|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$1,715.25 |
| Rate for Payer: Aetna Commercial |
$914.91
|
| Rate for Payer: Aetna Medicare |
$710.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.19
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$682.77
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$682.77
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$914.91
|
| Rate for Payer: Cofinity Commercial |
$983.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.91
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$751.05
|
| Rate for Payer: Nomi Health Commercial |
$819.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,715.25
|
| Rate for Payer: PACE SWMI |
$682.77
|
| Rate for Payer: PHP Commercial |
$955.88
|
| Rate for Payer: PHP Medicare Advantage |
$682.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,158.31
|
| Rate for Payer: Priority Health Medicare |
$682.77
|
| Rate for Payer: Priority Health SBD |
$1,158.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,158.31
|
| Rate for Payer: Railroad Medicare Medicare |
$682.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.33
|
| Rate for Payer: UHC Core |
$1,333.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$682.77
|
| Rate for Payer: UHC Exchange |
$1,333.33
|
| Rate for Payer: UHC Medicaid |
$431.54
|
| Rate for Payer: UHCCP Medicaid |
$431.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.02
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$1,054.50 |
| Rate for Payer: Aetna Commercial |
$102.17
|
| Rate for Payer: Aetna Medicare |
$79.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.80
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS MAPPO |
$76.25
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$76.25
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Cofinity Commercial |
$109.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.06
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.88
|
| Rate for Payer: Nomi Health Commercial |
$91.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,054.50
|
| Rate for Payer: PACE SWMI |
$76.25
|
| Rate for Payer: PHP Commercial |
$106.75
|
| Rate for Payer: PHP Medicare Advantage |
$76.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.76
|
| Rate for Payer: Priority Health Medicare |
$76.25
|
| Rate for Payer: Priority Health SBD |
$157.76
|
| Rate for Payer: Priority Health Tiered Network |
$157.76
|
| Rate for Payer: Railroad Medicare Medicare |
$76.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.74
|
| Rate for Payer: UHC Core |
$160.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.25
|
| Rate for Payer: UHC Exchange |
$160.74
|
| Rate for Payer: UHC Medicaid |
$48.56
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
| Rate for Payer: UMR Bronson Commercial |
$646.76
|
|
|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$933.75 |
| Rate for Payer: Aetna Commercial |
$75.68
|
| Rate for Payer: Aetna Medicare |
$58.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.33
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$56.48
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: BCN Medicare Advantage |
$56.48
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.30
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.13
|
| Rate for Payer: Nomi Health Commercial |
$67.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$933.75
|
| Rate for Payer: PACE SWMI |
$56.48
|
| Rate for Payer: PHP Commercial |
$79.07
|
| Rate for Payer: PHP Medicare Advantage |
$56.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$117.71
|
| Rate for Payer: Priority Health Medicare |
$56.48
|
| Rate for Payer: Priority Health SBD |
$117.71
|
| Rate for Payer: Priority Health Tiered Network |
$117.71
|
| Rate for Payer: Railroad Medicare Medicare |
$56.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.64
|
| Rate for Payer: UHC Core |
$117.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.48
|
| Rate for Payer: UHC Exchange |
$117.64
|
| Rate for Payer: UHC Medicaid |
$36.00
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
| Rate for Payer: UMR Bronson Commercial |
$572.70
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,538.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$1,153.50 |
| Rate for Payer: Aetna Commercial |
$156.78
|
| Rate for Payer: Aetna Medicare |
$121.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.48
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$117.00
|
| Rate for Payer: BCN Commercial |
$199.19
|
| Rate for Payer: BCN Medicare Advantage |
$117.00
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cofinity Commercial |
$156.78
|
| Rate for Payer: Cofinity Commercial |
$168.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.85
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.70
|
| Rate for Payer: Nomi Health Commercial |
$140.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,153.50
|
| Rate for Payer: PACE SWMI |
$117.00
|
| Rate for Payer: PHP Commercial |
$163.80
|
| Rate for Payer: PHP Medicare Advantage |
$117.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$242.71
|
| Rate for Payer: Priority Health Medicare |
$117.00
|
| Rate for Payer: Priority Health SBD |
$242.71
|
| Rate for Payer: Priority Health Tiered Network |
$242.71
|
| Rate for Payer: Railroad Medicare Medicare |
$117.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.62
|
| Rate for Payer: UHC Core |
$247.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.00
|
| Rate for Payer: UHC Exchange |
$247.62
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
| Rate for Payer: UMR Bronson Commercial |
$707.48
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$6,040.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$1,672.69 |
| Max. Negotiated Rate |
$4,995.66 |
| Rate for Payer: Aetna Commercial |
$3,520.80
|
| Rate for Payer: Aetna Medicare |
$2,732.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,520.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,783.54
|
| Rate for Payer: BCBS Complete |
$1,756.32
|
| Rate for Payer: BCBS MAPPO |
$2,627.46
|
| Rate for Payer: BCN Commercial |
$4,116.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,627.46
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Cofinity Commercial |
$3,520.80
|
| Rate for Payer: Cofinity Commercial |
$3,783.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,627.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,758.83
|
| Rate for Payer: Meridian Medicaid |
$1,756.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,890.21
|
| Rate for Payer: Nomi Health Commercial |
$3,152.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,530.00
|
| Rate for Payer: PACE SWMI |
$2,627.46
|
| Rate for Payer: PHP Commercial |
$3,678.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,627.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,672.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,426.57
|
| Rate for Payer: Priority Health Medicare |
$2,627.46
|
| Rate for Payer: Priority Health SBD |
$4,426.57
|
| Rate for Payer: Priority Health Tiered Network |
$4,426.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,627.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,995.66
|
| Rate for Payer: UHC Core |
$4,995.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,627.46
|
| Rate for Payer: UHC Exchange |
$4,995.66
|
| Rate for Payer: UHC Medicaid |
$1,672.69
|
| Rate for Payer: UHCCP Medicaid |
$1,672.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,778.40
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$1,062.65 |
| Rate for Payer: Aetna Commercial |
$674.45
|
| Rate for Payer: Aetna Medicare |
$523.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.78
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS MAPPO |
$503.32
|
| Rate for Payer: BCN Commercial |
$852.54
|
| Rate for Payer: BCN Medicare Advantage |
$503.32
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$674.45
|
| Rate for Payer: Cofinity Commercial |
$724.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.49
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$553.65
|
| Rate for Payer: Nomi Health Commercial |
$603.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: PACE SWMI |
$503.32
|
| Rate for Payer: PHP Commercial |
$704.65
|
| Rate for Payer: PHP Medicare Advantage |
$503.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$780.29
|
| Rate for Payer: Priority Health Medicare |
$503.32
|
| Rate for Payer: Priority Health SBD |
$780.29
|
| Rate for Payer: Priority Health Tiered Network |
$780.29
|
| Rate for Payer: Railroad Medicare Medicare |
$503.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,062.65
|
| Rate for Payer: UHC Core |
$1,062.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.32
|
| Rate for Payer: UHC Exchange |
$1,062.65
|
| Rate for Payer: UHC Medicaid |
$329.94
|
| Rate for Payer: UHCCP Medicaid |
$329.94
|
| Rate for Payer: UMR Bronson Commercial |
$523.02
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$9,074.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$1,634.99 |
| Max. Negotiated Rate |
$6,805.50 |
| Rate for Payer: Aetna Commercial |
$3,446.20
|
| Rate for Payer: Aetna Medicare |
$2,674.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,446.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,703.38
|
| Rate for Payer: BCBS Complete |
$1,716.74
|
| Rate for Payer: BCBS MAPPO |
$2,571.79
|
| Rate for Payer: BCN Commercial |
$4,039.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,571.79
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Cofinity Commercial |
$3,446.20
|
| Rate for Payer: Cofinity Commercial |
$3,703.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,571.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,700.38
|
| Rate for Payer: Meridian Medicaid |
$1,716.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,828.97
|
| Rate for Payer: Nomi Health Commercial |
$3,086.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,805.50
|
| Rate for Payer: PACE SWMI |
$2,571.79
|
| Rate for Payer: PHP Commercial |
$3,600.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,571.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,634.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,344.11
|
| Rate for Payer: Priority Health Medicare |
$2,571.79
|
| Rate for Payer: Priority Health SBD |
$4,344.11
|
| Rate for Payer: Priority Health Tiered Network |
$4,344.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,571.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,921.03
|
| Rate for Payer: UHC Core |
$4,921.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,571.79
|
| Rate for Payer: UHC Exchange |
$4,921.03
|
| Rate for Payer: UHC Medicaid |
$1,634.99
|
| Rate for Payer: UHCCP Medicaid |
$1,634.99
|
| Rate for Payer: UMR Bronson Commercial |
$4,174.04
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$509.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$381.75 |
| Rate for Payer: Aetna Commercial |
$191.45
|
| Rate for Payer: Aetna Medicare |
$148.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.73
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCBS MAPPO |
$142.87
|
| Rate for Payer: BCN Commercial |
$242.02
|
| Rate for Payer: BCN Medicare Advantage |
$142.87
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Cofinity Commercial |
$191.45
|
| Rate for Payer: Cofinity Commercial |
$205.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.01
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.16
|
| Rate for Payer: Nomi Health Commercial |
$171.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.75
|
| Rate for Payer: PACE SWMI |
$142.87
|
| Rate for Payer: PHP Commercial |
$200.02
|
| Rate for Payer: PHP Medicare Advantage |
$142.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$260.25
|
| Rate for Payer: Priority Health Medicare |
$142.87
|
| Rate for Payer: Priority Health SBD |
$260.25
|
| Rate for Payer: Priority Health Tiered Network |
$260.25
|
| Rate for Payer: Railroad Medicare Medicare |
$142.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.47
|
| Rate for Payer: UHC Core |
$310.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.87
|
| Rate for Payer: UHC Exchange |
$310.47
|
| Rate for Payer: UHC Medicaid |
$90.74
|
| Rate for Payer: UHCCP Medicaid |
$90.74
|
| Rate for Payer: UMR Bronson Commercial |
$234.14
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$118.63
|
| Rate for Payer: Aetna Medicare |
$92.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.48
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$88.53
|
| Rate for Payer: BCN Commercial |
$153.38
|
| Rate for Payer: BCN Medicare Advantage |
$88.53
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cofinity Commercial |
$118.63
|
| Rate for Payer: Cofinity Commercial |
$127.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.96
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.38
|
| Rate for Payer: Nomi Health Commercial |
$106.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: PACE SWMI |
$88.53
|
| Rate for Payer: PHP Commercial |
$123.94
|
| Rate for Payer: PHP Medicare Advantage |
$88.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.89
|
| Rate for Payer: Priority Health Medicare |
$88.53
|
| Rate for Payer: Priority Health SBD |
$186.89
|
| Rate for Payer: Priority Health Tiered Network |
$186.89
|
| Rate for Payer: Railroad Medicare Medicare |
$88.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.10
|
| Rate for Payer: UHC Core |
$185.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.53
|
| Rate for Payer: UHC Exchange |
$185.10
|
| Rate for Payer: UHC Medicaid |
$56.45
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
| Rate for Payer: UMR Bronson Commercial |
$178.02
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$228.98 |
| Max. Negotiated Rate |
$708.28 |
| Rate for Payer: Aetna Commercial |
$478.47
|
| Rate for Payer: Aetna Medicare |
$371.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.18
|
| Rate for Payer: BCBS Complete |
$240.43
|
| Rate for Payer: BCBS MAPPO |
$357.07
|
| Rate for Payer: BCN Commercial |
$592.59
|
| Rate for Payer: BCN Medicare Advantage |
$357.07
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$478.47
|
| Rate for Payer: Cofinity Commercial |
$514.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.92
|
| Rate for Payer: Meridian Medicaid |
$240.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.78
|
| Rate for Payer: Nomi Health Commercial |
$428.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$650.25
|
| Rate for Payer: PACE SWMI |
$357.07
|
| Rate for Payer: PHP Commercial |
$499.90
|
| Rate for Payer: PHP Medicare Advantage |
$357.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$637.26
|
| Rate for Payer: Priority Health Medicare |
$357.07
|
| Rate for Payer: Priority Health SBD |
$637.26
|
| Rate for Payer: Priority Health Tiered Network |
$637.26
|
| Rate for Payer: Railroad Medicare Medicare |
$357.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.28
|
| Rate for Payer: UHC Core |
$708.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.07
|
| Rate for Payer: UHC Exchange |
$708.28
|
| Rate for Payer: UHC Medicaid |
$228.98
|
| Rate for Payer: UHCCP Medicaid |
$228.98
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$98.95 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$132.59
|
| Rate for Payer: Aetna Medicare |
$102.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.49
|
| Rate for Payer: BCBS MAPPO |
$98.95
|
| Rate for Payer: BCN Commercial |
$182.32
|
| Rate for Payer: BCN Medicare Advantage |
$98.95
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$132.59
|
| Rate for Payer: Cofinity Commercial |
$142.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.84
|
| Rate for Payer: Nomi Health Commercial |
$118.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$98.95
|
| Rate for Payer: PHP Commercial |
$138.53
|
| Rate for Payer: PHP Medicare Advantage |
$98.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$153.28
|
| Rate for Payer: Priority Health Medicare |
$98.95
|
| Rate for Payer: Priority Health SBD |
$153.28
|
| Rate for Payer: Priority Health Tiered Network |
$153.28
|
| Rate for Payer: Railroad Medicare Medicare |
$98.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.05
|
| Rate for Payer: UHC Core |
$138.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.95
|
| Rate for Payer: UHC Exchange |
$138.05
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$5,079.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$1,224.11 |
| Max. Negotiated Rate |
$3,809.25 |
| Rate for Payer: Aetna Commercial |
$2,574.06
|
| Rate for Payer: Aetna Medicare |
$1,997.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,574.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,766.15
|
| Rate for Payer: BCBS Complete |
$1,285.32
|
| Rate for Payer: BCBS MAPPO |
$1,920.94
|
| Rate for Payer: BCN Commercial |
$3,012.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,920.94
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cofinity Commercial |
$2,766.15
|
| Rate for Payer: Cofinity Commercial |
$2,574.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,920.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,016.99
|
| Rate for Payer: Meridian Medicaid |
$1,285.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,113.03
|
| Rate for Payer: Nomi Health Commercial |
$2,305.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,809.25
|
| Rate for Payer: PACE SWMI |
$1,920.94
|
| Rate for Payer: PHP Commercial |
$2,689.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,920.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,224.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,836.68
|
| Rate for Payer: Priority Health Medicare |
$1,920.94
|
| Rate for Payer: Priority Health SBD |
$2,836.68
|
| Rate for Payer: Priority Health Tiered Network |
$2,836.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,920.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,638.25
|
| Rate for Payer: UHC Core |
$3,638.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,920.94
|
| Rate for Payer: UHC Exchange |
$3,638.25
|
| Rate for Payer: UHC Medicaid |
$1,224.11
|
| Rate for Payer: UHCCP Medicaid |
$1,224.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,336.34
|
|
|
PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ
|
Professional
|
Both
|
$3,780.00
|
|
|
Service Code
|
HCPCS 32503
|
| Min. Negotiated Rate |
$1,079.70 |
| Max. Negotiated Rate |
$3,190.27 |
| Rate for Payer: Aetna Commercial |
$2,267.39
|
| Rate for Payer: Aetna Medicare |
$1,759.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,267.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,436.60
|
| Rate for Payer: BCBS Complete |
$1,133.68
|
| Rate for Payer: BCBS MAPPO |
$1,692.08
|
| Rate for Payer: BCN Commercial |
$2,647.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,692.08
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Cash Price |
$3,024.00
|
| Rate for Payer: Cofinity Commercial |
$2,267.39
|
| Rate for Payer: Cofinity Commercial |
$2,436.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,692.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,776.68
|
| Rate for Payer: Meridian Medicaid |
$1,133.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,861.29
|
| Rate for Payer: Nomi Health Commercial |
$2,030.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,835.00
|
| Rate for Payer: PACE SWMI |
$1,692.08
|
| Rate for Payer: PHP Commercial |
$2,368.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,692.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,079.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,493.40
|
| Rate for Payer: Priority Health Medicare |
$1,692.08
|
| Rate for Payer: Priority Health SBD |
$2,493.40
|
| Rate for Payer: Priority Health Tiered Network |
$2,493.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,692.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,190.27
|
| Rate for Payer: UHC Core |
$3,190.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,692.08
|
| Rate for Payer: UHC Exchange |
$3,190.27
|
| Rate for Payer: UHC Medicaid |
$1,079.70
|
| Rate for Payer: UHCCP Medicaid |
$1,079.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,738.80
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$776.60 |
| Max. Negotiated Rate |
$2,191.46 |
| Rate for Payer: Aetna Commercial |
$1,613.72
|
| Rate for Payer: Aetna Medicare |
$1,252.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,613.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,734.15
|
| Rate for Payer: BCBS Complete |
$815.43
|
| Rate for Payer: BCBS MAPPO |
$1,204.27
|
| Rate for Payer: BCN Commercial |
$1,883.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,204.27
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,613.72
|
| Rate for Payer: Cofinity Commercial |
$1,734.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,204.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,264.48
|
| Rate for Payer: Meridian Medicaid |
$815.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,324.70
|
| Rate for Payer: Nomi Health Commercial |
$1,445.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: PACE SWMI |
$1,204.27
|
| Rate for Payer: PHP Commercial |
$1,685.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,204.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$776.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,025.86
|
| Rate for Payer: Priority Health Medicare |
$1,204.27
|
| Rate for Payer: Priority Health SBD |
$2,025.86
|
| Rate for Payer: Priority Health Tiered Network |
$2,025.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,204.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,191.46
|
| Rate for Payer: UHC Core |
$2,191.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,204.27
|
| Rate for Payer: UHC Exchange |
$2,191.46
|
| Rate for Payer: UHC Medicaid |
$776.60
|
| Rate for Payer: UHCCP Medicaid |
$776.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.34
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,786.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$483.94 |
| Max. Negotiated Rate |
$2,839.50 |
| Rate for Payer: Aetna Commercial |
$1,007.28
|
| Rate for Payer: Aetna Medicare |
$781.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.45
|
| Rate for Payer: BCBS Complete |
$508.14
|
| Rate for Payer: BCBS MAPPO |
$751.70
|
| Rate for Payer: BCN Commercial |
$1,205.61
|
| Rate for Payer: BCN Medicare Advantage |
$751.70
|
| Rate for Payer: Cash Price |
$3,028.80
|
| Rate for Payer: Cash Price |
$3,028.80
|
| Rate for Payer: Cofinity Commercial |
$1,007.28
|
| Rate for Payer: Cofinity Commercial |
$1,082.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$789.28
|
| Rate for Payer: Meridian Medicaid |
$508.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$826.87
|
| Rate for Payer: Nomi Health Commercial |
$902.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.50
|
| Rate for Payer: PACE SWMI |
$751.70
|
| Rate for Payer: PHP Commercial |
$1,052.38
|
| Rate for Payer: PHP Medicare Advantage |
$751.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,296.49
|
| Rate for Payer: Priority Health Medicare |
$751.70
|
| Rate for Payer: Priority Health SBD |
$1,296.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,296.49
|
| Rate for Payer: Railroad Medicare Medicare |
$751.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.85
|
| Rate for Payer: UHC Core |
$1,414.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$751.70
|
| Rate for Payer: UHC Exchange |
$1,414.85
|
| Rate for Payer: UHC Medicaid |
$483.94
|
| Rate for Payer: UHCCP Medicaid |
$483.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,741.56
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,580.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$1,221.13 |
| Max. Negotiated Rate |
$4,185.00 |
| Rate for Payer: Aetna Commercial |
$2,519.37
|
| Rate for Payer: Aetna Medicare |
$1,955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,519.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,707.39
|
| Rate for Payer: BCBS Complete |
$1,282.19
|
| Rate for Payer: BCBS MAPPO |
$1,880.13
|
| Rate for Payer: BCN Commercial |
$3,166.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,880.13
|
| Rate for Payer: Cash Price |
$4,464.00
|
| Rate for Payer: Cash Price |
$4,464.00
|
| Rate for Payer: Cofinity Commercial |
$2,519.37
|
| Rate for Payer: Cofinity Commercial |
$2,707.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,880.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,974.14
|
| Rate for Payer: Meridian Medicaid |
$1,282.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,068.14
|
| Rate for Payer: Nomi Health Commercial |
$2,256.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,185.00
|
| Rate for Payer: PACE SWMI |
$1,880.13
|
| Rate for Payer: PHP Commercial |
$2,632.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,880.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,221.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,678.01
|
| Rate for Payer: Priority Health Medicare |
$1,880.13
|
| Rate for Payer: Priority Health SBD |
$3,678.01
|
| Rate for Payer: Priority Health Tiered Network |
$3,678.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,880.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,718.10
|
| Rate for Payer: UHC Core |
$3,718.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,880.13
|
| Rate for Payer: UHC Exchange |
$3,718.10
|
| Rate for Payer: UHC Medicaid |
$1,221.13
|
| Rate for Payer: UHCCP Medicaid |
$1,221.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,566.80
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,688.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$1,530.83 |
| Max. Negotiated Rate |
$5,766.00 |
| Rate for Payer: Aetna Commercial |
$3,170.59
|
| Rate for Payer: Aetna Medicare |
$2,460.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,170.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,407.20
|
| Rate for Payer: BCBS Complete |
$1,607.37
|
| Rate for Payer: BCBS MAPPO |
$2,366.11
|
| Rate for Payer: BCN Commercial |
$5,040.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,366.11
|
| Rate for Payer: Cash Price |
$6,150.40
|
| Rate for Payer: Cash Price |
$6,150.40
|
| Rate for Payer: Cofinity Commercial |
$3,170.59
|
| Rate for Payer: Cofinity Commercial |
$3,407.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,366.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,484.42
|
| Rate for Payer: Meridian Medicaid |
$1,607.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,602.72
|
| Rate for Payer: Nomi Health Commercial |
$2,839.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,766.00
|
| Rate for Payer: PACE SWMI |
$2,366.11
|
| Rate for Payer: PHP Commercial |
$3,312.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,366.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,237.32
|
| Rate for Payer: Priority Health Medicare |
$2,366.11
|
| Rate for Payer: Priority Health SBD |
$4,237.32
|
| Rate for Payer: Priority Health Tiered Network |
$4,237.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,366.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,221.69
|
| Rate for Payer: UHC Core |
$4,221.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,366.11
|
| Rate for Payer: UHC Exchange |
$4,221.69
|
| Rate for Payer: UHC Medicaid |
$1,530.83
|
| Rate for Payer: UHCCP Medicaid |
$1,530.83
|
| Rate for Payer: UMR Bronson Commercial |
$3,536.48
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$7,183.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$2,012.21 |
| Max. Negotiated Rate |
$6,919.64 |
| Rate for Payer: Aetna Commercial |
$4,199.35
|
| Rate for Payer: Aetna Medicare |
$3,259.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,199.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,512.73
|
| Rate for Payer: BCBS Complete |
$2,112.82
|
| Rate for Payer: BCBS MAPPO |
$3,133.84
|
| Rate for Payer: BCN Commercial |
$6,919.64
|
| Rate for Payer: BCN Medicare Advantage |
$3,133.84
|
| Rate for Payer: Cash Price |
$5,746.40
|
| Rate for Payer: Cash Price |
$5,746.40
|
| Rate for Payer: Cofinity Commercial |
$4,199.35
|
| Rate for Payer: Cofinity Commercial |
$4,512.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,133.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,290.53
|
| Rate for Payer: Meridian Medicaid |
$2,112.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,447.22
|
| Rate for Payer: Nomi Health Commercial |
$3,760.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,387.25
|
| Rate for Payer: PACE SWMI |
$3,133.84
|
| Rate for Payer: PHP Commercial |
$4,387.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,133.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,012.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,817.50
|
| Rate for Payer: Priority Health Medicare |
$3,133.84
|
| Rate for Payer: Priority Health SBD |
$5,817.50
|
| Rate for Payer: Priority Health Tiered Network |
$5,817.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,133.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,847.58
|
| Rate for Payer: UHC Core |
$5,847.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,133.84
|
| Rate for Payer: UHC Exchange |
$5,847.58
|
| Rate for Payer: UHC Medicaid |
$2,012.21
|
| Rate for Payer: UHCCP Medicaid |
$2,012.21
|
| Rate for Payer: UMR Bronson Commercial |
$3,304.18
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,442.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$1,797.29 |
| Max. Negotiated Rate |
$5,581.50 |
| Rate for Payer: Aetna Commercial |
$3,726.37
|
| Rate for Payer: Aetna Medicare |
$2,892.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,726.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,004.45
|
| Rate for Payer: BCBS Complete |
$1,887.15
|
| Rate for Payer: BCBS MAPPO |
$2,780.87
|
| Rate for Payer: BCN Commercial |
$4,248.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,780.87
|
| Rate for Payer: Cash Price |
$5,953.60
|
| Rate for Payer: Cash Price |
$5,953.60
|
| Rate for Payer: Cofinity Commercial |
$3,726.37
|
| Rate for Payer: Cofinity Commercial |
$4,004.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,780.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,919.91
|
| Rate for Payer: Meridian Medicaid |
$1,887.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,058.96
|
| Rate for Payer: Nomi Health Commercial |
$3,337.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,581.50
|
| Rate for Payer: PACE SWMI |
$2,780.87
|
| Rate for Payer: PHP Commercial |
$3,893.22
|
| Rate for Payer: PHP Medicare Advantage |
$2,780.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,797.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,934.86
|
| Rate for Payer: Priority Health Medicare |
$2,780.87
|
| Rate for Payer: Priority Health SBD |
$4,934.86
|
| Rate for Payer: Priority Health Tiered Network |
$4,934.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,780.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,932.45
|
| Rate for Payer: UHC Core |
$4,932.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,780.87
|
| Rate for Payer: UHC Exchange |
$4,932.45
|
| Rate for Payer: UHC Medicaid |
$1,797.29
|
| Rate for Payer: UHCCP Medicaid |
$1,797.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,423.32
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,866.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,219.64 |
| Max. Negotiated Rate |
$3,776.22 |
| Rate for Payer: Aetna Commercial |
$2,517.35
|
| Rate for Payer: Aetna Medicare |
$1,953.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,517.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,705.21
|
| Rate for Payer: BCBS Complete |
$1,280.62
|
| Rate for Payer: BCBS MAPPO |
$1,878.62
|
| Rate for Payer: BCN Commercial |
$3,247.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,878.62
|
| Rate for Payer: Cash Price |
$3,892.80
|
| Rate for Payer: Cash Price |
$3,892.80
|
| Rate for Payer: Cofinity Commercial |
$2,517.35
|
| Rate for Payer: Cofinity Commercial |
$2,705.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,878.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,972.55
|
| Rate for Payer: Meridian Medicaid |
$1,280.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,066.48
|
| Rate for Payer: Nomi Health Commercial |
$2,254.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,649.50
|
| Rate for Payer: PACE SWMI |
$1,878.62
|
| Rate for Payer: PHP Commercial |
$2,630.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,878.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,772.30
|
| Rate for Payer: Priority Health Medicare |
$1,878.62
|
| Rate for Payer: Priority Health SBD |
$3,772.30
|
| Rate for Payer: Priority Health Tiered Network |
$3,772.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,878.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,776.22
|
| Rate for Payer: UHC Core |
$3,776.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,878.62
|
| Rate for Payer: UHC Exchange |
$3,776.22
|
| Rate for Payer: UHC Medicaid |
$1,219.64
|
| Rate for Payer: UHCCP Medicaid |
$1,219.64
|
| Rate for Payer: UMR Bronson Commercial |
$2,238.36
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,526.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$1,739.78 |
| Max. Negotiated Rate |
$7,894.50 |
| Rate for Payer: Aetna Commercial |
$3,633.38
|
| Rate for Payer: Aetna Medicare |
$2,819.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,633.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,904.53
|
| Rate for Payer: BCBS Complete |
$1,826.77
|
| Rate for Payer: BCBS MAPPO |
$2,711.48
|
| Rate for Payer: BCN Commercial |
$6,053.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,711.48
|
| Rate for Payer: Cash Price |
$8,420.80
|
| Rate for Payer: Cash Price |
$8,420.80
|
| Rate for Payer: Cofinity Commercial |
$3,633.38
|
| Rate for Payer: Cofinity Commercial |
$3,904.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,711.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,847.05
|
| Rate for Payer: Meridian Medicaid |
$1,826.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,982.63
|
| Rate for Payer: Nomi Health Commercial |
$3,253.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,894.50
|
| Rate for Payer: PACE SWMI |
$2,711.48
|
| Rate for Payer: PHP Commercial |
$3,796.07
|
| Rate for Payer: PHP Medicare Advantage |
$2,711.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,739.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,089.31
|
| Rate for Payer: Priority Health Medicare |
$2,711.48
|
| Rate for Payer: Priority Health SBD |
$5,089.31
|
| Rate for Payer: Priority Health Tiered Network |
$5,089.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,711.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.22
|
| Rate for Payer: UHC Core |
$5,166.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,711.48
|
| Rate for Payer: UHC Exchange |
$5,166.22
|
| Rate for Payer: UHC Medicaid |
$1,739.78
|
| Rate for Payer: UHCCP Medicaid |
$1,739.78
|
| Rate for Payer: UMR Bronson Commercial |
$4,841.96
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL
|
Professional
|
Both
|
$10,973.00
|
|
|
Service Code
|
HCPCS 61608
|
| Min. Negotiated Rate |
$2,016.05 |
| Max. Negotiated Rate |
$8,229.75 |
| Rate for Payer: Aetna Commercial |
$4,215.49
|
| Rate for Payer: Aetna Medicare |
$3,271.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,215.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,530.08
|
| Rate for Payer: BCBS Complete |
$2,116.85
|
| Rate for Payer: BCBS MAPPO |
$3,145.89
|
| Rate for Payer: BCN Commercial |
$6,830.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,145.89
|
| Rate for Payer: Cash Price |
$8,778.40
|
| Rate for Payer: Cash Price |
$8,778.40
|
| Rate for Payer: Cofinity Commercial |
$4,215.49
|
| Rate for Payer: Cofinity Commercial |
$4,530.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,145.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.18
|
| Rate for Payer: Meridian Medicaid |
$2,116.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.48
|
| Rate for Payer: Nomi Health Commercial |
$3,775.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,229.75
|
| Rate for Payer: PACE SWMI |
$3,145.89
|
| Rate for Payer: PHP Commercial |
$4,404.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,145.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,016.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,742.31
|
| Rate for Payer: Priority Health Medicare |
$3,145.89
|
| Rate for Payer: Priority Health SBD |
$5,742.31
|
| Rate for Payer: Priority Health Tiered Network |
$5,742.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,145.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,740.31
|
| Rate for Payer: UHC Core |
$5,740.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,145.89
|
| Rate for Payer: UHC Exchange |
$5,740.31
|
| Rate for Payer: UHC Medicaid |
$2,016.05
|
| Rate for Payer: UHCCP Medicaid |
$2,016.05
|
| Rate for Payer: UMR Bronson Commercial |
$5,047.58
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL
|
Professional
|
Both
|
$6,202.00
|
|
|
Service Code
|
HCPCS 61607
|
| Min. Negotiated Rate |
$1,589.83 |
| Max. Negotiated Rate |
$5,329.34 |
| Rate for Payer: Aetna Commercial |
$3,314.30
|
| Rate for Payer: Aetna Medicare |
$2,572.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,314.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,561.64
|
| Rate for Payer: BCBS Complete |
$1,669.32
|
| Rate for Payer: BCBS MAPPO |
$2,473.36
|
| Rate for Payer: BCN Commercial |
$4,588.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,473.36
|
| Rate for Payer: Cash Price |
$4,961.60
|
| Rate for Payer: Cash Price |
$4,961.60
|
| Rate for Payer: Cofinity Commercial |
$3,314.30
|
| Rate for Payer: Cofinity Commercial |
$3,561.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,473.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,597.03
|
| Rate for Payer: Meridian Medicaid |
$1,669.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,720.70
|
| Rate for Payer: Nomi Health Commercial |
$2,968.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,651.50
|
| Rate for Payer: PACE SWMI |
$2,473.36
|
| Rate for Payer: PHP Commercial |
$3,462.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,473.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,589.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,329.34
|
| Rate for Payer: Priority Health Medicare |
$2,473.36
|
| Rate for Payer: Priority Health SBD |
$5,329.34
|
| Rate for Payer: Priority Health Tiered Network |
$5,329.34
|
| Rate for Payer: Railroad Medicare Medicare |
$2,473.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,711.68
|
| Rate for Payer: UHC Core |
$4,711.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,473.36
|
| Rate for Payer: UHC Exchange |
$4,711.68
|
| Rate for Payer: UHC Medicaid |
$1,589.83
|
| Rate for Payer: UHCCP Medicaid |
$1,589.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,852.92
|
|
|
PR RESCJ PALATE/EXTENSIVE RESCJ LESION
|
Professional
|
Both
|
$2,114.00
|
|
|
Service Code
|
HCPCS 42120
|
| Min. Negotiated Rate |
$581.70 |
| Max. Negotiated Rate |
$1,829.38 |
| Rate for Payer: Aetna Commercial |
$1,177.32
|
| Rate for Payer: Aetna Medicare |
$913.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.18
|
| Rate for Payer: BCBS Complete |
$610.78
|
| Rate for Payer: BCBS MAPPO |
$878.60
|
| Rate for Payer: BCN Commercial |
$1,501.41
|
| Rate for Payer: BCN Medicare Advantage |
$878.60
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cash Price |
$1,691.20
|
| Rate for Payer: Cofinity Commercial |
$1,177.32
|
| Rate for Payer: Cofinity Commercial |
$1,265.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.53
|
| Rate for Payer: Meridian Medicaid |
$610.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.46
|
| Rate for Payer: Nomi Health Commercial |
$1,054.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.50
|
| Rate for Payer: PACE SWMI |
$878.60
|
| Rate for Payer: PHP Commercial |
$1,230.04
|
| Rate for Payer: PHP Medicare Advantage |
$878.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,829.38
|
| Rate for Payer: Priority Health Medicare |
$878.60
|
| Rate for Payer: Priority Health SBD |
$1,829.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,829.38
|
| Rate for Payer: Railroad Medicare Medicare |
$878.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.14
|
| Rate for Payer: UHC Core |
$1,723.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$878.60
|
| Rate for Payer: UHC Exchange |
$1,723.14
|
| Rate for Payer: UHC Medicaid |
$581.70
|
| Rate for Payer: UHCCP Medicaid |
$581.70
|
| Rate for Payer: UMR Bronson Commercial |
$972.44
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING
|
Professional
|
Both
|
$3,572.00
|
|
|
Service Code
|
HCPCS 58952
|
| Min. Negotiated Rate |
$969.15 |
| Max. Negotiated Rate |
$2,867.31 |
| Rate for Payer: Aetna Commercial |
$2,019.17
|
| Rate for Payer: Aetna Medicare |
$1,567.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,019.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,169.85
|
| Rate for Payer: BCBS Complete |
$1,017.61
|
| Rate for Payer: BCBS MAPPO |
$1,506.84
|
| Rate for Payer: BCN Commercial |
$2,470.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,506.84
|
| Rate for Payer: Cash Price |
$2,857.60
|
| Rate for Payer: Cash Price |
$2,857.60
|
| Rate for Payer: Cofinity Commercial |
$2,019.17
|
| Rate for Payer: Cofinity Commercial |
$2,169.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,506.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,582.18
|
| Rate for Payer: Meridian Medicaid |
$1,017.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,657.52
|
| Rate for Payer: Nomi Health Commercial |
$1,808.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,679.00
|
| Rate for Payer: PACE SWMI |
$1,506.84
|
| Rate for Payer: PHP Commercial |
$2,109.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,506.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$969.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,502.06
|
| Rate for Payer: Priority Health Medicare |
$1,506.84
|
| Rate for Payer: Priority Health SBD |
$2,502.06
|
| Rate for Payer: Priority Health Tiered Network |
$2,502.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,506.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,867.31
|
| Rate for Payer: UHC Core |
$2,867.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,506.84
|
| Rate for Payer: UHC Exchange |
$2,867.31
|
| Rate for Payer: UHC Medicaid |
$969.15
|
| Rate for Payer: UHCCP Medicaid |
$969.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,643.12
|
|
