotiated Rate |
$936.83 |
| Rate for Payer: Aetna Commercial |
$668.38
|
| Rate for Payer: Aetna Medicare |
$518.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$668.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.26
|
| Rate for Payer: BCBS Complete |
$343.75
|
| Rate for Payer: BCBS MAPPO |
$498.79
|
| Rate for Payer: BCN Commercial |
$768.88
|
| Rate for Payer: BCN Medicare Advantage |
$498.79
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$668.38
|
| Rate for Payer: Cofinity Commercial |
$718.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.73
|
| Rate for Payer: Meridian Medicaid |
$343.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.67
|
| Rate for Payer: Nomi Health Commercial |
$598.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.00
|
| Rate for Payer: PACE SWMI |
$498.79
|
| Rate for Payer: PHP Commercial |
$698.31
|
| Rate for Payer: PHP Medicare Advantage |
$498.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$936.83
|
| Rate for Payer: Priority Health Medicare |
$498.79
|
| Rate for Payer: Priority Health SBD |
$936.83
|
| Rate for Payer: Priority Health Tiered Network |
$936.83
|
| Rate for Payer: Railroad Medicare Medicare |
$498.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.31
|
| Rate for Payer: UHC Core |
$870.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.79
|
| Rate for Payer: UHC Exchange |
$870.31
|
| Rate for Payer: UHC Medicaid |
$327.38
|
| Rate for Payer: UHCCP Medicaid |
$327.38
|
| Rate for Payer: UMR Bronson Commercial |
$491.28
|
|
|
PR REPAIR BIFID EARLOBES - BILATERAL
|
Professional
|
Both
|
$1,391.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$556.40 |
| Max. Negotiated Rate |
$1,043.25 |
| Rate for Payer: Aetna Medicare |
$695.50
|
| Rate for Payer: BCBS Complete |
$556.40
|
| Rate for Payer: Cash Price |
$1,112.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,043.25
|
| Rate for Payer: UMR Bronson Commercial |
$639.86
|
|
