|
PR RPLCMT CATH CTR VAD SUBQ PORT/PMP
|
Professional
|
Both
|
$1,055.00
|
|
|
Service Code
|
HCPCS 36578
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$791.25 |
| Rate for Payer: Aetna Commercial |
$250.07
|
| Rate for Payer: Aetna Medicare |
$194.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.73
|
| Rate for Payer: BCBS Complete |
$126.59
|
| Rate for Payer: BCBS MAPPO |
$186.62
|
| Rate for Payer: BCN Commercial |
$298.29
|
| Rate for Payer: BCN Medicare Advantage |
$186.62
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cofinity Commercial |
$250.07
|
| Rate for Payer: Cofinity Commercial |
$268.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.95
|
| Rate for Payer: Meridian Medicaid |
$126.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$205.28
|
| Rate for Payer: Nomi Health Commercial |
$223.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$791.25
|
| Rate for Payer: PACE SWMI |
$186.62
|
| Rate for Payer: PHP Commercial |
$261.27
|
| Rate for Payer: PHP Medicare Advantage |
$186.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$320.78
|
| Rate for Payer: Priority Health Medicare |
$186.62
|
| Rate for Payer: Priority Health SBD |
$320.78
|
| Rate for Payer: Priority Health Tiered Network |
$320.78
|
| Rate for Payer: Railroad Medicare Medicare |
$186.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.94
|
| Rate for Payer: UHC Core |
$358.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.62
|
| Rate for Payer: UHC Exchange |
$358.94
|
| Rate for Payer: UHC Medicaid |
$120.56
|
| Rate for Payer: UHCCP Medicaid |
$120.56
|
| Rate for Payer: UMR Bronson Commercial |
$485.30
|
|
|
PR RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 36580
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$595.50 |
| Rate for Payer: Aetna Commercial |
$77.01
|
| Rate for Payer: Aetna Medicare |
$59.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.76
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$57.47
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$57.47
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$77.01
|
| Rate for Payer: Cofinity Commercial |
$82.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.34
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.22
|
| Rate for Payer: Nomi Health Commercial |
$68.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.50
|
| Rate for Payer: PACE SWMI |
$57.47
|
| Rate for Payer: PHP Commercial |
$80.46
|
| Rate for Payer: PHP Medicare Advantage |
$57.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$102.28
|
| Rate for Payer: Priority Health Medicare |
$57.47
|
| Rate for Payer: Priority Health SBD |
$102.28
|
| Rate for Payer: Priority Health Tiered Network |
$102.28
|
| Rate for Payer: Railroad Medicare Medicare |
$57.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.54
|
| Rate for Payer: UHC Core |
$117.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.47
|
| Rate for Payer: UHC Exchange |
$117.54
|
| Rate for Payer: UHC Medicaid |
$36.64
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
| Rate for Payer: UMR Bronson Commercial |
$365.24
|
|
|
PR RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 36585
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$1,654.50 |
| Rate for Payer: Aetna Commercial |
$388.73
|
| Rate for Payer: Aetna Medicare |
$301.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.74
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$290.10
|
| Rate for Payer: BCN Commercial |
$456.64
|
| Rate for Payer: BCN Medicare Advantage |
$290.10
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$388.73
|
| Rate for Payer: Cofinity Commercial |
$417.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.61
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.11
|
| Rate for Payer: Nomi Health Commercial |
$348.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,654.50
|
| Rate for Payer: PACE SWMI |
$290.10
|
| Rate for Payer: PHP Commercial |
$406.14
|
| Rate for Payer: PHP Medicare Advantage |
$290.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$491.07
|
| Rate for Payer: Priority Health Medicare |
$290.10
|
| Rate for Payer: Priority Health SBD |
$491.07
|
| Rate for Payer: Priority Health Tiered Network |
$491.07
|
| Rate for Payer: Railroad Medicare Medicare |
$290.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.29
|
| Rate for Payer: UHC Core |
$480.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$290.10
|
| Rate for Payer: UHC Exchange |
$480.29
|
| Rate for Payer: UHC Medicaid |
$187.44
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,014.76
|
|
|
PR RPLCMT COMPL TUN CTR VAD W/SUBQ PMP
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 36583
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$1,502.25 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.69
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCN Commercial |
$494.00
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.75
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.25
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Commercial |
$436.23
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$531.24
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: Priority Health SBD |
$531.24
|
| Rate for Payer: Priority Health Tiered Network |
$531.24
|
| Rate for Payer: Railroad Medicare Medicare |
$311.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.87
|
| Rate for Payer: UHC Core |
$579.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.59
|
| Rate for Payer: UHC Exchange |
$579.87
|
| Rate for Payer: UHC Medicaid |
$201.07
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
| Rate for Payer: UMR Bronson Commercial |
$921.38
|
|
|
PR RPLCMT COMPL TUN CTR VAD W/SUBQ PORT
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 36582
|
| Min. Negotiated Rate |
$165.29 |
| Max. Negotiated Rate |
$513.61 |
| Rate for Payer: Aetna Commercial |
$344.09
|
| Rate for Payer: Aetna Medicare |
$267.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.76
|
| Rate for Payer: BCBS Complete |
$173.55
|
| Rate for Payer: BCBS MAPPO |
$256.78
|
| Rate for Payer: BCN Commercial |
$424.28
|
| Rate for Payer: BCN Medicare Advantage |
$256.78
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$344.09
|
| Rate for Payer: Cofinity Commercial |
$369.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.62
|
| Rate for Payer: Meridian Medicaid |
$173.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$282.46
|
| Rate for Payer: Nomi Health Commercial |
$308.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.75
|
| Rate for Payer: PACE SWMI |
$256.78
|
| Rate for Payer: PHP Commercial |
$359.49
|
| Rate for Payer: PHP Medicare Advantage |
$256.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$456.26
|
| Rate for Payer: Priority Health Medicare |
$256.78
|
| Rate for Payer: Priority Health SBD |
$456.26
|
| Rate for Payer: Priority Health Tiered Network |
$456.26
|
| Rate for Payer: Railroad Medicare Medicare |
$256.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.61
|
| Rate for Payer: UHC Core |
$513.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$256.78
|
| Rate for Payer: UHC Exchange |
$513.61
|
| Rate for Payer: UHC Medicaid |
$165.29
|
| Rate for Payer: UHCCP Medicaid |
$165.29
|
| Rate for Payer: UMR Bronson Commercial |
$267.26
|
|
|
PR RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 36581
|
| Min. Negotiated Rate |
$105.01 |
| Max. Negotiated Rate |
$1,212.75 |
| Rate for Payer: Aetna Commercial |
$217.88
|
| Rate for Payer: Aetna Medicare |
$169.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.14
|
| Rate for Payer: BCBS Complete |
$110.26
|
| Rate for Payer: BCBS MAPPO |
$162.60
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$162.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$217.88
|
| Rate for Payer: Cofinity Commercial |
$234.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.73
|
| Rate for Payer: Meridian Medicaid |
$110.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.86
|
| Rate for Payer: Nomi Health Commercial |
$195.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,212.75
|
| Rate for Payer: PACE SWMI |
$162.60
|
| Rate for Payer: PHP Commercial |
$227.64
|
| Rate for Payer: PHP Medicare Advantage |
$162.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$290.25
|
| Rate for Payer: Priority Health Medicare |
$162.60
|
| Rate for Payer: Priority Health SBD |
$290.25
|
| Rate for Payer: Priority Health Tiered Network |
$290.25
|
| Rate for Payer: Railroad Medicare Medicare |
$162.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.83
|
| Rate for Payer: UHC Core |
$323.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.60
|
| Rate for Payer: UHC Exchange |
$323.83
|
| Rate for Payer: UHC Medicaid |
$105.01
|
| Rate for Payer: UHCCP Medicaid |
$105.01
|
| Rate for Payer: UMR Bronson Commercial |
$743.82
|
|
|
PR RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 62194
|
| Min. Negotiated Rate |
$335.90 |
| Max. Negotiated Rate |
$1,447.50 |
| Rate for Payer: Aetna Commercial |
$689.10
|
| Rate for Payer: Aetna Medicare |
$534.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.52
|
| Rate for Payer: BCBS Complete |
$352.69
|
| Rate for Payer: BCBS MAPPO |
$514.25
|
| Rate for Payer: BCN Commercial |
$762.90
|
| Rate for Payer: BCN Medicare Advantage |
$514.25
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$689.10
|
| Rate for Payer: Cofinity Commercial |
$740.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$514.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.96
|
| Rate for Payer: Meridian Medicaid |
$352.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$565.67
|
| Rate for Payer: Nomi Health Commercial |
$617.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,447.50
|
| Rate for Payer: PACE SWMI |
$514.25
|
| Rate for Payer: PHP Commercial |
$719.95
|
| Rate for Payer: PHP Medicare Advantage |
$514.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$886.10
|
| Rate for Payer: Priority Health Medicare |
$514.25
|
| Rate for Payer: Priority Health SBD |
$886.10
|
| Rate for Payer: Priority Health Tiered Network |
$886.10
|
| Rate for Payer: Railroad Medicare Medicare |
$514.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.96
|
| Rate for Payer: UHC Core |
$849.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$514.25
|
| Rate for Payer: UHC Exchange |
$849.96
|
| Rate for Payer: UHC Medicaid |
$335.90
|
| Rate for Payer: UHCCP Medicaid |
$335.90
|
| Rate for Payer: UMR Bronson Commercial |
$887.80
|
|
|
PR RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT
|
Professional
|
Both
|
$2,334.00
|
|
|
Service Code
|
HCPCS 63744
|
| Min. Negotiated Rate |
$469.45 |
| Max. Negotiated Rate |
$1,750.50 |
| Rate for Payer: Aetna Commercial |
$970.07
|
| Rate for Payer: Aetna Medicare |
$752.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.07
|
| Rate for Payer: BCBS Complete |
$492.92
|
| Rate for Payer: BCBS MAPPO |
$723.93
|
| Rate for Payer: BCN Commercial |
$1,203.55
|
| Rate for Payer: BCN Medicare Advantage |
$723.93
|
| Rate for Payer: Cash Price |
$1,867.20
|
| Rate for Payer: Cash Price |
$1,867.20
|
| Rate for Payer: Cofinity Commercial |
$1,042.46
|
| Rate for Payer: Cofinity Commercial |
$970.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.13
|
| Rate for Payer: Meridian Medicaid |
$492.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$796.32
|
| Rate for Payer: Nomi Health Commercial |
$868.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.50
|
| Rate for Payer: PACE SWMI |
$723.93
|
| Rate for Payer: PHP Commercial |
$1,013.50
|
| Rate for Payer: PHP Medicare Advantage |
$723.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,272.46
|
| Rate for Payer: Priority Health Medicare |
$723.93
|
| Rate for Payer: Priority Health SBD |
$1,272.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,272.46
|
| Rate for Payer: Railroad Medicare Medicare |
$723.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,192.39
|
| Rate for Payer: UHC Core |
$1,192.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$723.93
|
| Rate for Payer: UHC Exchange |
$1,192.39
|
| Rate for Payer: UHC Medicaid |
$469.45
|
| Rate for Payer: UHCCP Medicaid |
$469.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.64
|
|
|
PR RPLCMT/IRRIGATION VENTRICULAR CATHETER
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 62225
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$2,105.25 |
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: Aetna Medicare |
$580.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.58
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS MAPPO |
$558.04
|
| Rate for Payer: BCN Commercial |
$1,146.16
|
| Rate for Payer: BCN Medicare Advantage |
$558.04
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$747.77
|
| Rate for Payer: Cofinity Commercial |
$803.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.94
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$613.84
|
| Rate for Payer: Nomi Health Commercial |
$669.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$558.04
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: PHP Medicare Advantage |
$558.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$963.60
|
| Rate for Payer: Priority Health Medicare |
$558.04
|
| Rate for Payer: Priority Health SBD |
$963.60
|
| Rate for Payer: Priority Health Tiered Network |
$963.60
|
| Rate for Payer: Railroad Medicare Medicare |
$558.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.55
|
| Rate for Payer: UHC Core |
$916.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.04
|
| Rate for Payer: UHC Exchange |
$916.55
|
| Rate for Payer: UHC Medicaid |
$364.87
|
| Rate for Payer: UHCCP Medicaid |
$364.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.22
|
|
|
PR RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 69717
|
| Min. Negotiated Rate |
$314.18 |
| Max. Negotiated Rate |
$1,909.68 |
| Rate for Payer: Aetna Commercial |
$643.68
|
| Rate for Payer: Aetna Medicare |
$499.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.72
|
| Rate for Payer: BCBS Complete |
$329.89
|
| Rate for Payer: BCBS MAPPO |
$480.36
|
| Rate for Payer: BCN Commercial |
$841.58
|
| Rate for Payer: BCN Medicare Advantage |
$480.36
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$643.68
|
| Rate for Payer: Cofinity Commercial |
$691.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$504.38
|
| Rate for Payer: Meridian Medicaid |
$329.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$528.40
|
| Rate for Payer: Nomi Health Commercial |
$576.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: PACE SWMI |
$480.36
|
| Rate for Payer: PHP Commercial |
$672.50
|
| Rate for Payer: PHP Medicare Advantage |
$480.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$831.58
|
| Rate for Payer: Priority Health Medicare |
$480.36
|
| Rate for Payer: Priority Health SBD |
$831.58
|
| Rate for Payer: Priority Health Tiered Network |
$831.58
|
| Rate for Payer: Railroad Medicare Medicare |
$480.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,909.68
|
| Rate for Payer: UHC Core |
$1,909.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.36
|
| Rate for Payer: UHC Exchange |
$1,909.68
|
| Rate for Payer: UHC Medicaid |
$314.18
|
| Rate for Payer: UHCCP Medicaid |
$314.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.34
|
|
|
PR RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT
|
Professional
|
Both
|
$4,896.00
|
|
|
Service Code
|
HCPCS 33405
|
| Min. Negotiated Rate |
$1,355.75 |
| Max. Negotiated Rate |
$4,048.37 |
| Rate for Payer: Aetna Commercial |
$2,854.32
|
| Rate for Payer: Aetna Medicare |
$2,215.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,854.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,067.33
|
| Rate for Payer: BCBS Complete |
$1,423.54
|
| Rate for Payer: BCBS MAPPO |
$2,130.09
|
| Rate for Payer: BCN Commercial |
$3,335.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,130.09
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cofinity Commercial |
$2,854.32
|
| Rate for Payer: Cofinity Commercial |
$3,067.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,130.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,236.59
|
| Rate for Payer: Meridian Medicaid |
$1,423.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,343.10
|
| Rate for Payer: Nomi Health Commercial |
$2,556.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.00
|
| Rate for Payer: PACE SWMI |
$2,130.09
|
| Rate for Payer: PHP Commercial |
$2,982.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,130.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,355.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,586.89
|
| Rate for Payer: Priority Health Medicare |
$2,130.09
|
| Rate for Payer: Priority Health SBD |
$3,586.89
|
| Rate for Payer: Priority Health Tiered Network |
$3,586.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,130.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,048.37
|
| Rate for Payer: UHC Core |
$4,048.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,130.09
|
| Rate for Payer: UHC Exchange |
$4,048.37
|
| Rate for Payer: UHC Medicaid |
$1,355.75
|
| Rate for Payer: UHCCP Medicaid |
$1,355.75
|
| Rate for Payer: UMR Bronson Commercial |
$2,252.16
|
|
|
PR RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS
|
Professional
|
Both
|
$3,662.00
|
|
|
Service Code
|
HCPCS 62230
|
| Min. Negotiated Rate |
$535.27 |
| Max. Negotiated Rate |
$2,746.50 |
| Rate for Payer: Aetna Commercial |
$1,112.43
|
| Rate for Payer: Aetna Medicare |
$863.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,112.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,195.44
|
| Rate for Payer: BCBS Complete |
$562.03
|
| Rate for Payer: BCBS MAPPO |
$830.17
|
| Rate for Payer: BCN Commercial |
$1,775.66
|
| Rate for Payer: BCN Medicare Advantage |
$830.17
|
| Rate for Payer: Cash Price |
$2,929.60
|
| Rate for Payer: Cash Price |
$2,929.60
|
| Rate for Payer: Cofinity Commercial |
$1,112.43
|
| Rate for Payer: Cofinity Commercial |
$1,195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$871.68
|
| Rate for Payer: Meridian Medicaid |
$562.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$913.19
|
| Rate for Payer: Nomi Health Commercial |
$996.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,746.50
|
| Rate for Payer: PACE SWMI |
$830.17
|
| Rate for Payer: PHP Commercial |
$1,162.24
|
| Rate for Payer: PHP Medicare Advantage |
$830.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,492.83
|
| Rate for Payer: Priority Health Medicare |
$830.17
|
| Rate for Payer: Priority Health SBD |
$1,492.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,492.83
|
| Rate for Payer: Railroad Medicare Medicare |
$830.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,476.62
|
| Rate for Payer: UHC Core |
$1,476.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$830.17
|
| Rate for Payer: UHC Exchange |
$1,476.62
|
| Rate for Payer: UHC Medicaid |
$535.27
|
| Rate for Payer: UHCCP Medicaid |
$535.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,684.52
|
|
|
PR RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP
|
Professional
|
Both
|
$4,042.00
|
|
|
Service Code
|
HCPCS 20822
|
| Min. Negotiated Rate |
$1,021.97 |
| Max. Negotiated Rate |
$3,114.37 |
| Rate for Payer: Aetna Commercial |
$2,115.38
|
| Rate for Payer: Aetna Medicare |
$1,641.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,115.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,273.24
|
| Rate for Payer: BCBS Complete |
$1,073.07
|
| Rate for Payer: BCBS MAPPO |
$1,578.64
|
| Rate for Payer: BCN Commercial |
$2,670.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,578.64
|
| Rate for Payer: Cash Price |
$3,233.60
|
| Rate for Payer: Cash Price |
$3,233.60
|
| Rate for Payer: Cofinity Commercial |
$2,115.38
|
| Rate for Payer: Cofinity Commercial |
$2,273.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,578.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,657.57
|
| Rate for Payer: Meridian Medicaid |
$1,073.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,736.50
|
| Rate for Payer: Nomi Health Commercial |
$1,894.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,031.50
|
| Rate for Payer: PACE SWMI |
$1,578.64
|
| Rate for Payer: PHP Commercial |
$2,210.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,578.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,854.34
|
| Rate for Payer: Priority Health Medicare |
$1,578.64
|
| Rate for Payer: Priority Health SBD |
$2,854.34
|
| Rate for Payer: Priority Health Tiered Network |
$2,854.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,578.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,114.37
|
| Rate for Payer: UHC Core |
$3,114.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,578.64
|
| Rate for Payer: UHC Exchange |
$3,114.37
|
| Rate for Payer: UHC Medicaid |
$1,021.97
|
| Rate for Payer: UHCCP Medicaid |
$1,021.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,859.32
|
|
|
PR RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 20 MIN
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: Aetna Medicare |
$27.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$26.15
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.15
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$35.04
|
| Rate for Payer: Cofinity Commercial |
$37.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.46
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.77
|
| Rate for Payer: Nomi Health Commercial |
$31.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PACE SWMI |
$26.15
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: PHP Medicare Advantage |
$26.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.87
|
| Rate for Payer: Priority Health Medicare |
$26.15
|
| Rate for Payer: Priority Health SBD |
$39.87
|
| Rate for Payer: Priority Health Tiered Network |
$39.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.54
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.15
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$16.83
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
PR RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO EA ADDL 20
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$35.04
|
| Rate for Payer: Aetna Medicare |
$27.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$26.15
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.15
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$35.04
|
| Rate for Payer: Cofinity Commercial |
$37.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.46
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.77
|
| Rate for Payer: Nomi Health Commercial |
$31.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$26.15
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: PHP Medicare Advantage |
$26.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.87
|
| Rate for Payer: Priority Health Medicare |
$26.15
|
| Rate for Payer: Priority Health SBD |
$39.87
|
| Rate for Payer: Priority Health Tiered Network |
$39.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.54
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.15
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$16.83
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$38.64
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 49553
|
| Hospital Charge Code |
49553
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,167.41 |
| Rate for Payer: Aetna Commercial |
$806.95
|
| Rate for Payer: Aetna Medicare |
$626.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.17
|
| Rate for Payer: BCBS Complete |
$407.71
|
| Rate for Payer: BCBS MAPPO |
$602.20
|
| Rate for Payer: BCN Commercial |
$958.11
|
| Rate for Payer: BCN Medicare Advantage |
$602.20
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$806.95
|
| Rate for Payer: Cofinity Commercial |
$867.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.31
|
| Rate for Payer: Meridian Medicaid |
$407.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.42
|
| Rate for Payer: Nomi Health Commercial |
$722.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$602.20
|
| Rate for Payer: PHP Commercial |
$843.08
|
| Rate for Payer: PHP Medicare Advantage |
$602.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,167.41
|
| Rate for Payer: Priority Health Medicare |
$602.20
|
| Rate for Payer: Priority Health SBD |
$1,167.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,167.41
|
| Rate for Payer: Railroad Medicare Medicare |
$602.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.43
|
| Rate for Payer: UHC Core |
$1,121.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.20
|
| Rate for Payer: UHC Exchange |
$1,121.43
|
| Rate for Payer: UHC Medicaid |
$388.30
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
| Rate for Payer: UMR Bronson Commercial |
$534.98
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$430.31 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$755.95
|
| Rate for Payer: Aetna Commercial |
$988.55
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,191.89
|
| Rate for Payer: BCN Commercial |
$3,191.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Advantage |
$814.10
|
| Rate for Payer: Cofinity Commercial |
$1,000.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,046.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$814.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$872.25
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$988.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$732.69
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$430.31
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$872.25
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 49553
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,167.41 |
| Rate for Payer: Aetna Commercial |
$806.95
|
| Rate for Payer: Aetna Medicare |
$626.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.17
|
| Rate for Payer: BCBS Complete |
$407.71
|
| Rate for Payer: BCBS MAPPO |
$602.20
|
| Rate for Payer: BCN Commercial |
$958.11
|
| Rate for Payer: BCN Medicare Advantage |
$602.20
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$806.95
|
| Rate for Payer: Cofinity Commercial |
$867.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.31
|
| Rate for Payer: Meridian Medicaid |
$407.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$662.42
|
| Rate for Payer: Nomi Health Commercial |
$722.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$602.20
|
| Rate for Payer: PHP Commercial |
$843.08
|
| Rate for Payer: PHP Medicare Advantage |
$602.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,167.41
|
| Rate for Payer: Priority Health Medicare |
$602.20
|
| Rate for Payer: Priority Health SBD |
$1,167.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,167.41
|
| Rate for Payer: Railroad Medicare Medicare |
$602.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.43
|
| Rate for Payer: UHC Core |
$1,121.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$602.20
|
| Rate for Payer: UHC Exchange |
$1,121.43
|
| Rate for Payer: UHC Medicaid |
$388.30
|
| Rate for Payer: UHCCP Medicaid |
$388.30
|
| Rate for Payer: UMR Bronson Commercial |
$534.98
|
|
|
PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
49553
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$511.72 |
| Max. Negotiated Rate |
$1,046.70 |
| Rate for Payer: Aetna American Axle |
$755.95
|
| Rate for Payer: Aetna Commercial |
$988.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.95
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Advantage |
$814.10
|
| Rate for Payer: Cofinity Commercial |
$1,000.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Healthscope Commercial |
$1,046.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$814.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$872.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PHP Commercial |
$988.55
|
| Rate for Payer: Priority Health SBD |
$732.69
|
| Rate for Payer: UMR Bronson Commercial |
$511.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$872.25
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 49550
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,069.12 |
| Rate for Payer: Aetna Commercial |
$739.61
|
| Rate for Payer: Aetna Medicare |
$574.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$794.81
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$551.95
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$551.95
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$739.61
|
| Rate for Payer: Cofinity Commercial |
$794.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.55
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$607.14
|
| Rate for Payer: Nomi Health Commercial |
$662.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$551.95
|
| Rate for Payer: PHP Commercial |
$772.73
|
| Rate for Payer: PHP Medicare Advantage |
$551.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,069.12
|
| Rate for Payer: Priority Health Medicare |
$551.95
|
| Rate for Payer: Priority Health SBD |
$1,069.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,069.12
|
| Rate for Payer: Railroad Medicare Medicare |
$551.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,023.36
|
| Rate for Payer: UHC Core |
$1,023.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.95
|
| Rate for Payer: UHC Exchange |
$1,023.36
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
| Rate for Payer: UMR Bronson Commercial |
$409.40
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$391.60 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna American Axle |
$578.50
|
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.50
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Advantage |
$623.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: Priority Health SBD |
$560.70
|
| Rate for Payer: UMR Bronson Commercial |
$391.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$578.50
|
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,191.89
|
| Rate for Payer: BCN Commercial |
$3,191.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Advantage |
$623.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$756.50
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$560.70
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$329.30
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 49550
|
| Hospital Charge Code |
49550
|
| Min. Negotiated Rate |
$356.14 |
| Max. Negotiated Rate |
$1,069.12 |
| Rate for Payer: Aetna Commercial |
$739.61
|
| Rate for Payer: Aetna Medicare |
$574.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$794.81
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$551.95
|
| Rate for Payer: BCN Commercial |
$877.44
|
| Rate for Payer: BCN Medicare Advantage |
$551.95
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$739.61
|
| Rate for Payer: Cofinity Commercial |
$794.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.55
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$607.14
|
| Rate for Payer: Nomi Health Commercial |
$662.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$551.95
|
| Rate for Payer: PHP Commercial |
$772.73
|
| Rate for Payer: PHP Medicare Advantage |
$551.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,069.12
|
| Rate for Payer: Priority Health Medicare |
$551.95
|
| Rate for Payer: Priority Health SBD |
$1,069.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,069.12
|
| Rate for Payer: Railroad Medicare Medicare |
$551.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,023.36
|
| Rate for Payer: UHC Core |
$1,023.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.95
|
| Rate for Payer: UHC Exchange |
$1,023.36
|
| Rate for Payer: UHC Medicaid |
$356.14
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
| Rate for Payer: UMR Bronson Commercial |
$409.40
|
|
|
PR RPR 1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 49561
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Medicare |
$1,155.00
|
| Rate for Payer: BCBS Complete |
$924.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,062.60
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$752.01
|
| Rate for Payer: Aetna Medicare |
$583.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.13
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$561.20
|
| Rate for Payer: BCN Commercial |
$890.89
|
| Rate for Payer: BCN Medicare Advantage |
$561.20
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$752.01
|
| Rate for Payer: Cofinity Commercial |
$808.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.26
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.32
|
| Rate for Payer: Nomi Health Commercial |
$673.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$561.20
|
| Rate for Payer: PHP Commercial |
$785.68
|
| Rate for Payer: PHP Medicare Advantage |
$561.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.49
|
| Rate for Payer: Priority Health Medicare |
$561.20
|
| Rate for Payer: Priority Health SBD |
$1,085.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.49
|
| Rate for Payer: Railroad Medicare Medicare |
$561.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.78
|
| Rate for Payer: UHC Core |
$1,040.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.20
|
| Rate for Payer: UHC Exchange |
$1,040.78
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$788.90
|
|
