|
PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 48000
|
| Min. Negotiated Rate |
$1,206.01 |
| Max. Negotiated Rate |
$3,361.81 |
| Rate for Payer: Aetna Commercial |
$2,451.42
|
| Rate for Payer: Aetna Medicare |
$1,902.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,634.36
|
| Rate for Payer: BCBS Complete |
$1,266.31
|
| Rate for Payer: BCBS MAPPO |
$1,829.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,234.25
|
| Rate for Payer: BCN Commercial |
$2,742.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,829.42
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$2,451.42
|
| Rate for Payer: Cofinity Commercial |
$2,634.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,829.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,920.89
|
| Rate for Payer: Meridian Medicaid |
$1,266.31
|
| Rate for Payer: Nomi Health Commercial |
$2,195.30
|
| Rate for Payer: PACE SWMI |
$1,829.42
|
| Rate for Payer: PHP Commercial |
$2,561.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,829.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,206.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,361.81
|
| Rate for Payer: Priority Health Medicare |
$1,829.42
|
| Rate for Payer: Priority Health Narrow Network |
$3,361.81
|
| Rate for Payer: Priority Health SBD |
$3,361.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,829.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,829.42
|
| Rate for Payer: UHCCP Medicaid |
$1,206.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,510.18
|
|
|
PR PLACEMENT CHOLEDOCHAL STENT
|
Professional
|
Both
|
$2,547.00
|
|
|
Service Code
|
HCPCS 47801
|
| Min. Negotiated Rate |
$711.85 |
| Max. Negotiated Rate |
$2,000.97 |
| Rate for Payer: Aetna Commercial |
$1,436.37
|
| Rate for Payer: Aetna Medicare |
$1,114.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.56
|
| Rate for Payer: BCBS Complete |
$747.44
|
| Rate for Payer: BCBS MAPPO |
$1,071.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.18
|
| Rate for Payer: BCN Commercial |
$1,632.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.92
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,436.37
|
| Rate for Payer: Cofinity Commercial |
$1,543.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.52
|
| Rate for Payer: Meridian Medicaid |
$747.44
|
| Rate for Payer: Nomi Health Commercial |
$1,286.30
|
| Rate for Payer: PACE SWMI |
$1,071.92
|
| Rate for Payer: PHP Commercial |
$1,500.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,000.97
|
| Rate for Payer: Priority Health Medicare |
$1,071.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,000.97
|
| Rate for Payer: Priority Health SBD |
$2,000.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.92
|
| Rate for Payer: UHCCP Medicaid |
$711.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.62
|
|
|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$541.45 |
| Max. Negotiated Rate |
$3,186.71 |
| Rate for Payer: Aetna Commercial |
$1,094.95
|
| Rate for Payer: Aetna Medicare |
$849.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.67
|
| Rate for Payer: BCBS Complete |
$568.52
|
| Rate for Payer: BCBS MAPPO |
$817.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,186.71
|
| Rate for Payer: BCN Commercial |
$1,228.54
|
| Rate for Payer: BCN Medicare Advantage |
$817.13
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,094.95
|
| Rate for Payer: Cofinity Commercial |
$1,176.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$817.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.99
|
| Rate for Payer: Meridian Medicaid |
$568.52
|
| Rate for Payer: Nomi Health Commercial |
$980.56
|
| Rate for Payer: PACE SWMI |
$817.13
|
| Rate for Payer: PHP Commercial |
$1,143.98
|
| Rate for Payer: PHP Medicare Advantage |
$817.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,509.38
|
| Rate for Payer: Priority Health Medicare |
$817.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,509.38
|
| Rate for Payer: Priority Health SBD |
$1,509.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$817.13
|
| Rate for Payer: UHC Medicare Advantage |
$817.13
|
| Rate for Payer: UHCCP Medicaid |
$541.45
|
| Rate for Payer: UMR Bronson Commercial |
$906.66
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$835.77 |
| Rate for Payer: Aetna Commercial |
$77.30
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.07
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$57.69
|
| Rate for Payer: BCBS Trust/PPO |
$835.77
|
| Rate for Payer: BCN Commercial |
$86.01
|
| Rate for Payer: BCN Medicare Advantage |
$57.69
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$77.30
|
| Rate for Payer: Cofinity Commercial |
$83.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.57
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$69.23
|
| Rate for Payer: PACE SWMI |
$57.69
|
| Rate for Payer: PHP Commercial |
$80.77
|
| Rate for Payer: PHP Medicare Advantage |
$57.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.13
|
| Rate for Payer: Priority Health Medicare |
$57.69
|
| Rate for Payer: Priority Health Narrow Network |
$94.13
|
| Rate for Payer: Priority Health SBD |
$94.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.69
|
| Rate for Payer: UHC Medicare Advantage |
$57.69
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$259.90
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$75.19 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$150.54
|
| Rate for Payer: Aetna Medicare |
$116.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.77
|
| Rate for Payer: BCBS Complete |
$78.95
|
| Rate for Payer: BCBS MAPPO |
$112.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$112.34
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$150.54
|
| Rate for Payer: Cofinity Commercial |
$161.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.96
|
| Rate for Payer: Meridian Medicaid |
$78.95
|
| Rate for Payer: Nomi Health Commercial |
$134.81
|
| Rate for Payer: PACE SWMI |
$112.34
|
| Rate for Payer: PHP Commercial |
$157.28
|
| Rate for Payer: PHP Medicare Advantage |
$112.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$112.34
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: Priority Health SBD |
$208.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.34
|
| Rate for Payer: UHC Medicare Advantage |
$112.34
|
| Rate for Payer: UHCCP Medicaid |
$75.19
|
| Rate for Payer: UMR Bronson Commercial |
$179.40
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$681.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$200.22 |
| Max. Negotiated Rate |
$2,173.43 |
| Rate for Payer: Aetna Commercial |
$413.97
|
| Rate for Payer: Aetna Medicare |
$321.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.86
|
| Rate for Payer: BCBS Complete |
$210.23
|
| Rate for Payer: BCBS MAPPO |
$308.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.43
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: BCN Medicare Advantage |
$308.93
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cofinity Commercial |
$413.97
|
| Rate for Payer: Cofinity Commercial |
$444.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.38
|
| Rate for Payer: Meridian Medicaid |
$210.23
|
| Rate for Payer: Nomi Health Commercial |
$370.72
|
| Rate for Payer: PACE SWMI |
$308.93
|
| Rate for Payer: PHP Commercial |
$432.50
|
| Rate for Payer: PHP Medicare Advantage |
$308.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.38
|
| Rate for Payer: Priority Health Medicare |
$308.93
|
| Rate for Payer: Priority Health Narrow Network |
$499.38
|
| Rate for Payer: Priority Health SBD |
$499.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.93
|
| Rate for Payer: UHC Medicare Advantage |
$308.93
|
| Rate for Payer: UHCCP Medicaid |
$200.22
|
| Rate for Payer: UMR Bronson Commercial |
$313.26
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$981.50 |
| Rate for Payer: Aetna Medicare |
$755.00
|
| Rate for Payer: BCBS Complete |
$604.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$981.50
|
| Rate for Payer: UMR Bronson Commercial |
$694.60
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$269.20 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Medicare |
$336.50
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: UMR Bronson Commercial |
$309.58
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$711.74 |
| Max. Negotiated Rate |
$2,964.74 |
| Rate for Payer: Aetna Commercial |
$711.74
|
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.74
|
| Rate for Payer: BCBS Complete |
$777.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.35
|
| Rate for Payer: BCN Commercial |
$2,964.74
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Meridian Medicaid |
$777.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$892.64
|
| Rate for Payer: Priority Health Narrow Network |
$892.64
|
| Rate for Payer: Priority Health SBD |
$892.64
|
| Rate for Payer: UHCCP Medicaid |
$740.06
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$163.16 |
| Max. Negotiated Rate |
$1,759.77 |
| Rate for Payer: Aetna Commercial |
$324.90
|
| Rate for Payer: Aetna Medicare |
$252.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.14
|
| Rate for Payer: BCBS Complete |
$171.32
|
| Rate for Payer: BCBS MAPPO |
$242.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,759.77
|
| Rate for Payer: BCN Commercial |
$372.37
|
| Rate for Payer: BCN Medicare Advantage |
$242.46
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cofinity Commercial |
$324.90
|
| Rate for Payer: Cofinity Commercial |
$349.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.58
|
| Rate for Payer: Meridian Medicaid |
$171.32
|
| Rate for Payer: Nomi Health Commercial |
$290.95
|
| Rate for Payer: PACE SWMI |
$242.46
|
| Rate for Payer: PHP Commercial |
$339.44
|
| Rate for Payer: PHP Medicare Advantage |
$242.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.97
|
| Rate for Payer: Priority Health Medicare |
$242.46
|
| Rate for Payer: Priority Health Narrow Network |
$379.97
|
| Rate for Payer: Priority Health SBD |
$379.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.46
|
| Rate for Payer: UHC Medicare Advantage |
$242.46
|
| Rate for Payer: UHCCP Medicaid |
$163.16
|
| Rate for Payer: UMR Bronson Commercial |
$413.54
|
|
|
PR PLASTIC REPAIR URETHROCELE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 57230
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$629.98 |
| Rate for Payer: Aetna Commercial |
$534.04
|
| Rate for Payer: Aetna Medicare |
$414.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.90
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$398.54
|
| Rate for Payer: BCBS Trust/PPO |
$286.34
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$398.54
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$534.04
|
| Rate for Payer: Cofinity Commercial |
$573.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.47
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Nomi Health Commercial |
$478.25
|
| Rate for Payer: PACE SWMI |
$398.54
|
| Rate for Payer: PHP Commercial |
$557.96
|
| Rate for Payer: PHP Medicare Advantage |
$398.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.98
|
| Rate for Payer: Priority Health Medicare |
$398.54
|
| Rate for Payer: Priority Health Narrow Network |
$629.98
|
| Rate for Payer: Priority Health SBD |
$629.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.54
|
| Rate for Payer: UHC Medicare Advantage |
$398.54
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
| Rate for Payer: UMR Bronson Commercial |
$372.14
|
|
|
PR PLASTIC RPR PENIS CORRECT ANGULATION
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 54360
|
| Min. Negotiated Rate |
$462.21 |
| Max. Negotiated Rate |
$2,470.65 |
| Rate for Payer: Aetna Commercial |
$923.77
|
| Rate for Payer: Aetna Medicare |
$716.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.71
|
| Rate for Payer: BCBS Complete |
$485.32
|
| Rate for Payer: BCBS MAPPO |
$689.38
|
| Rate for Payer: BCBS Trust/PPO |
$602.79
|
| Rate for Payer: BCN Commercial |
$1,040.88
|
| Rate for Payer: BCN Medicare Advantage |
$689.38
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cofinity Commercial |
$923.77
|
| Rate for Payer: Cofinity Commercial |
$992.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.85
|
| Rate for Payer: Meridian Medicaid |
$485.32
|
| Rate for Payer: Nomi Health Commercial |
$827.26
|
| Rate for Payer: PACE SWMI |
$689.38
|
| Rate for Payer: PHP Commercial |
$965.13
|
| Rate for Payer: PHP Medicare Advantage |
$689.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.29
|
| Rate for Payer: Priority Health Medicare |
$689.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.29
|
| Rate for Payer: Priority Health SBD |
$1,148.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.38
|
| Rate for Payer: UHC Medicare Advantage |
$689.38
|
| Rate for Payer: UHCCP Medicaid |
$462.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,748.46
|
|
|
PR PLASTICS COSMETIC CONSULT OFFICE VISIT
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 00690
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Medicare |
$36.00
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
PR PLASTICS COSMETIC FAT GRAFTING
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 00691
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Medicare |
$1,250.00
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.00
|
|
|
PR PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH
|
Professional
|
Both
|
$1,097.00
|
|
|
Service Code
|
HCPCS 57220
|
| Min. Negotiated Rate |
$223.22 |
| Max. Negotiated Rate |
$2,103.16 |
| Rate for Payer: Aetna Commercial |
$441.61
|
| Rate for Payer: Aetna Medicare |
$342.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.57
|
| Rate for Payer: BCBS Complete |
$234.38
|
| Rate for Payer: BCBS MAPPO |
$329.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.16
|
| Rate for Payer: BCN Commercial |
$509.20
|
| Rate for Payer: BCN Medicare Advantage |
$329.56
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cofinity Commercial |
$441.61
|
| Rate for Payer: Cofinity Commercial |
$474.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.04
|
| Rate for Payer: Meridian Medicaid |
$234.38
|
| Rate for Payer: Nomi Health Commercial |
$395.47
|
| Rate for Payer: PACE SWMI |
$329.56
|
| Rate for Payer: PHP Commercial |
$461.38
|
| Rate for Payer: PHP Medicare Advantage |
$329.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.36
|
| Rate for Payer: Priority Health Medicare |
$329.56
|
| Rate for Payer: Priority Health Narrow Network |
$520.36
|
| Rate for Payer: Priority Health SBD |
$520.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.56
|
| Rate for Payer: UHC Medicare Advantage |
$329.56
|
| Rate for Payer: UHCCP Medicaid |
$223.22
|
| Rate for Payer: UMR Bronson Commercial |
$504.62
|
|
|
PR PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 94726
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$369.28 |
| Rate for Payer: Aetna Commercial |
$68.47
|
| Rate for Payer: Aetna Commercial |
$68.47
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.47
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$369.28
|
| Rate for Payer: BCBS Trust/PPO |
$369.28
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$68.47
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$68.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Nomi Health Commercial |
$61.32
|
| Rate for Payer: Nomi Health Commercial |
$61.32
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PHP Commercial |
$71.54
|
| Rate for Payer: PHP Commercial |
$71.54
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.98
|
| Rate for Payer: Priority Health Medicare |
$51.10
|
| Rate for Payer: Priority Health Medicare |
$51.10
|
| Rate for Payer: Priority Health Narrow Network |
$75.98
|
| Rate for Payer: Priority Health Narrow Network |
$75.98
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
PR PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX
|
Professional
|
Both
|
$2,177.00
|
|
|
Service Code
|
HCPCS 32215
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,415.05 |
| Rate for Payer: Aetna Commercial |
$1,034.53
|
| Rate for Payer: Aetna Medicare |
$802.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.74
|
| Rate for Payer: BCBS Complete |
$536.98
|
| Rate for Payer: BCBS MAPPO |
$772.04
|
| Rate for Payer: BCBS Trust/PPO |
$509.28
|
| Rate for Payer: BCN Commercial |
$1,159.15
|
| Rate for Payer: BCN Medicare Advantage |
$772.04
|
| Rate for Payer: Cash Price |
$1,741.60
|
| Rate for Payer: Cash Price |
$1,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,034.53
|
| Rate for Payer: Cofinity Commercial |
$1,111.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.64
|
| Rate for Payer: Meridian Medicaid |
$536.98
|
| Rate for Payer: Nomi Health Commercial |
$926.45
|
| Rate for Payer: PACE SWMI |
$772.04
|
| Rate for Payer: PHP Commercial |
$1,080.86
|
| Rate for Payer: PHP Medicare Advantage |
$772.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,415.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.22
|
| Rate for Payer: Priority Health Medicare |
$772.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.22
|
| Rate for Payer: Priority Health SBD |
$1,107.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.04
|
| Rate for Payer: UHC Medicare Advantage |
$772.04
|
| Rate for Payer: UHCCP Medicaid |
$511.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,001.42
|
|
|
PR PLEURECTOMY PARIETAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,949.00
|
|
|
Service Code
|
HCPCS 32310
|
| Min. Negotiated Rate |
$409.96 |
| Max. Negotiated Rate |
$1,916.85 |
| Rate for Payer: Aetna Commercial |
$1,184.53
|
| Rate for Payer: Aetna Medicare |
$919.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.93
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$883.98
|
| Rate for Payer: BCBS Trust/PPO |
$409.96
|
| Rate for Payer: BCN Commercial |
$1,325.29
|
| Rate for Payer: BCN Medicare Advantage |
$883.98
|
| Rate for Payer: Cash Price |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,184.53
|
| Rate for Payer: Cofinity Commercial |
$1,272.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.18
|
| Rate for Payer: Meridian Medicaid |
$613.47
|
| Rate for Payer: Nomi Health Commercial |
$1,060.78
|
| Rate for Payer: PACE SWMI |
$883.98
|
| Rate for Payer: PHP Commercial |
$1,237.57
|
| Rate for Payer: PHP Medicare Advantage |
$883.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.80
|
| Rate for Payer: Priority Health Medicare |
$883.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,264.80
|
| Rate for Payer: Priority Health SBD |
$1,264.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.98
|
| Rate for Payer: UHC Medicare Advantage |
$883.98
|
| Rate for Payer: UHCCP Medicaid |
$584.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,356.54
|
|
|
PR PL GLYCOLIC 35/70
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 00067
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR PL ILLUMINIZE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 00069
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR PL JESSNERS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 00068
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 47541
|
| Min. Negotiated Rate |
$209.17 |
| Max. Negotiated Rate |
$1,714.77 |
| Rate for Payer: Aetna Commercial |
$422.21
|
| Rate for Payer: Aetna Medicare |
$327.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.72
|
| Rate for Payer: BCBS Complete |
$219.63
|
| Rate for Payer: BCBS MAPPO |
$315.08
|
| Rate for Payer: BCN Commercial |
$1,714.77
|
| Rate for Payer: BCN Medicare Advantage |
$315.08
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$453.72
|
| Rate for Payer: Cofinity Commercial |
$422.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.83
|
| Rate for Payer: Meridian Medicaid |
$219.63
|
| Rate for Payer: Nomi Health Commercial |
$378.10
|
| Rate for Payer: PACE SWMI |
$315.08
|
| Rate for Payer: PHP Commercial |
$441.11
|
| Rate for Payer: PHP Medicare Advantage |
$315.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$581.08
|
| Rate for Payer: Priority Health Medicare |
$315.08
|
| Rate for Payer: Priority Health Narrow Network |
$581.08
|
| Rate for Payer: Priority Health SBD |
$581.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.08
|
| Rate for Payer: UHC Medicare Advantage |
$315.08
|
| Rate for Payer: UHCCP Medicaid |
$209.17
|
| Rate for Payer: UMR Bronson Commercial |
$985.32
|
|
|
PR PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST
|
Professional
|
Both
|
$10,186.00
|
|
|
Service Code
|
HCPCS 19296
|
| Min. Negotiated Rate |
$134.62 |
| Max. Negotiated Rate |
$6,620.90 |
| Rate for Payer: Aetna Commercial |
$273.67
|
| Rate for Payer: Aetna Medicare |
$212.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.09
|
| Rate for Payer: BCBS Complete |
$141.35
|
| Rate for Payer: BCBS MAPPO |
$204.23
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$5,484.92
|
| Rate for Payer: BCN Medicare Advantage |
$204.23
|
| Rate for Payer: Cash Price |
$8,148.80
|
| Rate for Payer: Cash Price |
$8,148.80
|
| Rate for Payer: Cofinity Commercial |
$273.67
|
| Rate for Payer: Cofinity Commercial |
$294.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.44
|
| Rate for Payer: Meridian Medicaid |
$141.35
|
| Rate for Payer: Nomi Health Commercial |
$245.08
|
| Rate for Payer: PACE SWMI |
$204.23
|
| Rate for Payer: PHP Commercial |
$285.92
|
| Rate for Payer: PHP Medicare Advantage |
$204.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,620.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.56
|
| Rate for Payer: Priority Health Medicare |
$204.23
|
| Rate for Payer: Priority Health Narrow Network |
$283.56
|
| Rate for Payer: Priority Health SBD |
$283.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.23
|
| Rate for Payer: UHC Medicare Advantage |
$204.23
|
| Rate for Payer: UHCCP Medicaid |
$134.62
|
| Rate for Payer: UMR Bronson Commercial |
$4,685.56
|
|
|
PR PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 34813
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$792.35 |
| Rate for Payer: Aetna Commercial |
$302.13
|
| Rate for Payer: Aetna Medicare |
$234.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$225.47
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$225.47
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cofinity Commercial |
$302.13
|
| Rate for Payer: Cofinity Commercial |
$324.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.74
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Nomi Health Commercial |
$270.56
|
| Rate for Payer: PACE SWMI |
$225.47
|
| Rate for Payer: PHP Commercial |
$315.66
|
| Rate for Payer: PHP Medicare Advantage |
$225.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.30
|
| Rate for Payer: Priority Health Medicare |
$225.47
|
| Rate for Payer: Priority Health Narrow Network |
$364.30
|
| Rate for Payer: Priority Health SBD |
$364.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.47
|
| Rate for Payer: UHC Medicare Advantage |
$225.47
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
| Rate for Payer: UMR Bronson Commercial |
$560.74
|
|
|
PR PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 55876
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$2,499.92 |
| Rate for Payer: Aetna Commercial |
$129.83
|
| Rate for Payer: Aetna Medicare |
$100.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.52
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$96.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.92
|
| Rate for Payer: BCN Commercial |
$220.88
|
| Rate for Payer: BCN Medicare Advantage |
$96.89
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$139.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.73
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Nomi Health Commercial |
$116.27
|
| Rate for Payer: PACE SWMI |
$96.89
|
| Rate for Payer: PHP Commercial |
$135.65
|
| Rate for Payer: PHP Medicare Advantage |
$96.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.45
|
| Rate for Payer: Priority Health Medicare |
$96.89
|
| Rate for Payer: Priority Health Narrow Network |
$162.45
|
| Rate for Payer: Priority Health SBD |
$162.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.89
|
| Rate for Payer: UHC Medicare Advantage |
$96.89
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
|
