|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD
|
Professional
|
Both
|
$5,084.00
|
|
|
Service Code
|
HCPCS 58951
|
| Min. Negotiated Rate |
$848.59 |
| Max. Negotiated Rate |
$3,813.00 |
| Rate for Payer: Aetna Commercial |
$1,769.58
|
| Rate for Payer: Aetna Medicare |
$1,373.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,769.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,901.64
|
| Rate for Payer: BCBS Complete |
$891.02
|
| Rate for Payer: BCBS MAPPO |
$1,320.58
|
| Rate for Payer: BCN Commercial |
$2,166.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,320.58
|
| Rate for Payer: Cash Price |
$4,067.20
|
| Rate for Payer: Cash Price |
$4,067.20
|
| Rate for Payer: Cofinity Commercial |
$1,769.58
|
| Rate for Payer: Cofinity Commercial |
$1,901.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,320.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,386.61
|
| Rate for Payer: Meridian Medicaid |
$891.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,452.64
|
| Rate for Payer: Nomi Health Commercial |
$1,584.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,813.00
|
| Rate for Payer: PACE SWMI |
$1,320.58
|
| Rate for Payer: PHP Commercial |
$1,848.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,320.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$848.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,194.42
|
| Rate for Payer: Priority Health Medicare |
$1,320.58
|
| Rate for Payer: Priority Health SBD |
$2,194.42
|
| Rate for Payer: Priority Health Tiered Network |
$2,194.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,320.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,526.17
|
| Rate for Payer: UHC Core |
$2,526.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,320.58
|
| Rate for Payer: UHC Exchange |
$2,526.17
|
| Rate for Payer: UHC Medicaid |
$848.59
|
| Rate for Payer: UHCCP Medicaid |
$848.59
|
| Rate for Payer: UMR Bronson Commercial |
$2,338.64
|
|
|
PR RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS
|
Professional
|
Both
|
$6,835.00
|
|
|
Service Code
|
HCPCS 48105
|
| Min. Negotiated Rate |
$1,629.88 |
| Max. Negotiated Rate |
$5,142.88 |
| Rate for Payer: Aetna Commercial |
$3,414.52
|
| Rate for Payer: Aetna Medicare |
$2,650.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,414.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,669.34
|
| Rate for Payer: BCBS Complete |
$1,711.37
|
| Rate for Payer: BCBS MAPPO |
$2,548.15
|
| Rate for Payer: BCN Commercial |
$4,220.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,548.15
|
| Rate for Payer: Cash Price |
$5,468.00
|
| Rate for Payer: Cash Price |
$5,468.00
|
| Rate for Payer: Cofinity Commercial |
$3,414.52
|
| Rate for Payer: Cofinity Commercial |
$3,669.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,548.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,675.56
|
| Rate for Payer: Meridian Medicaid |
$1,711.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,802.97
|
| Rate for Payer: Nomi Health Commercial |
$3,057.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,126.25
|
| Rate for Payer: PACE SWMI |
$2,548.15
|
| Rate for Payer: PHP Commercial |
$3,567.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,548.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,629.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,142.88
|
| Rate for Payer: Priority Health Medicare |
$2,548.15
|
| Rate for Payer: Priority Health SBD |
$5,142.88
|
| Rate for Payer: Priority Health Tiered Network |
$5,142.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,548.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,076.82
|
| Rate for Payer: UHC Core |
$5,076.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,548.15
|
| Rate for Payer: UHC Exchange |
$5,076.82
|
| Rate for Payer: UHC Medicaid |
$1,629.88
|
| Rate for Payer: UHCCP Medicaid |
$1,629.88
|
| Rate for Payer: UMR Bronson Commercial |
$3,144.10
|
|
|
PR RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY
|
Professional
|
Both
|
$3,425.00
|
|
|
Service Code
|
HCPCS 58957
|
| Min. Negotiated Rate |
$1,370.00 |
| Max. Negotiated Rate |
$2,568.75 |
| Rate for Payer: Aetna Commercial |
$1,889.07
|
| Rate for Payer: Aetna Medicare |
$1,712.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,889.07
|
| Rate for Payer: BCBS Complete |
$1,370.00
|
| Rate for Payer: BCN Commercial |
$2,362.28
|
| Rate for Payer: Cash Price |
$2,740.00
|
| Rate for Payer: Cash Price |
$2,740.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,568.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,575.50
|
|
|
PR RESEC RECURRENT LARYNX NERVE
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 31595
|
| Min. Negotiated Rate |
$567.20 |
| Max. Negotiated Rate |
$1,063.50 |
| Rate for Payer: Aetna Medicare |
$709.00
|
| Rate for Payer: BCBS Complete |
$567.20
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,063.50
|
| Rate for Payer: UMR Bronson Commercial |
$652.28
|
|
|
PR RESECTION CONDYLE DISTAL END PHALANX EACH TOE
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 28153
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$505.50 |
| Rate for Payer: Aetna Commercial |
$324.82
|
| Rate for Payer: Aetna Medicare |
$252.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.06
|
| Rate for Payer: BCBS Complete |
$167.96
|
| Rate for Payer: BCBS MAPPO |
$242.40
|
| Rate for Payer: BCN Commercial |
$400.87
|
| Rate for Payer: BCN Medicare Advantage |
$242.40
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cofinity Commercial |
$349.06
|
| Rate for Payer: Cofinity Commercial |
$324.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.52
|
| Rate for Payer: Meridian Medicaid |
$167.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$266.64
|
| Rate for Payer: Nomi Health Commercial |
$290.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$505.50
|
| Rate for Payer: PACE SWMI |
$242.40
|
| Rate for Payer: PHP Commercial |
$339.36
|
| Rate for Payer: PHP Medicare Advantage |
$242.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.52
|
| Rate for Payer: Priority Health Medicare |
$242.40
|
| Rate for Payer: Priority Health SBD |
$428.52
|
| Rate for Payer: Priority Health Tiered Network |
$428.52
|
| Rate for Payer: Railroad Medicare Medicare |
$242.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.22
|
| Rate for Payer: UHC Core |
$461.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$242.40
|
| Rate for Payer: UHC Exchange |
$461.22
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$310.04
|
|
|
PR RESECTION EXTERNAL CARDIAC TUMOR
|
Professional
|
Both
|
$4,783.00
|
|
|
Service Code
|
HCPCS 33130
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$3,587.25 |
| Rate for Payer: Aetna Commercial |
$1,748.86
|
| Rate for Payer: Aetna Medicare |
$1,357.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,748.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,879.37
|
| Rate for Payer: BCBS Complete |
$877.16
|
| Rate for Payer: BCBS MAPPO |
$1,305.12
|
| Rate for Payer: BCN Commercial |
$2,011.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,305.12
|
| Rate for Payer: Cash Price |
$3,826.40
|
| Rate for Payer: Cash Price |
$3,826.40
|
| Rate for Payer: Cofinity Commercial |
$1,748.86
|
| Rate for Payer: Cofinity Commercial |
$1,879.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,370.38
|
| Rate for Payer: Meridian Medicaid |
$877.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,435.63
|
| Rate for Payer: Nomi Health Commercial |
$1,566.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,587.25
|
| Rate for Payer: PACE SWMI |
$1,305.12
|
| Rate for Payer: PHP Commercial |
$1,827.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,305.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,163.48
|
| Rate for Payer: Priority Health Medicare |
$1,305.12
|
| Rate for Payer: Priority Health SBD |
$2,163.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,163.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,305.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,429.61
|
| Rate for Payer: UHC Core |
$2,429.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,305.12
|
| Rate for Payer: UHC Exchange |
$2,429.61
|
| Rate for Payer: UHC Medicaid |
$835.39
|
| Rate for Payer: UHCCP Medicaid |
$835.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,200.18
|
|
|
PR RESECTION HUMERAL HEAD
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 23195
|
| Min. Negotiated Rate |
$452.63 |
| Max. Negotiated Rate |
$1,305.70 |
| Rate for Payer: Aetna Commercial |
$928.46
|
| Rate for Payer: Aetna Medicare |
$720.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$997.75
|
| Rate for Payer: BCBS Complete |
$475.26
|
| Rate for Payer: BCBS MAPPO |
$692.88
|
| Rate for Payer: BCN Commercial |
$1,143.36
|
| Rate for Payer: BCN Medicare Advantage |
$692.88
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cofinity Commercial |
$928.46
|
| Rate for Payer: Cofinity Commercial |
$997.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$727.52
|
| Rate for Payer: Meridian Medicaid |
$475.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$762.17
|
| Rate for Payer: Nomi Health Commercial |
$831.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,270.50
|
| Rate for Payer: PACE SWMI |
$692.88
|
| Rate for Payer: PHP Commercial |
$970.03
|
| Rate for Payer: PHP Medicare Advantage |
$692.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,222.23
|
| Rate for Payer: Priority Health Medicare |
$692.88
|
| Rate for Payer: Priority Health SBD |
$1,222.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,222.23
|
| Rate for Payer: Railroad Medicare Medicare |
$692.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.70
|
| Rate for Payer: UHC Core |
$1,305.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$692.88
|
| Rate for Payer: UHC Exchange |
$1,305.70
|
| Rate for Payer: UHC Medicaid |
$452.63
|
| Rate for Payer: UHCCP Medicaid |
$452.63
|
| Rate for Payer: UMR Bronson Commercial |
$779.24
|
|
|
PR RESECTION/INCISION SUBVALVULAR TISSUE
|
Professional
|
Both
|
$6,407.00
|
|
|
Service Code
|
HCPCS 33415
|
| Min. Negotiated Rate |
$1,214.31 |
| Max. Negotiated Rate |
$4,805.25 |
| Rate for Payer: Aetna Commercial |
$2,558.13
|
| Rate for Payer: Aetna Medicare |
$1,985.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,558.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,749.03
|
| Rate for Payer: BCBS Complete |
$1,275.03
|
| Rate for Payer: BCBS MAPPO |
$1,909.05
|
| Rate for Payer: BCN Commercial |
$2,979.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,909.05
|
| Rate for Payer: Cash Price |
$5,125.60
|
| Rate for Payer: Cash Price |
$5,125.60
|
| Rate for Payer: Cofinity Commercial |
$2,558.13
|
| Rate for Payer: Cofinity Commercial |
$2,749.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,909.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,004.50
|
| Rate for Payer: Meridian Medicaid |
$1,275.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,099.95
|
| Rate for Payer: Nomi Health Commercial |
$2,290.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,805.25
|
| Rate for Payer: PACE SWMI |
$1,909.05
|
| Rate for Payer: PHP Commercial |
$2,672.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,909.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,214.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,204.52
|
| Rate for Payer: Priority Health Medicare |
$1,909.05
|
| Rate for Payer: Priority Health SBD |
$3,204.52
|
| Rate for Payer: Priority Health Tiered Network |
$3,204.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,909.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,622.30
|
| Rate for Payer: UHC Core |
$3,622.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,909.05
|
| Rate for Payer: UHC Exchange |
$3,622.30
|
| Rate for Payer: UHC Medicaid |
$1,214.31
|
| Rate for Payer: UHCCP Medicaid |
$1,214.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,947.22
|
|
|
PR RESECTION MEDIASTINAL TUMOR
|
Professional
|
Both
|
$5,955.00
|
|
|
Service Code
|
HCPCS 39220
|
| Min. Negotiated Rate |
$680.96 |
| Max. Negotiated Rate |
$4,466.25 |
| Rate for Payer: Aetna Commercial |
$1,423.54
|
| Rate for Payer: Aetna Medicare |
$1,104.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.77
|
| Rate for Payer: BCBS Complete |
$715.01
|
| Rate for Payer: BCBS MAPPO |
$1,062.34
|
| Rate for Payer: BCN Commercial |
$1,690.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,062.34
|
| Rate for Payer: Cash Price |
$4,764.00
|
| Rate for Payer: Cash Price |
$4,764.00
|
| Rate for Payer: Cofinity Commercial |
$1,423.54
|
| Rate for Payer: Cofinity Commercial |
$1,529.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,062.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,115.46
|
| Rate for Payer: Meridian Medicaid |
$715.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,168.57
|
| Rate for Payer: Nomi Health Commercial |
$1,274.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,466.25
|
| Rate for Payer: PACE SWMI |
$1,062.34
|
| Rate for Payer: PHP Commercial |
$1,487.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,062.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,818.07
|
| Rate for Payer: Priority Health Medicare |
$1,062.34
|
| Rate for Payer: Priority Health SBD |
$1,818.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,818.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,062.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,011.51
|
| Rate for Payer: UHC Core |
$2,011.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,062.34
|
| Rate for Payer: UHC Exchange |
$2,011.51
|
| Rate for Payer: UHC Medicaid |
$680.96
|
| Rate for Payer: UHCCP Medicaid |
$680.96
|
| Rate for Payer: UMR Bronson Commercial |
$2,739.30
|
|
|
PR RESECTION OF MEDIASTINAL CYST
|
Professional
|
Both
|
$5,192.00
|
|
|
Service Code
|
HCPCS 39200
|
| Min. Negotiated Rate |
$530.37 |
| Max. Negotiated Rate |
$3,894.00 |
| Rate for Payer: Aetna Commercial |
$1,110.55
|
| Rate for Payer: Aetna Medicare |
$861.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.43
|
| Rate for Payer: BCBS Complete |
$556.89
|
| Rate for Payer: BCBS MAPPO |
$828.77
|
| Rate for Payer: BCN Commercial |
$1,289.77
|
| Rate for Payer: BCN Medicare Advantage |
$828.77
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cofinity Commercial |
$1,110.55
|
| Rate for Payer: Cofinity Commercial |
$1,193.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.21
|
| Rate for Payer: Meridian Medicaid |
$556.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$911.65
|
| Rate for Payer: Nomi Health Commercial |
$994.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,894.00
|
| Rate for Payer: PACE SWMI |
$828.77
|
| Rate for Payer: PHP Commercial |
$1,160.28
|
| Rate for Payer: PHP Medicare Advantage |
$828.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,386.98
|
| Rate for Payer: Priority Health Medicare |
$828.77
|
| Rate for Payer: Priority Health SBD |
$1,386.98
|
| Rate for Payer: Priority Health Tiered Network |
$1,386.98
|
| Rate for Payer: Railroad Medicare Medicare |
$828.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,547.21
|
| Rate for Payer: UHC Core |
$1,547.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$828.77
|
| Rate for Payer: UHC Exchange |
$1,547.21
|
| Rate for Payer: UHC Medicaid |
$530.37
|
| Rate for Payer: UHCCP Medicaid |
$530.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,388.32
|
|
|
PR RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 28126
|
| Min. Negotiated Rate |
$151.87 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$308.86
|
| Rate for Payer: Aetna Medicare |
$239.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.91
|
| Rate for Payer: BCBS Complete |
$159.46
|
| Rate for Payer: BCBS MAPPO |
$230.49
|
| Rate for Payer: BCN Commercial |
$379.96
|
| Rate for Payer: BCN Medicare Advantage |
$230.49
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$308.86
|
| Rate for Payer: Cofinity Commercial |
$331.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.01
|
| Rate for Payer: Meridian Medicaid |
$159.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$253.54
|
| Rate for Payer: Nomi Health Commercial |
$276.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$535.50
|
| Rate for Payer: PACE SWMI |
$230.49
|
| Rate for Payer: PHP Commercial |
$322.69
|
| Rate for Payer: PHP Medicare Advantage |
$230.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$406.16
|
| Rate for Payer: Priority Health Medicare |
$230.49
|
| Rate for Payer: Priority Health SBD |
$406.16
|
| Rate for Payer: Priority Health Tiered Network |
$406.16
|
| Rate for Payer: Railroad Medicare Medicare |
$230.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.75
|
| Rate for Payer: UHC Core |
$429.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$230.49
|
| Rate for Payer: UHC Exchange |
$429.75
|
| Rate for Payer: UHC Medicaid |
$151.87
|
| Rate for Payer: UHCCP Medicaid |
$151.87
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR RESECTION PERICARDIAL CYST/TUMOR
|
Professional
|
Both
|
$2,955.00
|
|
|
Service Code
|
HCPCS 33050
|
| Min. Negotiated Rate |
$618.13 |
| Max. Negotiated Rate |
$2,216.25 |
| Rate for Payer: Aetna Commercial |
$1,290.61
|
| Rate for Payer: Aetna Medicare |
$1,001.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,290.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.92
|
| Rate for Payer: BCBS Complete |
$649.04
|
| Rate for Payer: BCBS MAPPO |
$963.14
|
| Rate for Payer: BCN Commercial |
$1,493.94
|
| Rate for Payer: BCN Medicare Advantage |
$963.14
|
| Rate for Payer: Cash Price |
$2,364.00
|
| Rate for Payer: Cash Price |
$2,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.61
|
| Rate for Payer: Cofinity Commercial |
$1,386.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$963.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,011.30
|
| Rate for Payer: Meridian Medicaid |
$649.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,059.45
|
| Rate for Payer: Nomi Health Commercial |
$1,155.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,216.25
|
| Rate for Payer: PACE SWMI |
$963.14
|
| Rate for Payer: PHP Commercial |
$1,348.40
|
| Rate for Payer: PHP Medicare Advantage |
$963.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,606.55
|
| Rate for Payer: Priority Health Medicare |
$963.14
|
| Rate for Payer: Priority Health SBD |
$1,606.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,606.55
|
| Rate for Payer: Railroad Medicare Medicare |
$963.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,777.81
|
| Rate for Payer: UHC Core |
$1,777.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$963.14
|
| Rate for Payer: UHC Exchange |
$1,777.81
|
| Rate for Payer: UHC Medicaid |
$618.13
|
| Rate for Payer: UHCCP Medicaid |
$618.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,359.30
|
|
|
PR RESECTION RIBS EXTRAPLEURAL ALL STAGES
|
Professional
|
Both
|
$3,238.00
|
|
|
Service Code
|
HCPCS 32900
|
| Min. Negotiated Rate |
$823.88 |
| Max. Negotiated Rate |
$2,513.92 |
| Rate for Payer: Aetna Commercial |
$1,727.53
|
| Rate for Payer: Aetna Medicare |
$1,340.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,727.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,856.45
|
| Rate for Payer: BCBS Complete |
$865.07
|
| Rate for Payer: BCBS MAPPO |
$1,289.20
|
| Rate for Payer: BCN Commercial |
$2,174.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.20
|
| Rate for Payer: Cash Price |
$2,590.40
|
| Rate for Payer: Cash Price |
$2,590.40
|
| Rate for Payer: Cofinity Commercial |
$1,727.53
|
| Rate for Payer: Cofinity Commercial |
$1,856.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.66
|
| Rate for Payer: Meridian Medicaid |
$865.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,418.12
|
| Rate for Payer: Nomi Health Commercial |
$1,547.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.50
|
| Rate for Payer: PACE SWMI |
$1,289.20
|
| Rate for Payer: PHP Commercial |
$1,804.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$823.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,047.44
|
| Rate for Payer: Priority Health Medicare |
$1,289.20
|
| Rate for Payer: Priority Health SBD |
$2,047.44
|
| Rate for Payer: Priority Health Tiered Network |
$2,047.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,289.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,513.92
|
| Rate for Payer: UHC Core |
$2,513.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,289.20
|
| Rate for Payer: UHC Exchange |
$2,513.92
|
| Rate for Payer: UHC Medicaid |
$823.88
|
| Rate for Payer: UHCCP Medicaid |
$823.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,489.48
|
|
|
PR RESECTION SCROTUM
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 55150
|
| Min. Negotiated Rate |
$290.53 |
| Max. Negotiated Rate |
$1,225.50 |
| Rate for Payer: Aetna Commercial |
$598.74
|
| Rate for Payer: Aetna Medicare |
$464.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.42
|
| Rate for Payer: BCBS Complete |
$305.06
|
| Rate for Payer: BCBS MAPPO |
$446.82
|
| Rate for Payer: BCN Commercial |
$743.98
|
| Rate for Payer: BCN Medicare Advantage |
$446.82
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$598.74
|
| Rate for Payer: Cofinity Commercial |
$643.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.16
|
| Rate for Payer: Meridian Medicaid |
$305.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.50
|
| Rate for Payer: Nomi Health Commercial |
$536.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$446.82
|
| Rate for Payer: PHP Commercial |
$625.55
|
| Rate for Payer: PHP Medicare Advantage |
$446.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$810.45
|
| Rate for Payer: Priority Health Medicare |
$446.82
|
| Rate for Payer: Priority Health SBD |
$810.45
|
| Rate for Payer: Priority Health Tiered Network |
$810.45
|
| Rate for Payer: Railroad Medicare Medicare |
$446.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.57
|
| Rate for Payer: UHC Core |
$864.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.82
|
| Rate for Payer: UHC Exchange |
$864.57
|
| Rate for Payer: UHC Medicaid |
$290.53
|
| Rate for Payer: UHCCP Medicaid |
$290.53
|
| Rate for Payer: UMR Bronson Commercial |
$751.64
|
|
|
PR RESECTION/TRANSPLANTATION LONG TENDON BICEPS
|
Professional
|
Both
|
$1,394.00
|
|
|
Service Code
|
HCPCS 23440
|
| Min. Negotiated Rate |
$447.30 |
| Max. Negotiated Rate |
$1,321.97 |
| Rate for Payer: Aetna Commercial |
$919.49
|
| Rate for Payer: Aetna Medicare |
$713.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.11
|
| Rate for Payer: BCBS Complete |
$469.67
|
| Rate for Payer: BCBS MAPPO |
$686.19
|
| Rate for Payer: BCN Commercial |
$1,152.83
|
| Rate for Payer: BCN Medicare Advantage |
$686.19
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cofinity Commercial |
$919.49
|
| Rate for Payer: Cofinity Commercial |
$988.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.50
|
| Rate for Payer: Meridian Medicaid |
$469.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.81
|
| Rate for Payer: Nomi Health Commercial |
$823.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.50
|
| Rate for Payer: PACE SWMI |
$686.19
|
| Rate for Payer: PHP Commercial |
$960.67
|
| Rate for Payer: PHP Medicare Advantage |
$686.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,232.34
|
| Rate for Payer: Priority Health Medicare |
$686.19
|
| Rate for Payer: Priority Health SBD |
$1,232.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,232.34
|
| Rate for Payer: Railroad Medicare Medicare |
$686.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.97
|
| Rate for Payer: UHC Core |
$1,321.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.19
|
| Rate for Payer: UHC Exchange |
$1,321.97
|
| Rate for Payer: UHC Medicaid |
$447.30
|
| Rate for Payer: UHCCP Medicaid |
$447.30
|
| Rate for Payer: UMR Bronson Commercial |
$641.24
|
|
|
PR RESPIRATORY FLOW VOLUME LOOP
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 94375
|
| Min. Negotiated Rate |
$39.44 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Aetna Commercial |
$52.85
|
| Rate for Payer: Aetna Medicare |
$41.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.79
|
| Rate for Payer: BCBS MAPPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Medicare Advantage |
$39.44
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$52.85
|
| Rate for Payer: Cofinity Commercial |
$56.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.38
|
| Rate for Payer: Nomi Health Commercial |
$47.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$39.44
|
| Rate for Payer: PHP Commercial |
$55.22
|
| Rate for Payer: PHP Medicare Advantage |
$39.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.74
|
| Rate for Payer: Priority Health Medicare |
$39.44
|
| Rate for Payer: Priority Health SBD |
$53.74
|
| Rate for Payer: Priority Health Tiered Network |
$53.74
|
| Rate for Payer: Railroad Medicare Medicare |
$39.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.12
|
| Rate for Payer: UHC Core |
$60.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.44
|
| Rate for Payer: UHC Exchange |
$60.12
|
| Rate for Payer: UMR Bronson Commercial |
$52.90
|
|
|
PR RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 90378
|
| Min. Negotiated Rate |
$1,748.46 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Aetna Commercial |
$1,857.07
|
| Rate for Payer: Aetna Medicare |
$1,900.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,857.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,820.66
|
| Rate for Payer: BCN Commercial |
$1,791.52
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,850.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,875.28
|
| Rate for Payer: UHC Core |
$1,875.28
|
| Rate for Payer: UHC Exchange |
$1,875.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,748.46
|
|
|
PR REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 37222
|
| Min. Negotiated Rate |
$245.60 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$249.11
|
| Rate for Payer: Aetna Medicare |
$307.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.11
|
| Rate for Payer: BCBS Complete |
$245.60
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 37220
|
| Min. Negotiated Rate |
$399.20 |
| Max. Negotiated Rate |
$748.50 |
| Rate for Payer: Aetna Commercial |
$538.63
|
| Rate for Payer: Aetna Medicare |
$499.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.63
|
| Rate for Payer: BCBS Complete |
$399.20
|
| Rate for Payer: BCN Commercial |
$581.14
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.08
|
|
|
PR REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT
|
Professional
|
Both
|
$5,149.00
|
|
|
Service Code
|
HCPCS 24371
|
| Min. Negotiated Rate |
$1,002.17 |
| Max. Negotiated Rate |
$3,861.75 |
| Rate for Payer: Aetna Commercial |
$2,078.84
|
| Rate for Payer: Aetna Medicare |
$1,613.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,078.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.97
|
| Rate for Payer: BCBS Complete |
$1,052.28
|
| Rate for Payer: BCBS MAPPO |
$1,551.37
|
| Rate for Payer: BCN Commercial |
$2,660.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,551.37
|
| Rate for Payer: Cash Price |
$4,119.20
|
| Rate for Payer: Cash Price |
$4,119.20
|
| Rate for Payer: Cofinity Commercial |
$2,233.97
|
| Rate for Payer: Cofinity Commercial |
$2,078.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,551.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,628.94
|
| Rate for Payer: Meridian Medicaid |
$1,052.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,706.51
|
| Rate for Payer: Nomi Health Commercial |
$1,861.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,861.75
|
| Rate for Payer: PACE SWMI |
$1,551.37
|
| Rate for Payer: PHP Commercial |
$2,171.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,551.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,002.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,843.69
|
| Rate for Payer: Priority Health Medicare |
$1,551.37
|
| Rate for Payer: Priority Health SBD |
$2,843.69
|
| Rate for Payer: Priority Health Tiered Network |
$2,843.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,551.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,133.20
|
| Rate for Payer: UHC Core |
$3,133.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,551.37
|
| Rate for Payer: UHC Exchange |
$3,133.20
|
| Rate for Payer: UHC Medicaid |
$1,002.17
|
| Rate for Payer: UHCCP Medicaid |
$1,002.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,368.54
|
|
|
PR REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT
|
Professional
|
Both
|
$3,893.00
|
|
|
Service Code
|
HCPCS 24370
|
| Min. Negotiated Rate |
$877.99 |
| Max. Negotiated Rate |
$2,919.75 |
| Rate for Payer: Aetna Commercial |
$1,818.35
|
| Rate for Payer: Aetna Medicare |
$1,411.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,818.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,954.05
|
| Rate for Payer: BCBS Complete |
$921.89
|
| Rate for Payer: BCBS MAPPO |
$1,356.98
|
| Rate for Payer: BCN Commercial |
$2,320.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,356.98
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cofinity Commercial |
$1,818.35
|
| Rate for Payer: Cofinity Commercial |
$1,954.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,356.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,424.83
|
| Rate for Payer: Meridian Medicaid |
$921.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,492.68
|
| Rate for Payer: Nomi Health Commercial |
$1,628.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,919.75
|
| Rate for Payer: PACE SWMI |
$1,356.98
|
| Rate for Payer: PHP Commercial |
$1,899.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,356.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,480.65
|
| Rate for Payer: Priority Health Medicare |
$1,356.98
|
| Rate for Payer: Priority Health SBD |
$2,480.65
|
| Rate for Payer: Priority Health Tiered Network |
$2,480.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,356.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,713.95
|
| Rate for Payer: UHC Core |
$2,713.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,356.98
|
| Rate for Payer: UHC Exchange |
$2,713.95
|
| Rate for Payer: UHC Medicaid |
$877.99
|
| Rate for Payer: UHCCP Medicaid |
$877.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,790.78
|
|
|
PR REVISION OF LARYNX, UNSPECIFIED
|
Professional
|
Both
|
$2,122.00
|
|
|
Service Code
|
HCPCS 31588
|
| Min. Negotiated Rate |
$848.80 |
| Max. Negotiated Rate |
$1,591.50 |
| Rate for Payer: Aetna Medicare |
$1,061.00
|
| Rate for Payer: BCBS Complete |
$848.80
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,591.50
|
| Rate for Payer: UMR Bronson Commercial |
$976.12
|
|
|
PR REVISION OF RECONSTRUCTED BREAST
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 19380
|
| Min. Negotiated Rate |
$469.24 |
| Max. Negotiated Rate |
$1,356.42 |
| Rate for Payer: Aetna Commercial |
$962.44
|
| Rate for Payer: Aetna Medicare |
$746.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.44
|
| Rate for Payer: BCBS Complete |
$492.70
|
| Rate for Payer: BCBS MAPPO |
$718.24
|
| Rate for Payer: BCN Commercial |
$1,222.54
|
| Rate for Payer: BCN Medicare Advantage |
$718.24
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$962.44
|
| Rate for Payer: Cofinity Commercial |
$1,034.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$718.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.15
|
| Rate for Payer: Meridian Medicaid |
$492.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$790.06
|
| Rate for Payer: Nomi Health Commercial |
$861.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$941.25
|
| Rate for Payer: PACE SWMI |
$718.24
|
| Rate for Payer: PHP Commercial |
$1,005.54
|
| Rate for Payer: PHP Medicare Advantage |
$718.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,118.95
|
| Rate for Payer: Priority Health Medicare |
$718.24
|
| Rate for Payer: Priority Health SBD |
$1,118.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,118.95
|
| Rate for Payer: Railroad Medicare Medicare |
$718.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,356.42
|
| Rate for Payer: UHC Core |
$1,356.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$718.24
|
| Rate for Payer: UHC Exchange |
$1,356.42
|
| Rate for Payer: UHC Medicaid |
$469.24
|
| Rate for Payer: UHCCP Medicaid |
$469.24
|
| Rate for Payer: UMR Bronson Commercial |
$577.30
|
|
|
PR REVISION PERI-IMPLANT CAPSULE BREAST
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 19370
|
| Min. Negotiated Rate |
$392.77 |
| Max. Negotiated Rate |
$1,201.54 |
| Rate for Payer: Aetna Commercial |
$804.58
|
| Rate for Payer: Aetna Medicare |
$624.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.62
|
| Rate for Payer: BCBS Complete |
$412.41
|
| Rate for Payer: BCBS MAPPO |
$600.43
|
| Rate for Payer: BCN Commercial |
$1,018.37
|
| Rate for Payer: BCN Medicare Advantage |
$600.43
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$804.58
|
| Rate for Payer: Cofinity Commercial |
$864.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.45
|
| Rate for Payer: Meridian Medicaid |
$412.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.47
|
| Rate for Payer: Nomi Health Commercial |
$720.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$600.43
|
| Rate for Payer: PHP Commercial |
$840.60
|
| Rate for Payer: PHP Medicare Advantage |
$600.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$932.08
|
| Rate for Payer: Priority Health Medicare |
$600.43
|
| Rate for Payer: Priority Health SBD |
$932.08
|
| Rate for Payer: Priority Health Tiered Network |
$932.08
|
| Rate for Payer: Railroad Medicare Medicare |
$600.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,201.54
|
| Rate for Payer: UHC Core |
$1,201.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$600.43
|
| Rate for Payer: UHC Exchange |
$1,201.54
|
| Rate for Payer: UHC Medicaid |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$392.77
|
| Rate for Payer: UMR Bronson Commercial |
$589.26
|
|
|
PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 57426
|
| Min. Negotiated Rate |
$494.80 |
| Max. Negotiated Rate |
$1,516.39 |
| Rate for Payer: Aetna Commercial |
$1,026.06
|
| Rate for Payer: Aetna Medicare |
$796.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.64
|
| Rate for Payer: BCBS Complete |
$519.54
|
| Rate for Payer: BCBS MAPPO |
$765.72
|
| Rate for Payer: BCN Commercial |
$1,309.20
|
| Rate for Payer: BCN Medicare Advantage |
$765.72
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$1,026.06
|
| Rate for Payer: Cofinity Commercial |
$1,102.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$804.01
|
| Rate for Payer: Meridian Medicaid |
$519.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$842.29
|
| Rate for Payer: Nomi Health Commercial |
$918.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,245.00
|
| Rate for Payer: PACE SWMI |
$765.72
|
| Rate for Payer: PHP Commercial |
$1,072.01
|
| Rate for Payer: PHP Medicare Advantage |
$765.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,325.93
|
| Rate for Payer: Priority Health Medicare |
$765.72
|
| Rate for Payer: Priority Health SBD |
$1,325.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,325.93
|
| Rate for Payer: Railroad Medicare Medicare |
$765.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,516.39
|
| Rate for Payer: UHC Core |
$1,516.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$765.72
|
| Rate for Payer: UHC Exchange |
$1,516.39
|
| Rate for Payer: UHC Medicaid |
$494.80
|
| Rate for Payer: UHCCP Medicaid |
$494.80
|
| Rate for Payer: UMR Bronson Commercial |
$763.60
|
|
