|
PR REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 61888
|
| Min. Negotiated Rate |
$257.09 |
| Max. Negotiated Rate |
$840.01 |
| Rate for Payer: Aetna Commercial |
$532.80
|
| Rate for Payer: Aetna Medicare |
$413.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.56
|
| Rate for Payer: BCBS Complete |
$269.94
|
| Rate for Payer: BCBS MAPPO |
$397.61
|
| Rate for Payer: BCN Commercial |
$840.01
|
| Rate for Payer: BCN Medicare Advantage |
$397.61
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cofinity Commercial |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$572.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.49
|
| Rate for Payer: Meridian Medicaid |
$269.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.37
|
| Rate for Payer: Nomi Health Commercial |
$477.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$809.25
|
| Rate for Payer: PACE SWMI |
$397.61
|
| Rate for Payer: PHP Commercial |
$556.65
|
| Rate for Payer: PHP Medicare Advantage |
$397.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$706.22
|
| Rate for Payer: Priority Health Medicare |
$397.61
|
| Rate for Payer: Priority Health SBD |
$706.22
|
| Rate for Payer: Priority Health Tiered Network |
$706.22
|
| Rate for Payer: Railroad Medicare Medicare |
$397.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.96
|
| Rate for Payer: UHC Core |
$691.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$397.61
|
| Rate for Payer: UHC Exchange |
$691.96
|
| Rate for Payer: UHC Medicaid |
$257.09
|
| Rate for Payer: UHCCP Medicaid |
$257.09
|
| Rate for Payer: UMR Bronson Commercial |
$496.34
|
|
|
PR REVJ/RMVL PERPH NEUROSTIMULATOR ELECTRODE ARRAY
|
Professional
|
Both
|
$1,378.00
|
|
|
Service Code
|
HCPCS 64585
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$1,033.50 |
| Rate for Payer: Aetna Commercial |
$177.13
|
| Rate for Payer: Aetna Medicare |
$137.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.35
|
| Rate for Payer: BCBS Complete |
$91.02
|
| Rate for Payer: BCBS MAPPO |
$132.19
|
| Rate for Payer: BCN Commercial |
$216.62
|
| Rate for Payer: BCN Medicare Advantage |
$132.19
|
| Rate for Payer: Cash Price |
$1,102.40
|
| Rate for Payer: Cash Price |
$1,102.40
|
| Rate for Payer: Cofinity Commercial |
$177.13
|
| Rate for Payer: Cofinity Commercial |
$190.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.80
|
| Rate for Payer: Meridian Medicaid |
$91.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.41
|
| Rate for Payer: Nomi Health Commercial |
$158.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,033.50
|
| Rate for Payer: PACE SWMI |
$132.19
|
| Rate for Payer: PHP Commercial |
$185.07
|
| Rate for Payer: PHP Medicare Advantage |
$132.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.61
|
| Rate for Payer: Priority Health Medicare |
$132.19
|
| Rate for Payer: Priority Health SBD |
$251.61
|
| Rate for Payer: Priority Health Tiered Network |
$251.61
|
| Rate for Payer: Railroad Medicare Medicare |
$132.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.61
|
| Rate for Payer: UHC Core |
$250.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.19
|
| Rate for Payer: UHC Exchange |
$250.61
|
| Rate for Payer: UHC Medicaid |
$86.69
|
| Rate for Payer: UHCCP Medicaid |
$86.69
|
| Rate for Payer: UMR Bronson Commercial |
$633.88
|
|
|
PR REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 57295
|
| Min. Negotiated Rate |
$286.06 |
| Max. Negotiated Rate |
$1,097.25 |
| Rate for Payer: Aetna Commercial |
$590.46
|
| Rate for Payer: Aetna Medicare |
$458.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.52
|
| Rate for Payer: BCBS Complete |
$300.36
|
| Rate for Payer: BCBS MAPPO |
$440.64
|
| Rate for Payer: BCN Commercial |
$1,041.59
|
| Rate for Payer: BCN Medicare Advantage |
$440.64
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cofinity Commercial |
$590.46
|
| Rate for Payer: Cofinity Commercial |
$634.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.67
|
| Rate for Payer: Meridian Medicaid |
$300.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$484.70
|
| Rate for Payer: Nomi Health Commercial |
$528.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,097.25
|
| Rate for Payer: PACE SWMI |
$440.64
|
| Rate for Payer: PHP Commercial |
$616.90
|
| Rate for Payer: PHP Medicare Advantage |
$440.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.59
|
| Rate for Payer: Priority Health Medicare |
$440.64
|
| Rate for Payer: Priority Health SBD |
$763.59
|
| Rate for Payer: Priority Health Tiered Network |
$763.59
|
| Rate for Payer: Railroad Medicare Medicare |
$440.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.34
|
| Rate for Payer: UHC Core |
$865.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$440.64
|
| Rate for Payer: UHC Exchange |
$865.34
|
| Rate for Payer: UHC Medicaid |
$286.06
|
| Rate for Payer: UHCCP Medicaid |
$286.06
|
| Rate for Payer: UMR Bronson Commercial |
$672.98
|
|
|
PR REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 64583
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$1,506.73 |
| Rate for Payer: Aetna Commercial |
$986.64
|
| Rate for Payer: Aetna Medicare |
$765.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,060.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.64
|
| Rate for Payer: BCBS Complete |
$498.96
|
| Rate for Payer: BCBS MAPPO |
$736.30
|
| Rate for Payer: BCN Commercial |
$1,297.24
|
| Rate for Payer: BCN Medicare Advantage |
$736.30
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Cofinity Commercial |
$986.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.12
|
| Rate for Payer: Meridian Medicaid |
$498.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$809.93
|
| Rate for Payer: Nomi Health Commercial |
$883.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,355.25
|
| Rate for Payer: PACE SWMI |
$736.30
|
| Rate for Payer: PHP Commercial |
$1,030.82
|
| Rate for Payer: PHP Medicare Advantage |
$736.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,506.73
|
| Rate for Payer: Priority Health Medicare |
$736.30
|
| Rate for Payer: Priority Health SBD |
$1,506.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,506.73
|
| Rate for Payer: Railroad Medicare Medicare |
$736.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,424.22
|
| Rate for Payer: UHC Core |
$1,424.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.30
|
| Rate for Payer: UHC Exchange |
$1,424.22
|
| Rate for Payer: UHC Medicaid |
$475.20
|
| Rate for Payer: UHCCP Medicaid |
$475.20
|
| Rate for Payer: UMR Bronson Commercial |
$831.22
|
|
|
PR REVJ/RPLMNT CH WAL RESPIR ELTRD & CONJ PULSE GEN
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 0467T
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Medicare |
$420.00
|
| Rate for Payer: BCBS Complete |
$336.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$630.00
|
| Rate for Payer: UMR Bronson Commercial |
$386.40
|
|
|
PR REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT
|
Professional
|
Both
|
$4,705.00
|
|
|
Service Code
|
HCPCS 27486
|
| Min. Negotiated Rate |
$813.02 |
| Max. Negotiated Rate |
$3,528.75 |
| Rate for Payer: Aetna Commercial |
$1,681.98
|
| Rate for Payer: Aetna Medicare |
$1,305.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,681.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,807.50
|
| Rate for Payer: BCBS Complete |
$853.67
|
| Rate for Payer: BCBS MAPPO |
$1,255.21
|
| Rate for Payer: BCN Commercial |
$2,121.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,255.21
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cofinity Commercial |
$1,807.50
|
| Rate for Payer: Cofinity Commercial |
$1,681.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,255.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,317.97
|
| Rate for Payer: Meridian Medicaid |
$853.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,380.73
|
| Rate for Payer: Nomi Health Commercial |
$1,506.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,528.75
|
| Rate for Payer: PACE SWMI |
$1,255.21
|
| Rate for Payer: PHP Commercial |
$1,757.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,255.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,267.71
|
| Rate for Payer: Priority Health Medicare |
$1,255.21
|
| Rate for Payer: Priority Health SBD |
$2,267.71
|
| Rate for Payer: Priority Health Tiered Network |
$2,267.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,255.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,472.07
|
| Rate for Payer: UHC Core |
$2,472.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,255.21
|
| Rate for Payer: UHC Exchange |
$2,472.07
|
| Rate for Payer: UHC Medicaid |
$813.02
|
| Rate for Payer: UHCCP Medicaid |
$813.02
|
| Rate for Payer: UMR Bronson Commercial |
$2,164.30
|
|
|
PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,129.00
|
|
|
Service Code
|
HCPCS 27137
|
| Min. Negotiated Rate |
$840.29 |
| Max. Negotiated Rate |
$2,590.84 |
| Rate for Payer: Aetna Commercial |
$1,743.77
|
| Rate for Payer: Aetna Medicare |
$1,353.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,743.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,873.90
|
| Rate for Payer: BCBS Complete |
$882.30
|
| Rate for Payer: BCBS MAPPO |
$1,301.32
|
| Rate for Payer: BCN Commercial |
$2,208.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,301.32
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$1,743.77
|
| Rate for Payer: Cofinity Commercial |
$1,873.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,301.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,366.39
|
| Rate for Payer: Meridian Medicaid |
$882.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,431.45
|
| Rate for Payer: Nomi Health Commercial |
$1,561.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,346.75
|
| Rate for Payer: PACE SWMI |
$1,301.32
|
| Rate for Payer: PHP Commercial |
$1,821.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,301.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,360.33
|
| Rate for Payer: Priority Health Medicare |
$1,301.32
|
| Rate for Payer: Priority Health SBD |
$2,360.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,360.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,301.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,590.84
|
| Rate for Payer: UHC Core |
$2,590.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,301.32
|
| Rate for Payer: UHC Exchange |
$2,590.84
|
| Rate for Payer: UHC Medicaid |
$840.29
|
| Rate for Payer: UHCCP Medicaid |
$840.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,439.34
|
|
|
PR REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$4,077.00
|
|
|
Service Code
|
HCPCS 27134
|
| Min. Negotiated Rate |
$1,081.19 |
| Max. Negotiated Rate |
$3,375.67 |
| Rate for Payer: Aetna Commercial |
$2,249.89
|
| Rate for Payer: Aetna Medicare |
$1,746.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,249.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,417.79
|
| Rate for Payer: BCBS Complete |
$1,135.25
|
| Rate for Payer: BCBS MAPPO |
$1,679.02
|
| Rate for Payer: BCN Commercial |
$3,143.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,679.02
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cofinity Commercial |
$2,249.89
|
| Rate for Payer: Cofinity Commercial |
$2,417.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,679.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,762.97
|
| Rate for Payer: Meridian Medicaid |
$1,135.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,846.92
|
| Rate for Payer: Nomi Health Commercial |
$2,014.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,057.75
|
| Rate for Payer: PACE SWMI |
$1,679.02
|
| Rate for Payer: PHP Commercial |
$2,350.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,679.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,081.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,058.76
|
| Rate for Payer: Priority Health Medicare |
$1,679.02
|
| Rate for Payer: Priority Health SBD |
$3,058.76
|
| Rate for Payer: Priority Health Tiered Network |
$3,058.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,679.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,375.67
|
| Rate for Payer: UHC Core |
$3,375.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,679.02
|
| Rate for Payer: UHC Exchange |
$3,375.67
|
| Rate for Payer: UHC Medicaid |
$1,081.19
|
| Rate for Payer: UHCCP Medicaid |
$1,081.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,875.42
|
|
|
PR REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT
|
Professional
|
Both
|
$3,252.00
|
|
|
Service Code
|
HCPCS 27138
|
| Min. Negotiated Rate |
$871.81 |
| Max. Negotiated Rate |
$2,693.66 |
| Rate for Payer: Aetna Commercial |
$1,809.90
|
| Rate for Payer: Aetna Medicare |
$1,404.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,944.96
|
| Rate for Payer: BCBS Complete |
$915.40
|
| Rate for Payer: BCBS MAPPO |
$1,350.67
|
| Rate for Payer: BCN Commercial |
$2,293.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,350.67
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cofinity Commercial |
$1,809.90
|
| Rate for Payer: Cofinity Commercial |
$1,944.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,350.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,418.20
|
| Rate for Payer: Meridian Medicaid |
$915.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,485.74
|
| Rate for Payer: Nomi Health Commercial |
$1,620.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,439.00
|
| Rate for Payer: PACE SWMI |
$1,350.67
|
| Rate for Payer: PHP Commercial |
$1,890.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,350.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$871.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,451.38
|
| Rate for Payer: Priority Health Medicare |
$1,350.67
|
| Rate for Payer: Priority Health SBD |
$2,451.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,451.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,350.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,693.66
|
| Rate for Payer: UHC Core |
$2,693.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,350.67
|
| Rate for Payer: UHC Exchange |
$2,693.66
|
| Rate for Payer: UHC Medicaid |
$871.81
|
| Rate for Payer: UHCCP Medicaid |
$871.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,495.92
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Professional
|
Both
|
$6,183.00
|
|
|
Service Code
|
HCPCS 27487
|
| Min. Negotiated Rate |
$1,004.08 |
| Max. Negotiated Rate |
$4,637.25 |
| Rate for Payer: Aetna Commercial |
$2,083.35
|
| Rate for Payer: Aetna Medicare |
$1,616.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,083.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,238.83
|
| Rate for Payer: BCBS Complete |
$1,054.28
|
| Rate for Payer: BCBS MAPPO |
$1,554.74
|
| Rate for Payer: BCN Commercial |
$2,899.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,554.74
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cofinity Commercial |
$2,083.35
|
| Rate for Payer: Cofinity Commercial |
$2,238.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,554.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,632.48
|
| Rate for Payer: Meridian Medicaid |
$1,054.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,710.21
|
| Rate for Payer: Nomi Health Commercial |
$1,865.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,637.25
|
| Rate for Payer: PACE SWMI |
$1,554.74
|
| Rate for Payer: PHP Commercial |
$2,176.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,554.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,004.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,821.33
|
| Rate for Payer: Priority Health Medicare |
$1,554.74
|
| Rate for Payer: Priority Health SBD |
$2,821.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,821.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,554.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,096.40
|
| Rate for Payer: UHC Core |
$3,096.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,554.74
|
| Rate for Payer: UHC Exchange |
$3,096.40
|
| Rate for Payer: UHC Medicaid |
$1,004.08
|
| Rate for Payer: UHCCP Medicaid |
$1,004.08
|
| Rate for Payer: UMR Bronson Commercial |
$2,844.18
|
|
|
PR REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 50728
|
| Min. Negotiated Rate |
$406.19 |
| Max. Negotiated Rate |
$1,297.43 |
| Rate for Payer: Aetna Commercial |
$840.13
|
| Rate for Payer: Aetna Medicare |
$652.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.82
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$626.96
|
| Rate for Payer: BCN Commercial |
$1,050.74
|
| Rate for Payer: BCN Medicare Advantage |
$626.96
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$840.13
|
| Rate for Payer: Cofinity Commercial |
$902.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.31
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.66
|
| Rate for Payer: Nomi Health Commercial |
$752.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.50
|
| Rate for Payer: PACE SWMI |
$626.96
|
| Rate for Payer: PHP Commercial |
$877.74
|
| Rate for Payer: PHP Medicare Advantage |
$626.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,144.60
|
| Rate for Payer: Priority Health Medicare |
$626.96
|
| Rate for Payer: Priority Health SBD |
$1,144.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,144.60
|
| Rate for Payer: Railroad Medicare Medicare |
$626.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,297.43
|
| Rate for Payer: UHC Core |
$1,297.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.96
|
| Rate for Payer: UHC Exchange |
$1,297.43
|
| Rate for Payer: UHC Medicaid |
$406.19
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
| Rate for Payer: UMR Bronson Commercial |
$679.88
|
|
|
PR REVJ URINARY-CUTANEOUS ANASTAMOSIS
|
Professional
|
Both
|
$1,335.00
|
|
|
Service Code
|
HCPCS 50727
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$1,001.25 |
| Rate for Payer: Aetna Commercial |
$621.60
|
| Rate for Payer: Aetna Medicare |
$482.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.99
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$463.88
|
| Rate for Payer: BCN Commercial |
$768.38
|
| Rate for Payer: BCN Medicare Advantage |
$463.88
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cofinity Commercial |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$667.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$487.07
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$510.27
|
| Rate for Payer: Nomi Health Commercial |
$556.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.25
|
| Rate for Payer: PACE SWMI |
$463.88
|
| Rate for Payer: PHP Commercial |
$649.43
|
| Rate for Payer: PHP Medicare Advantage |
$463.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$837.03
|
| Rate for Payer: Priority Health Medicare |
$463.88
|
| Rate for Payer: Priority Health SBD |
$837.03
|
| Rate for Payer: Priority Health Tiered Network |
$837.03
|
| Rate for Payer: Railroad Medicare Medicare |
$463.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$893.75
|
| Rate for Payer: UHC Core |
$893.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$463.88
|
| Rate for Payer: UHC Exchange |
$893.75
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
| Rate for Payer: UMR Bronson Commercial |
$614.10
|
|
|
PR REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 64595
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$537.75 |
| Rate for Payer: Aetna Commercial |
$276.35
|
| Rate for Payer: Aetna Medicare |
$214.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.97
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$206.23
|
| Rate for Payer: BCN Commercial |
$345.59
|
| Rate for Payer: BCN Medicare Advantage |
$206.23
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cofinity Commercial |
$276.35
|
| Rate for Payer: Cofinity Commercial |
$296.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.54
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.85
|
| Rate for Payer: Nomi Health Commercial |
$247.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$537.75
|
| Rate for Payer: PACE SWMI |
$206.23
|
| Rate for Payer: PHP Commercial |
$288.72
|
| Rate for Payer: PHP Medicare Advantage |
$206.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$401.40
|
| Rate for Payer: Priority Health Medicare |
$206.23
|
| Rate for Payer: Priority Health SBD |
$401.40
|
| Rate for Payer: Priority Health Tiered Network |
$401.40
|
| Rate for Payer: Railroad Medicare Medicare |
$206.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.97
|
| Rate for Payer: UHC Core |
$219.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.23
|
| Rate for Payer: UHC Exchange |
$219.97
|
| Rate for Payer: UHC Medicaid |
$133.76
|
| Rate for Payer: UHCCP Medicaid |
$133.76
|
| Rate for Payer: UMR Bronson Commercial |
$329.82
|
|
|
PR REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 37265
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$915.00 |
| Rate for Payer: Aetna Commercial |
$654.11
|
| Rate for Payer: Aetna Medicare |
$507.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.92
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$488.14
|
| Rate for Payer: BCN Medicare Advantage |
$488.14
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cofinity Commercial |
$702.92
|
| Rate for Payer: Cofinity Commercial |
$654.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.55
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$536.95
|
| Rate for Payer: Nomi Health Commercial |
$585.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.00
|
| Rate for Payer: PACE SWMI |
$488.14
|
| Rate for Payer: PHP Commercial |
$683.40
|
| Rate for Payer: PHP Medicare Advantage |
$488.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$709.67
|
| Rate for Payer: Priority Health Medicare |
$488.14
|
| Rate for Payer: Priority Health SBD |
$709.67
|
| Rate for Payer: Priority Health Tiered Network |
$709.67
|
| Rate for Payer: Railroad Medicare Medicare |
$488.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.68
|
| Rate for Payer: UHC Core |
$897.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$488.14
|
| Rate for Payer: UHC Exchange |
$897.68
|
| Rate for Payer: UHC Medicaid |
$307.15
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
| Rate for Payer: UMR Bronson Commercial |
$561.20
|
|
|
PR REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 37263
|
| Min. Negotiated Rate |
$227.06 |
| Max. Negotiated Rate |
$676.50 |
| Rate for Payer: Aetna Commercial |
$483.47
|
| Rate for Payer: Aetna Medicare |
$375.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.55
|
| Rate for Payer: BCBS Complete |
$238.41
|
| Rate for Payer: BCBS MAPPO |
$360.80
|
| Rate for Payer: BCN Medicare Advantage |
$360.80
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$519.55
|
| Rate for Payer: Cofinity Commercial |
$483.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.84
|
| Rate for Payer: Meridian Medicaid |
$238.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.88
|
| Rate for Payer: Nomi Health Commercial |
$432.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.50
|
| Rate for Payer: PACE SWMI |
$360.80
|
| Rate for Payer: PHP Commercial |
$505.12
|
| Rate for Payer: PHP Medicare Advantage |
$360.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$524.99
|
| Rate for Payer: Priority Health Medicare |
$360.80
|
| Rate for Payer: Priority Health SBD |
$524.99
|
| Rate for Payer: Priority Health Tiered Network |
$524.99
|
| Rate for Payer: Railroad Medicare Medicare |
$360.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.53
|
| Rate for Payer: UHC Core |
$663.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.80
|
| Rate for Payer: UHC Exchange |
$663.53
|
| Rate for Payer: UHC Medicaid |
$227.06
|
| Rate for Payer: UHCCP Medicaid |
$227.06
|
| Rate for Payer: UMR Bronson Commercial |
$414.92
|
|
|
PR REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 37273
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$781.23
|
| Rate for Payer: Aetna Medicare |
$606.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.53
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$583.01
|
| Rate for Payer: BCN Medicare Advantage |
$583.01
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$839.53
|
| Rate for Payer: Cofinity Commercial |
$781.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.16
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$641.31
|
| Rate for Payer: Nomi Health Commercial |
$699.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.50
|
| Rate for Payer: PACE SWMI |
$583.01
|
| Rate for Payer: PHP Commercial |
$816.21
|
| Rate for Payer: PHP Medicare Advantage |
$583.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$849.04
|
| Rate for Payer: Priority Health Medicare |
$583.01
|
| Rate for Payer: Priority Health SBD |
$849.04
|
| Rate for Payer: Priority Health Tiered Network |
$849.04
|
| Rate for Payer: Railroad Medicare Medicare |
$583.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.39
|
| Rate for Payer: UHC Core |
$1,073.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.01
|
| Rate for Payer: UHC Exchange |
$1,073.39
|
| Rate for Payer: UHC Medicaid |
$367.43
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
| Rate for Payer: UMR Bronson Commercial |
$670.68
|
|
|
PR REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 37271
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$766.47 |
| Rate for Payer: Aetna Commercial |
$557.82
|
| Rate for Payer: Aetna Medicare |
$432.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.44
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$416.28
|
| Rate for Payer: BCN Medicare Advantage |
$416.28
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$599.44
|
| Rate for Payer: Cofinity Commercial |
$557.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.09
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.91
|
| Rate for Payer: Nomi Health Commercial |
$499.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.00
|
| Rate for Payer: PACE SWMI |
$416.28
|
| Rate for Payer: PHP Commercial |
$582.79
|
| Rate for Payer: PHP Medicare Advantage |
$416.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$606.74
|
| Rate for Payer: Priority Health Medicare |
$416.28
|
| Rate for Payer: Priority Health SBD |
$606.74
|
| Rate for Payer: Priority Health Tiered Network |
$606.74
|
| Rate for Payer: Railroad Medicare Medicare |
$416.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.47
|
| Rate for Payer: UHC Core |
$766.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.28
|
| Rate for Payer: UHC Exchange |
$766.47
|
| Rate for Payer: UHC Medicaid |
$262.42
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
| Rate for Payer: UMR Bronson Commercial |
$356.96
|
|
|
PR REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL
|
Professional
|
Both
|
$9,832.00
|
|
|
Service Code
|
HCPCS 37267
|
| Min. Negotiated Rate |
$256.03 |
| Max. Negotiated Rate |
$7,374.00 |
| Rate for Payer: Aetna Commercial |
$545.46
|
| Rate for Payer: Aetna Medicare |
$423.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.17
|
| Rate for Payer: BCBS Complete |
$268.83
|
| Rate for Payer: BCBS MAPPO |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$407.06
|
| Rate for Payer: Cash Price |
$7,865.60
|
| Rate for Payer: Cash Price |
$7,865.60
|
| Rate for Payer: Cofinity Commercial |
$586.17
|
| Rate for Payer: Cofinity Commercial |
$545.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.41
|
| Rate for Payer: Meridian Medicaid |
$268.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$447.77
|
| Rate for Payer: Nomi Health Commercial |
$488.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,374.00
|
| Rate for Payer: PACE SWMI |
$407.06
|
| Rate for Payer: PHP Commercial |
$569.88
|
| Rate for Payer: PHP Medicare Advantage |
$407.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$591.97
|
| Rate for Payer: Priority Health Medicare |
$407.06
|
| Rate for Payer: Priority Health SBD |
$591.97
|
| Rate for Payer: Priority Health Tiered Network |
$591.97
|
| Rate for Payer: Railroad Medicare Medicare |
$407.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.37
|
| Rate for Payer: UHC Core |
$748.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$407.06
|
| Rate for Payer: UHC Exchange |
$748.37
|
| Rate for Payer: UHC Medicaid |
$256.03
|
| Rate for Payer: UHCCP Medicaid |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$4,522.72
|
|
|
PR REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 37296
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$934.71 |
| Rate for Payer: Aetna Commercial |
$681.04
|
| Rate for Payer: Aetna Medicare |
$528.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.87
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS MAPPO |
$508.24
|
| Rate for Payer: BCN Medicare Advantage |
$508.24
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$731.87
|
| Rate for Payer: Cofinity Commercial |
$681.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.65
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$559.06
|
| Rate for Payer: Nomi Health Commercial |
$609.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$508.24
|
| Rate for Payer: PHP Commercial |
$711.54
|
| Rate for Payer: PHP Medicare Advantage |
$508.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$739.22
|
| Rate for Payer: Priority Health Medicare |
$508.24
|
| Rate for Payer: Priority Health SBD |
$739.22
|
| Rate for Payer: Priority Health Tiered Network |
$739.22
|
| Rate for Payer: Railroad Medicare Medicare |
$508.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.71
|
| Rate for Payer: UHC Core |
$934.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$508.24
|
| Rate for Payer: UHC Exchange |
$934.71
|
| Rate for Payer: UHC Medicaid |
$319.71
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
| Rate for Payer: UMR Bronson Commercial |
$435.16
|
|
|
PR REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 37254
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$625.44 |
| Rate for Payer: Aetna Commercial |
$455.63
|
| Rate for Payer: Aetna Medicare |
$353.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.63
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$340.02
|
| Rate for Payer: BCN Medicare Advantage |
$340.02
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cofinity Commercial |
$489.63
|
| Rate for Payer: Cofinity Commercial |
$455.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.02
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.02
|
| Rate for Payer: Nomi Health Commercial |
$408.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.75
|
| Rate for Payer: PACE SWMI |
$340.02
|
| Rate for Payer: PHP Commercial |
$476.03
|
| Rate for Payer: PHP Medicare Advantage |
$340.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$494.95
|
| Rate for Payer: Priority Health Medicare |
$340.02
|
| Rate for Payer: Priority Health SBD |
$494.95
|
| Rate for Payer: Priority Health Tiered Network |
$494.95
|
| Rate for Payer: Railroad Medicare Medicare |
$340.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.44
|
| Rate for Payer: UHC Core |
$625.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.02
|
| Rate for Payer: UHC Exchange |
$625.44
|
| Rate for Payer: UHC Medicaid |
$214.07
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
| Rate for Payer: UMR Bronson Commercial |
$291.18
|
|
|
PR REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 37255
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$253.61 |
| Rate for Payer: Aetna Commercial |
$184.85
|
| Rate for Payer: Aetna Medicare |
$143.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.65
|
| Rate for Payer: BCBS Complete |
$91.02
|
| Rate for Payer: BCBS MAPPO |
$137.95
|
| Rate for Payer: BCN Medicare Advantage |
$137.95
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$198.65
|
| Rate for Payer: Cofinity Commercial |
$184.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.85
|
| Rate for Payer: Meridian Medicaid |
$91.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.75
|
| Rate for Payer: Nomi Health Commercial |
$165.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$137.95
|
| Rate for Payer: PHP Commercial |
$193.13
|
| Rate for Payer: PHP Medicare Advantage |
$137.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$200.44
|
| Rate for Payer: Priority Health Medicare |
$137.95
|
| Rate for Payer: Priority Health SBD |
$200.44
|
| Rate for Payer: Priority Health Tiered Network |
$200.44
|
| Rate for Payer: Railroad Medicare Medicare |
$137.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.61
|
| Rate for Payer: UHC Core |
$253.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.95
|
| Rate for Payer: UHC Exchange |
$253.61
|
| Rate for Payer: UHC Medicaid |
$86.69
|
| Rate for Payer: UHCCP Medicaid |
$86.69
|
| Rate for Payer: UMR Bronson Commercial |
$117.76
|
|
|
PR REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,470.00
|
|
|
Service Code
|
HCPCS 37260
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,102.50 |
| Rate for Payer: Aetna Commercial |
$788.00
|
| Rate for Payer: Aetna Medicare |
$611.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.81
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$588.06
|
| Rate for Payer: BCN Medicare Advantage |
$588.06
|
| Rate for Payer: Cash Price |
$1,176.00
|
| Rate for Payer: Cash Price |
$1,176.00
|
| Rate for Payer: Cofinity Commercial |
$846.81
|
| Rate for Payer: Cofinity Commercial |
$788.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.46
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$646.87
|
| Rate for Payer: Nomi Health Commercial |
$705.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,102.50
|
| Rate for Payer: PACE SWMI |
$588.06
|
| Rate for Payer: PHP Commercial |
$823.28
|
| Rate for Payer: PHP Medicare Advantage |
$588.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$854.95
|
| Rate for Payer: Priority Health Medicare |
$588.06
|
| Rate for Payer: Priority Health SBD |
$854.95
|
| Rate for Payer: Priority Health Tiered Network |
$854.95
|
| Rate for Payer: Railroad Medicare Medicare |
$588.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.13
|
| Rate for Payer: UHC Core |
$1,081.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$588.06
|
| Rate for Payer: UHC Exchange |
$1,081.13
|
| Rate for Payer: UHC Medicaid |
$369.77
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
| Rate for Payer: UMR Bronson Commercial |
$676.20
|
|
|
PR REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 37258
|
| Min. Negotiated Rate |
$255.81 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$545.04
|
| Rate for Payer: Aetna Medicare |
$423.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.72
|
| Rate for Payer: BCBS Complete |
$268.60
|
| Rate for Payer: BCBS MAPPO |
$406.75
|
| Rate for Payer: BCN Medicare Advantage |
$406.75
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$585.72
|
| Rate for Payer: Cofinity Commercial |
$545.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.09
|
| Rate for Payer: Meridian Medicaid |
$268.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$447.43
|
| Rate for Payer: Nomi Health Commercial |
$488.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$406.75
|
| Rate for Payer: PHP Commercial |
$569.45
|
| Rate for Payer: PHP Medicare Advantage |
$406.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$591.47
|
| Rate for Payer: Priority Health Medicare |
$406.75
|
| Rate for Payer: Priority Health SBD |
$591.47
|
| Rate for Payer: Priority Health Tiered Network |
$591.47
|
| Rate for Payer: Railroad Medicare Medicare |
$406.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.80
|
| Rate for Payer: UHC Core |
$747.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$406.75
|
| Rate for Payer: UHC Exchange |
$747.80
|
| Rate for Payer: UHC Medicaid |
$255.81
|
| Rate for Payer: UHCCP Medicaid |
$255.81
|
| Rate for Payer: UMR Bronson Commercial |
$467.36
|
|
|
PR REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 37259
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$338.52 |
| Rate for Payer: Aetna Commercial |
$246.94
|
| Rate for Payer: Aetna Medicare |
$191.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.36
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$184.28
|
| Rate for Payer: BCN Medicare Advantage |
$184.28
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$265.36
|
| Rate for Payer: Cofinity Commercial |
$246.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.49
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.71
|
| Rate for Payer: Nomi Health Commercial |
$221.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: PACE SWMI |
$184.28
|
| Rate for Payer: PHP Commercial |
$257.99
|
| Rate for Payer: PHP Medicare Advantage |
$184.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$267.42
|
| Rate for Payer: Priority Health Medicare |
$184.28
|
| Rate for Payer: Priority Health SBD |
$267.42
|
| Rate for Payer: Priority Health Tiered Network |
$267.42
|
| Rate for Payer: Railroad Medicare Medicare |
$184.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.52
|
| Rate for Payer: UHC Core |
$338.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.28
|
| Rate for Payer: UHC Exchange |
$338.52
|
| Rate for Payer: UHC Medicaid |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
| Rate for Payer: UMR Bronson Commercial |
$157.32
|
|
|
PR REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 37282
|
| Min. Negotiated Rate |
$358.05 |
| Max. Negotiated Rate |
$1,046.87 |
| Rate for Payer: Aetna Commercial |
$762.89
|
| Rate for Payer: Aetna Medicare |
$592.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.82
|
| Rate for Payer: BCBS Complete |
$375.95
|
| Rate for Payer: BCBS MAPPO |
$569.32
|
| Rate for Payer: BCN Medicare Advantage |
$569.32
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cofinity Commercial |
$819.82
|
| Rate for Payer: Cofinity Commercial |
$762.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.79
|
| Rate for Payer: Meridian Medicaid |
$375.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$626.25
|
| Rate for Payer: Nomi Health Commercial |
$683.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.50
|
| Rate for Payer: PACE SWMI |
$569.32
|
| Rate for Payer: PHP Commercial |
$797.05
|
| Rate for Payer: PHP Medicare Advantage |
$569.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$826.88
|
| Rate for Payer: Priority Health Medicare |
$569.32
|
| Rate for Payer: Priority Health SBD |
$826.88
|
| Rate for Payer: Priority Health Tiered Network |
$826.88
|
| Rate for Payer: Railroad Medicare Medicare |
$569.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,046.87
|
| Rate for Payer: UHC Core |
$1,046.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$569.32
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicaid |
$358.05
|
| Rate for Payer: UHCCP Medicaid |
$358.05
|
| Rate for Payer: UMR Bronson Commercial |
$486.68
|
|
