|
PR RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 49617
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,621.26 |
| Rate for Payer: Aetna Commercial |
$1,088.43
|
| Rate for Payer: Aetna Medicare |
$844.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.65
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$812.26
|
| Rate for Payer: BCN Commercial |
$1,330.61
|
| Rate for Payer: BCN Medicare Advantage |
$812.26
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,088.43
|
| Rate for Payer: Cofinity Commercial |
$1,169.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$852.87
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$893.49
|
| Rate for Payer: Nomi Health Commercial |
$974.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.25
|
| Rate for Payer: PACE SWMI |
$812.26
|
| Rate for Payer: PHP Commercial |
$1,137.16
|
| Rate for Payer: PHP Medicare Advantage |
$812.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,621.26
|
| Rate for Payer: Priority Health Medicare |
$812.26
|
| Rate for Payer: Priority Health SBD |
$1,621.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,621.26
|
| Rate for Payer: Railroad Medicare Medicare |
$812.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,621.25
|
| Rate for Payer: UHC Core |
$1,621.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.26
|
| Rate for Payer: UHC Exchange |
$1,621.25
|
| Rate for Payer: UHC Medicaid |
$515.46
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
| Rate for Payer: UMR Bronson Commercial |
$875.38
|
|
|
PR RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,804.00
|
|
|
Service Code
|
HCPCS 49616
|
| Min. Negotiated Rate |
$499.49 |
| Max. Negotiated Rate |
$1,574.44 |
| Rate for Payer: Aetna Commercial |
$1,055.46
|
| Rate for Payer: Aetna Medicare |
$819.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.23
|
| Rate for Payer: BCBS Complete |
$524.46
|
| Rate for Payer: BCBS MAPPO |
$787.66
|
| Rate for Payer: BCN Commercial |
$1,285.78
|
| Rate for Payer: BCN Medicare Advantage |
$787.66
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cofinity Commercial |
$1,055.46
|
| Rate for Payer: Cofinity Commercial |
$1,134.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.04
|
| Rate for Payer: Meridian Medicaid |
$524.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.43
|
| Rate for Payer: Nomi Health Commercial |
$945.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.00
|
| Rate for Payer: PACE SWMI |
$787.66
|
| Rate for Payer: PHP Commercial |
$1,102.72
|
| Rate for Payer: PHP Medicare Advantage |
$787.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,566.65
|
| Rate for Payer: Priority Health Medicare |
$787.66
|
| Rate for Payer: Priority Health SBD |
$1,566.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,566.65
|
| Rate for Payer: Railroad Medicare Medicare |
$787.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.44
|
| Rate for Payer: UHC Core |
$1,574.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.66
|
| Rate for Payer: UHC Exchange |
$1,574.44
|
| Rate for Payer: UHC Medicaid |
$499.49
|
| Rate for Payer: UHCCP Medicaid |
$499.49
|
| Rate for Payer: UMR Bronson Commercial |
$829.84
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 49615
|
| Min. Negotiated Rate |
$372.32 |
| Max. Negotiated Rate |
$1,227.75 |
| Rate for Payer: Aetna Commercial |
$785.92
|
| Rate for Payer: Aetna Medicare |
$609.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.57
|
| Rate for Payer: BCBS Complete |
$390.94
|
| Rate for Payer: BCBS MAPPO |
$586.51
|
| Rate for Payer: BCN Commercial |
$957.62
|
| Rate for Payer: BCN Medicare Advantage |
$586.51
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$785.92
|
| Rate for Payer: Cofinity Commercial |
$844.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.84
|
| Rate for Payer: Meridian Medicaid |
$390.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.16
|
| Rate for Payer: Nomi Health Commercial |
$703.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.75
|
| Rate for Payer: PACE SWMI |
$586.51
|
| Rate for Payer: PHP Commercial |
$821.11
|
| Rate for Payer: PHP Medicare Advantage |
$586.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,166.79
|
| Rate for Payer: Priority Health Medicare |
$586.51
|
| Rate for Payer: Priority Health SBD |
$1,166.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,166.79
|
| Rate for Payer: Railroad Medicare Medicare |
$586.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,171.51
|
| Rate for Payer: UHC Core |
$1,171.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$586.51
|
| Rate for Payer: UHC Exchange |
$1,171.51
|
| Rate for Payer: UHC Medicaid |
$372.32
|
| Rate for Payer: UHCCP Medicaid |
$372.32
|
| Rate for Payer: UMR Bronson Commercial |
$753.02
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 49614
|
| Min. Negotiated Rate |
$334.20 |
| Max. Negotiated Rate |
$1,047.46 |
| Rate for Payer: Aetna Commercial |
$705.28
|
| Rate for Payer: Aetna Medicare |
$547.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.92
|
| Rate for Payer: BCBS Complete |
$350.91
|
| Rate for Payer: BCBS MAPPO |
$526.33
|
| Rate for Payer: BCN Commercial |
$856.53
|
| Rate for Payer: BCN Medicare Advantage |
$526.33
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Cofinity Commercial |
$705.28
|
| Rate for Payer: Cofinity Commercial |
$757.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.65
|
| Rate for Payer: Meridian Medicaid |
$350.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.96
|
| Rate for Payer: Nomi Health Commercial |
$631.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.00
|
| Rate for Payer: PACE SWMI |
$526.33
|
| Rate for Payer: PHP Commercial |
$736.86
|
| Rate for Payer: PHP Medicare Advantage |
$526.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,043.62
|
| Rate for Payer: Priority Health Medicare |
$526.33
|
| Rate for Payer: Priority Health SBD |
$1,043.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,043.62
|
| Rate for Payer: Railroad Medicare Medicare |
$526.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.46
|
| Rate for Payer: UHC Core |
$1,047.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$526.33
|
| Rate for Payer: UHC Exchange |
$1,047.46
|
| Rate for Payer: UHC Medicaid |
$334.20
|
| Rate for Payer: UHCCP Medicaid |
$334.20
|
| Rate for Payer: UMR Bronson Commercial |
$552.00
|
|
|
PR RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 49613
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$771.19 |
| Rate for Payer: Aetna Commercial |
$519.75
|
| Rate for Payer: Aetna Medicare |
$403.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.53
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$387.87
|
| Rate for Payer: BCN Commercial |
$631.44
|
| Rate for Payer: BCN Medicare Advantage |
$387.87
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$519.75
|
| Rate for Payer: Cofinity Commercial |
$558.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.26
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.66
|
| Rate for Payer: Nomi Health Commercial |
$465.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$662.25
|
| Rate for Payer: PACE SWMI |
$387.87
|
| Rate for Payer: PHP Commercial |
$543.02
|
| Rate for Payer: PHP Medicare Advantage |
$387.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$769.36
|
| Rate for Payer: Priority Health Medicare |
$387.87
|
| Rate for Payer: Priority Health SBD |
$769.36
|
| Rate for Payer: Priority Health Tiered Network |
$769.36
|
| Rate for Payer: Railroad Medicare Medicare |
$387.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.19
|
| Rate for Payer: UHC Core |
$771.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.87
|
| Rate for Payer: UHC Exchange |
$771.19
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
| Rate for Payer: UMR Bronson Commercial |
$406.18
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 35190
|
| Min. Negotiated Rate |
$437.50 |
| Max. Negotiated Rate |
$1,360.42 |
| Rate for Payer: Aetna Commercial |
$922.55
|
| Rate for Payer: Aetna Medicare |
$716.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.40
|
| Rate for Payer: BCBS Complete |
$459.38
|
| Rate for Payer: BCBS MAPPO |
$688.47
|
| Rate for Payer: BCN Commercial |
$1,108.51
|
| Rate for Payer: BCN Medicare Advantage |
$688.47
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$922.55
|
| Rate for Payer: Cofinity Commercial |
$991.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.89
|
| Rate for Payer: Meridian Medicaid |
$459.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$757.32
|
| Rate for Payer: Nomi Health Commercial |
$826.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.25
|
| Rate for Payer: PACE SWMI |
$688.47
|
| Rate for Payer: PHP Commercial |
$963.86
|
| Rate for Payer: PHP Medicare Advantage |
$688.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,192.05
|
| Rate for Payer: Priority Health Medicare |
$688.47
|
| Rate for Payer: Priority Health SBD |
$1,192.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,192.05
|
| Rate for Payer: Railroad Medicare Medicare |
$688.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.42
|
| Rate for Payer: UHC Core |
$1,360.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$688.47
|
| Rate for Payer: UHC Exchange |
$1,360.42
|
| Rate for Payer: UHC Medicaid |
$437.50
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: UMR Bronson Commercial |
$730.02
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 35188
|
| Min. Negotiated Rate |
$805.57 |
| Max. Negotiated Rate |
$3,275.25 |
| Rate for Payer: Aetna Commercial |
$1,685.43
|
| Rate for Payer: Aetna Medicare |
$1,308.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.20
|
| Rate for Payer: BCBS Complete |
$845.85
|
| Rate for Payer: BCBS MAPPO |
$1,257.78
|
| Rate for Payer: BCN Commercial |
$1,956.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.78
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,685.43
|
| Rate for Payer: Cofinity Commercial |
$1,811.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.67
|
| Rate for Payer: Meridian Medicaid |
$845.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,383.56
|
| Rate for Payer: Nomi Health Commercial |
$1,509.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,275.25
|
| Rate for Payer: PACE SWMI |
$1,257.78
|
| Rate for Payer: PHP Commercial |
$1,760.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,104.03
|
| Rate for Payer: Priority Health Medicare |
$1,257.78
|
| Rate for Payer: Priority Health SBD |
$2,104.03
|
| Rate for Payer: Priority Health Tiered Network |
$2,104.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,255.91
|
| Rate for Payer: UHC Core |
$2,255.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,257.78
|
| Rate for Payer: UHC Exchange |
$2,255.91
|
| Rate for Payer: UHC Medicaid |
$805.57
|
| Rate for Payer: UHCCP Medicaid |
$805.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,008.82
|
|
|
PR RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26350
|
| Min. Negotiated Rate |
$471.16 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$938.96
|
| Rate for Payer: Aetna Medicare |
$728.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.96
|
| Rate for Payer: BCBS Complete |
$494.72
|
| Rate for Payer: BCBS MAPPO |
$700.72
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$700.72
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$1,009.04
|
| Rate for Payer: Cofinity Commercial |
$938.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$700.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$735.76
|
| Rate for Payer: Meridian Medicaid |
$494.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$770.79
|
| Rate for Payer: Nomi Health Commercial |
$840.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$700.72
|
| Rate for Payer: PHP Commercial |
$981.01
|
| Rate for Payer: PHP Medicare Advantage |
$700.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.53
|
| Rate for Payer: Priority Health Medicare |
$700.72
|
| Rate for Payer: Priority Health SBD |
$1,202.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,202.53
|
| Rate for Payer: Railroad Medicare Medicare |
$700.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,234.86
|
| Rate for Payer: UHC Core |
$1,234.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$700.72
|
| Rate for Payer: UHC Exchange |
$1,234.86
|
| Rate for Payer: UHC Medicaid |
$471.16
|
| Rate for Payer: UHCCP Medicaid |
$471.16
|
| Rate for Payer: UMR Bronson Commercial |
$939.32
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$595.12 |
| Max. Negotiated Rate |
$2,092.50 |
| Rate for Payer: Aetna Commercial |
$1,214.80
|
| Rate for Payer: Aetna Medicare |
$942.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.46
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$906.57
|
| Rate for Payer: BCN Commercial |
$1,499.42
|
| Rate for Payer: BCN Medicare Advantage |
$906.57
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,214.80
|
| Rate for Payer: Cofinity Commercial |
$1,305.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.90
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.23
|
| Rate for Payer: Nomi Health Commercial |
$1,087.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,092.50
|
| Rate for Payer: PACE SWMI |
$906.57
|
| Rate for Payer: PHP Commercial |
$1,269.20
|
| Rate for Payer: PHP Medicare Advantage |
$906.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,602.83
|
| Rate for Payer: Priority Health Medicare |
$906.57
|
| Rate for Payer: Priority Health SBD |
$1,602.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,602.83
|
| Rate for Payer: Railroad Medicare Medicare |
$906.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.95
|
| Rate for Payer: UHC Core |
$1,709.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$906.57
|
| Rate for Payer: UHC Exchange |
$1,709.95
|
| Rate for Payer: UHC Medicaid |
$595.12
|
| Rate for Payer: UHCCP Medicaid |
$595.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,283.40
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 26356
|
| Min. Negotiated Rate |
$480.53 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Aetna Commercial |
$975.47
|
| Rate for Payer: Aetna Medicare |
$757.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.47
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$727.96
|
| Rate for Payer: BCN Commercial |
$1,218.56
|
| Rate for Payer: BCN Medicare Advantage |
$727.96
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$1,048.26
|
| Rate for Payer: Cofinity Commercial |
$975.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.36
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$800.76
|
| Rate for Payer: Nomi Health Commercial |
$873.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.75
|
| Rate for Payer: PACE SWMI |
$727.96
|
| Rate for Payer: PHP Commercial |
$1,019.14
|
| Rate for Payer: PHP Medicare Advantage |
$727.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,302.61
|
| Rate for Payer: Priority Health Medicare |
$727.96
|
| Rate for Payer: Priority Health SBD |
$1,302.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,302.61
|
| Rate for Payer: Railroad Medicare Medicare |
$727.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.49
|
| Rate for Payer: UHC Core |
$1,373.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$727.96
|
| Rate for Payer: UHC Exchange |
$1,373.49
|
| Rate for Payer: UHC Medicaid |
$480.53
|
| Rate for Payer: UHCCP Medicaid |
$480.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.02
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 26357
|
| Min. Negotiated Rate |
$544.22 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$1,107.89
|
| Rate for Payer: Aetna Medicare |
$859.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,107.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,190.56
|
| Rate for Payer: BCBS Complete |
$571.43
|
| Rate for Payer: BCBS MAPPO |
$826.78
|
| Rate for Payer: BCN Commercial |
$1,360.99
|
| Rate for Payer: BCN Medicare Advantage |
$826.78
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,107.89
|
| Rate for Payer: Cofinity Commercial |
$1,190.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$826.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.12
|
| Rate for Payer: Meridian Medicaid |
$571.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$909.46
|
| Rate for Payer: Nomi Health Commercial |
$992.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: PACE SWMI |
$826.78
|
| Rate for Payer: PHP Commercial |
$1,157.49
|
| Rate for Payer: PHP Medicare Advantage |
$826.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,454.85
|
| Rate for Payer: Priority Health Medicare |
$826.78
|
| Rate for Payer: Priority Health SBD |
$1,454.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,454.85
|
| Rate for Payer: Railroad Medicare Medicare |
$826.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.25
|
| Rate for Payer: UHC Core |
$1,542.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$826.78
|
| Rate for Payer: UHC Exchange |
$1,542.25
|
| Rate for Payer: UHC Medicaid |
$544.22
|
| Rate for Payer: UHCCP Medicaid |
$544.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,314.68
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 26370
|
| Min. Negotiated Rate |
$484.58 |
| Max. Negotiated Rate |
$1,807.50 |
| Rate for Payer: Aetna Commercial |
$970.24
|
| Rate for Payer: Aetna Medicare |
$753.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.24
|
| Rate for Payer: BCBS Complete |
$508.81
|
| Rate for Payer: BCBS MAPPO |
$724.06
|
| Rate for Payer: BCN Commercial |
$1,181.21
|
| Rate for Payer: BCN Medicare Advantage |
$724.06
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$1,042.65
|
| Rate for Payer: Cofinity Commercial |
$970.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.26
|
| Rate for Payer: Meridian Medicaid |
$508.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$796.47
|
| Rate for Payer: Nomi Health Commercial |
$868.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.50
|
| Rate for Payer: PACE SWMI |
$724.06
|
| Rate for Payer: PHP Commercial |
$1,013.68
|
| Rate for Payer: PHP Medicare Advantage |
$724.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,262.68
|
| Rate for Payer: Priority Health Medicare |
$724.06
|
| Rate for Payer: Priority Health SBD |
$1,262.68
|
| Rate for Payer: Priority Health Tiered Network |
$1,262.68
|
| Rate for Payer: Railroad Medicare Medicare |
$724.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.71
|
| Rate for Payer: UHC Core |
$1,308.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$724.06
|
| Rate for Payer: UHC Exchange |
$1,308.71
|
| Rate for Payer: UHC Medicaid |
$484.58
|
| Rate for Payer: UHCCP Medicaid |
$484.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,108.60
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA
|
Professional
|
Both
|
$3,199.00
|
|
|
Service Code
|
HCPCS 26372
|
| Min. Negotiated Rate |
$572.54 |
| Max. Negotiated Rate |
$2,399.25 |
| Rate for Payer: Aetna Commercial |
$1,150.67
|
| Rate for Payer: Aetna Medicare |
$893.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.54
|
| Rate for Payer: BCBS Complete |
$601.17
|
| Rate for Payer: BCBS MAPPO |
$858.71
|
| Rate for Payer: BCN Commercial |
$1,376.42
|
| Rate for Payer: BCN Medicare Advantage |
$858.71
|
| Rate for Payer: Cash Price |
$2,559.20
|
| Rate for Payer: Cash Price |
$2,559.20
|
| Rate for Payer: Cofinity Commercial |
$1,150.67
|
| Rate for Payer: Cofinity Commercial |
$1,236.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.65
|
| Rate for Payer: Meridian Medicaid |
$601.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$944.58
|
| Rate for Payer: Nomi Health Commercial |
$1,030.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.25
|
| Rate for Payer: PACE SWMI |
$858.71
|
| Rate for Payer: PHP Commercial |
$1,202.19
|
| Rate for Payer: PHP Medicare Advantage |
$858.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,471.36
|
| Rate for Payer: Priority Health Medicare |
$858.71
|
| Rate for Payer: Priority Health SBD |
$1,471.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,471.36
|
| Rate for Payer: Railroad Medicare Medicare |
$858.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.56
|
| Rate for Payer: UHC Core |
$1,536.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$858.71
|
| Rate for Payer: UHC Exchange |
$1,536.56
|
| Rate for Payer: UHC Medicaid |
$572.54
|
| Rate for Payer: UHCCP Medicaid |
$572.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,471.54
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA
|
Professional
|
Both
|
$2,940.00
|
|
|
Service Code
|
HCPCS 26373
|
| Min. Negotiated Rate |
$553.80 |
| Max. Negotiated Rate |
$2,205.00 |
| Rate for Payer: Aetna Commercial |
$1,111.19
|
| Rate for Payer: Aetna Medicare |
$862.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,194.12
|
| Rate for Payer: BCBS Complete |
$581.49
|
| Rate for Payer: BCBS MAPPO |
$829.25
|
| Rate for Payer: BCN Commercial |
$1,324.63
|
| Rate for Payer: BCN Medicare Advantage |
$829.25
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,111.19
|
| Rate for Payer: Cofinity Commercial |
$1,194.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.71
|
| Rate for Payer: Meridian Medicaid |
$581.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$912.17
|
| Rate for Payer: Nomi Health Commercial |
$995.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,205.00
|
| Rate for Payer: PACE SWMI |
$829.25
|
| Rate for Payer: PHP Commercial |
$1,160.95
|
| Rate for Payer: PHP Medicare Advantage |
$829.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,416.00
|
| Rate for Payer: Priority Health Medicare |
$829.25
|
| Rate for Payer: Priority Health SBD |
$1,416.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,416.00
|
| Rate for Payer: Railroad Medicare Medicare |
$829.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,473.48
|
| Rate for Payer: UHC Core |
$1,473.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$829.25
|
| Rate for Payer: UHC Exchange |
$1,473.48
|
| Rate for Payer: UHC Medicaid |
$553.80
|
| Rate for Payer: UHCCP Medicaid |
$553.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,352.40
|
|
|
PR RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ
|
Professional
|
Both
|
$3,710.00
|
|
|
Service Code
|
HCPCS 33507
|
| Min. Negotiated Rate |
$1,022.61 |
| Max. Negotiated Rate |
$3,071.97 |
| Rate for Payer: Aetna Commercial |
$2,155.71
|
| Rate for Payer: Aetna Medicare |
$1,673.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,155.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,316.59
|
| Rate for Payer: BCBS Complete |
$1,073.74
|
| Rate for Payer: BCBS MAPPO |
$1,608.74
|
| Rate for Payer: BCN Commercial |
$2,530.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,608.74
|
| Rate for Payer: Cash Price |
$2,968.00
|
| Rate for Payer: Cash Price |
$2,968.00
|
| Rate for Payer: Cofinity Commercial |
$2,155.71
|
| Rate for Payer: Cofinity Commercial |
$2,316.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,608.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,689.18
|
| Rate for Payer: Meridian Medicaid |
$1,073.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,769.61
|
| Rate for Payer: Nomi Health Commercial |
$1,930.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,782.50
|
| Rate for Payer: PACE SWMI |
$1,608.74
|
| Rate for Payer: PHP Commercial |
$2,252.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,608.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,022.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,720.96
|
| Rate for Payer: Priority Health Medicare |
$1,608.74
|
| Rate for Payer: Priority Health SBD |
$2,720.96
|
| Rate for Payer: Priority Health Tiered Network |
$2,720.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,608.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,071.97
|
| Rate for Payer: UHC Core |
$3,071.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,608.74
|
| Rate for Payer: UHC Exchange |
$3,071.97
|
| Rate for Payer: UHC Medicaid |
$1,022.61
|
| Rate for Payer: UHCCP Medicaid |
$1,022.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,706.60
|
|
|
PR RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP
|
Professional
|
Both
|
$5,192.00
|
|
|
Service Code
|
HCPCS 33504
|
| Min. Negotiated Rate |
$890.77 |
| Max. Negotiated Rate |
$3,894.00 |
| Rate for Payer: Aetna Commercial |
$1,865.98
|
| Rate for Payer: Aetna Medicare |
$1,448.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,865.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,005.23
|
| Rate for Payer: BCBS Complete |
$935.31
|
| Rate for Payer: BCBS MAPPO |
$1,392.52
|
| Rate for Payer: BCN Commercial |
$2,171.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,392.52
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cofinity Commercial |
$1,865.98
|
| Rate for Payer: Cofinity Commercial |
$2,005.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,392.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,462.15
|
| Rate for Payer: Meridian Medicaid |
$935.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,531.77
|
| Rate for Payer: Nomi Health Commercial |
$1,671.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,894.00
|
| Rate for Payer: PACE SWMI |
$1,392.52
|
| Rate for Payer: PHP Commercial |
$1,949.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,392.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,335.38
|
| Rate for Payer: Priority Health Medicare |
$1,392.52
|
| Rate for Payer: Priority Health SBD |
$2,335.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,335.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,392.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,601.53
|
| Rate for Payer: UHC Core |
$2,601.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,392.52
|
| Rate for Payer: UHC Exchange |
$2,601.53
|
| Rate for Payer: UHC Medicaid |
$890.77
|
| Rate for Payer: UHCCP Medicaid |
$890.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,388.32
|
|
|
PR RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH
|
Professional
|
Both
|
$5,223.00
|
|
|
Service Code
|
HCPCS 33641
|
| Min. Negotiated Rate |
$978.31 |
| Max. Negotiated Rate |
$3,917.25 |
| Rate for Payer: Aetna Commercial |
$2,059.53
|
| Rate for Payer: Aetna Medicare |
$1,598.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,059.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,213.22
|
| Rate for Payer: BCBS Complete |
$1,027.23
|
| Rate for Payer: BCBS MAPPO |
$1,536.96
|
| Rate for Payer: BCN Commercial |
$2,412.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.96
|
| Rate for Payer: Cash Price |
$4,178.40
|
| Rate for Payer: Cash Price |
$4,178.40
|
| Rate for Payer: Cofinity Commercial |
$2,059.53
|
| Rate for Payer: Cofinity Commercial |
$2,213.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,613.81
|
| Rate for Payer: Meridian Medicaid |
$1,027.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,690.66
|
| Rate for Payer: Nomi Health Commercial |
$1,844.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,917.25
|
| Rate for Payer: PACE SWMI |
$1,536.96
|
| Rate for Payer: PHP Commercial |
$2,151.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,594.03
|
| Rate for Payer: Priority Health Medicare |
$1,536.96
|
| Rate for Payer: Priority Health SBD |
$2,594.03
|
| Rate for Payer: Priority Health Tiered Network |
$2,594.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,536.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,920.47
|
| Rate for Payer: UHC Core |
$2,920.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,536.96
|
| Rate for Payer: UHC Exchange |
$2,920.47
|
| Rate for Payer: UHC Medicaid |
$978.31
|
| Rate for Payer: UHCCP Medicaid |
$978.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,402.58
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL
|
Professional
|
Both
|
$1,173.00
|
|
|
Service Code
|
HCPCS 67903
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$879.75 |
| Rate for Payer: Aetna Commercial |
$529.31
|
| Rate for Payer: Aetna Medicare |
$410.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.81
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$395.01
|
| Rate for Payer: BCN Commercial |
$711.62
|
| Rate for Payer: BCN Medicare Advantage |
$395.01
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$529.31
|
| Rate for Payer: Cofinity Commercial |
$568.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.76
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$434.51
|
| Rate for Payer: Nomi Health Commercial |
$474.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$879.75
|
| Rate for Payer: PACE SWMI |
$395.01
|
| Rate for Payer: PHP Commercial |
$553.01
|
| Rate for Payer: PHP Medicare Advantage |
$395.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$833.54
|
| Rate for Payer: Priority Health Medicare |
$395.01
|
| Rate for Payer: Priority Health SBD |
$833.54
|
| Rate for Payer: Priority Health Tiered Network |
$833.54
|
| Rate for Payer: Railroad Medicare Medicare |
$395.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.38
|
| Rate for Payer: UHC Core |
$822.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.01
|
| Rate for Payer: UHC Exchange |
$822.38
|
| Rate for Payer: UHC Medicaid |
$260.50
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
| Rate for Payer: UMR Bronson Commercial |
$539.58
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 67904
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,032.45 |
| Rate for Payer: Aetna Commercial |
$658.07
|
| Rate for Payer: Aetna Medicare |
$510.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.18
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$491.10
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: BCN Medicare Advantage |
$491.10
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$658.07
|
| Rate for Payer: Cofinity Commercial |
$707.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.65
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$540.21
|
| Rate for Payer: Nomi Health Commercial |
$589.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$491.10
|
| Rate for Payer: PHP Commercial |
$687.54
|
| Rate for Payer: PHP Medicare Advantage |
$491.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,032.45
|
| Rate for Payer: Priority Health Medicare |
$491.10
|
| Rate for Payer: Priority Health SBD |
$1,032.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,032.45
|
| Rate for Payer: Railroad Medicare Medicare |
$491.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.76
|
| Rate for Payer: UHC Core |
$1,015.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$491.10
|
| Rate for Payer: UHC Exchange |
$1,015.76
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
| Rate for Payer: UMR Bronson Commercial |
$459.08
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS
|
Professional
|
Both
|
$2,980.00
|
|
|
Service Code
|
HCPCS 35211
|
| Min. Negotiated Rate |
$841.99 |
| Max. Negotiated Rate |
$2,472.59 |
| Rate for Payer: Aetna Commercial |
$1,765.99
|
| Rate for Payer: Aetna Medicare |
$1,370.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,765.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,897.78
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS MAPPO |
$1,317.90
|
| Rate for Payer: BCN Commercial |
$2,051.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.90
|
| Rate for Payer: Cash Price |
$2,384.00
|
| Rate for Payer: Cash Price |
$2,384.00
|
| Rate for Payer: Cofinity Commercial |
$1,765.99
|
| Rate for Payer: Cofinity Commercial |
$1,897.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.80
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,449.69
|
| Rate for Payer: Nomi Health Commercial |
$1,581.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,235.00
|
| Rate for Payer: PACE SWMI |
$1,317.90
|
| Rate for Payer: PHP Commercial |
$1,845.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,205.78
|
| Rate for Payer: Priority Health Medicare |
$1,317.90
|
| Rate for Payer: Priority Health SBD |
$2,205.78
|
| Rate for Payer: Priority Health Tiered Network |
$2,205.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,317.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,472.59
|
| Rate for Payer: UHC Core |
$2,472.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,317.90
|
| Rate for Payer: UHC Exchange |
$2,472.59
|
| Rate for Payer: UHC Medicaid |
$841.99
|
| Rate for Payer: UHCCP Medicaid |
$841.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,370.80
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS
|
Professional
|
Both
|
$5,486.00
|
|
|
Service Code
|
HCPCS 35216
|
| Min. Negotiated Rate |
$1,216.44 |
| Max. Negotiated Rate |
$4,114.50 |
| Rate for Payer: Aetna Commercial |
$2,555.82
|
| Rate for Payer: Aetna Medicare |
$1,983.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,555.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,746.56
|
| Rate for Payer: BCBS Complete |
$1,277.26
|
| Rate for Payer: BCBS MAPPO |
$1,907.33
|
| Rate for Payer: BCN Commercial |
$3,069.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,907.33
|
| Rate for Payer: Cash Price |
$4,388.80
|
| Rate for Payer: Cash Price |
$4,388.80
|
| Rate for Payer: Cofinity Commercial |
$2,555.82
|
| Rate for Payer: Cofinity Commercial |
$2,746.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,907.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,002.70
|
| Rate for Payer: Meridian Medicaid |
$1,277.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,098.06
|
| Rate for Payer: Nomi Health Commercial |
$2,288.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,114.50
|
| Rate for Payer: PACE SWMI |
$1,907.33
|
| Rate for Payer: PHP Commercial |
$2,670.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,907.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,216.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,300.92
|
| Rate for Payer: Priority Health Medicare |
$1,907.33
|
| Rate for Payer: Priority Health SBD |
$3,300.92
|
| Rate for Payer: Priority Health Tiered Network |
$3,300.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,907.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,691.50
|
| Rate for Payer: UHC Core |
$3,691.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,907.33
|
| Rate for Payer: UHC Exchange |
$3,691.50
|
| Rate for Payer: UHC Medicaid |
$1,216.44
|
| Rate for Payer: UHCCP Medicaid |
$1,216.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,523.56
|
|
|
PR RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP
|
Professional
|
Both
|
$6,715.00
|
|
|
Service Code
|
HCPCS 35241
|
| Min. Negotiated Rate |
$873.73 |
| Max. Negotiated Rate |
$5,036.25 |
| Rate for Payer: Aetna Commercial |
$1,831.14
|
| Rate for Payer: Aetna Medicare |
$1,421.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,831.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,967.79
|
| Rate for Payer: BCBS Complete |
$917.42
|
| Rate for Payer: BCBS MAPPO |
$1,366.52
|
| Rate for Payer: BCN Commercial |
$2,110.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,366.52
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,831.14
|
| Rate for Payer: Cofinity Commercial |
$1,967.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,366.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,434.85
|
| Rate for Payer: Meridian Medicaid |
$917.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,503.17
|
| Rate for Payer: Nomi Health Commercial |
$1,639.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,036.25
|
| Rate for Payer: PACE SWMI |
$1,366.52
|
| Rate for Payer: PHP Commercial |
$1,913.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,366.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,269.51
|
| Rate for Payer: Priority Health Medicare |
$1,366.52
|
| Rate for Payer: Priority Health SBD |
$2,269.51
|
| Rate for Payer: Priority Health Tiered Network |
$2,269.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,366.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,552.48
|
| Rate for Payer: UHC Core |
$2,552.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,366.52
|
| Rate for Payer: UHC Exchange |
$2,552.48
|
| Rate for Payer: UHC Medicaid |
$873.73
|
| Rate for Payer: UHCCP Medicaid |
$873.73
|
| Rate for Payer: UMR Bronson Commercial |
$3,088.90
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP
|
Professional
|
Both
|
$6,946.00
|
|
|
Service Code
|
HCPCS 35271
|
| Min. Negotiated Rate |
$843.27 |
| Max. Negotiated Rate |
$5,209.50 |
| Rate for Payer: Aetna Commercial |
$1,766.51
|
| Rate for Payer: Aetna Medicare |
$1,371.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,898.34
|
| Rate for Payer: BCBS Complete |
$885.43
|
| Rate for Payer: BCBS MAPPO |
$1,318.29
|
| Rate for Payer: BCN Commercial |
$2,033.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.29
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Cofinity Commercial |
$1,766.51
|
| Rate for Payer: Cofinity Commercial |
$1,898.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.20
|
| Rate for Payer: Meridian Medicaid |
$885.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.12
|
| Rate for Payer: Nomi Health Commercial |
$1,581.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,209.50
|
| Rate for Payer: PACE SWMI |
$1,318.29
|
| Rate for Payer: PHP Commercial |
$1,845.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,187.04
|
| Rate for Payer: Priority Health Medicare |
$1,318.29
|
| Rate for Payer: Priority Health SBD |
$2,187.04
|
| Rate for Payer: Priority Health Tiered Network |
$2,187.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,318.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,456.34
|
| Rate for Payer: UHC Core |
$2,456.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,318.29
|
| Rate for Payer: UHC Exchange |
$2,456.34
|
| Rate for Payer: UHC Medicaid |
$843.27
|
| Rate for Payer: UHCCP Medicaid |
$843.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,195.16
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 35266
|
| Min. Negotiated Rate |
$502.47 |
| Max. Negotiated Rate |
$1,547.10 |
| Rate for Payer: Aetna Commercial |
$1,061.95
|
| Rate for Payer: Aetna Medicare |
$824.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,061.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.20
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS MAPPO |
$792.50
|
| Rate for Payer: BCN Commercial |
$1,271.84
|
| Rate for Payer: BCN Medicare Advantage |
$792.50
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,061.95
|
| Rate for Payer: Cofinity Commercial |
$1,141.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.12
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$871.75
|
| Rate for Payer: Nomi Health Commercial |
$951.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.25
|
| Rate for Payer: PACE SWMI |
$792.50
|
| Rate for Payer: PHP Commercial |
$1,109.50
|
| Rate for Payer: PHP Medicare Advantage |
$792.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,367.71
|
| Rate for Payer: Priority Health Medicare |
$792.50
|
| Rate for Payer: Priority Health SBD |
$1,367.71
|
| Rate for Payer: Priority Health Tiered Network |
$1,367.71
|
| Rate for Payer: Railroad Medicare Medicare |
$792.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,547.10
|
| Rate for Payer: UHC Core |
$1,547.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$792.50
|
| Rate for Payer: UHC Exchange |
$1,547.10
|
| Rate for Payer: UHC Medicaid |
$502.47
|
| Rate for Payer: UHCCP Medicaid |
$502.47
|
| Rate for Payer: UMR Bronson Commercial |
$849.62
|
|
|
PR RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY
|
Professional
|
Both
|
$3,906.00
|
|
|
Service Code
|
HCPCS 35286
|
| Min. Negotiated Rate |
$536.76 |
| Max. Negotiated Rate |
$2,929.50 |
| Rate for Payer: Aetna Commercial |
$1,136.20
|
| Rate for Payer: Aetna Medicare |
$881.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,220.99
|
| Rate for Payer: BCBS Complete |
$563.60
|
| Rate for Payer: BCBS MAPPO |
$847.91
|
| Rate for Payer: BCN Commercial |
$1,357.50
|
| Rate for Payer: BCN Medicare Advantage |
$847.91
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,136.20
|
| Rate for Payer: Cofinity Commercial |
$1,220.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$847.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.31
|
| Rate for Payer: Meridian Medicaid |
$563.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$932.70
|
| Rate for Payer: Nomi Health Commercial |
$1,017.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,929.50
|
| Rate for Payer: PACE SWMI |
$847.91
|
| Rate for Payer: PHP Commercial |
$1,187.07
|
| Rate for Payer: PHP Medicare Advantage |
$847.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,459.82
|
| Rate for Payer: Priority Health Medicare |
$847.91
|
| Rate for Payer: Priority Health SBD |
$1,459.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,459.82
|
| Rate for Payer: Railroad Medicare Medicare |
$847.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,673.64
|
| Rate for Payer: UHC Core |
$1,673.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$847.91
|
| Rate for Payer: UHC Exchange |
$1,673.64
|
| Rate for Payer: UHC Medicaid |
$536.76
|
| Rate for Payer: UHCCP Medicaid |
$536.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,796.76
|
|
