|
PR RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 65220
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$49.73
|
| Rate for Payer: Aetna Medicare |
$38.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.44
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$37.11
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Medicare Advantage |
$37.11
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$49.73
|
| Rate for Payer: Cofinity Commercial |
$53.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.97
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.82
|
| Rate for Payer: Nomi Health Commercial |
$44.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.50
|
| Rate for Payer: PACE SWMI |
$37.11
|
| Rate for Payer: PHP Commercial |
$51.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.16
|
| Rate for Payer: Priority Health Medicare |
$37.11
|
| Rate for Payer: Priority Health SBD |
$71.16
|
| Rate for Payer: Priority Health Tiered Network |
$71.16
|
| Rate for Payer: Railroad Medicare Medicare |
$37.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.65
|
| Rate for Payer: UHC Core |
$72.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.11
|
| Rate for Payer: UHC Exchange |
$72.65
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 65222
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$141.00 |
| Rate for Payer: Aetna Commercial |
$54.66
|
| Rate for Payer: Aetna Medicare |
$42.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.74
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$40.79
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$40.79
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$54.66
|
| Rate for Payer: Cofinity Commercial |
$58.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.83
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.87
|
| Rate for Payer: Nomi Health Commercial |
$48.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.00
|
| Rate for Payer: PACE SWMI |
$40.79
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicare Advantage |
$40.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$86.32
|
| Rate for Payer: Priority Health Medicare |
$40.79
|
| Rate for Payer: Priority Health SBD |
$86.32
|
| Rate for Payer: Priority Health Tiered Network |
$86.32
|
| Rate for Payer: Railroad Medicare Medicare |
$40.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.64
|
| Rate for Payer: UHC Core |
$88.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.79
|
| Rate for Payer: UHC Exchange |
$88.64
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$86.48
|
|
|
PR RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 65210
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Commercial |
$39.37
|
| Rate for Payer: Aetna Medicare |
$30.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.31
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$29.38
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$29.38
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$42.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.85
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.32
|
| Rate for Payer: Nomi Health Commercial |
$35.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.75
|
| Rate for Payer: PACE SWMI |
$29.38
|
| Rate for Payer: PHP Commercial |
$41.13
|
| Rate for Payer: PHP Medicare Advantage |
$29.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.41
|
| Rate for Payer: Priority Health Medicare |
$29.38
|
| Rate for Payer: Priority Health SBD |
$62.41
|
| Rate for Payer: Priority Health Tiered Network |
$62.41
|
| Rate for Payer: Railroad Medicare Medicare |
$29.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$63.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.38
|
| Rate for Payer: UHC Exchange |
$63.18
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR RMVL FECAL IMPACTION/FB SPX UNDER ANES
|
Professional
|
Both
|
$631.00
|
|
|
Service Code
|
HCPCS 45915
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$473.25 |
| Rate for Payer: Aetna Commercial |
$301.70
|
| Rate for Payer: Aetna Medicare |
$234.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.22
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS MAPPO |
$225.15
|
| Rate for Payer: BCN Commercial |
$347.09
|
| Rate for Payer: BCN Medicare Advantage |
$225.15
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cofinity Commercial |
$301.70
|
| Rate for Payer: Cofinity Commercial |
$324.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.41
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$247.66
|
| Rate for Payer: Nomi Health Commercial |
$270.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$473.25
|
| Rate for Payer: PACE SWMI |
$225.15
|
| Rate for Payer: PHP Commercial |
$315.21
|
| Rate for Payer: PHP Medicare Advantage |
$225.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$422.92
|
| Rate for Payer: Priority Health Medicare |
$225.15
|
| Rate for Payer: Priority Health SBD |
$422.92
|
| Rate for Payer: Priority Health Tiered Network |
$422.92
|
| Rate for Payer: Railroad Medicare Medicare |
$225.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.97
|
| Rate for Payer: UHC Core |
$401.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$225.15
|
| Rate for Payer: UHC Exchange |
$401.97
|
| Rate for Payer: UHC Medicaid |
$147.82
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
| Rate for Payer: UMR Bronson Commercial |
$290.26
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
IP
|
$791.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$711.90 |
| Rate for Payer: Aetna American Axle |
$514.15
|
| Rate for Payer: Aetna Commercial |
$672.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.15
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Advantage |
$553.70
|
| Rate for Payer: Cofinity Commercial |
$680.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.80
|
| Rate for Payer: Healthscope Commercial |
$711.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PHP Commercial |
$672.35
|
| Rate for Payer: Priority Health SBD |
$498.33
|
| Rate for Payer: UMR Bronson Commercial |
$348.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.25
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 20525
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$593.25 |
| Rate for Payer: Aetna Commercial |
$305.04
|
| Rate for Payer: Aetna Medicare |
$236.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.80
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCBS MAPPO |
$227.64
|
| Rate for Payer: BCN Commercial |
$376.48
|
| Rate for Payer: BCN Medicare Advantage |
$227.64
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$305.04
|
| Rate for Payer: Cofinity Commercial |
$327.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$239.02
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.40
|
| Rate for Payer: Nomi Health Commercial |
$273.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PACE SWMI |
$227.64
|
| Rate for Payer: PHP Commercial |
$318.70
|
| Rate for Payer: PHP Medicare Advantage |
$227.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$402.44
|
| Rate for Payer: Priority Health Medicare |
$227.64
|
| Rate for Payer: Priority Health SBD |
$402.44
|
| Rate for Payer: Priority Health Tiered Network |
$402.44
|
| Rate for Payer: Railroad Medicare Medicare |
$227.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.70
|
| Rate for Payer: UHC Core |
$430.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.64
|
| Rate for Payer: UHC Exchange |
$430.70
|
| Rate for Payer: UHC Medicaid |
$148.67
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
| Rate for Payer: UMR Bronson Commercial |
$363.86
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
20525
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$593.25 |
| Rate for Payer: Aetna Commercial |
$305.04
|
| Rate for Payer: Aetna Medicare |
$236.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.80
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCBS MAPPO |
$227.64
|
| Rate for Payer: BCN Commercial |
$376.48
|
| Rate for Payer: BCN Medicare Advantage |
$227.64
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$305.04
|
| Rate for Payer: Cofinity Commercial |
$327.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$239.02
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.40
|
| Rate for Payer: Nomi Health Commercial |
$273.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PACE SWMI |
$227.64
|
| Rate for Payer: PHP Commercial |
$318.70
|
| Rate for Payer: PHP Medicare Advantage |
$227.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$402.44
|
| Rate for Payer: Priority Health Medicare |
$227.64
|
| Rate for Payer: Priority Health SBD |
$402.44
|
| Rate for Payer: Priority Health Tiered Network |
$402.44
|
| Rate for Payer: Railroad Medicare Medicare |
$227.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.70
|
| Rate for Payer: UHC Core |
$430.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.64
|
| Rate for Payer: UHC Exchange |
$430.70
|
| Rate for Payer: UHC Medicaid |
$148.67
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
| Rate for Payer: UMR Bronson Commercial |
$363.86
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
OP
|
$791.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$292.67 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$514.15
|
| Rate for Payer: Aetna Commercial |
$672.35
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.27
|
| Rate for Payer: BCN Commercial |
$2,264.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Advantage |
$553.70
|
| Rate for Payer: Cofinity Commercial |
$680.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$711.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.25
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.35
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$672.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$498.33
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$292.67
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.25
|
|
|
PR RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
HCPCS 27086
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$313.50 |
| Rate for Payer: Aetna Commercial |
$215.87
|
| Rate for Payer: Aetna Medicare |
$167.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.98
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$161.10
|
| Rate for Payer: BCN Commercial |
$258.45
|
| Rate for Payer: BCN Medicare Advantage |
$161.10
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cofinity Commercial |
$215.87
|
| Rate for Payer: Cofinity Commercial |
$231.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.16
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.21
|
| Rate for Payer: Nomi Health Commercial |
$193.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$313.50
|
| Rate for Payer: PACE SWMI |
$161.10
|
| Rate for Payer: PHP Commercial |
$225.54
|
| Rate for Payer: PHP Medicare Advantage |
$161.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$276.28
|
| Rate for Payer: Priority Health Medicare |
$161.10
|
| Rate for Payer: Priority Health SBD |
$276.28
|
| Rate for Payer: Priority Health Tiered Network |
$276.28
|
| Rate for Payer: Railroad Medicare Medicare |
$161.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.26
|
| Rate for Payer: UHC Core |
$289.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.10
|
| Rate for Payer: UHC Exchange |
$289.26
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
| Rate for Payer: UMR Bronson Commercial |
$192.28
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 24200
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$185.64
|
| Rate for Payer: Aetna Medicare |
$144.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.50
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$138.54
|
| Rate for Payer: BCN Commercial |
$218.61
|
| Rate for Payer: BCN Medicare Advantage |
$138.54
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$185.64
|
| Rate for Payer: Cofinity Commercial |
$199.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.47
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.39
|
| Rate for Payer: Nomi Health Commercial |
$166.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$138.54
|
| Rate for Payer: PHP Commercial |
$193.96
|
| Rate for Payer: PHP Medicare Advantage |
$138.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$233.69
|
| Rate for Payer: Priority Health Medicare |
$138.54
|
| Rate for Payer: Priority Health SBD |
$233.69
|
| Rate for Payer: Priority Health Tiered Network |
$233.69
|
| Rate for Payer: Railroad Medicare Medicare |
$138.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.00
|
| Rate for Payer: UHC Core |
$244.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.54
|
| Rate for Payer: UHC Exchange |
$244.00
|
| Rate for Payer: UHC Medicaid |
$91.38
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
| Rate for Payer: UMR Bronson Commercial |
$155.48
|
|
|
PR RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA
|
Professional
|
Both
|
$3,391.00
|
|
|
Service Code
|
HCPCS 27091
|
| Min. Negotiated Rate |
$916.54 |
| Max. Negotiated Rate |
$2,808.24 |
| Rate for Payer: Aetna Commercial |
$1,899.42
|
| Rate for Payer: Aetna Medicare |
$1,474.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,899.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,041.17
|
| Rate for Payer: BCBS Complete |
$962.37
|
| Rate for Payer: BCBS MAPPO |
$1,417.48
|
| Rate for Payer: BCN Commercial |
$2,401.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,417.48
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cofinity Commercial |
$1,899.42
|
| Rate for Payer: Cofinity Commercial |
$2,041.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,417.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,488.35
|
| Rate for Payer: Meridian Medicaid |
$962.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,559.23
|
| Rate for Payer: Nomi Health Commercial |
$1,700.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,543.25
|
| Rate for Payer: PACE SWMI |
$1,417.48
|
| Rate for Payer: PHP Commercial |
$1,984.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,417.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,567.41
|
| Rate for Payer: Priority Health Medicare |
$1,417.48
|
| Rate for Payer: Priority Health SBD |
$2,567.41
|
| Rate for Payer: Priority Health Tiered Network |
$2,567.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,417.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,808.24
|
| Rate for Payer: UHC Core |
$2,808.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,417.48
|
| Rate for Payer: UHC Exchange |
$2,808.24
|
| Rate for Payer: UHC Medicaid |
$916.54
|
| Rate for Payer: UHCCP Medicaid |
$916.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,559.86
|
|
|
PR RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 33971
|
| Min. Negotiated Rate |
$428.13 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna Commercial |
$893.65
|
| Rate for Payer: Aetna Medicare |
$693.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.34
|
| Rate for Payer: BCBS Complete |
$449.54
|
| Rate for Payer: BCBS MAPPO |
$666.90
|
| Rate for Payer: BCN Commercial |
$1,044.26
|
| Rate for Payer: BCN Medicare Advantage |
$666.90
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cofinity Commercial |
$893.65
|
| Rate for Payer: Cofinity Commercial |
$960.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.25
|
| Rate for Payer: Meridian Medicaid |
$449.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$733.59
|
| Rate for Payer: Nomi Health Commercial |
$800.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
| Rate for Payer: PACE SWMI |
$666.90
|
| Rate for Payer: PHP Commercial |
$933.66
|
| Rate for Payer: PHP Medicare Advantage |
$666.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,122.98
|
| Rate for Payer: Priority Health Medicare |
$666.90
|
| Rate for Payer: Priority Health SBD |
$1,122.98
|
| Rate for Payer: Priority Health Tiered Network |
$1,122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$666.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,248.61
|
| Rate for Payer: UHC Core |
$1,248.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.90
|
| Rate for Payer: UHC Exchange |
$1,248.61
|
| Rate for Payer: UHC Medicaid |
$428.13
|
| Rate for Payer: UHCCP Medicaid |
$428.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 33284
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: UMR Bronson Commercial |
$232.30
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 33262
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$660.03 |
| Rate for Payer: Aetna Commercial |
$437.80
|
| Rate for Payer: Aetna Medicare |
$339.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.48
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$326.72
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$326.72
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$470.48
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.06
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.39
|
| Rate for Payer: Nomi Health Commercial |
$392.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.25
|
| Rate for Payer: PACE SWMI |
$326.72
|
| Rate for Payer: PHP Commercial |
$457.41
|
| Rate for Payer: PHP Medicare Advantage |
$326.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$590.14
|
| Rate for Payer: Priority Health Medicare |
$326.72
|
| Rate for Payer: Priority Health SBD |
$590.14
|
| Rate for Payer: Priority Health Tiered Network |
$590.14
|
| Rate for Payer: Railroad Medicare Medicare |
$326.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.03
|
| Rate for Payer: UHC Core |
$660.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.72
|
| Rate for Payer: UHC Exchange |
$660.03
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
| Rate for Payer: UMR Bronson Commercial |
$317.86
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 33263
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$686.45 |
| Rate for Payer: Aetna Commercial |
$455.48
|
| Rate for Payer: Aetna Medicare |
$353.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.47
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$339.91
|
| Rate for Payer: BCN Commercial |
$570.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.91
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$455.48
|
| Rate for Payer: Cofinity Commercial |
$489.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.91
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$373.90
|
| Rate for Payer: Nomi Health Commercial |
$407.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.25
|
| Rate for Payer: PACE SWMI |
$339.91
|
| Rate for Payer: PHP Commercial |
$475.87
|
| Rate for Payer: PHP Medicare Advantage |
$339.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$613.70
|
| Rate for Payer: Priority Health Medicare |
$339.91
|
| Rate for Payer: Priority Health SBD |
$613.70
|
| Rate for Payer: Priority Health Tiered Network |
$613.70
|
| Rate for Payer: Railroad Medicare Medicare |
$339.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$686.45
|
| Rate for Payer: UHC Core |
$686.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$339.91
|
| Rate for Payer: UHC Exchange |
$686.45
|
| Rate for Payer: UHC Medicaid |
$218.33
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
| Rate for Payer: UMR Bronson Commercial |
$373.06
|
|
|
PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 33264
|
| Min. Negotiated Rate |
$226.63 |
| Max. Negotiated Rate |
$717.66 |
| Rate for Payer: Aetna Commercial |
$473.01
|
| Rate for Payer: Aetna Medicare |
$367.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.31
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCBS MAPPO |
$352.99
|
| Rate for Payer: BCN Commercial |
$594.59
|
| Rate for Payer: BCN Medicare Advantage |
$352.99
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cofinity Commercial |
$473.01
|
| Rate for Payer: Cofinity Commercial |
$508.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.64
|
| Rate for Payer: Meridian Medicaid |
$237.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$388.29
|
| Rate for Payer: Nomi Health Commercial |
$423.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$635.25
|
| Rate for Payer: PACE SWMI |
$352.99
|
| Rate for Payer: PHP Commercial |
$494.19
|
| Rate for Payer: PHP Medicare Advantage |
$352.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$639.41
|
| Rate for Payer: Priority Health Medicare |
$352.99
|
| Rate for Payer: Priority Health SBD |
$639.41
|
| Rate for Payer: Priority Health Tiered Network |
$639.41
|
| Rate for Payer: Railroad Medicare Medicare |
$352.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.66
|
| Rate for Payer: UHC Core |
$717.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$352.99
|
| Rate for Payer: UHC Exchange |
$717.66
|
| Rate for Payer: UHC Medicaid |
$226.63
|
| Rate for Payer: UHCCP Medicaid |
$226.63
|
| Rate for Payer: UMR Bronson Commercial |
$389.62
|
|
|
PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 54406
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,289.55 |
| Rate for Payer: Aetna Commercial |
$877.07
|
| Rate for Payer: Aetna Medicare |
$680.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.52
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS MAPPO |
$654.53
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: BCN Medicare Advantage |
$654.53
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cofinity Commercial |
$877.07
|
| Rate for Payer: Cofinity Commercial |
$942.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.26
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.98
|
| Rate for Payer: Nomi Health Commercial |
$785.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,075.50
|
| Rate for Payer: PACE SWMI |
$654.53
|
| Rate for Payer: PHP Commercial |
$916.34
|
| Rate for Payer: PHP Medicare Advantage |
$654.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,195.04
|
| Rate for Payer: Priority Health Medicare |
$654.53
|
| Rate for Payer: Priority Health SBD |
$1,195.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,195.04
|
| Rate for Payer: Railroad Medicare Medicare |
$654.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,289.55
|
| Rate for Payer: UHC Core |
$1,289.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$654.53
|
| Rate for Payer: UHC Exchange |
$1,289.55
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
| Rate for Payer: UMR Bronson Commercial |
$659.64
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY
|
Professional
|
Both
|
$3,802.00
|
|
|
Service Code
|
HCPCS 32484
|
| Min. Negotiated Rate |
$862.86 |
| Max. Negotiated Rate |
$2,851.50 |
| Rate for Payer: Aetna Commercial |
$1,811.79
|
| Rate for Payer: Aetna Medicare |
$1,406.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.00
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: BCBS MAPPO |
$1,352.08
|
| Rate for Payer: BCN Commercial |
$2,118.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.08
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Cofinity Commercial |
$1,811.79
|
| Rate for Payer: Cofinity Commercial |
$1,947.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,419.68
|
| Rate for Payer: Meridian Medicaid |
$906.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,487.29
|
| Rate for Payer: Nomi Health Commercial |
$1,622.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,851.50
|
| Rate for Payer: PACE SWMI |
$1,352.08
|
| Rate for Payer: PHP Commercial |
$1,892.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,995.38
|
| Rate for Payer: Priority Health Medicare |
$1,352.08
|
| Rate for Payer: Priority Health SBD |
$1,995.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,995.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,352.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,546.51
|
| Rate for Payer: UHC Core |
$2,546.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,352.08
|
| Rate for Payer: UHC Exchange |
$2,546.51
|
| Rate for Payer: UHC Medicaid |
$862.86
|
| Rate for Payer: UHCCP Medicaid |
$862.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,748.92
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC
|
Professional
|
Both
|
$5,523.00
|
|
|
Service Code
|
HCPCS 32482
|
| Min. Negotiated Rate |
$959.14 |
| Max. Negotiated Rate |
$4,142.25 |
| Rate for Payer: Aetna Commercial |
$2,009.01
|
| Rate for Payer: Aetna Medicare |
$1,559.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,009.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,158.93
|
| Rate for Payer: BCBS Complete |
$1,007.10
|
| Rate for Payer: BCBS MAPPO |
$1,499.26
|
| Rate for Payer: BCN Commercial |
$2,341.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,499.26
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Cofinity Commercial |
$2,009.01
|
| Rate for Payer: Cofinity Commercial |
$2,158.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,499.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,574.22
|
| Rate for Payer: Meridian Medicaid |
$1,007.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,649.19
|
| Rate for Payer: Nomi Health Commercial |
$1,799.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,142.25
|
| Rate for Payer: PACE SWMI |
$1,499.26
|
| Rate for Payer: PHP Commercial |
$2,098.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,499.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$959.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,204.54
|
| Rate for Payer: Priority Health Medicare |
$1,499.26
|
| Rate for Payer: Priority Health SBD |
$2,204.54
|
| Rate for Payer: Priority Health Tiered Network |
$2,204.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,499.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,811.65
|
| Rate for Payer: UHC Core |
$2,811.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,499.26
|
| Rate for Payer: UHC Exchange |
$2,811.65
|
| Rate for Payer: UHC Medicaid |
$959.14
|
| Rate for Payer: UHCCP Medicaid |
$959.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,540.58
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT
|
Professional
|
Both
|
$4,909.00
|
|
|
Service Code
|
HCPCS 32480
|
| Min. Negotiated Rate |
$894.39 |
| Max. Negotiated Rate |
$3,681.75 |
| Rate for Payer: Aetna Commercial |
$1,874.67
|
| Rate for Payer: Aetna Medicare |
$1,454.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,874.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,014.57
|
| Rate for Payer: BCBS Complete |
$939.11
|
| Rate for Payer: BCBS MAPPO |
$1,399.01
|
| Rate for Payer: BCN Commercial |
$2,187.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.01
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Cofinity Commercial |
$1,874.67
|
| Rate for Payer: Cofinity Commercial |
$2,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,468.96
|
| Rate for Payer: Meridian Medicaid |
$939.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,538.91
|
| Rate for Payer: Nomi Health Commercial |
$1,678.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,681.75
|
| Rate for Payer: PACE SWMI |
$1,399.01
|
| Rate for Payer: PHP Commercial |
$1,958.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,059.63
|
| Rate for Payer: Priority Health Medicare |
$1,399.01
|
| Rate for Payer: Priority Health SBD |
$2,059.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,059.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,399.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,624.55
|
| Rate for Payer: UHC Core |
$2,624.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,399.01
|
| Rate for Payer: UHC Exchange |
$2,624.55
|
| Rate for Payer: UHC Medicaid |
$894.39
|
| Rate for Payer: UHCCP Medicaid |
$894.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,258.14
|
|
|
PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC
|
Professional
|
Both
|
$4,617.00
|
|
|
Service Code
|
HCPCS 32488
|
| Min. Negotiated Rate |
$1,427.95 |
| Max. Negotiated Rate |
$4,256.86 |
| Rate for Payer: Aetna Commercial |
$3,004.90
|
| Rate for Payer: Aetna Medicare |
$2,332.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,004.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,229.14
|
| Rate for Payer: BCBS Complete |
$1,499.35
|
| Rate for Payer: BCBS MAPPO |
$2,242.46
|
| Rate for Payer: BCN Commercial |
$3,521.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,242.46
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Cofinity Commercial |
$3,004.90
|
| Rate for Payer: Cofinity Commercial |
$3,229.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,242.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,354.58
|
| Rate for Payer: Meridian Medicaid |
$1,499.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,466.71
|
| Rate for Payer: Nomi Health Commercial |
$2,690.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,462.75
|
| Rate for Payer: PACE SWMI |
$2,242.46
|
| Rate for Payer: PHP Commercial |
$3,139.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,242.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,427.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,315.95
|
| Rate for Payer: Priority Health Medicare |
$2,242.46
|
| Rate for Payer: Priority Health SBD |
$3,315.95
|
| Rate for Payer: Priority Health Tiered Network |
$3,315.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,242.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,256.86
|
| Rate for Payer: UHC Core |
$4,256.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,242.46
|
| Rate for Payer: UHC Exchange |
$4,256.86
|
| Rate for Payer: UHC Medicaid |
$1,427.95
|
| Rate for Payer: UHCCP Medicaid |
$1,427.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,123.82
|
|
|
PR RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY
|
Professional
|
Both
|
$4,569.00
|
|
|
Service Code
|
HCPCS 32486
|
| Min. Negotiated Rate |
$1,387.70 |
| Max. Negotiated Rate |
$4,192.63 |
| Rate for Payer: Aetna Commercial |
$2,927.04
|
| Rate for Payer: Aetna Medicare |
$2,271.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,927.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,145.48
|
| Rate for Payer: BCBS Complete |
$1,457.09
|
| Rate for Payer: BCBS MAPPO |
$2,184.36
|
| Rate for Payer: BCN Commercial |
$3,440.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,184.36
|
| Rate for Payer: Cash Price |
$3,655.20
|
| Rate for Payer: Cash Price |
$3,655.20
|
| Rate for Payer: Cofinity Commercial |
$2,927.04
|
| Rate for Payer: Cofinity Commercial |
$3,145.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,184.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,293.58
|
| Rate for Payer: Meridian Medicaid |
$1,457.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,402.80
|
| Rate for Payer: Nomi Health Commercial |
$2,621.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,426.75
|
| Rate for Payer: PACE SWMI |
$2,184.36
|
| Rate for Payer: PHP Commercial |
$3,058.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,184.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,387.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,239.98
|
| Rate for Payer: Priority Health Medicare |
$2,184.36
|
| Rate for Payer: Priority Health SBD |
$3,239.98
|
| Rate for Payer: Priority Health Tiered Network |
$3,239.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,184.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,192.63
|
| Rate for Payer: UHC Core |
$4,192.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,184.36
|
| Rate for Payer: UHC Exchange |
$4,192.63
|
| Rate for Payer: UHC Medicaid |
$1,387.70
|
| Rate for Payer: UHCCP Medicaid |
$1,387.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,101.74
|
|
|
PR RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 32552
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$276.78 |
| Rate for Payer: Aetna Commercial |
$193.71
|
| Rate for Payer: Aetna Medicare |
$150.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.17
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$144.56
|
| Rate for Payer: BCN Commercial |
$232.55
|
| Rate for Payer: BCN Medicare Advantage |
$144.56
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$193.71
|
| Rate for Payer: Cofinity Commercial |
$208.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.79
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.02
|
| Rate for Payer: Nomi Health Commercial |
$173.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.00
|
| Rate for Payer: PACE SWMI |
$144.56
|
| Rate for Payer: PHP Commercial |
$202.38
|
| Rate for Payer: PHP Medicare Advantage |
$144.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$219.00
|
| Rate for Payer: Priority Health Medicare |
$144.56
|
| Rate for Payer: Priority Health SBD |
$219.00
|
| Rate for Payer: Priority Health Tiered Network |
$219.00
|
| Rate for Payer: Railroad Medicare Medicare |
$144.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.78
|
| Rate for Payer: UHC Core |
$276.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.56
|
| Rate for Payer: UHC Exchange |
$276.78
|
| Rate for Payer: UHC Medicaid |
$94.15
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$163.76
|
|
|
PR RMVL NFROS TUBE REQ FLUORO GUIDANCE
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 50389
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$233.25 |
| Rate for Payer: Aetna Commercial |
$61.30
|
| Rate for Payer: Aetna Medicare |
$47.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.88
|
| Rate for Payer: BCBS Complete |
$30.64
|
| Rate for Payer: BCBS MAPPO |
$45.75
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$45.75
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$65.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.04
|
| Rate for Payer: Meridian Medicaid |
$30.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.33
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.25
|
| Rate for Payer: PACE SWMI |
$45.75
|
| Rate for Payer: PHP Commercial |
$64.05
|
| Rate for Payer: PHP Medicare Advantage |
$45.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.71
|
| Rate for Payer: Priority Health Medicare |
$45.75
|
| Rate for Payer: Priority Health SBD |
$85.71
|
| Rate for Payer: Priority Health Tiered Network |
$85.71
|
| Rate for Payer: Railroad Medicare Medicare |
$45.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.40
|
| Rate for Payer: UHC Core |
$95.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.75
|
| Rate for Payer: UHC Exchange |
$95.40
|
| Rate for Payer: UHC Medicaid |
$29.18
|
| Rate for Payer: UHCCP Medicaid |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$143.06
|
|
|
PR RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 49623
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$368.91 |
| Rate for Payer: Aetna Commercial |
$248.60
|
| Rate for Payer: Aetna Medicare |
$192.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.15
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS MAPPO |
$185.52
|
| Rate for Payer: BCN Commercial |
$302.77
|
| Rate for Payer: BCN Medicare Advantage |
$185.52
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$248.60
|
| Rate for Payer: Cofinity Commercial |
$267.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.80
|
| Rate for Payer: Meridian Medicaid |
$123.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.07
|
| Rate for Payer: Nomi Health Commercial |
$222.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$185.52
|
| Rate for Payer: PHP Commercial |
$259.73
|
| Rate for Payer: PHP Medicare Advantage |
$185.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$368.91
|
| Rate for Payer: Priority Health Medicare |
$185.52
|
| Rate for Payer: Priority Health SBD |
$368.91
|
| Rate for Payer: Priority Health Tiered Network |
$368.91
|
| Rate for Payer: Railroad Medicare Medicare |
$185.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.04
|
| Rate for Payer: UHC Core |
$362.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.52
|
| Rate for Payer: UHC Exchange |
$362.04
|
| Rate for Payer: UHC Medicaid |
$117.36
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
| Rate for Payer: UMR Bronson Commercial |
$190.44
|
|
