|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$188.72 |
| Max. Negotiated Rate |
$1,170.75 |
| Rate for Payer: Aetna Commercial |
$386.44
|
| Rate for Payer: Aetna Medicare |
$299.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.28
|
| Rate for Payer: BCBS Complete |
$198.16
|
| Rate for Payer: BCBS MAPPO |
$288.39
|
| Rate for Payer: BCN Commercial |
$453.66
|
| Rate for Payer: BCN Medicare Advantage |
$288.39
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$386.44
|
| Rate for Payer: Cofinity Commercial |
$415.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.81
|
| Rate for Payer: Meridian Medicaid |
$198.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.23
|
| Rate for Payer: Nomi Health Commercial |
$346.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.75
|
| Rate for Payer: PACE SWMI |
$288.39
|
| Rate for Payer: PHP Commercial |
$403.75
|
| Rate for Payer: PHP Medicare Advantage |
$288.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$526.92
|
| Rate for Payer: Priority Health Medicare |
$288.39
|
| Rate for Payer: Priority Health SBD |
$526.92
|
| Rate for Payer: Priority Health Tiered Network |
$526.92
|
| Rate for Payer: Railroad Medicare Medicare |
$288.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.97
|
| Rate for Payer: UHC Core |
$512.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.39
|
| Rate for Payer: UHC Exchange |
$512.97
|
| Rate for Payer: UHC Medicaid |
$188.72
|
| Rate for Payer: UHCCP Medicaid |
$188.72
|
| Rate for Payer: UMR Bronson Commercial |
$718.06
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$620.26 |
| Max. Negotiated Rate |
$1,690.17 |
| Rate for Payer: Aetna Commercial |
$1,250.89
|
| Rate for Payer: Aetna Medicare |
$970.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.24
|
| Rate for Payer: BCBS Complete |
$651.27
|
| Rate for Payer: BCBS MAPPO |
$933.50
|
| Rate for Payer: BCN Commercial |
$1,504.90
|
| Rate for Payer: BCN Medicare Advantage |
$933.50
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,250.89
|
| Rate for Payer: Cofinity Commercial |
$1,344.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.17
|
| Rate for Payer: Meridian Medicaid |
$651.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,026.85
|
| Rate for Payer: Nomi Health Commercial |
$1,120.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,257.75
|
| Rate for Payer: PACE SWMI |
$933.50
|
| Rate for Payer: PHP Commercial |
$1,306.90
|
| Rate for Payer: PHP Medicare Advantage |
$933.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,608.69
|
| Rate for Payer: Priority Health Medicare |
$933.50
|
| Rate for Payer: Priority Health SBD |
$1,608.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,608.69
|
| Rate for Payer: Railroad Medicare Medicare |
$933.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.17
|
| Rate for Payer: UHC Core |
$1,690.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$933.50
|
| Rate for Payer: UHC Exchange |
$1,690.17
|
| Rate for Payer: UHC Medicaid |
$620.26
|
| Rate for Payer: UHCCP Medicaid |
$620.26
|
| Rate for Payer: UMR Bronson Commercial |
$771.42
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$486.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$447.79 |
| Rate for Payer: Aetna Commercial |
$308.87
|
| Rate for Payer: Aetna Medicare |
$239.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.92
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCBS MAPPO |
$230.50
|
| Rate for Payer: BCN Commercial |
$367.51
|
| Rate for Payer: BCN Medicare Advantage |
$230.50
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$308.87
|
| Rate for Payer: Cofinity Commercial |
$331.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.03
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$253.55
|
| Rate for Payer: Nomi Health Commercial |
$276.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.50
|
| Rate for Payer: PACE SWMI |
$230.50
|
| Rate for Payer: PHP Commercial |
$322.70
|
| Rate for Payer: PHP Medicare Advantage |
$230.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$447.79
|
| Rate for Payer: Priority Health Medicare |
$230.50
|
| Rate for Payer: Priority Health SBD |
$447.79
|
| Rate for Payer: Priority Health Tiered Network |
$447.79
|
| Rate for Payer: Railroad Medicare Medicare |
$230.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.53
|
| Rate for Payer: UHC Core |
$406.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$230.50
|
| Rate for Payer: UHC Exchange |
$406.53
|
| Rate for Payer: UHC Medicaid |
$152.93
|
| Rate for Payer: UHCCP Medicaid |
$152.93
|
| Rate for Payer: UMR Bronson Commercial |
$223.56
|
|
|
PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 33234
|
| Min. Negotiated Rate |
$273.71 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Aetna Commercial |
$571.20
|
| Rate for Payer: Aetna Medicare |
$443.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.83
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$426.27
|
| Rate for Payer: BCN Commercial |
$714.11
|
| Rate for Payer: BCN Medicare Advantage |
$426.27
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$613.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.58
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.90
|
| Rate for Payer: Nomi Health Commercial |
$511.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.00
|
| Rate for Payer: PACE SWMI |
$426.27
|
| Rate for Payer: PHP Commercial |
$596.78
|
| Rate for Payer: PHP Medicare Advantage |
$426.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$767.93
|
| Rate for Payer: Priority Health Medicare |
$426.27
|
| Rate for Payer: Priority Health SBD |
$767.93
|
| Rate for Payer: Priority Health Tiered Network |
$767.93
|
| Rate for Payer: Railroad Medicare Medicare |
$426.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.39
|
| Rate for Payer: UHC Core |
$859.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.27
|
| Rate for Payer: UHC Exchange |
$859.39
|
| Rate for Payer: UHC Medicaid |
$273.71
|
| Rate for Payer: UHCCP Medicaid |
$273.71
|
| Rate for Payer: UMR Bronson Commercial |
$794.88
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$362.10 |
| Max. Negotiated Rate |
$1,127.38 |
| Rate for Payer: Aetna Commercial |
$754.30
|
| Rate for Payer: Aetna Medicare |
$585.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.59
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS MAPPO |
$562.91
|
| Rate for Payer: BCN Commercial |
$938.20
|
| Rate for Payer: BCN Medicare Advantage |
$562.91
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$754.30
|
| Rate for Payer: Cofinity Commercial |
$810.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.06
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$619.20
|
| Rate for Payer: Nomi Health Commercial |
$675.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$562.91
|
| Rate for Payer: PHP Commercial |
$788.07
|
| Rate for Payer: PHP Medicare Advantage |
$562.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,008.91
|
| Rate for Payer: Priority Health Medicare |
$562.91
|
| Rate for Payer: Priority Health SBD |
$1,008.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,008.91
|
| Rate for Payer: Railroad Medicare Medicare |
$562.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,127.38
|
| Rate for Payer: UHC Core |
$1,127.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.91
|
| Rate for Payer: UHC Exchange |
$1,127.38
|
| Rate for Payer: UHC Medicaid |
$362.10
|
| Rate for Payer: UHCCP Medicaid |
$362.10
|
| Rate for Payer: UMR Bronson Commercial |
$628.82
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$737.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$272.69 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$479.05
|
| Rate for Payer: Aetna Commercial |
$626.45
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.80
|
| Rate for Payer: BCN Commercial |
$1,429.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Advantage |
$515.90
|
| Rate for Payer: Cofinity Commercial |
$633.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$663.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.75
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.45
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$626.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$464.31
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$272.69
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.75
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$228.15
|
| Rate for Payer: Aetna Medicare |
$177.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.17
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$170.26
|
| Rate for Payer: BCN Commercial |
$281.36
|
| Rate for Payer: BCN Medicare Advantage |
$170.26
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$228.15
|
| Rate for Payer: Cofinity Commercial |
$245.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.77
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.29
|
| Rate for Payer: Nomi Health Commercial |
$204.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$170.26
|
| Rate for Payer: PHP Commercial |
$238.36
|
| Rate for Payer: PHP Medicare Advantage |
$170.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$302.57
|
| Rate for Payer: Priority Health Medicare |
$170.26
|
| Rate for Payer: Priority Health SBD |
$302.57
|
| Rate for Payer: Priority Health Tiered Network |
$302.57
|
| Rate for Payer: Railroad Medicare Medicare |
$170.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.99
|
| Rate for Payer: UHC Core |
$335.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.26
|
| Rate for Payer: UHC Exchange |
$335.99
|
| Rate for Payer: UHC Medicaid |
$110.12
|
| Rate for Payer: UHCCP Medicaid |
$110.12
|
| Rate for Payer: UMR Bronson Commercial |
$339.02
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$228.15
|
| Rate for Payer: Aetna Medicare |
$177.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.17
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$170.26
|
| Rate for Payer: BCN Commercial |
$281.36
|
| Rate for Payer: BCN Medicare Advantage |
$170.26
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$228.15
|
| Rate for Payer: Cofinity Commercial |
$245.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.77
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.29
|
| Rate for Payer: Nomi Health Commercial |
$204.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$170.26
|
| Rate for Payer: PHP Commercial |
$238.36
|
| Rate for Payer: PHP Medicare Advantage |
$170.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$302.57
|
| Rate for Payer: Priority Health Medicare |
$170.26
|
| Rate for Payer: Priority Health SBD |
$302.57
|
| Rate for Payer: Priority Health Tiered Network |
$302.57
|
| Rate for Payer: Railroad Medicare Medicare |
$170.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.99
|
| Rate for Payer: UHC Core |
$335.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.26
|
| Rate for Payer: UHC Exchange |
$335.99
|
| Rate for Payer: UHC Medicaid |
$110.12
|
| Rate for Payer: UHCCP Medicaid |
$110.12
|
| Rate for Payer: UMR Bronson Commercial |
$339.02
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$324.28 |
| Max. Negotiated Rate |
$663.30 |
| Rate for Payer: Aetna American Axle |
$479.05
|
| Rate for Payer: Aetna Commercial |
$626.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.05
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Advantage |
$515.90
|
| Rate for Payer: Cofinity Commercial |
$633.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.60
|
| Rate for Payer: Healthscope Commercial |
$663.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PHP Commercial |
$626.45
|
| Rate for Payer: Priority Health SBD |
$464.31
|
| Rate for Payer: UMR Bronson Commercial |
$324.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 36589
|
| Min. Negotiated Rate |
$79.88 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Commercial |
$165.26
|
| Rate for Payer: Aetna Medicare |
$128.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.60
|
| Rate for Payer: BCBS Complete |
$83.87
|
| Rate for Payer: BCBS MAPPO |
$123.33
|
| Rate for Payer: BCN Commercial |
$202.18
|
| Rate for Payer: BCN Medicare Advantage |
$123.33
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$165.26
|
| Rate for Payer: Cofinity Commercial |
$177.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.50
|
| Rate for Payer: Meridian Medicaid |
$83.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.66
|
| Rate for Payer: Nomi Health Commercial |
$148.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.50
|
| Rate for Payer: PACE SWMI |
$123.33
|
| Rate for Payer: PHP Commercial |
$172.66
|
| Rate for Payer: PHP Medicare Advantage |
$123.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$217.42
|
| Rate for Payer: Priority Health Medicare |
$123.33
|
| Rate for Payer: Priority Health SBD |
$217.42
|
| Rate for Payer: Priority Health Tiered Network |
$217.42
|
| Rate for Payer: Railroad Medicare Medicare |
$123.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.96
|
| Rate for Payer: UHC Core |
$241.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.33
|
| Rate for Payer: UHC Exchange |
$241.96
|
| Rate for Payer: UHC Medicaid |
$79.88
|
| Rate for Payer: UHCCP Medicaid |
$79.88
|
| Rate for Payer: UMR Bronson Commercial |
$203.32
|
|
|
PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 11983
|
| Min. Negotiated Rate |
$56.66 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$119.22
|
| Rate for Payer: Aetna Medicare |
$92.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.12
|
| Rate for Payer: BCBS Complete |
$59.49
|
| Rate for Payer: BCBS MAPPO |
$88.97
|
| Rate for Payer: BCN Commercial |
$154.38
|
| Rate for Payer: BCN Medicare Advantage |
$88.97
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$119.22
|
| Rate for Payer: Cofinity Commercial |
$128.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.42
|
| Rate for Payer: Meridian Medicaid |
$59.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.87
|
| Rate for Payer: Nomi Health Commercial |
$106.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$88.97
|
| Rate for Payer: PHP Commercial |
$124.56
|
| Rate for Payer: PHP Medicare Advantage |
$88.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.29
|
| Rate for Payer: Priority Health Medicare |
$88.97
|
| Rate for Payer: Priority Health SBD |
$141.29
|
| Rate for Payer: Priority Health Tiered Network |
$141.29
|
| Rate for Payer: Railroad Medicare Medicare |
$88.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.79
|
| Rate for Payer: UHC Core |
$184.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.97
|
| Rate for Payer: UHC Exchange |
$184.79
|
| Rate for Payer: UHC Medicaid |
$56.66
|
| Rate for Payer: UHCCP Medicaid |
$56.66
|
| Rate for Payer: UMR Bronson Commercial |
$190.44
|
|
|
PR RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 50575
|
| Min. Negotiated Rate |
$396.61 |
| Max. Negotiated Rate |
$1,268.95 |
| Rate for Payer: Aetna Commercial |
$830.79
|
| Rate for Payer: Aetna Medicare |
$644.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$892.79
|
| Rate for Payer: BCBS Complete |
$416.44
|
| Rate for Payer: BCBS MAPPO |
$619.99
|
| Rate for Payer: BCN Commercial |
$1,051.24
|
| Rate for Payer: BCN Medicare Advantage |
$619.99
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$830.79
|
| Rate for Payer: Cofinity Commercial |
$892.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.99
|
| Rate for Payer: Meridian Medicaid |
$416.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.99
|
| Rate for Payer: Nomi Health Commercial |
$743.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,071.00
|
| Rate for Payer: PACE SWMI |
$619.99
|
| Rate for Payer: PHP Commercial |
$867.99
|
| Rate for Payer: PHP Medicare Advantage |
$619.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,145.13
|
| Rate for Payer: Priority Health Medicare |
$619.99
|
| Rate for Payer: Priority Health SBD |
$1,145.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,145.13
|
| Rate for Payer: Railroad Medicare Medicare |
$619.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.95
|
| Rate for Payer: UHC Core |
$1,268.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.99
|
| Rate for Payer: UHC Exchange |
$1,268.95
|
| Rate for Payer: UHC Medicaid |
$396.61
|
| Rate for Payer: UHCCP Medicaid |
$396.61
|
| Rate for Payer: UMR Bronson Commercial |
$656.88
|
|
|
PR ROBOTIC SURGICAL SYSTEM
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS S2900
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$318.14 |
| Rate for Payer: Aetna Commercial |
$318.14
|
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.14
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCN Commercial |
$51.06
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 95852
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$61.50 |
| Rate for Payer: Aetna Commercial |
$6.66
|
| Rate for Payer: Aetna Medicare |
$5.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.16
|
| Rate for Payer: BCBS Complete |
$3.36
|
| Rate for Payer: BCBS MAPPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$8.46
|
| Rate for Payer: BCN Medicare Advantage |
$4.97
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Cofinity Commercial |
$6.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.47
|
| Rate for Payer: Nomi Health Commercial |
$5.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.50
|
| Rate for Payer: PACE SWMI |
$4.97
|
| Rate for Payer: PHP Commercial |
$6.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.81
|
| Rate for Payer: Priority Health Medicare |
$4.97
|
| Rate for Payer: Priority Health SBD |
$7.81
|
| Rate for Payer: Priority Health Tiered Network |
$7.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.63
|
| Rate for Payer: UHC Core |
$9.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.97
|
| Rate for Payer: UHC Exchange |
$9.63
|
| Rate for Payer: UHC Medicaid |
$3.20
|
| Rate for Payer: UHCCP Medicaid |
$3.20
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR ROPRTJ > 1 MO AFTER ORIGINAL OPRATION
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 35700
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$446.25 |
| Rate for Payer: Aetna Commercial |
$186.35
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.26
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCN Commercial |
$220.60
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$186.35
|
| Rate for Payer: Cofinity Commercial |
$200.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.98
|
| Rate for Payer: Nomi Health Commercial |
$166.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.25
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$194.70
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$237.23
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health SBD |
$237.23
|
| Rate for Payer: Priority Health Tiered Network |
$237.23
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.41
|
| Rate for Payer: UHC Core |
$275.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.07
|
| Rate for Payer: UHC Exchange |
$275.41
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
| Rate for Payer: UMR Bronson Commercial |
$273.70
|
|
|
PR ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
HCPCS 33530
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$1,315.50 |
| Rate for Payer: Aetna Commercial |
$645.80
|
| Rate for Payer: Aetna Medicare |
$501.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$645.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.99
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$481.94
|
| Rate for Payer: BCN Commercial |
$764.90
|
| Rate for Payer: BCN Medicare Advantage |
$481.94
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cofinity Commercial |
$645.80
|
| Rate for Payer: Cofinity Commercial |
$693.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.04
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$530.13
|
| Rate for Payer: Nomi Health Commercial |
$578.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,315.50
|
| Rate for Payer: PACE SWMI |
$481.94
|
| Rate for Payer: PHP Commercial |
$674.72
|
| Rate for Payer: PHP Medicare Advantage |
$481.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$822.55
|
| Rate for Payer: Priority Health Medicare |
$481.94
|
| Rate for Payer: Priority Health SBD |
$822.55
|
| Rate for Payer: Priority Health Tiered Network |
$822.55
|
| Rate for Payer: Railroad Medicare Medicare |
$481.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.96
|
| Rate for Payer: UHC Core |
$942.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$481.94
|
| Rate for Payer: UHC Exchange |
$942.96
|
| Rate for Payer: UHC Medicaid |
$304.38
|
| Rate for Payer: UHCCP Medicaid |
$304.38
|
| Rate for Payer: UMR Bronson Commercial |
$806.84
|
|
|
PR ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 35390
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$288.21 |
| Rate for Payer: Aetna Commercial |
$195.05
|
| Rate for Payer: Aetna Medicare |
$151.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.61
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$145.56
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: BCN Medicare Advantage |
$145.56
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$195.05
|
| Rate for Payer: Cofinity Commercial |
$209.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.84
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.12
|
| Rate for Payer: Nomi Health Commercial |
$174.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$145.56
|
| Rate for Payer: PHP Commercial |
$203.78
|
| Rate for Payer: PHP Medicare Advantage |
$145.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$249.54
|
| Rate for Payer: Priority Health Medicare |
$145.56
|
| Rate for Payer: Priority Health SBD |
$249.54
|
| Rate for Payer: Priority Health Tiered Network |
$249.54
|
| Rate for Payer: Railroad Medicare Medicare |
$145.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.21
|
| Rate for Payer: UHC Core |
$288.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$145.56
|
| Rate for Payer: UHC Exchange |
$288.21
|
| Rate for Payer: UHC Medicaid |
$91.38
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
PR ROUT FOOT CARE PER VISIT
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS S0390
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.38
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB
|
Professional
|
Both
|
$4,149.00
|
|
|
Service Code
|
HCPCS 59610
|
| Min. Negotiated Rate |
$1,908.54 |
| Max. Negotiated Rate |
$3,585.89 |
| Rate for Payer: Aetna Commercial |
$3,122.44
|
| Rate for Payer: Aetna Medicare |
$2,423.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,355.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,122.44
|
| Rate for Payer: BCBS Complete |
$2,324.35
|
| Rate for Payer: BCBS MAPPO |
$2,330.18
|
| Rate for Payer: BCN Commercial |
$3,440.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,330.18
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cash Price |
$3,319.20
|
| Rate for Payer: Cofinity Commercial |
$3,355.46
|
| Rate for Payer: Cofinity Commercial |
$3,122.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,330.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,446.69
|
| Rate for Payer: Meridian Medicaid |
$2,324.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,563.20
|
| Rate for Payer: Nomi Health Commercial |
$2,796.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,111.75
|
| Rate for Payer: PACE SWMI |
$2,330.18
|
| Rate for Payer: PHP Commercial |
$3,262.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,330.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,213.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,585.89
|
| Rate for Payer: Priority Health Medicare |
$2,330.18
|
| Rate for Payer: Priority Health SBD |
$3,585.89
|
| Rate for Payer: Priority Health Tiered Network |
$3,585.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,330.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,814.95
|
| Rate for Payer: UHC Core |
$2,814.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,330.18
|
| Rate for Payer: UHC Exchange |
$2,814.95
|
| Rate for Payer: UHC Medicaid |
$2,213.67
|
| Rate for Payer: UHCCP Medicaid |
$2,213.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,908.54
|
|
|
PR ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC
|
Professional
|
Both
|
$4,453.00
|
|
|
Service Code
|
HCPCS 59618
|
| Min. Negotiated Rate |
$2,048.38 |
| Max. Negotiated Rate |
$3,843.04 |
| Rate for Payer: Aetna Commercial |
$3,350.05
|
| Rate for Payer: Aetna Medicare |
$2,600.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,350.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,600.06
|
| Rate for Payer: BCBS Complete |
$2,493.41
|
| Rate for Payer: BCBS MAPPO |
$2,500.04
|
| Rate for Payer: BCN Commercial |
$3,440.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,500.04
|
| Rate for Payer: Cash Price |
$3,562.40
|
| Rate for Payer: Cash Price |
$3,562.40
|
| Rate for Payer: Cofinity Commercial |
$3,350.05
|
| Rate for Payer: Cofinity Commercial |
$3,600.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,500.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,625.04
|
| Rate for Payer: Meridian Medicaid |
$2,493.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,750.04
|
| Rate for Payer: Nomi Health Commercial |
$3,000.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,339.75
|
| Rate for Payer: PACE SWMI |
$2,500.04
|
| Rate for Payer: PHP Commercial |
$3,500.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,500.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,374.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,843.04
|
| Rate for Payer: Priority Health Medicare |
$2,500.04
|
| Rate for Payer: Priority Health SBD |
$3,843.04
|
| Rate for Payer: Priority Health Tiered Network |
$3,843.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2,500.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,005.45
|
| Rate for Payer: UHC Core |
$3,005.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,500.04
|
| Rate for Payer: UHC Exchange |
$3,005.45
|
| Rate for Payer: UHC Medicaid |
$2,374.68
|
| Rate for Payer: UHCCP Medicaid |
$2,374.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,048.38
|
|
|
PR RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST
|
Professional
|
Both
|
$2,615.00
|
|
|
Service Code
|
HCPCS 50840
|
| Min. Negotiated Rate |
$703.75 |
| Max. Negotiated Rate |
$2,173.36 |
| Rate for Payer: Aetna Commercial |
$1,462.29
|
| Rate for Payer: Aetna Medicare |
$1,134.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.41
|
| Rate for Payer: BCBS Complete |
$738.94
|
| Rate for Payer: BCBS MAPPO |
$1,091.26
|
| Rate for Payer: BCN Commercial |
$1,837.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.26
|
| Rate for Payer: Cash Price |
$2,092.00
|
| Rate for Payer: Cash Price |
$2,092.00
|
| Rate for Payer: Cofinity Commercial |
$1,462.29
|
| Rate for Payer: Cofinity Commercial |
$1,571.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.82
|
| Rate for Payer: Meridian Medicaid |
$738.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,200.39
|
| Rate for Payer: Nomi Health Commercial |
$1,309.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,961.25
|
| Rate for Payer: PACE SWMI |
$1,091.26
|
| Rate for Payer: PHP Commercial |
$1,527.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,001.14
|
| Rate for Payer: Priority Health Medicare |
$1,091.26
|
| Rate for Payer: Priority Health SBD |
$2,001.14
|
| Rate for Payer: Priority Health Tiered Network |
$2,001.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,091.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,173.36
|
| Rate for Payer: UHC Core |
$2,173.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,091.26
|
| Rate for Payer: UHC Exchange |
$2,173.36
|
| Rate for Payer: UHC Medicaid |
$703.75
|
| Rate for Payer: UHCCP Medicaid |
$703.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,202.90
|
|
|
PR RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS
|
Professional
|
Both
|
$9,981.00
|
|
|
Service Code
|
HCPCS 33411
|
| Min. Negotiated Rate |
$1,988.14 |
| Max. Negotiated Rate |
$7,485.75 |
| Rate for Payer: Aetna Commercial |
$4,194.28
|
| Rate for Payer: Aetna Medicare |
$3,255.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,194.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,507.29
|
| Rate for Payer: BCBS Complete |
$2,087.55
|
| Rate for Payer: BCBS MAPPO |
$3,130.06
|
| Rate for Payer: BCN Commercial |
$4,916.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,130.06
|
| Rate for Payer: Cash Price |
$7,984.80
|
| Rate for Payer: Cash Price |
$7,984.80
|
| Rate for Payer: Cofinity Commercial |
$4,194.28
|
| Rate for Payer: Cofinity Commercial |
$4,507.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,130.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,286.56
|
| Rate for Payer: Meridian Medicaid |
$2,087.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,443.07
|
| Rate for Payer: Nomi Health Commercial |
$3,756.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,485.75
|
| Rate for Payer: PACE SWMI |
$3,130.06
|
| Rate for Payer: PHP Commercial |
$4,382.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,130.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,988.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,286.61
|
| Rate for Payer: Priority Health Medicare |
$3,130.06
|
| Rate for Payer: Priority Health SBD |
$5,286.61
|
| Rate for Payer: Priority Health Tiered Network |
$5,286.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3,130.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,002.60
|
| Rate for Payer: UHC Core |
$6,002.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,130.06
|
| Rate for Payer: UHC Exchange |
$6,002.60
|
| Rate for Payer: UHC Medicaid |
$1,988.14
|
| Rate for Payer: UHCCP Medicaid |
$1,988.14
|
| Rate for Payer: UMR Bronson Commercial |
$4,591.26
|
|
|
PR RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND
|
Professional
|
Both
|
$7,052.00
|
|
|
Service Code
|
HCPCS 33406
|
| Min. Negotiated Rate |
$1,708.69 |
| Max. Negotiated Rate |
$5,289.00 |
| Rate for Payer: Aetna Commercial |
$3,603.43
|
| Rate for Payer: Aetna Medicare |
$2,796.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,603.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,872.35
|
| Rate for Payer: BCBS Complete |
$1,794.12
|
| Rate for Payer: BCBS MAPPO |
$2,689.13
|
| Rate for Payer: BCN Commercial |
$4,234.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,689.13
|
| Rate for Payer: Cash Price |
$5,641.60
|
| Rate for Payer: Cash Price |
$5,641.60
|
| Rate for Payer: Cofinity Commercial |
$3,603.43
|
| Rate for Payer: Cofinity Commercial |
$3,872.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,689.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,823.59
|
| Rate for Payer: Meridian Medicaid |
$1,794.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,958.04
|
| Rate for Payer: Nomi Health Commercial |
$3,226.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,289.00
|
| Rate for Payer: PACE SWMI |
$2,689.13
|
| Rate for Payer: PHP Commercial |
$3,764.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,689.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,708.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,553.48
|
| Rate for Payer: Priority Health Medicare |
$2,689.13
|
| Rate for Payer: Priority Health SBD |
$4,553.48
|
| Rate for Payer: Priority Health Tiered Network |
$4,553.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,689.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,140.33
|
| Rate for Payer: UHC Core |
$5,140.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,689.13
|
| Rate for Payer: UHC Exchange |
$5,140.33
|
| Rate for Payer: UHC Medicaid |
$1,708.69
|
| Rate for Payer: UHCCP Medicaid |
$1,708.69
|
| Rate for Payer: UMR Bronson Commercial |
$3,243.92
|
|
|
PR RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE
|
Professional
|
Both
|
$8,371.00
|
|
|
Service Code
|
HCPCS 33410
|
| Min. Negotiated Rate |
$1,520.18 |
| Max. Negotiated Rate |
$6,278.25 |
| Rate for Payer: Aetna Commercial |
$3,201.66
|
| Rate for Payer: Aetna Medicare |
$2,484.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,201.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,440.59
|
| Rate for Payer: BCBS Complete |
$1,596.19
|
| Rate for Payer: BCBS MAPPO |
$2,389.30
|
| Rate for Payer: BCN Commercial |
$3,739.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,389.30
|
| Rate for Payer: Cash Price |
$6,696.80
|
| Rate for Payer: Cash Price |
$6,696.80
|
| Rate for Payer: Cofinity Commercial |
$3,201.66
|
| Rate for Payer: Cofinity Commercial |
$3,440.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,389.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,508.76
|
| Rate for Payer: Meridian Medicaid |
$1,596.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,628.23
|
| Rate for Payer: Nomi Health Commercial |
$2,867.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,278.25
|
| Rate for Payer: PACE SWMI |
$2,389.30
|
| Rate for Payer: PHP Commercial |
$3,345.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,389.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,021.72
|
| Rate for Payer: Priority Health Medicare |
$2,389.30
|
| Rate for Payer: Priority Health SBD |
$4,021.72
|
| Rate for Payer: Priority Health Tiered Network |
$4,021.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,389.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,537.47
|
| Rate for Payer: UHC Core |
$4,537.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,389.30
|
| Rate for Payer: UHC Exchange |
$4,537.47
|
| Rate for Payer: UHC Medicaid |
$1,520.18
|
| Rate for Payer: UHCCP Medicaid |
$1,520.18
|
| Rate for Payer: UMR Bronson Commercial |
$3,850.66
|
|
|
PR RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL
|
Professional
|
Both
|
$5,184.00
|
|
|
Service Code
|
HCPCS 62143
|
| Min. Negotiated Rate |
$664.99 |
| Max. Negotiated Rate |
$3,888.00 |
| Rate for Payer: Aetna Commercial |
$1,383.91
|
| Rate for Payer: Aetna Medicare |
$1,074.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.19
|
| Rate for Payer: BCBS Complete |
$698.24
|
| Rate for Payer: BCBS MAPPO |
$1,032.77
|
| Rate for Payer: BCN Commercial |
$2,213.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,032.77
|
| Rate for Payer: Cash Price |
$4,147.20
|
| Rate for Payer: Cash Price |
$4,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,383.91
|
| Rate for Payer: Cofinity Commercial |
$1,487.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,032.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.41
|
| Rate for Payer: Meridian Medicaid |
$698.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,136.05
|
| Rate for Payer: Nomi Health Commercial |
$1,239.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,888.00
|
| Rate for Payer: PACE SWMI |
$1,032.77
|
| Rate for Payer: PHP Commercial |
$1,445.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,032.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,860.70
|
| Rate for Payer: Priority Health Medicare |
$1,032.77
|
| Rate for Payer: Priority Health SBD |
$1,860.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,860.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,032.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,827.70
|
| Rate for Payer: UHC Core |
$1,827.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,032.77
|
| Rate for Payer: UHC Exchange |
$1,827.70
|
| Rate for Payer: UHC Medicaid |
$664.99
|
| Rate for Payer: UHCCP Medicaid |
$664.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,384.64
|
|
