|
PR REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV
|
Professional
|
Both
|
$2,297.00
|
|
|
Service Code
|
HCPCS 64569
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$1,722.75 |
| Rate for Payer: Aetna Commercial |
$990.64
|
| Rate for Payer: Aetna Medicare |
$768.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,064.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.64
|
| Rate for Payer: BCBS Complete |
$499.63
|
| Rate for Payer: BCBS MAPPO |
$739.28
|
| Rate for Payer: BCN Commercial |
$1,178.72
|
| Rate for Payer: BCN Medicare Advantage |
$739.28
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cash Price |
$1,837.60
|
| Rate for Payer: Cofinity Commercial |
$1,064.56
|
| Rate for Payer: Cofinity Commercial |
$990.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.24
|
| Rate for Payer: Meridian Medicaid |
$499.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$813.21
|
| Rate for Payer: Nomi Health Commercial |
$887.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.75
|
| Rate for Payer: PACE SWMI |
$739.28
|
| Rate for Payer: PHP Commercial |
$1,034.99
|
| Rate for Payer: PHP Medicare Advantage |
$739.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,369.06
|
| Rate for Payer: Priority Health Medicare |
$739.28
|
| Rate for Payer: Priority Health SBD |
$1,369.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,369.06
|
| Rate for Payer: Railroad Medicare Medicare |
$739.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,334.20
|
| Rate for Payer: UHC Core |
$1,334.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$739.28
|
| Rate for Payer: UHC Exchange |
$1,334.20
|
| Rate for Payer: UHC Medicaid |
$475.84
|
| Rate for Payer: UHCCP Medicaid |
$475.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,056.62
|
|
|
PR REVISION STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$4,035.00
|
|
|
Service Code
|
HCPCS 69662
|
| Min. Negotiated Rate |
$650.72 |
| Max. Negotiated Rate |
$3,026.25 |
| Rate for Payer: Aetna Commercial |
$1,330.03
|
| Rate for Payer: Aetna Medicare |
$1,032.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.29
|
| Rate for Payer: BCBS Complete |
$683.26
|
| Rate for Payer: BCBS MAPPO |
$992.56
|
| Rate for Payer: BCN Commercial |
$1,718.53
|
| Rate for Payer: BCN Medicare Advantage |
$992.56
|
| Rate for Payer: Cash Price |
$3,228.00
|
| Rate for Payer: Cash Price |
$3,228.00
|
| Rate for Payer: Cofinity Commercial |
$1,330.03
|
| Rate for Payer: Cofinity Commercial |
$1,429.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.19
|
| Rate for Payer: Meridian Medicaid |
$683.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,091.82
|
| Rate for Payer: Nomi Health Commercial |
$1,191.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,026.25
|
| Rate for Payer: PACE SWMI |
$992.56
|
| Rate for Payer: PHP Commercial |
$1,389.58
|
| Rate for Payer: PHP Medicare Advantage |
$992.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,698.08
|
| Rate for Payer: Priority Health Medicare |
$992.56
|
| Rate for Payer: Priority Health SBD |
$1,698.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,698.08
|
| Rate for Payer: Railroad Medicare Medicare |
$992.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.48
|
| Rate for Payer: UHC Core |
$1,974.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$992.56
|
| Rate for Payer: UHC Exchange |
$1,974.48
|
| Rate for Payer: UHC Medicaid |
$650.72
|
| Rate for Payer: UHCCP Medicaid |
$650.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,856.10
|
|
|
PR REVISION TRACHEOSTOMY SCAR
|
Professional
|
Both
|
$718.00
|
|
|
Service Code
|
HCPCS 31830
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$608.43 |
| Rate for Payer: Aetna Commercial |
$428.76
|
| Rate for Payer: Aetna Medicare |
$332.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.76
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$319.97
|
| Rate for Payer: BCN Commercial |
$554.25
|
| Rate for Payer: BCN Medicare Advantage |
$319.97
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cofinity Commercial |
$428.76
|
| Rate for Payer: Cofinity Commercial |
$460.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.97
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$351.97
|
| Rate for Payer: Nomi Health Commercial |
$383.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.50
|
| Rate for Payer: PACE SWMI |
$319.97
|
| Rate for Payer: PHP Commercial |
$447.96
|
| Rate for Payer: PHP Medicare Advantage |
$319.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$319.97
|
| Rate for Payer: Priority Health SBD |
$521.95
|
| Rate for Payer: Priority Health Tiered Network |
$521.95
|
| Rate for Payer: Railroad Medicare Medicare |
$319.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.43
|
| Rate for Payer: UHC Core |
$608.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$319.97
|
| Rate for Payer: UHC Exchange |
$608.43
|
| Rate for Payer: UHC Medicaid |
$211.08
|
| Rate for Payer: UHCCP Medicaid |
$211.08
|
| Rate for Payer: UMR Bronson Commercial |
$330.28
|
|
|
PR REVIS PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$2,122.00
|
|
|
Service Code
|
HCPCS 49426
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,591.50 |
| Rate for Payer: Aetna Commercial |
$851.93
|
| Rate for Payer: Aetna Medicare |
$661.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.51
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$635.77
|
| Rate for Payer: BCN Commercial |
$1,013.39
|
| Rate for Payer: BCN Medicare Advantage |
$635.77
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Cash Price |
$1,697.60
|
| Rate for Payer: Cofinity Commercial |
$851.93
|
| Rate for Payer: Cofinity Commercial |
$915.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$635.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$667.56
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$699.35
|
| Rate for Payer: Nomi Health Commercial |
$762.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,591.50
|
| Rate for Payer: PACE SWMI |
$635.77
|
| Rate for Payer: PHP Commercial |
$890.08
|
| Rate for Payer: PHP Medicare Advantage |
$635.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,234.75
|
| Rate for Payer: Priority Health Medicare |
$635.77
|
| Rate for Payer: Priority Health SBD |
$1,234.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,234.75
|
| Rate for Payer: Railroad Medicare Medicare |
$635.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,186.58
|
| Rate for Payer: UHC Core |
$1,186.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$635.77
|
| Rate for Payer: UHC Exchange |
$1,186.58
|
| Rate for Payer: UHC Medicaid |
$409.81
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
| Rate for Payer: UMR Bronson Commercial |
$976.12
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT
|
Professional
|
Both
|
$4,318.00
|
|
|
Service Code
|
HCPCS 23474
|
| Min. Negotiated Rate |
$989.81 |
| Max. Negotiated Rate |
$3,238.50 |
| Rate for Payer: Aetna Commercial |
$2,054.23
|
| Rate for Payer: Aetna Medicare |
$1,594.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,054.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,207.53
|
| Rate for Payer: BCBS Complete |
$1,039.30
|
| Rate for Payer: BCBS MAPPO |
$1,533.01
|
| Rate for Payer: BCN Commercial |
$2,612.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,533.01
|
| Rate for Payer: Cash Price |
$3,454.40
|
| Rate for Payer: Cash Price |
$3,454.40
|
| Rate for Payer: Cofinity Commercial |
$2,054.23
|
| Rate for Payer: Cofinity Commercial |
$2,207.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,533.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,609.66
|
| Rate for Payer: Meridian Medicaid |
$1,039.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,686.31
|
| Rate for Payer: Nomi Health Commercial |
$1,839.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,238.50
|
| Rate for Payer: PACE SWMI |
$1,533.01
|
| Rate for Payer: PHP Commercial |
$2,146.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,533.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$989.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,793.12
|
| Rate for Payer: Priority Health Medicare |
$1,533.01
|
| Rate for Payer: Priority Health SBD |
$2,793.12
|
| Rate for Payer: Priority Health Tiered Network |
$2,793.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,533.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.11
|
| Rate for Payer: UHC Core |
$3,080.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,533.01
|
| Rate for Payer: UHC Exchange |
$3,080.11
|
| Rate for Payer: UHC Medicaid |
$989.81
|
| Rate for Payer: UHCCP Medicaid |
$989.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,986.28
|
|
|
PR REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT
|
Professional
|
Both
|
$3,694.00
|
|
|
Service Code
|
HCPCS 23473
|
| Min. Negotiated Rate |
$918.46 |
| Max. Negotiated Rate |
$2,849.48 |
| Rate for Payer: Aetna Commercial |
$1,904.23
|
| Rate for Payer: Aetna Medicare |
$1,477.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,046.34
|
| Rate for Payer: BCBS Complete |
$964.38
|
| Rate for Payer: BCBS MAPPO |
$1,421.07
|
| Rate for Payer: BCN Commercial |
$2,421.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,421.07
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cofinity Commercial |
$1,904.23
|
| Rate for Payer: Cofinity Commercial |
$2,046.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,421.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,492.12
|
| Rate for Payer: Meridian Medicaid |
$964.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,563.18
|
| Rate for Payer: Nomi Health Commercial |
$1,705.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,770.50
|
| Rate for Payer: PACE SWMI |
$1,421.07
|
| Rate for Payer: PHP Commercial |
$1,989.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,421.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$918.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,588.18
|
| Rate for Payer: Priority Health Medicare |
$1,421.07
|
| Rate for Payer: Priority Health SBD |
$2,588.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,588.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,421.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,849.48
|
| Rate for Payer: UHC Core |
$2,849.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,421.07
|
| Rate for Payer: UHC Exchange |
$2,849.48
|
| Rate for Payer: UHC Medicaid |
$918.46
|
| Rate for Payer: UHCCP Medicaid |
$918.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,699.24
|
|
|
PR REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 25449
|
| Min. Negotiated Rate |
$594.48 |
| Max. Negotiated Rate |
$1,810.42 |
| Rate for Payer: Aetna Commercial |
$1,224.40
|
| Rate for Payer: Aetna Medicare |
$950.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,224.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.77
|
| Rate for Payer: BCBS Complete |
$624.20
|
| Rate for Payer: BCBS MAPPO |
$913.73
|
| Rate for Payer: BCN Commercial |
$1,569.64
|
| Rate for Payer: BCN Medicare Advantage |
$913.73
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cofinity Commercial |
$1,224.40
|
| Rate for Payer: Cofinity Commercial |
$1,315.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$913.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$959.42
|
| Rate for Payer: Meridian Medicaid |
$624.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,005.10
|
| Rate for Payer: Nomi Health Commercial |
$1,096.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,608.75
|
| Rate for Payer: PACE SWMI |
$913.73
|
| Rate for Payer: PHP Commercial |
$1,279.22
|
| Rate for Payer: PHP Medicare Advantage |
$913.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,677.89
|
| Rate for Payer: Priority Health Medicare |
$913.73
|
| Rate for Payer: Priority Health SBD |
$1,677.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,677.89
|
| Rate for Payer: Railroad Medicare Medicare |
$913.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,810.42
|
| Rate for Payer: UHC Core |
$1,810.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$913.73
|
| Rate for Payer: UHC Exchange |
$1,810.42
|
| Rate for Payer: UHC Medicaid |
$594.48
|
| Rate for Payer: UHCCP Medicaid |
$594.48
|
| Rate for Payer: UMR Bronson Commercial |
$986.70
|
|
|
PR REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,189.00
|
|
|
Service Code
|
HCPCS 44345
|
| Min. Negotiated Rate |
$629.20 |
| Max. Negotiated Rate |
$1,921.59 |
| Rate for Payer: Aetna Commercial |
$1,308.74
|
| Rate for Payer: Aetna Medicare |
$1,015.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,308.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,406.40
|
| Rate for Payer: BCBS Complete |
$660.66
|
| Rate for Payer: BCBS MAPPO |
$976.67
|
| Rate for Payer: BCN Commercial |
$1,577.10
|
| Rate for Payer: BCN Medicare Advantage |
$976.67
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Cash Price |
$1,751.20
|
| Rate for Payer: Cofinity Commercial |
$1,308.74
|
| Rate for Payer: Cofinity Commercial |
$1,406.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$976.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,025.50
|
| Rate for Payer: Meridian Medicaid |
$660.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,074.34
|
| Rate for Payer: Nomi Health Commercial |
$1,172.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.75
|
| Rate for Payer: PACE SWMI |
$976.67
|
| Rate for Payer: PHP Commercial |
$1,367.34
|
| Rate for Payer: PHP Medicare Advantage |
$976.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,921.59
|
| Rate for Payer: Priority Health Medicare |
$976.67
|
| Rate for Payer: Priority Health SBD |
$1,921.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,921.59
|
| Rate for Payer: Railroad Medicare Medicare |
$976.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,861.97
|
| Rate for Payer: UHC Core |
$1,861.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$976.67
|
| Rate for Payer: UHC Exchange |
$1,861.97
|
| Rate for Payer: UHC Medicaid |
$629.20
|
| Rate for Payer: UHCCP Medicaid |
$629.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,006.94
|
|
|
PR REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 44340
|
| Min. Negotiated Rate |
$387.23 |
| Max. Negotiated Rate |
$1,153.45 |
| Rate for Payer: Aetna Commercial |
$797.57
|
| Rate for Payer: Aetna Medicare |
$619.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.09
|
| Rate for Payer: BCBS Complete |
$406.59
|
| Rate for Payer: BCBS MAPPO |
$595.20
|
| Rate for Payer: BCN Commercial |
$946.66
|
| Rate for Payer: BCN Medicare Advantage |
$595.20
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$797.57
|
| Rate for Payer: Cofinity Commercial |
$857.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.96
|
| Rate for Payer: Meridian Medicaid |
$406.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$654.72
|
| Rate for Payer: Nomi Health Commercial |
$714.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE SWMI |
$595.20
|
| Rate for Payer: PHP Commercial |
$833.28
|
| Rate for Payer: PHP Medicare Advantage |
$595.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,153.45
|
| Rate for Payer: Priority Health Medicare |
$595.20
|
| Rate for Payer: Priority Health SBD |
$1,153.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,153.45
|
| Rate for Payer: Railroad Medicare Medicare |
$595.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,097.57
|
| Rate for Payer: UHC Core |
$1,097.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$595.20
|
| Rate for Payer: UHC Exchange |
$1,097.57
|
| Rate for Payer: UHC Medicaid |
$387.23
|
| Rate for Payer: UHCCP Medicaid |
$387.23
|
| Rate for Payer: UMR Bronson Commercial |
$527.62
|
|
|
PR REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX
|
Professional
|
Both
|
$2,947.00
|
|
|
Service Code
|
HCPCS 44346
|
| Min. Negotiated Rate |
$701.62 |
| Max. Negotiated Rate |
$2,210.25 |
| Rate for Payer: Aetna Commercial |
$1,461.36
|
| Rate for Payer: Aetna Medicare |
$1,134.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,570.42
|
| Rate for Payer: BCBS Complete |
$736.70
|
| Rate for Payer: BCBS MAPPO |
$1,090.57
|
| Rate for Payer: BCN Commercial |
$1,773.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.57
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,461.36
|
| Rate for Payer: Cofinity Commercial |
$1,570.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.10
|
| Rate for Payer: Meridian Medicaid |
$736.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,199.63
|
| Rate for Payer: Nomi Health Commercial |
$1,308.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,210.25
|
| Rate for Payer: PACE SWMI |
$1,090.57
|
| Rate for Payer: PHP Commercial |
$1,526.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,160.67
|
| Rate for Payer: Priority Health Medicare |
$1,090.57
|
| Rate for Payer: Priority Health SBD |
$2,160.67
|
| Rate for Payer: Priority Health Tiered Network |
$2,160.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,090.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,100.93
|
| Rate for Payer: UHC Core |
$2,100.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,090.57
|
| Rate for Payer: UHC Exchange |
$2,100.93
|
| Rate for Payer: UHC Medicaid |
$701.62
|
| Rate for Payer: UHCCP Medicaid |
$701.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,355.62
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,698.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$718.88 |
| Max. Negotiated Rate |
$2,232.45 |
| Rate for Payer: Aetna Commercial |
$1,532.16
|
| Rate for Payer: Aetna Medicare |
$1,189.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.50
|
| Rate for Payer: BCBS Complete |
$754.82
|
| Rate for Payer: BCBS MAPPO |
$1,143.40
|
| Rate for Payer: BCN Commercial |
$1,810.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,143.40
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,532.16
|
| Rate for Payer: Cofinity Commercial |
$1,646.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,143.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,200.57
|
| Rate for Payer: Meridian Medicaid |
$754.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,257.74
|
| Rate for Payer: Nomi Health Commercial |
$1,372.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.50
|
| Rate for Payer: PACE SWMI |
$1,143.40
|
| Rate for Payer: PHP Commercial |
$1,600.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,143.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,947.14
|
| Rate for Payer: Priority Health Medicare |
$1,143.40
|
| Rate for Payer: Priority Health SBD |
$1,947.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,947.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,143.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,232.45
|
| Rate for Payer: UHC Core |
$2,232.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,143.40
|
| Rate for Payer: UHC Exchange |
$2,232.45
|
| Rate for Payer: UHC Medicaid |
$718.88
|
| Rate for Payer: UHCCP Medicaid |
$718.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,241.08
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,433.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$690.97 |
| Max. Negotiated Rate |
$2,160.12 |
| Rate for Payer: Aetna Commercial |
$1,468.99
|
| Rate for Payer: Aetna Medicare |
$1,140.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.61
|
| Rate for Payer: BCBS Complete |
$725.52
|
| Rate for Payer: BCBS MAPPO |
$1,096.26
|
| Rate for Payer: BCN Commercial |
$1,741.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.26
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cofinity Commercial |
$1,468.99
|
| Rate for Payer: Cofinity Commercial |
$1,578.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,151.07
|
| Rate for Payer: Meridian Medicaid |
$725.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,205.89
|
| Rate for Payer: Nomi Health Commercial |
$1,315.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.75
|
| Rate for Payer: PACE SWMI |
$1,096.26
|
| Rate for Payer: PHP Commercial |
$1,534.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,873.23
|
| Rate for Payer: Priority Health Medicare |
$1,096.26
|
| Rate for Payer: Priority Health SBD |
$1,873.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,873.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,096.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,160.12
|
| Rate for Payer: UHC Core |
$2,160.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,096.26
|
| Rate for Payer: UHC Exchange |
$2,160.12
|
| Rate for Payer: UHC Medicaid |
$690.97
|
| Rate for Payer: UHCCP Medicaid |
$690.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.18
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,546.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$966.81 |
| Max. Negotiated Rate |
$4,159.50 |
| Rate for Payer: Aetna Commercial |
$2,027.46
|
| Rate for Payer: Aetna Medicare |
$1,573.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,027.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.76
|
| Rate for Payer: BCBS Complete |
$1,015.15
|
| Rate for Payer: BCBS MAPPO |
$1,513.03
|
| Rate for Payer: BCN Commercial |
$2,455.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,513.03
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Cofinity Commercial |
$2,027.46
|
| Rate for Payer: Cofinity Commercial |
$2,178.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,513.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,588.68
|
| Rate for Payer: Meridian Medicaid |
$1,015.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,664.33
|
| Rate for Payer: Nomi Health Commercial |
$1,815.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,159.50
|
| Rate for Payer: PACE SWMI |
$1,513.03
|
| Rate for Payer: PHP Commercial |
$2,118.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,513.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$966.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,991.31
|
| Rate for Payer: Priority Health Medicare |
$1,513.03
|
| Rate for Payer: Priority Health SBD |
$2,991.31
|
| Rate for Payer: Priority Health Tiered Network |
$2,991.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,513.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,924.75
|
| Rate for Payer: UHC Core |
$2,924.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,513.03
|
| Rate for Payer: UHC Exchange |
$2,924.75
|
| Rate for Payer: UHC Medicaid |
$966.81
|
| Rate for Payer: UHCCP Medicaid |
$966.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,551.16
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,665.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$596.61 |
| Max. Negotiated Rate |
$1,998.75 |
| Rate for Payer: Aetna Commercial |
$1,240.61
|
| Rate for Payer: Aetna Medicare |
$962.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.20
|
| Rate for Payer: BCBS Complete |
$626.44
|
| Rate for Payer: BCBS MAPPO |
$925.83
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: BCN Medicare Advantage |
$925.83
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cofinity Commercial |
$1,240.61
|
| Rate for Payer: Cofinity Commercial |
$1,333.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.12
|
| Rate for Payer: Meridian Medicaid |
$626.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,018.41
|
| Rate for Payer: Nomi Health Commercial |
$1,111.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,998.75
|
| Rate for Payer: PACE SWMI |
$925.83
|
| Rate for Payer: PHP Commercial |
$1,296.16
|
| Rate for Payer: PHP Medicare Advantage |
$925.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$596.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,830.58
|
| Rate for Payer: Priority Health Medicare |
$925.83
|
| Rate for Payer: Priority Health SBD |
$1,830.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,830.58
|
| Rate for Payer: Railroad Medicare Medicare |
$925.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,783.19
|
| Rate for Payer: UHC Core |
$1,783.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$925.83
|
| Rate for Payer: UHC Exchange |
$1,783.19
|
| Rate for Payer: UHC Medicaid |
$596.61
|
| Rate for Payer: UHCCP Medicaid |
$596.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,225.90
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,095.19 |
| Rate for Payer: Aetna Commercial |
$750.11
|
| Rate for Payer: Aetna Medicare |
$582.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.08
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$559.78
|
| Rate for Payer: BCN Commercial |
$898.85
|
| Rate for Payer: BCN Medicare Advantage |
$559.78
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$750.11
|
| Rate for Payer: Cofinity Commercial |
$806.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.77
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.76
|
| Rate for Payer: Nomi Health Commercial |
$671.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PACE SWMI |
$559.78
|
| Rate for Payer: PHP Commercial |
$783.69
|
| Rate for Payer: PHP Medicare Advantage |
$559.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,095.19
|
| Rate for Payer: Priority Health Medicare |
$559.78
|
| Rate for Payer: Priority Health SBD |
$1,095.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,095.19
|
| Rate for Payer: Railroad Medicare Medicare |
$559.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.46
|
| Rate for Payer: UHC Core |
$1,049.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.78
|
| Rate for Payer: UHC Exchange |
$1,049.46
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$586.50
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,252.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$565.30 |
| Max. Negotiated Rate |
$3,189.00 |
| Rate for Payer: Aetna Commercial |
$1,167.97
|
| Rate for Payer: Aetna Medicare |
$906.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,255.13
|
| Rate for Payer: BCBS Complete |
$593.57
|
| Rate for Payer: BCBS MAPPO |
$871.62
|
| Rate for Payer: BCN Commercial |
$1,356.50
|
| Rate for Payer: BCN Medicare Advantage |
$871.62
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Cofinity Commercial |
$1,167.97
|
| Rate for Payer: Cofinity Commercial |
$1,255.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.20
|
| Rate for Payer: Meridian Medicaid |
$593.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$958.78
|
| Rate for Payer: Nomi Health Commercial |
$1,045.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,189.00
|
| Rate for Payer: PACE SWMI |
$871.62
|
| Rate for Payer: PHP Commercial |
$1,220.27
|
| Rate for Payer: PHP Medicare Advantage |
$871.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$565.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,575.55
|
| Rate for Payer: Priority Health Medicare |
$871.62
|
| Rate for Payer: Priority Health SBD |
$1,575.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,575.55
|
| Rate for Payer: Railroad Medicare Medicare |
$871.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,534.28
|
| Rate for Payer: UHC Core |
$1,534.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$871.62
|
| Rate for Payer: UHC Exchange |
$1,534.28
|
| Rate for Payer: UHC Medicaid |
$565.30
|
| Rate for Payer: UHCCP Medicaid |
$565.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,955.92
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,962.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$261.14 |
| Max. Negotiated Rate |
$3,721.50 |
| Rate for Payer: Aetna Commercial |
$540.86
|
| Rate for Payer: Aetna Medicare |
$419.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.23
|
| Rate for Payer: BCBS Complete |
$274.20
|
| Rate for Payer: BCBS MAPPO |
$403.63
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: BCN Medicare Advantage |
$403.63
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Cofinity Commercial |
$540.86
|
| Rate for Payer: Cofinity Commercial |
$581.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.81
|
| Rate for Payer: Meridian Medicaid |
$274.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.99
|
| Rate for Payer: Nomi Health Commercial |
$484.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,721.50
|
| Rate for Payer: PACE SWMI |
$403.63
|
| Rate for Payer: PHP Commercial |
$565.08
|
| Rate for Payer: PHP Medicare Advantage |
$403.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$785.47
|
| Rate for Payer: Priority Health Medicare |
$403.63
|
| Rate for Payer: Priority Health SBD |
$785.47
|
| Rate for Payer: Priority Health Tiered Network |
$785.47
|
| Rate for Payer: Railroad Medicare Medicare |
$403.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.81
|
| Rate for Payer: UHC Core |
$793.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.63
|
| Rate for Payer: UHC Exchange |
$793.81
|
| Rate for Payer: UHC Medicaid |
$261.14
|
| Rate for Payer: UHCCP Medicaid |
$261.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,282.52
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$536.33 |
| Max. Negotiated Rate |
$1,660.50 |
| Rate for Payer: Aetna Commercial |
$1,136.78
|
| Rate for Payer: Aetna Medicare |
$882.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.61
|
| Rate for Payer: BCBS Complete |
$563.15
|
| Rate for Payer: BCBS MAPPO |
$848.34
|
| Rate for Payer: BCN Commercial |
$1,348.53
|
| Rate for Payer: BCN Medicare Advantage |
$848.34
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$1,136.78
|
| Rate for Payer: Cofinity Commercial |
$1,221.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.76
|
| Rate for Payer: Meridian Medicaid |
$563.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$933.17
|
| Rate for Payer: Nomi Health Commercial |
$1,018.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,410.00
|
| Rate for Payer: PACE SWMI |
$848.34
|
| Rate for Payer: PHP Commercial |
$1,187.68
|
| Rate for Payer: PHP Medicare Advantage |
$848.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,450.17
|
| Rate for Payer: Priority Health Medicare |
$848.34
|
| Rate for Payer: Priority Health SBD |
$1,450.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,450.17
|
| Rate for Payer: Railroad Medicare Medicare |
$848.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,660.50
|
| Rate for Payer: UHC Core |
$1,660.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$848.34
|
| Rate for Payer: UHC Exchange |
$1,660.50
|
| Rate for Payer: UHC Medicaid |
$536.33
|
| Rate for Payer: UHCCP Medicaid |
$536.33
|
| Rate for Payer: UMR Bronson Commercial |
$864.80
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,183.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$595.97 |
| Max. Negotiated Rate |
$1,833.07 |
| Rate for Payer: Aetna Commercial |
$1,262.86
|
| Rate for Payer: Aetna Medicare |
$980.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,357.10
|
| Rate for Payer: BCBS Complete |
$625.77
|
| Rate for Payer: BCBS MAPPO |
$942.43
|
| Rate for Payer: BCN Commercial |
$1,495.93
|
| Rate for Payer: BCN Medicare Advantage |
$942.43
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Cofinity Commercial |
$1,262.86
|
| Rate for Payer: Cofinity Commercial |
$1,357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$942.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.55
|
| Rate for Payer: Meridian Medicaid |
$625.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.67
|
| Rate for Payer: Nomi Health Commercial |
$1,130.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,637.25
|
| Rate for Payer: PACE SWMI |
$942.43
|
| Rate for Payer: PHP Commercial |
$1,319.40
|
| Rate for Payer: PHP Medicare Advantage |
$942.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,608.69
|
| Rate for Payer: Priority Health Medicare |
$942.43
|
| Rate for Payer: Priority Health SBD |
$1,608.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,608.69
|
| Rate for Payer: Railroad Medicare Medicare |
$942.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,833.07
|
| Rate for Payer: UHC Core |
$1,833.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$942.43
|
| Rate for Payer: UHC Exchange |
$1,833.07
|
| Rate for Payer: UHC Medicaid |
$595.97
|
| Rate for Payer: UHCCP Medicaid |
$595.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.18
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$577.23 |
| Max. Negotiated Rate |
$1,759.85 |
| Rate for Payer: Aetna Commercial |
$1,176.91
|
| Rate for Payer: Aetna Medicare |
$913.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.74
|
| Rate for Payer: BCBS Complete |
$606.09
|
| Rate for Payer: BCBS MAPPO |
$878.29
|
| Rate for Payer: BCN Commercial |
$1,519.84
|
| Rate for Payer: BCN Medicare Advantage |
$878.29
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,176.91
|
| Rate for Payer: Cofinity Commercial |
$1,264.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.20
|
| Rate for Payer: Meridian Medicaid |
$606.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.12
|
| Rate for Payer: Nomi Health Commercial |
$1,053.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: PACE SWMI |
$878.29
|
| Rate for Payer: PHP Commercial |
$1,229.61
|
| Rate for Payer: PHP Medicare Advantage |
$878.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$577.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,501.76
|
| Rate for Payer: Priority Health Medicare |
$878.29
|
| Rate for Payer: Priority Health SBD |
$1,501.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,501.76
|
| Rate for Payer: Railroad Medicare Medicare |
$878.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.85
|
| Rate for Payer: UHC Core |
$1,759.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$878.29
|
| Rate for Payer: UHC Exchange |
$1,759.85
|
| Rate for Payer: UHC Medicaid |
$577.23
|
| Rate for Payer: UHCCP Medicaid |
$577.23
|
| Rate for Payer: UMR Bronson Commercial |
$989.00
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$628.99 |
| Max. Negotiated Rate |
$1,899.99 |
| Rate for Payer: Aetna Commercial |
$1,280.16
|
| Rate for Payer: Aetna Medicare |
$993.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,280.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.69
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$955.34
|
| Rate for Payer: BCN Commercial |
$1,658.77
|
| Rate for Payer: BCN Medicare Advantage |
$955.34
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cofinity Commercial |
$1,280.16
|
| Rate for Payer: Cofinity Commercial |
$1,375.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,003.11
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,050.87
|
| Rate for Payer: Nomi Health Commercial |
$1,146.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,729.50
|
| Rate for Payer: PACE SWMI |
$955.34
|
| Rate for Payer: PHP Commercial |
$1,337.48
|
| Rate for Payer: PHP Medicare Advantage |
$955.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,639.03
|
| Rate for Payer: Priority Health Medicare |
$955.34
|
| Rate for Payer: Priority Health SBD |
$1,639.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,639.03
|
| Rate for Payer: Railroad Medicare Medicare |
$955.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.99
|
| Rate for Payer: UHC Core |
$1,899.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$955.34
|
| Rate for Payer: UHC Exchange |
$1,899.99
|
| Rate for Payer: UHC Medicaid |
$628.99
|
| Rate for Payer: UHCCP Medicaid |
$628.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,060.76
|
|
|
PR REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF
|
Professional
|
Both
|
$1,261.00
|
|
|
Service Code
|
HCPCS 36832
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,351.25 |
| Rate for Payer: Aetna Commercial |
$925.54
|
| Rate for Payer: Aetna Medicare |
$718.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.61
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS MAPPO |
$690.70
|
| Rate for Payer: BCN Commercial |
$1,108.01
|
| Rate for Payer: BCN Medicare Advantage |
$690.70
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cofinity Commercial |
$925.54
|
| Rate for Payer: Cofinity Commercial |
$994.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.24
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$759.77
|
| Rate for Payer: Nomi Health Commercial |
$828.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$945.75
|
| Rate for Payer: PACE SWMI |
$690.70
|
| Rate for Payer: PHP Commercial |
$966.98
|
| Rate for Payer: PHP Medicare Advantage |
$690.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,191.52
|
| Rate for Payer: Priority Health Medicare |
$690.70
|
| Rate for Payer: Priority Health SBD |
$1,191.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,191.52
|
| Rate for Payer: Railroad Medicare Medicare |
$690.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,351.25
|
| Rate for Payer: UHC Core |
$1,351.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$690.70
|
| Rate for Payer: UHC Exchange |
$1,351.25
|
| Rate for Payer: UHC Medicaid |
$438.99
|
| Rate for Payer: UHCCP Medicaid |
$438.99
|
| Rate for Payer: UMR Bronson Commercial |
$580.06
|
|
|
PR REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 36833
|
| Min. Negotiated Rate |
$469.67 |
| Max. Negotiated Rate |
$1,802.25 |
| Rate for Payer: Aetna Commercial |
$991.00
|
| Rate for Payer: Aetna Medicare |
$769.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,064.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.00
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS MAPPO |
$739.55
|
| Rate for Payer: BCN Commercial |
$1,182.20
|
| Rate for Payer: BCN Medicare Advantage |
$739.55
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$1,064.95
|
| Rate for Payer: Cofinity Commercial |
$991.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.53
|
| Rate for Payer: Meridian Medicaid |
$493.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$813.50
|
| Rate for Payer: Nomi Health Commercial |
$887.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,802.25
|
| Rate for Payer: PACE SWMI |
$739.55
|
| Rate for Payer: PHP Commercial |
$1,035.37
|
| Rate for Payer: PHP Medicare Advantage |
$739.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,271.32
|
| Rate for Payer: Priority Health Medicare |
$739.55
|
| Rate for Payer: Priority Health SBD |
$1,271.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,271.32
|
| Rate for Payer: Railroad Medicare Medicare |
$739.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,449.32
|
| Rate for Payer: UHC Core |
$1,449.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$739.55
|
| Rate for Payer: UHC Exchange |
$1,449.32
|
| Rate for Payer: UHC Medicaid |
$469.67
|
| Rate for Payer: UHCCP Medicaid |
$469.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,105.38
|
|
|
PR REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 63688
|
| Min. Negotiated Rate |
$194.90 |
| Max. Negotiated Rate |
$1,405.50 |
| Rate for Payer: Aetna Commercial |
$400.66
|
| Rate for Payer: Aetna Medicare |
$310.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.56
|
| Rate for Payer: BCBS Complete |
$204.65
|
| Rate for Payer: BCBS MAPPO |
$299.00
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.00
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cofinity Commercial |
$400.66
|
| Rate for Payer: Cofinity Commercial |
$430.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.95
|
| Rate for Payer: Meridian Medicaid |
$204.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.90
|
| Rate for Payer: Nomi Health Commercial |
$358.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.50
|
| Rate for Payer: PACE SWMI |
$299.00
|
| Rate for Payer: PHP Commercial |
$418.60
|
| Rate for Payer: PHP Medicare Advantage |
$299.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$526.33
|
| Rate for Payer: Priority Health Medicare |
$299.00
|
| Rate for Payer: Priority Health SBD |
$526.33
|
| Rate for Payer: Priority Health Tiered Network |
$526.33
|
| Rate for Payer: Railroad Medicare Medicare |
$299.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.00
|
| Rate for Payer: UHC Core |
$649.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.00
|
| Rate for Payer: UHC Exchange |
$649.00
|
| Rate for Payer: UHC Medicaid |
$194.90
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
| Rate for Payer: UMR Bronson Commercial |
$862.04
|
|
|
PR REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS
|
Professional
|
Both
|
$3,280.00
|
|
|
Service Code
|
HCPCS 61880
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$2,460.00 |
| Rate for Payer: Aetna Commercial |
$811.87
|
| Rate for Payer: Aetna Medicare |
$630.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.45
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCBS MAPPO |
$605.87
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$605.87
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cofinity Commercial |
$811.87
|
| Rate for Payer: Cofinity Commercial |
$872.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.16
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$666.46
|
| Rate for Payer: Nomi Health Commercial |
$727.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,460.00
|
| Rate for Payer: PACE SWMI |
$605.87
|
| Rate for Payer: PHP Commercial |
$848.22
|
| Rate for Payer: PHP Medicare Advantage |
$605.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,050.95
|
| Rate for Payer: Priority Health Medicare |
$605.87
|
| Rate for Payer: Priority Health SBD |
$1,050.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,050.95
|
| Rate for Payer: Railroad Medicare Medicare |
$605.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.51
|
| Rate for Payer: UHC Core |
$1,005.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$605.87
|
| Rate for Payer: UHC Exchange |
$1,005.51
|
| Rate for Payer: UHC Medicaid |
$395.12
|
| Rate for Payer: UHCCP Medicaid |
$395.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,508.80
|
|
