|
PR RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 93040
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$19.16
|
| Rate for Payer: Aetna Medicare |
$14.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCN Commercial |
$19.92
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$20.59
|
| Rate for Payer: Cofinity Commercial |
$19.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.73
|
| Rate for Payer: Nomi Health Commercial |
$17.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$20.02
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.93
|
| Rate for Payer: Priority Health Medicare |
$14.30
|
| Rate for Payer: Priority Health SBD |
$18.93
|
| Rate for Payer: Priority Health Tiered Network |
$18.93
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.98
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.30
|
| Rate for Payer: UHC Exchange |
$19.98
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR RHYTIDECTOMY 3 HOURS
|
Professional
|
Both
|
$7,210.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,884.00 |
| Max. Negotiated Rate |
$5,407.50 |
| Rate for Payer: Aetna Medicare |
$3,605.00
|
| Rate for Payer: BCBS Complete |
$2,884.00
|
| Rate for Payer: Cash Price |
$5,768.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,407.50
|
| Rate for Payer: UMR Bronson Commercial |
$3,316.60
|
|
|
PR RHYTIDECTOMY SMAS FLAP
|
Professional
|
Both
|
$5,043.00
|
|
|
Service Code
|
HCPCS 15829
|
| Min. Negotiated Rate |
$2,319.78 |
| Max. Negotiated Rate |
$4,667.18 |
| Rate for Payer: Aetna Commercial |
$2,885.67
|
| Rate for Payer: Aetna Medicare |
$2,521.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,885.67
|
| Rate for Payer: BCN Commercial |
$3,423.01
|
| Rate for Payer: Cash Price |
$4,034.40
|
| Rate for Payer: Cash Price |
$4,034.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,782.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,663.57
|
| Rate for Payer: Priority Health SBD |
$3,663.57
|
| Rate for Payer: Priority Health Tiered Network |
$3,663.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,667.18
|
| Rate for Payer: UHC Core |
$4,667.18
|
| Rate for Payer: UHC Exchange |
$4,667.18
|
| Rate for Payer: UMR Bronson Commercial |
$2,319.78
|
|
|
PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT
|
Professional
|
Both
|
$2,266.00
|
|
|
Service Code
|
HCPCS 93451
|
| Min. Negotiated Rate |
$787.35 |
| Max. Negotiated Rate |
$1,699.50 |
| Rate for Payer: Aetna Commercial |
$1,055.05
|
| Rate for Payer: Aetna Commercial |
$1,055.05
|
| Rate for Payer: Aetna Medicare |
$818.84
|
| Rate for Payer: Aetna Medicare |
$818.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.78
|
| Rate for Payer: BCBS MAPPO |
$787.35
|
| Rate for Payer: BCBS MAPPO |
$787.35
|
| Rate for Payer: BCN Commercial |
$1,220.05
|
| Rate for Payer: BCN Commercial |
$1,220.05
|
| Rate for Payer: BCN Medicare Advantage |
$787.35
|
| Rate for Payer: BCN Medicare Advantage |
$787.35
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$1,055.05
|
| Rate for Payer: Cofinity Commercial |
$1,133.78
|
| Rate for Payer: Cofinity Commercial |
$1,133.78
|
| Rate for Payer: Cofinity Commercial |
$1,055.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.09
|
| Rate for Payer: Nomi Health Commercial |
$944.82
|
| Rate for Payer: Nomi Health Commercial |
$944.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,699.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PACE SWMI |
$787.35
|
| Rate for Payer: PACE SWMI |
$787.35
|
| Rate for Payer: PHP Commercial |
$1,102.29
|
| Rate for Payer: PHP Commercial |
$1,102.29
|
| Rate for Payer: PHP Medicare Advantage |
$787.35
|
| Rate for Payer: PHP Medicare Advantage |
$787.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,159.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,159.60
|
| Rate for Payer: Priority Health Medicare |
$787.35
|
| Rate for Payer: Priority Health Medicare |
$787.35
|
| Rate for Payer: Priority Health SBD |
$1,159.60
|
| Rate for Payer: Priority Health SBD |
$1,159.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,159.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,159.60
|
| Rate for Payer: Railroad Medicare Medicare |
$787.35
|
| Rate for Payer: Railroad Medicare Medicare |
$787.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.28
|
| Rate for Payer: UHC Core |
$1,287.28
|
| Rate for Payer: UHC Core |
$1,287.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.35
|
| Rate for Payer: UHC Exchange |
$1,287.28
|
| Rate for Payer: UHC Exchange |
$1,287.28
|
| Rate for Payer: UMR Bronson Commercial |
$211.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.36
|
|
|
PR RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 35697
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$266.20 |
| Rate for Payer: Aetna Commercial |
$179.88
|
| Rate for Payer: Aetna Medicare |
$139.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.31
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: BCBS MAPPO |
$134.24
|
| Rate for Payer: BCN Commercial |
$213.13
|
| Rate for Payer: BCN Medicare Advantage |
$134.24
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$179.88
|
| Rate for Payer: Cofinity Commercial |
$193.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.95
|
| Rate for Payer: Meridian Medicaid |
$88.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.66
|
| Rate for Payer: Nomi Health Commercial |
$161.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$134.24
|
| Rate for Payer: PHP Commercial |
$187.94
|
| Rate for Payer: PHP Medicare Advantage |
$134.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$229.20
|
| Rate for Payer: Priority Health Medicare |
$134.24
|
| Rate for Payer: Priority Health SBD |
$229.20
|
| Rate for Payer: Priority Health Tiered Network |
$229.20
|
| Rate for Payer: Railroad Medicare Medicare |
$134.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.20
|
| Rate for Payer: UHC Core |
$266.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.24
|
| Rate for Payer: UHC Exchange |
$266.20
|
| Rate for Payer: UHC Medicaid |
$84.14
|
| Rate for Payer: UHCCP Medicaid |
$84.14
|
| Rate for Payer: UMR Bronson Commercial |
$155.48
|
|
|
PR RINGERS LACTATE INFUSION
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS J7120
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$3.48
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.48
|
| Rate for Payer: BCBS MAPPO |
$2.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.72
|
| Rate for Payer: BCN Commercial |
$0.70
|
| Rate for Payer: BCN Medicare Advantage |
$2.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$3.48
|
| Rate for Payer: Cofinity Commercial |
$3.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.86
|
| Rate for Payer: Nomi Health Commercial |
$3.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$2.60
|
| Rate for Payer: PHP Commercial |
$3.64
|
| Rate for Payer: PHP Medicare Advantage |
$2.60
|
| Rate for Payer: Priority Health Medicare |
$2.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.38
|
| Rate for Payer: UHC Core |
$2.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.60
|
| Rate for Payer: UHC Exchange |
$2.38
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF
|
Professional
|
Both
|
$2,711.00
|
|
|
Service Code
|
HCPCS 24342
|
| Min. Negotiated Rate |
$456.67 |
| Max. Negotiated Rate |
$2,033.25 |
| Rate for Payer: Aetna Commercial |
$937.75
|
| Rate for Payer: Aetna Medicare |
$727.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.73
|
| Rate for Payer: BCBS Complete |
$479.50
|
| Rate for Payer: BCBS MAPPO |
$699.81
|
| Rate for Payer: BCN Commercial |
$1,180.71
|
| Rate for Payer: BCN Medicare Advantage |
$699.81
|
| Rate for Payer: Cash Price |
$2,168.80
|
| Rate for Payer: Cash Price |
$2,168.80
|
| Rate for Payer: Cofinity Commercial |
$937.75
|
| Rate for Payer: Cofinity Commercial |
$1,007.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.80
|
| Rate for Payer: Meridian Medicaid |
$479.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$769.79
|
| Rate for Payer: Nomi Health Commercial |
$839.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,033.25
|
| Rate for Payer: PACE SWMI |
$699.81
|
| Rate for Payer: PHP Commercial |
$979.73
|
| Rate for Payer: PHP Medicare Advantage |
$699.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,262.16
|
| Rate for Payer: Priority Health Medicare |
$699.81
|
| Rate for Payer: Priority Health SBD |
$1,262.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,262.16
|
| Rate for Payer: Railroad Medicare Medicare |
$699.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,355.16
|
| Rate for Payer: UHC Core |
$1,355.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$699.81
|
| Rate for Payer: UHC Exchange |
$1,355.16
|
| Rate for Payer: UHC Medicaid |
$456.67
|
| Rate for Payer: UHCCP Medicaid |
$456.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,247.06
|
|
|
PR RISK ASCVD TST ONCE PR 12 MO
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS G0537
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$10.60
|
| Rate for Payer: Aetna Medicare |
$8.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$7.91
|
| Rate for Payer: BCN Commercial |
$13.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.91
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$11.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.31
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.70
|
| Rate for Payer: Nomi Health Commercial |
$9.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
| Rate for Payer: PACE SWMI |
$7.91
|
| Rate for Payer: PHP Commercial |
$11.07
|
| Rate for Payer: PHP Medicare Advantage |
$7.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Medicare |
$7.91
|
| Rate for Payer: Priority Health SBD |
$12.09
|
| Rate for Payer: Priority Health Tiered Network |
$12.09
|
| Rate for Payer: Railroad Medicare Medicare |
$7.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.30
|
| Rate for Payer: UHC Core |
$15.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.91
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 90673
|
| Min. Negotiated Rate |
$42.45 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$131.53
|
| Rate for Payer: Aetna Medicare |
$102.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.35
|
| Rate for Payer: BCBS MAPPO |
$98.16
|
| Rate for Payer: BCBS Trust/PPO |
$86.23
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$98.16
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Commercial |
$141.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$117.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$98.16
|
| Rate for Payer: PHP Commercial |
$137.42
|
| Rate for Payer: PHP Medicare Advantage |
$98.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.45
|
| Rate for Payer: Priority Health Medicare |
$98.16
|
| Rate for Payer: Priority Health SBD |
$42.45
|
| Rate for Payer: Priority Health Tiered Network |
$42.45
|
| Rate for Payer: Railroad Medicare Medicare |
$98.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.16
|
| Rate for Payer: UHC Core |
$98.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.16
|
| Rate for Payer: UHC Exchange |
$98.16
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
PR RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 90682
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$73.62 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$64.51
|
| Rate for Payer: BCN Commercial |
$73.62
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.40
|
| Rate for Payer: UHC Core |
$73.40
|
| Rate for Payer: UHC Exchange |
$73.40
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I
|
Professional
|
Both
|
$3,007.00
|
|
|
Service Code
|
HCPCS 93461
|
| Min. Negotiated Rate |
$1,246.88 |
| Max. Negotiated Rate |
$2,255.25 |
| Rate for Payer: Aetna Commercial |
$1,670.82
|
| Rate for Payer: Aetna Commercial |
$1,670.82
|
| Rate for Payer: Aetna Medicare |
$1,296.76
|
| Rate for Payer: Aetna Medicare |
$1,296.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,670.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,795.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,795.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,670.82
|
| Rate for Payer: BCBS MAPPO |
$1,246.88
|
| Rate for Payer: BCBS MAPPO |
$1,246.88
|
| Rate for Payer: BCN Commercial |
$1,953.58
|
| Rate for Payer: BCN Commercial |
$1,953.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.88
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,405.60
|
| Rate for Payer: Cash Price |
$2,405.60
|
| Rate for Payer: Cofinity Commercial |
$1,795.51
|
| Rate for Payer: Cofinity Commercial |
$1,795.51
|
| Rate for Payer: Cofinity Commercial |
$1,670.82
|
| Rate for Payer: Cofinity Commercial |
$1,670.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,309.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,309.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,371.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,371.57
|
| Rate for Payer: Nomi Health Commercial |
$1,496.26
|
| Rate for Payer: Nomi Health Commercial |
$1,496.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,255.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,166.00
|
| Rate for Payer: PACE SWMI |
$1,246.88
|
| Rate for Payer: PACE SWMI |
$1,246.88
|
| Rate for Payer: PHP Commercial |
$1,745.63
|
| Rate for Payer: PHP Commercial |
$1,745.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,856.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,856.77
|
| Rate for Payer: Priority Health Medicare |
$1,246.88
|
| Rate for Payer: Priority Health Medicare |
$1,246.88
|
| Rate for Payer: Priority Health SBD |
$1,856.77
|
| Rate for Payer: Priority Health SBD |
$1,856.77
|
| Rate for Payer: Priority Health Tiered Network |
$1,856.77
|
| Rate for Payer: Priority Health Tiered Network |
$1,856.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,246.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,246.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,225.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,225.83
|
| Rate for Payer: UHC Core |
$2,225.83
|
| Rate for Payer: UHC Core |
$2,225.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,246.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,246.88
|
| Rate for Payer: UHC Exchange |
$2,225.83
|
| Rate for Payer: UHC Exchange |
$2,225.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,328.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,383.22
|
|
|
PR R & L HRT CATH WINJX HRT ART& L VENTR IMG
|
Professional
|
Both
|
$1,266.00
|
|
|
Service Code
|
HCPCS 93460
|
| Min. Negotiated Rate |
$582.36 |
| Max. Negotiated Rate |
$1,989.11 |
| Rate for Payer: Aetna Commercial |
$1,515.65
|
| Rate for Payer: Aetna Medicare |
$1,176.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.76
|
| Rate for Payer: BCBS MAPPO |
$1,131.08
|
| Rate for Payer: BCN Commercial |
$1,770.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.08
|
| Rate for Payer: Cash Price |
$1,012.80
|
| Rate for Payer: Cash Price |
$1,012.80
|
| Rate for Payer: Cofinity Commercial |
$1,515.65
|
| Rate for Payer: Cofinity Commercial |
$1,628.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,244.19
|
| Rate for Payer: Nomi Health Commercial |
$1,357.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$949.50
|
| Rate for Payer: PACE SWMI |
$1,131.08
|
| Rate for Payer: PHP Commercial |
$1,583.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,683.07
|
| Rate for Payer: Priority Health Medicare |
$1,131.08
|
| Rate for Payer: Priority Health SBD |
$1,683.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,683.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,131.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,989.11
|
| Rate for Payer: UHC Core |
$1,989.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,131.08
|
| Rate for Payer: UHC Exchange |
$1,989.11
|
| Rate for Payer: UMR Bronson Commercial |
$582.36
|
|
|
PR R & L HRT CATH W/NJX L VENTRICULOG IMG S&I
|
Professional
|
Both
|
$692.00
|
|
|
Service Code
|
HCPCS 93453
|
| Min. Negotiated Rate |
$318.32 |
| Max. Negotiated Rate |
$1,810.35 |
| Rate for Payer: Aetna Commercial |
$1,398.08
|
| Rate for Payer: Aetna Medicare |
$1,085.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,398.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.41
|
| Rate for Payer: BCBS MAPPO |
$1,043.34
|
| Rate for Payer: BCN Commercial |
$1,630.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,043.34
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$1,502.41
|
| Rate for Payer: Cofinity Commercial |
$1,398.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,043.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,095.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,147.67
|
| Rate for Payer: Nomi Health Commercial |
$1,252.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$519.00
|
| Rate for Payer: PACE SWMI |
$1,043.34
|
| Rate for Payer: PHP Commercial |
$1,460.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,043.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,550.08
|
| Rate for Payer: Priority Health Medicare |
$1,043.34
|
| Rate for Payer: Priority Health SBD |
$1,550.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,550.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,043.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,810.35
|
| Rate for Payer: UHC Core |
$1,810.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,043.34
|
| Rate for Payer: UHC Exchange |
$1,810.35
|
| Rate for Payer: UMR Bronson Commercial |
$318.32
|
|
|
PR RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ
|
Professional
|
Both
|
$1,850.00
|
|
|
Service Code
|
HCPCS 33244
|
| Min. Negotiated Rate |
$488.84 |
| Max. Negotiated Rate |
$1,532.37 |
| Rate for Payer: Aetna Commercial |
$1,020.73
|
| Rate for Payer: Aetna Medicare |
$792.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.91
|
| Rate for Payer: BCBS Complete |
$513.28
|
| Rate for Payer: BCBS MAPPO |
$761.74
|
| Rate for Payer: BCN Commercial |
$1,268.85
|
| Rate for Payer: BCN Medicare Advantage |
$761.74
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cofinity Commercial |
$1,020.73
|
| Rate for Payer: Cofinity Commercial |
$1,096.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.83
|
| Rate for Payer: Meridian Medicaid |
$513.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$837.91
|
| Rate for Payer: Nomi Health Commercial |
$914.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,387.50
|
| Rate for Payer: PACE SWMI |
$761.74
|
| Rate for Payer: PHP Commercial |
$1,066.44
|
| Rate for Payer: PHP Medicare Advantage |
$761.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,364.50
|
| Rate for Payer: Priority Health Medicare |
$761.74
|
| Rate for Payer: Priority Health SBD |
$1,364.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,364.50
|
| Rate for Payer: Railroad Medicare Medicare |
$761.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,532.37
|
| Rate for Payer: UHC Core |
$1,532.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.74
|
| Rate for Payer: UHC Exchange |
$1,532.37
|
| Rate for Payer: UHC Medicaid |
$488.84
|
| Rate for Payer: UHCCP Medicaid |
$488.84
|
| Rate for Payer: UMR Bronson Commercial |
$851.00
|
|
|
PR RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA
|
Professional
|
Both
|
$2,554.00
|
|
|
Service Code
|
HCPCS 33974
|
| Min. Negotiated Rate |
$555.93 |
| Max. Negotiated Rate |
$1,915.50 |
| Rate for Payer: Aetna Commercial |
$1,157.41
|
| Rate for Payer: Aetna Medicare |
$898.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.79
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS MAPPO |
$863.74
|
| Rate for Payer: BCN Commercial |
$1,318.65
|
| Rate for Payer: BCN Medicare Advantage |
$863.74
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cofinity Commercial |
$1,157.41
|
| Rate for Payer: Cofinity Commercial |
$1,243.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$863.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$906.93
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$950.11
|
| Rate for Payer: Nomi Health Commercial |
$1,036.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,915.50
|
| Rate for Payer: PACE SWMI |
$863.74
|
| Rate for Payer: PHP Commercial |
$1,209.24
|
| Rate for Payer: PHP Medicare Advantage |
$863.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,418.05
|
| Rate for Payer: Priority Health Medicare |
$863.74
|
| Rate for Payer: Priority Health SBD |
$1,418.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,418.05
|
| Rate for Payer: Railroad Medicare Medicare |
$863.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.73
|
| Rate for Payer: UHC Core |
$1,574.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$863.74
|
| Rate for Payer: UHC Exchange |
$1,574.73
|
| Rate for Payer: UHC Medicaid |
$555.93
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,174.84
|
|
|
PR RMVL BONE FLAP/PROSTHETIC PLATE SKULL
|
Professional
|
Both
|
$3,472.00
|
|
|
Service Code
|
HCPCS 62142
|
| Min. Negotiated Rate |
$574.67 |
| Max. Negotiated Rate |
$2,604.00 |
| Rate for Payer: Aetna Commercial |
$1,192.25
|
| Rate for Payer: Aetna Medicare |
$925.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.23
|
| Rate for Payer: BCBS Complete |
$603.40
|
| Rate for Payer: BCBS MAPPO |
$889.74
|
| Rate for Payer: BCN Commercial |
$1,895.37
|
| Rate for Payer: BCN Medicare Advantage |
$889.74
|
| Rate for Payer: Cash Price |
$2,777.60
|
| Rate for Payer: Cash Price |
$2,777.60
|
| Rate for Payer: Cofinity Commercial |
$1,192.25
|
| Rate for Payer: Cofinity Commercial |
$1,281.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.23
|
| Rate for Payer: Meridian Medicaid |
$603.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$978.71
|
| Rate for Payer: Nomi Health Commercial |
$1,067.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,604.00
|
| Rate for Payer: PACE SWMI |
$889.74
|
| Rate for Payer: PHP Commercial |
$1,245.64
|
| Rate for Payer: PHP Medicare Advantage |
$889.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,593.49
|
| Rate for Payer: Priority Health Medicare |
$889.74
|
| Rate for Payer: Priority Health SBD |
$1,593.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,593.49
|
| Rate for Payer: Railroad Medicare Medicare |
$889.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,551.68
|
| Rate for Payer: UHC Core |
$1,551.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$889.74
|
| Rate for Payer: UHC Exchange |
$1,551.68
|
| Rate for Payer: UHC Medicaid |
$574.67
|
| Rate for Payer: UHCCP Medicaid |
$574.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,597.12
|
|
|
PR RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT
|
Professional
|
Both
|
$2,273.00
|
|
|
Service Code
|
HCPCS 62256
|
| Min. Negotiated Rate |
$408.11 |
| Max. Negotiated Rate |
$1,704.75 |
| Rate for Payer: Aetna Commercial |
$839.79
|
| Rate for Payer: Aetna Medicare |
$651.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.46
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS MAPPO |
$626.71
|
| Rate for Payer: BCN Commercial |
$1,298.20
|
| Rate for Payer: BCN Medicare Advantage |
$626.71
|
| Rate for Payer: Cash Price |
$1,818.40
|
| Rate for Payer: Cash Price |
$1,818.40
|
| Rate for Payer: Cofinity Commercial |
$839.79
|
| Rate for Payer: Cofinity Commercial |
$902.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.05
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.38
|
| Rate for Payer: Nomi Health Commercial |
$752.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,704.75
|
| Rate for Payer: PACE SWMI |
$626.71
|
| Rate for Payer: PHP Commercial |
$877.39
|
| Rate for Payer: PHP Medicare Advantage |
$626.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,091.44
|
| Rate for Payer: Priority Health Medicare |
$626.71
|
| Rate for Payer: Priority Health SBD |
$1,091.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,091.44
|
| Rate for Payer: Railroad Medicare Medicare |
$626.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.69
|
| Rate for Payer: UHC Core |
$1,051.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.71
|
| Rate for Payer: UHC Exchange |
$1,051.69
|
| Rate for Payer: UHC Medicaid |
$408.11
|
| Rate for Payer: UHCCP Medicaid |
$408.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,045.58
|
|
|
PR RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT
|
Professional
|
Both
|
$5,281.00
|
|
|
Service Code
|
HCPCS 62258
|
| Min. Negotiated Rate |
$704.82 |
| Max. Negotiated Rate |
$3,960.75 |
| Rate for Payer: Aetna Commercial |
$1,470.23
|
| Rate for Payer: Aetna Medicare |
$1,141.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,470.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,579.95
|
| Rate for Payer: BCBS Complete |
$740.06
|
| Rate for Payer: BCBS MAPPO |
$1,097.19
|
| Rate for Payer: BCN Commercial |
$2,341.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.19
|
| Rate for Payer: Cash Price |
$4,224.80
|
| Rate for Payer: Cash Price |
$4,224.80
|
| Rate for Payer: Cofinity Commercial |
$1,470.23
|
| Rate for Payer: Cofinity Commercial |
$1,579.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.05
|
| Rate for Payer: Meridian Medicaid |
$740.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,206.91
|
| Rate for Payer: Nomi Health Commercial |
$1,316.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,960.75
|
| Rate for Payer: PACE SWMI |
$1,097.19
|
| Rate for Payer: PHP Commercial |
$1,536.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$704.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,968.85
|
| Rate for Payer: Priority Health Medicare |
$1,097.19
|
| Rate for Payer: Priority Health SBD |
$1,968.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,968.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.87
|
| Rate for Payer: UHC Core |
$1,952.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.19
|
| Rate for Payer: UHC Exchange |
$1,952.87
|
| Rate for Payer: UHC Medicaid |
$704.82
|
| Rate for Payer: UHCCP Medicaid |
$704.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,429.26
|
|
|
PR RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 65435
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$120.75 |
| Rate for Payer: Aetna Commercial |
$78.15
|
| Rate for Payer: Aetna Medicare |
$60.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.98
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$58.32
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$58.32
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cofinity Commercial |
$78.15
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.24
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.15
|
| Rate for Payer: Nomi Health Commercial |
$69.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.00
|
| Rate for Payer: PACE SWMI |
$58.32
|
| Rate for Payer: PHP Commercial |
$81.65
|
| Rate for Payer: PHP Medicare Advantage |
$58.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.75
|
| Rate for Payer: Priority Health Medicare |
$58.32
|
| Rate for Payer: Priority Health SBD |
$120.75
|
| Rate for Payer: Priority Health Tiered Network |
$120.75
|
| Rate for Payer: Railroad Medicare Medicare |
$58.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.10
|
| Rate for Payer: UHC Core |
$119.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.32
|
| Rate for Payer: UHC Exchange |
$119.10
|
| Rate for Payer: UHC Medicaid |
$38.55
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$69.92
|
|
|
PR RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 97602
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$185.78 |
| Rate for Payer: Aetna Commercial |
$89.75
|
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.75
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCN Commercial |
$185.78
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$109.57
|
| Rate for Payer: Priority Health SBD |
$109.57
|
| Rate for Payer: Priority Health Tiered Network |
$109.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.19
|
| Rate for Payer: UHC Core |
$72.19
|
| Rate for Payer: UHC Exchange |
$72.19
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 40805
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Aetna Commercial |
$238.65
|
| Rate for Payer: Aetna Medicare |
$185.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.46
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS MAPPO |
$178.10
|
| Rate for Payer: BCN Commercial |
$302.28
|
| Rate for Payer: BCN Medicare Advantage |
$178.10
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$238.65
|
| Rate for Payer: Cofinity Commercial |
$256.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.00
|
| Rate for Payer: Meridian Medicaid |
$123.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.91
|
| Rate for Payer: Nomi Health Commercial |
$213.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.50
|
| Rate for Payer: PACE SWMI |
$178.10
|
| Rate for Payer: PHP Commercial |
$249.34
|
| Rate for Payer: PHP Medicare Advantage |
$178.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$368.30
|
| Rate for Payer: Priority Health Medicare |
$178.10
|
| Rate for Payer: Priority Health SBD |
$368.30
|
| Rate for Payer: Priority Health Tiered Network |
$368.30
|
| Rate for Payer: Railroad Medicare Medicare |
$178.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.96
|
| Rate for Payer: UHC Core |
$360.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.10
|
| Rate for Payer: UHC Exchange |
$360.96
|
| Rate for Payer: UHC Medicaid |
$117.36
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
| Rate for Payer: UMR Bronson Commercial |
$333.96
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 40804
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$148.16
|
| Rate for Payer: Aetna Medicare |
$114.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.22
|
| Rate for Payer: BCBS Complete |
$77.39
|
| Rate for Payer: BCBS MAPPO |
$110.57
|
| Rate for Payer: BCN Commercial |
$178.77
|
| Rate for Payer: BCN Medicare Advantage |
$110.57
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$148.16
|
| Rate for Payer: Cofinity Commercial |
$159.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.10
|
| Rate for Payer: Meridian Medicaid |
$77.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.63
|
| Rate for Payer: Nomi Health Commercial |
$132.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.50
|
| Rate for Payer: PACE SWMI |
$110.57
|
| Rate for Payer: PHP Commercial |
$154.80
|
| Rate for Payer: PHP Medicare Advantage |
$110.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$217.82
|
| Rate for Payer: Priority Health Medicare |
$110.57
|
| Rate for Payer: Priority Health SBD |
$217.82
|
| Rate for Payer: Priority Health Tiered Network |
$217.82
|
| Rate for Payer: Railroad Medicare Medicare |
$110.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.68
|
| Rate for Payer: UHC Core |
$202.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$110.57
|
| Rate for Payer: UHC Exchange |
$202.68
|
| Rate for Payer: UHC Medicaid |
$73.70
|
| Rate for Payer: UHCCP Medicaid |
$73.70
|
| Rate for Payer: UMR Bronson Commercial |
$161.00
|
|
|
PR RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 63746
|
| Min. Negotiated Rate |
$410.24 |
| Max. Negotiated Rate |
$1,281.00 |
| Rate for Payer: Aetna Commercial |
$843.97
|
| Rate for Payer: Aetna Medicare |
$655.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.96
|
| Rate for Payer: BCBS Complete |
$430.75
|
| Rate for Payer: BCBS MAPPO |
$629.83
|
| Rate for Payer: BCN Commercial |
$1,035.60
|
| Rate for Payer: BCN Medicare Advantage |
$629.83
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cofinity Commercial |
$843.97
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.32
|
| Rate for Payer: Meridian Medicaid |
$430.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$692.81
|
| Rate for Payer: Nomi Health Commercial |
$755.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: PACE SWMI |
$629.83
|
| Rate for Payer: PHP Commercial |
$881.76
|
| Rate for Payer: PHP Medicare Advantage |
$629.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,094.90
|
| Rate for Payer: Priority Health Medicare |
$629.83
|
| Rate for Payer: Priority Health SBD |
$1,094.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,094.90
|
| Rate for Payer: Railroad Medicare Medicare |
$629.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.24
|
| Rate for Payer: UHC Core |
$1,053.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$629.83
|
| Rate for Payer: UHC Exchange |
$1,053.24
|
| Rate for Payer: UHC Medicaid |
$410.24
|
| Rate for Payer: UHCCP Medicaid |
$410.24
|
| Rate for Payer: UMR Bronson Commercial |
$785.68
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL ANES
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 69205
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$166.47 |
| Rate for Payer: Aetna Commercial |
$113.30
|
| Rate for Payer: Aetna Medicare |
$87.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.75
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$84.55
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: BCN Medicare Advantage |
$84.55
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$113.30
|
| Rate for Payer: Cofinity Commercial |
$121.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.78
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.00
|
| Rate for Payer: Nomi Health Commercial |
$101.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: PACE SWMI |
$84.55
|
| Rate for Payer: PHP Commercial |
$118.37
|
| Rate for Payer: PHP Medicare Advantage |
$84.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.21
|
| Rate for Payer: Priority Health Medicare |
$84.55
|
| Rate for Payer: Priority Health SBD |
$141.21
|
| Rate for Payer: Priority Health Tiered Network |
$141.21
|
| Rate for Payer: Railroad Medicare Medicare |
$84.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.47
|
| Rate for Payer: UHC Core |
$166.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.55
|
| Rate for Payer: UHC Exchange |
$166.47
|
| Rate for Payer: UHC Medicaid |
$55.81
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL W/O ANES
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 69200
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$55.06
|
| Rate for Payer: Aetna Medicare |
$42.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.17
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.09
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.09
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$55.06
|
| Rate for Payer: Cofinity Commercial |
$59.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.14
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.20
|
| Rate for Payer: Nomi Health Commercial |
$49.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: PACE SWMI |
$41.09
|
| Rate for Payer: PHP Commercial |
$57.53
|
| Rate for Payer: PHP Medicare Advantage |
$41.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$70.86
|
| Rate for Payer: Priority Health Medicare |
$41.09
|
| Rate for Payer: Priority Health SBD |
$70.86
|
| Rate for Payer: Priority Health Tiered Network |
$70.86
|
| Rate for Payer: Railroad Medicare Medicare |
$41.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.27
|
| Rate for Payer: UHC Core |
$82.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.09
|
| Rate for Payer: UHC Exchange |
$82.27
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
