|
PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING
|
Professional
|
Both
|
$984.00
|
|
|
Service Code
|
HCPCS 32557
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$980.78 |
| Rate for Payer: Aetna Commercial |
$188.28
|
| Rate for Payer: Aetna Medicare |
$146.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.33
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$140.51
|
| Rate for Payer: BCBS Trust/PPO |
$656.15
|
| Rate for Payer: BCN Commercial |
$980.78
|
| Rate for Payer: BCN Medicare Advantage |
$140.51
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cofinity Commercial |
$188.28
|
| Rate for Payer: Cofinity Commercial |
$202.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.54
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Nomi Health Commercial |
$168.61
|
| Rate for Payer: PACE SWMI |
$140.51
|
| Rate for Payer: PHP Commercial |
$196.71
|
| Rate for Payer: PHP Medicare Advantage |
$140.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.54
|
| Rate for Payer: Priority Health Medicare |
$140.51
|
| Rate for Payer: Priority Health Narrow Network |
$202.54
|
| Rate for Payer: Priority Health SBD |
$202.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.51
|
| Rate for Payer: UHC Medicare Advantage |
$140.51
|
| Rate for Payer: UHCCP Medicaid |
$93.29
|
| Rate for Payer: UMR Bronson Commercial |
$452.64
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 32556
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$1,091.21 |
| Rate for Payer: Aetna Commercial |
$159.66
|
| Rate for Payer: Aetna Medicare |
$123.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.58
|
| Rate for Payer: BCBS Complete |
$82.53
|
| Rate for Payer: BCBS MAPPO |
$119.15
|
| Rate for Payer: BCBS Trust/PPO |
$507.70
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$119.15
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$159.66
|
| Rate for Payer: Cofinity Commercial |
$171.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$82.53
|
| Rate for Payer: Nomi Health Commercial |
$142.98
|
| Rate for Payer: PACE SWMI |
$119.15
|
| Rate for Payer: PHP Commercial |
$166.81
|
| Rate for Payer: PHP Medicare Advantage |
$119.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.63
|
| Rate for Payer: Priority Health Medicare |
$119.15
|
| Rate for Payer: Priority Health Narrow Network |
$169.63
|
| Rate for Payer: Priority Health SBD |
$169.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.15
|
| Rate for Payer: UHC Medicare Advantage |
$119.15
|
| Rate for Payer: UHCCP Medicaid |
$78.60
|
| Rate for Payer: UMR Bronson Commercial |
$406.64
|
|
|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$716.11 |
| Max. Negotiated Rate |
$2,246.86 |
| Rate for Payer: Aetna Commercial |
$1,436.71
|
| Rate for Payer: Aetna Medicare |
$1,115.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.92
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,072.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.86
|
| Rate for Payer: BCN Commercial |
$1,618.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.17
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,436.71
|
| Rate for Payer: Cofinity Commercial |
$1,543.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.78
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Nomi Health Commercial |
$1,286.60
|
| Rate for Payer: PACE SWMI |
$1,072.17
|
| Rate for Payer: PHP Commercial |
$1,501.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.01
|
| Rate for Payer: Priority Health Medicare |
$1,072.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,781.01
|
| Rate for Payer: Priority Health SBD |
$1,781.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.17
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,126.08
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,107.28 |
| Rate for Payer: Aetna Commercial |
$891.48
|
| Rate for Payer: Aetna Medicare |
$691.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.00
|
| Rate for Payer: BCBS Complete |
$468.10
|
| Rate for Payer: BCBS MAPPO |
$665.28
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$1,004.24
|
| Rate for Payer: BCN Medicare Advantage |
$665.28
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$891.48
|
| Rate for Payer: Cofinity Commercial |
$958.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.54
|
| Rate for Payer: Meridian Medicaid |
$468.10
|
| Rate for Payer: Nomi Health Commercial |
$798.34
|
| Rate for Payer: PACE SWMI |
$665.28
|
| Rate for Payer: PHP Commercial |
$931.39
|
| Rate for Payer: PHP Medicare Advantage |
$665.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.28
|
| Rate for Payer: Priority Health Medicare |
$665.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.28
|
| Rate for Payer: Priority Health SBD |
$1,107.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.28
|
| Rate for Payer: UHC Medicare Advantage |
$665.28
|
| Rate for Payer: UHCCP Medicaid |
$445.81
|
| Rate for Payer: UMR Bronson Commercial |
$765.44
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$750.19 |
| Rate for Payer: Aetna Commercial |
$315.69
|
| Rate for Payer: Aetna Medicare |
$245.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.25
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$235.59
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$235.59
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cofinity Commercial |
$315.69
|
| Rate for Payer: Cofinity Commercial |
$339.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.37
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Nomi Health Commercial |
$282.71
|
| Rate for Payer: PACE SWMI |
$235.59
|
| Rate for Payer: PHP Commercial |
$329.83
|
| Rate for Payer: PHP Medicare Advantage |
$235.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.57
|
| Rate for Payer: Priority Health Medicare |
$235.59
|
| Rate for Payer: Priority Health Narrow Network |
$385.57
|
| Rate for Payer: Priority Health SBD |
$385.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.59
|
| Rate for Payer: UHC Medicare Advantage |
$235.59
|
| Rate for Payer: UHCCP Medicaid |
$154.43
|
| Rate for Payer: UMR Bronson Commercial |
$233.68
|
|
|
PR PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 43762
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$334.75 |
| Rate for Payer: Aetna Commercial |
$48.82
|
| Rate for Payer: Aetna Medicare |
$37.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.46
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$36.43
|
| Rate for Payer: BCBS Trust/PPO |
$210.26
|
| Rate for Payer: BCN Commercial |
$334.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.43
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$48.82
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.25
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Nomi Health Commercial |
$43.72
|
| Rate for Payer: PACE SWMI |
$36.43
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$36.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.22
|
| Rate for Payer: Priority Health Medicare |
$36.43
|
| Rate for Payer: Priority Health Narrow Network |
$66.22
|
| Rate for Payer: Priority Health SBD |
$66.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.43
|
| Rate for Payer: UHC Medicare Advantage |
$36.43
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
| Rate for Payer: UMR Bronson Commercial |
$198.26
|
|
|
PR PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 43763
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$750.19 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$87.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.86
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$83.93
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$83.93
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.13
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Nomi Health Commercial |
$100.72
|
| Rate for Payer: PACE SWMI |
$83.93
|
| Rate for Payer: PHP Commercial |
$117.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.71
|
| Rate for Payer: Priority Health Medicare |
$83.93
|
| Rate for Payer: Priority Health Narrow Network |
$155.71
|
| Rate for Payer: Priority Health SBD |
$155.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$83.93
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
| Rate for Payer: UMR Bronson Commercial |
$295.78
|
|
|
PR PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 0201T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,118.53 |
| Rate for Payer: Aetna Commercial |
$2,396.07
|
| Rate for Payer: Aetna Medicare |
$1,222.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,396.07
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,600.00
|
| Rate for Payer: BCN Commercial |
$6,118.53
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,124.24
|
|
|
PR PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL
|
Professional
|
Both
|
$2,317.00
|
|
|
Service Code
|
HCPCS 0200T
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$6,118.53 |
| Rate for Payer: Aetna Commercial |
$2,325.11
|
| Rate for Payer: Aetna Medicare |
$1,158.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,325.11
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCBS Trust/PPO |
$64.33
|
| Rate for Payer: BCN Commercial |
$6,118.53
|
| Rate for Payer: Cash Price |
$1,853.60
|
| Rate for Payer: Cash Price |
$1,853.60
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,506.05
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,065.82
|
|
|
PR PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS
|
Professional
|
Both
|
$3,172.00
|
|
|
Service Code
|
HCPCS 27216
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$2,061.80 |
| Rate for Payer: Aetna Commercial |
$1,191.27
|
| Rate for Payer: Aetna Medicare |
$1,586.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.27
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,616.07
|
| Rate for Payer: BCN Commercial |
$1,302.33
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,365.79
|
| Rate for Payer: Priority Health SBD |
$1,365.79
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,459.12
|
|
|
PR PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 25651
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,380.45 |
| Rate for Payer: Aetna Commercial |
$636.66
|
| Rate for Payer: Aetna Medicare |
$494.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.17
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS MAPPO |
$475.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.45
|
| Rate for Payer: BCN Commercial |
$727.64
|
| Rate for Payer: BCN Medicare Advantage |
$475.12
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$636.66
|
| Rate for Payer: Cofinity Commercial |
$684.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.88
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Nomi Health Commercial |
$570.14
|
| Rate for Payer: PACE SWMI |
$475.12
|
| Rate for Payer: PHP Commercial |
$665.17
|
| Rate for Payer: PHP Medicare Advantage |
$475.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$475.12
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: Priority Health SBD |
$768.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.12
|
| Rate for Payer: UHC Medicare Advantage |
$475.12
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$354.01 |
| Max. Negotiated Rate |
$1,651.47 |
| Rate for Payer: Aetna Commercial |
$696.06
|
| Rate for Payer: Aetna Medicare |
$540.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.01
|
| Rate for Payer: BCBS Complete |
$371.71
|
| Rate for Payer: BCBS MAPPO |
$519.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.47
|
| Rate for Payer: BCN Commercial |
$788.24
|
| Rate for Payer: BCN Medicare Advantage |
$519.45
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$696.06
|
| Rate for Payer: Cofinity Commercial |
$748.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.42
|
| Rate for Payer: Meridian Medicaid |
$371.71
|
| Rate for Payer: Nomi Health Commercial |
$623.34
|
| Rate for Payer: PACE SWMI |
$519.45
|
| Rate for Payer: PHP Commercial |
$727.23
|
| Rate for Payer: PHP Medicare Advantage |
$519.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$837.58
|
| Rate for Payer: Priority Health Medicare |
$519.45
|
| Rate for Payer: Priority Health Narrow Network |
$837.58
|
| Rate for Payer: Priority Health SBD |
$837.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.45
|
| Rate for Payer: UHC Medicare Advantage |
$519.45
|
| Rate for Payer: UHCCP Medicaid |
$354.01
|
| Rate for Payer: UMR Bronson Commercial |
$656.88
|
|
|
PR PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25606
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$867.77
|
| Rate for Payer: Aetna Medicare |
$673.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.53
|
| Rate for Payer: BCBS Complete |
$462.74
|
| Rate for Payer: BCBS MAPPO |
$647.59
|
| Rate for Payer: BCBS Trust/PPO |
$72.38
|
| Rate for Payer: BCN Commercial |
$988.59
|
| Rate for Payer: BCN Medicare Advantage |
$647.59
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$867.77
|
| Rate for Payer: Cofinity Commercial |
$932.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.97
|
| Rate for Payer: Meridian Medicaid |
$462.74
|
| Rate for Payer: Nomi Health Commercial |
$777.11
|
| Rate for Payer: PACE SWMI |
$647.59
|
| Rate for Payer: PHP Commercial |
$906.63
|
| Rate for Payer: PHP Medicare Advantage |
$647.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.15
|
| Rate for Payer: Priority Health Medicare |
$647.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,042.15
|
| Rate for Payer: Priority Health SBD |
$1,042.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.59
|
| Rate for Payer: UHC Medicare Advantage |
$647.59
|
| Rate for Payer: UHCCP Medicaid |
$440.70
|
| Rate for Payer: UMR Bronson Commercial |
$894.24
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 36906
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$7,992.80 |
| Rate for Payer: Aetna Commercial |
$645.97
|
| Rate for Payer: Aetna Medicare |
$501.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$645.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.18
|
| Rate for Payer: BCBS Complete |
$333.46
|
| Rate for Payer: BCBS MAPPO |
$482.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,420.60
|
| Rate for Payer: BCN Commercial |
$7,992.80
|
| Rate for Payer: BCN Medicare Advantage |
$482.07
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$645.97
|
| Rate for Payer: Cofinity Commercial |
$694.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.17
|
| Rate for Payer: Meridian Medicaid |
$333.46
|
| Rate for Payer: Nomi Health Commercial |
$578.48
|
| Rate for Payer: PACE SWMI |
$482.07
|
| Rate for Payer: PHP Commercial |
$674.90
|
| Rate for Payer: PHP Medicare Advantage |
$482.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.29
|
| Rate for Payer: Priority Health Medicare |
$482.07
|
| Rate for Payer: Priority Health Narrow Network |
$790.29
|
| Rate for Payer: Priority Health SBD |
$790.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.07
|
| Rate for Payer: UHC Medicare Advantage |
$482.07
|
| Rate for Payer: UHCCP Medicaid |
$317.58
|
| Rate for Payer: UMR Bronson Commercial |
$709.32
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 36905
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$3,353.79 |
| Rate for Payer: Aetna Commercial |
$560.37
|
| Rate for Payer: Aetna Medicare |
$434.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.19
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS MAPPO |
$418.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,385.73
|
| Rate for Payer: BCN Commercial |
$3,353.79
|
| Rate for Payer: BCN Medicare Advantage |
$418.19
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$602.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$418.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$439.10
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Nomi Health Commercial |
$501.83
|
| Rate for Payer: PACE SWMI |
$418.19
|
| Rate for Payer: PHP Commercial |
$585.47
|
| Rate for Payer: PHP Medicare Advantage |
$418.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.46
|
| Rate for Payer: Priority Health Medicare |
$418.19
|
| Rate for Payer: Priority Health Narrow Network |
$684.46
|
| Rate for Payer: Priority Health SBD |
$684.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$418.19
|
| Rate for Payer: UHC Medicare Advantage |
$418.19
|
| Rate for Payer: UHCCP Medicaid |
$275.84
|
| Rate for Payer: UMR Bronson Commercial |
$608.12
|
|
|
PR PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH
|
Professional
|
Both
|
$887.00
|
|
|
Service Code
|
HCPCS 36904
|
| Min. Negotiated Rate |
$229.19 |
| Max. Negotiated Rate |
$2,663.30 |
| Rate for Payer: Aetna Commercial |
$466.31
|
| Rate for Payer: Aetna Medicare |
$361.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.11
|
| Rate for Payer: BCBS Complete |
$240.65
|
| Rate for Payer: BCBS MAPPO |
$347.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,699.01
|
| Rate for Payer: BCN Commercial |
$2,663.30
|
| Rate for Payer: BCN Medicare Advantage |
$347.99
|
| Rate for Payer: Cash Price |
$709.60
|
| Rate for Payer: Cash Price |
$709.60
|
| Rate for Payer: Cofinity Commercial |
$501.11
|
| Rate for Payer: Cofinity Commercial |
$466.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.39
|
| Rate for Payer: Meridian Medicaid |
$240.65
|
| Rate for Payer: Nomi Health Commercial |
$417.59
|
| Rate for Payer: PACE SWMI |
$347.99
|
| Rate for Payer: PHP Commercial |
$487.19
|
| Rate for Payer: PHP Medicare Advantage |
$347.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.11
|
| Rate for Payer: Priority Health Medicare |
$347.99
|
| Rate for Payer: Priority Health Narrow Network |
$570.11
|
| Rate for Payer: Priority Health SBD |
$570.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$347.99
|
| Rate for Payer: UHC Medicare Advantage |
$347.99
|
| Rate for Payer: UHCCP Medicaid |
$229.19
|
| Rate for Payer: UMR Bronson Commercial |
$408.02
|
|
|
PR PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 33897
|
| Min. Negotiated Rate |
$362.10 |
| Max. Negotiated Rate |
$903.04 |
| Rate for Payer: Aetna Commercial |
$740.91
|
| Rate for Payer: Aetna Medicare |
$575.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.20
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS MAPPO |
$552.92
|
| Rate for Payer: BCN Commercial |
$827.82
|
| Rate for Payer: BCN Medicare Advantage |
$552.92
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$740.91
|
| Rate for Payer: Cofinity Commercial |
$796.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.57
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Nomi Health Commercial |
$663.50
|
| Rate for Payer: PACE SWMI |
$552.92
|
| Rate for Payer: PHP Commercial |
$774.09
|
| Rate for Payer: PHP Medicare Advantage |
$552.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$903.04
|
| Rate for Payer: Priority Health Medicare |
$552.92
|
| Rate for Payer: Priority Health Narrow Network |
$903.04
|
| Rate for Payer: Priority Health SBD |
$903.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.92
|
| Rate for Payer: UHC Medicare Advantage |
$552.92
|
| Rate for Payer: UHCCP Medicaid |
$362.10
|
| Rate for Payer: UMR Bronson Commercial |
$572.24
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 22513
|
| Min. Negotiated Rate |
$219.77 |
| Max. Negotiated Rate |
$8,492.73 |
| Rate for Payer: Aetna Commercial |
$653.48
|
| Rate for Payer: Aetna Medicare |
$507.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.24
|
| Rate for Payer: BCBS Complete |
$341.07
|
| Rate for Payer: BCBS MAPPO |
$487.67
|
| Rate for Payer: BCBS Trust/PPO |
$219.77
|
| Rate for Payer: BCN Commercial |
$8,492.73
|
| Rate for Payer: BCN Medicare Advantage |
$487.67
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$653.48
|
| Rate for Payer: Cofinity Commercial |
$702.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.05
|
| Rate for Payer: Meridian Medicaid |
$341.07
|
| Rate for Payer: Nomi Health Commercial |
$585.20
|
| Rate for Payer: PACE SWMI |
$487.67
|
| Rate for Payer: PHP Commercial |
$682.74
|
| Rate for Payer: PHP Medicare Advantage |
$487.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.97
|
| Rate for Payer: Priority Health Medicare |
$487.67
|
| Rate for Payer: Priority Health Narrow Network |
$773.97
|
| Rate for Payer: Priority Health SBD |
$773.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.67
|
| Rate for Payer: UHC Medicare Advantage |
$487.67
|
| Rate for Payer: UHCCP Medicaid |
$324.83
|
| Rate for Payer: UMR Bronson Commercial |
$711.16
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 22515
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$4,362.91 |
| Rate for Payer: Aetna Commercial |
$280.40
|
| Rate for Payer: Aetna Medicare |
$217.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.32
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS MAPPO |
$209.25
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$4,362.91
|
| Rate for Payer: BCN Medicare Advantage |
$209.25
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$280.40
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.71
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Nomi Health Commercial |
$251.10
|
| Rate for Payer: PACE SWMI |
$209.25
|
| Rate for Payer: PHP Commercial |
$292.95
|
| Rate for Payer: PHP Medicare Advantage |
$209.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.21
|
| Rate for Payer: Priority Health Medicare |
$209.25
|
| Rate for Payer: Priority Health Narrow Network |
$328.21
|
| Rate for Payer: Priority Health SBD |
$328.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.25
|
| Rate for Payer: UHC Medicare Advantage |
$209.25
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
| Rate for Payer: UMR Bronson Commercial |
$370.76
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR
|
Professional
|
Both
|
$1,444.00
|
|
|
Service Code
|
HCPCS 22514
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$8,451.68 |
| Rate for Payer: Aetna Commercial |
$610.20
|
| Rate for Payer: Aetna Medicare |
$473.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.73
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS MAPPO |
$455.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,205.12
|
| Rate for Payer: BCN Commercial |
$8,451.68
|
| Rate for Payer: BCN Medicare Advantage |
$455.37
|
| Rate for Payer: Cash Price |
$1,155.20
|
| Rate for Payer: Cash Price |
$1,155.20
|
| Rate for Payer: Cofinity Commercial |
$610.20
|
| Rate for Payer: Cofinity Commercial |
$655.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.14
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE SWMI |
$455.37
|
| Rate for Payer: PHP Commercial |
$637.52
|
| Rate for Payer: PHP Medicare Advantage |
$455.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.57
|
| Rate for Payer: Priority Health Medicare |
$455.37
|
| Rate for Payer: Priority Health Narrow Network |
$721.57
|
| Rate for Payer: Priority Health SBD |
$721.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.37
|
| Rate for Payer: UHC Medicare Advantage |
$455.37
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
| Rate for Payer: UMR Bronson Commercial |
$664.24
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL
|
Professional
|
Both
|
$1,057.00
|
|
|
Service Code
|
HCPCS 22511
|
| Min. Negotiated Rate |
$190.19 |
| Max. Negotiated Rate |
$2,669.64 |
| Rate for Payer: Aetna Commercial |
$520.64
|
| Rate for Payer: Aetna Medicare |
$404.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.50
|
| Rate for Payer: BCBS Complete |
$272.18
|
| Rate for Payer: BCBS MAPPO |
$388.54
|
| Rate for Payer: BCBS Trust/PPO |
$190.19
|
| Rate for Payer: BCN Commercial |
$2,669.64
|
| Rate for Payer: BCN Medicare Advantage |
$388.54
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Cofinity Commercial |
$520.64
|
| Rate for Payer: Cofinity Commercial |
$559.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.97
|
| Rate for Payer: Meridian Medicaid |
$272.18
|
| Rate for Payer: Nomi Health Commercial |
$466.25
|
| Rate for Payer: PACE SWMI |
$388.54
|
| Rate for Payer: PHP Commercial |
$543.96
|
| Rate for Payer: PHP Medicare Advantage |
$388.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$687.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.70
|
| Rate for Payer: Priority Health Medicare |
$388.54
|
| Rate for Payer: Priority Health Narrow Network |
$614.70
|
| Rate for Payer: Priority Health SBD |
$614.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.54
|
| Rate for Payer: UHC Medicare Advantage |
$388.54
|
| Rate for Payer: UHCCP Medicaid |
$259.22
|
| Rate for Payer: UMR Bronson Commercial |
$486.22
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC
|
Professional
|
Both
|
$3,421.00
|
|
|
Service Code
|
HCPCS 22510
|
| Min. Negotiated Rate |
$275.20 |
| Max. Negotiated Rate |
$2,683.33 |
| Rate for Payer: Aetna Commercial |
$553.47
|
| Rate for Payer: Aetna Medicare |
$429.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.78
|
| Rate for Payer: BCBS Complete |
$288.96
|
| Rate for Payer: BCBS MAPPO |
$413.04
|
| Rate for Payer: BCBS Trust/PPO |
$825.51
|
| Rate for Payer: BCN Commercial |
$2,683.33
|
| Rate for Payer: BCN Medicare Advantage |
$413.04
|
| Rate for Payer: Cash Price |
$2,736.80
|
| Rate for Payer: Cash Price |
$2,736.80
|
| Rate for Payer: Cofinity Commercial |
$594.78
|
| Rate for Payer: Cofinity Commercial |
$553.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.69
|
| Rate for Payer: Meridian Medicaid |
$288.96
|
| Rate for Payer: Nomi Health Commercial |
$495.65
|
| Rate for Payer: PACE SWMI |
$413.04
|
| Rate for Payer: PHP Commercial |
$578.26
|
| Rate for Payer: PHP Medicare Advantage |
$413.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,223.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.87
|
| Rate for Payer: Priority Health Medicare |
$413.04
|
| Rate for Payer: Priority Health Narrow Network |
$652.87
|
| Rate for Payer: Priority Health SBD |
$652.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.04
|
| Rate for Payer: UHC Medicare Advantage |
$413.04
|
| Rate for Payer: UHCCP Medicaid |
$275.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,573.66
|
|
|
PR PESSARY REUSABLE NONRUBBER
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4562
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$56.07 |
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCN Commercial |
$56.07
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR PESSARY REUSABLE RUB ANYTYPE
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4561
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$50.05 |
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCN Commercial |
$22.57
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR PHALANGECTOMY TOE EACH TOE
|
Professional
|
Both
|
$849.00
|
|
|
Service Code
|
HCPCS 28150
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$1,132.15 |
| Rate for Payer: Aetna Commercial |
$358.81
|
| Rate for Payer: Aetna Medicare |
$278.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.81
|
| Rate for Payer: BCBS Complete |
$191.23
|
| Rate for Payer: BCBS MAPPO |
$267.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.15
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$267.77
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cofinity Commercial |
$358.81
|
| Rate for Payer: Cofinity Commercial |
$385.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.16
|
| Rate for Payer: Meridian Medicaid |
$191.23
|
| Rate for Payer: Nomi Health Commercial |
$321.32
|
| Rate for Payer: PACE SWMI |
$267.77
|
| Rate for Payer: PHP Commercial |
$374.88
|
| Rate for Payer: PHP Medicare Advantage |
$267.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.01
|
| Rate for Payer: Priority Health Medicare |
$267.77
|
| Rate for Payer: Priority Health Narrow Network |
$431.01
|
| Rate for Payer: Priority Health SBD |
$431.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.77
|
| Rate for Payer: UHC Medicare Advantage |
$267.77
|
| Rate for Payer: UHCCP Medicaid |
$182.12
|
| Rate for Payer: UMR Bronson Commercial |
$390.54
|
|
