|
PR PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26727
|
| Min. Negotiated Rate |
$314.18 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$615.03
|
| Rate for Payer: Aetna Medicare |
$477.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.93
|
| Rate for Payer: BCBS Complete |
$329.89
|
| Rate for Payer: BCBS MAPPO |
$458.98
|
| Rate for Payer: BCBS Trust/PPO |
$765.51
|
| Rate for Payer: BCN Commercial |
$706.14
|
| Rate for Payer: BCN Medicare Advantage |
$458.98
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$615.03
|
| Rate for Payer: Cofinity Commercial |
$660.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.93
|
| Rate for Payer: Meridian Medicaid |
$329.89
|
| Rate for Payer: Nomi Health Commercial |
$550.78
|
| Rate for Payer: PACE SWMI |
$458.98
|
| Rate for Payer: PHP Commercial |
$642.57
|
| Rate for Payer: PHP Medicare Advantage |
$458.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.47
|
| Rate for Payer: Priority Health Medicare |
$458.98
|
| Rate for Payer: Priority Health Narrow Network |
$744.47
|
| Rate for Payer: Priority Health SBD |
$744.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.98
|
| Rate for Payer: UHC Medicare Advantage |
$458.98
|
| Rate for Payer: UHCCP Medicaid |
$314.18
|
| Rate for Payer: UMR Bronson Commercial |
$708.40
|
|
|
PR PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$1,014.29
|
| Rate for Payer: Aetna Medicare |
$787.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.98
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$756.93
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: BCN Medicare Advantage |
$756.93
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cofinity Commercial |
$1,014.29
|
| Rate for Payer: Cofinity Commercial |
$1,089.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.78
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Nomi Health Commercial |
$908.32
|
| Rate for Payer: PACE SWMI |
$756.93
|
| Rate for Payer: PHP Commercial |
$1,059.70
|
| Rate for Payer: PHP Medicare Advantage |
$756.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,223.80
|
| Rate for Payer: Priority Health Medicare |
$756.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.80
|
| Rate for Payer: Priority Health SBD |
$1,223.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$756.93
|
| Rate for Payer: UHC Medicare Advantage |
$756.93
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,185.42
|
|
|
PR PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ
|
Professional
|
Both
|
$978.00
|
|
|
Service Code
|
HCPCS 28576
|
| Min. Negotiated Rate |
$258.80 |
| Max. Negotiated Rate |
$1,476.60 |
| Rate for Payer: Aetna Commercial |
$508.18
|
| Rate for Payer: Aetna Medicare |
$394.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.11
|
| Rate for Payer: BCBS Complete |
$271.74
|
| Rate for Payer: BCBS MAPPO |
$379.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.60
|
| Rate for Payer: BCN Commercial |
$572.73
|
| Rate for Payer: BCN Medicare Advantage |
$379.24
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cofinity Commercial |
$508.18
|
| Rate for Payer: Cofinity Commercial |
$546.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.20
|
| Rate for Payer: Meridian Medicaid |
$271.74
|
| Rate for Payer: Nomi Health Commercial |
$455.09
|
| Rate for Payer: PACE SWMI |
$379.24
|
| Rate for Payer: PHP Commercial |
$530.94
|
| Rate for Payer: PHP Medicare Advantage |
$379.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.60
|
| Rate for Payer: Priority Health Medicare |
$379.24
|
| Rate for Payer: Priority Health Narrow Network |
$608.60
|
| Rate for Payer: Priority Health SBD |
$608.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.24
|
| Rate for Payer: UHC Medicare Advantage |
$379.24
|
| Rate for Payer: UHCCP Medicaid |
$258.80
|
| Rate for Payer: UMR Bronson Commercial |
$449.88
|
|
|
PR PRQ SKEL FIXJ TARS JT DISLC W/MANJ
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28606
|
| Min. Negotiated Rate |
$261.99 |
| Max. Negotiated Rate |
$2,188.75 |
| Rate for Payer: Aetna Commercial |
$515.31
|
| Rate for Payer: Aetna Medicare |
$399.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.77
|
| Rate for Payer: BCBS Complete |
$275.09
|
| Rate for Payer: BCBS MAPPO |
$384.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,188.75
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: BCN Medicare Advantage |
$384.56
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$515.31
|
| Rate for Payer: Cofinity Commercial |
$553.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.79
|
| Rate for Payer: Meridian Medicaid |
$275.09
|
| Rate for Payer: Nomi Health Commercial |
$461.47
|
| Rate for Payer: PACE SWMI |
$384.56
|
| Rate for Payer: PHP Commercial |
$538.38
|
| Rate for Payer: PHP Medicare Advantage |
$384.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.63
|
| Rate for Payer: Priority Health Medicare |
$384.56
|
| Rate for Payer: Priority Health Narrow Network |
$610.63
|
| Rate for Payer: Priority Health SBD |
$610.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.56
|
| Rate for Payer: UHC Medicare Advantage |
$384.56
|
| Rate for Payer: UHCCP Medicaid |
$261.99
|
| Rate for Payer: UMR Bronson Commercial |
$619.16
|
|
|
PR PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 28546
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$455.53
|
| Rate for Payer: Aetna Medicare |
$353.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.53
|
| Rate for Payer: BCBS Complete |
$246.02
|
| Rate for Payer: BCBS MAPPO |
$339.95
|
| Rate for Payer: BCBS Trust/PPO |
$938.26
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$339.95
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$455.53
|
| Rate for Payer: Cofinity Commercial |
$489.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.95
|
| Rate for Payer: Meridian Medicaid |
$246.02
|
| Rate for Payer: Nomi Health Commercial |
$407.94
|
| Rate for Payer: PACE SWMI |
$339.95
|
| Rate for Payer: PHP Commercial |
$475.93
|
| Rate for Payer: PHP Medicare Advantage |
$339.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Medicare |
$339.95
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: Priority Health SBD |
$553.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.95
|
| Rate for Payer: UHC Medicare Advantage |
$339.95
|
| Rate for Payer: UHCCP Medicaid |
$234.30
|
| Rate for Payer: UMR Bronson Commercial |
$367.08
|
|
|
PR PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 28456
|
| Min. Negotiated Rate |
$213.44 |
| Max. Negotiated Rate |
$580.11 |
| Rate for Payer: Aetna Commercial |
$469.86
|
| Rate for Payer: Aetna Medicare |
$364.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.92
|
| Rate for Payer: BCBS Complete |
$256.08
|
| Rate for Payer: BCBS MAPPO |
$350.64
|
| Rate for Payer: BCBS Trust/PPO |
$385.66
|
| Rate for Payer: BCN Commercial |
$552.21
|
| Rate for Payer: BCN Medicare Advantage |
$350.64
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$469.86
|
| Rate for Payer: Cofinity Commercial |
$504.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.17
|
| Rate for Payer: Meridian Medicaid |
$256.08
|
| Rate for Payer: Nomi Health Commercial |
$420.77
|
| Rate for Payer: PACE SWMI |
$350.64
|
| Rate for Payer: PHP Commercial |
$490.90
|
| Rate for Payer: PHP Medicare Advantage |
$350.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$243.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.11
|
| Rate for Payer: Priority Health Medicare |
$350.64
|
| Rate for Payer: Priority Health Narrow Network |
$580.11
|
| Rate for Payer: Priority Health SBD |
$580.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.64
|
| Rate for Payer: UHC Medicare Advantage |
$350.64
|
| Rate for Payer: UHCCP Medicaid |
$243.89
|
| Rate for Payer: UMR Bronson Commercial |
$213.44
|
|
|
PR PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 93580
|
| Min. Negotiated Rate |
$222.94 |
| Max. Negotiated Rate |
$1,387.84 |
| Rate for Payer: Aetna Commercial |
$1,241.98
|
| Rate for Payer: Aetna Medicare |
$963.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,334.66
|
| Rate for Payer: BCBS Complete |
$638.53
|
| Rate for Payer: BCBS MAPPO |
$926.85
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$926.85
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,241.98
|
| Rate for Payer: Cofinity Commercial |
$1,334.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$973.19
|
| Rate for Payer: Meridian Medicaid |
$638.53
|
| Rate for Payer: Nomi Health Commercial |
$1,112.22
|
| Rate for Payer: PACE SWMI |
$926.85
|
| Rate for Payer: PHP Commercial |
$1,297.59
|
| Rate for Payer: PHP Medicare Advantage |
$926.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.83
|
| Rate for Payer: Priority Health Medicare |
$926.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.83
|
| Rate for Payer: Priority Health SBD |
$1,342.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$926.85
|
| Rate for Payer: UHC Medicare Advantage |
$926.85
|
| Rate for Payer: UHCCP Medicaid |
$608.12
|
| Rate for Payer: UMR Bronson Commercial |
$944.38
|
|
|
PR PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 37197
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$2,291.90 |
| Rate for Payer: Aetna Commercial |
$382.02
|
| Rate for Payer: Aetna Medicare |
$296.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.53
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$285.09
|
| Rate for Payer: BCBS Trust/PPO |
$922.41
|
| Rate for Payer: BCN Commercial |
$2,291.90
|
| Rate for Payer: BCN Medicare Advantage |
$285.09
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$382.02
|
| Rate for Payer: Cofinity Commercial |
$410.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.34
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Nomi Health Commercial |
$342.11
|
| Rate for Payer: PACE SWMI |
$285.09
|
| Rate for Payer: PHP Commercial |
$399.13
|
| Rate for Payer: PHP Medicare Advantage |
$285.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.88
|
| Rate for Payer: Priority Health Medicare |
$285.09
|
| Rate for Payer: Priority Health Narrow Network |
$465.88
|
| Rate for Payer: Priority Health SBD |
$465.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.09
|
| Rate for Payer: UHC Medicare Advantage |
$285.09
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
| Rate for Payer: UMR Bronson Commercial |
$235.98
|
|
|
PR PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 92973
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$679.90 |
| Rate for Payer: Aetna Commercial |
$224.30
|
| Rate for Payer: Aetna Medicare |
$174.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.04
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$167.39
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$250.20
|
| Rate for Payer: BCN Medicare Advantage |
$167.39
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$224.30
|
| Rate for Payer: Cofinity Commercial |
$241.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.76
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$200.87
|
| Rate for Payer: PACE SWMI |
$167.39
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: PHP Medicare Advantage |
$167.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.48
|
| Rate for Payer: Priority Health Medicare |
$167.39
|
| Rate for Payer: Priority Health Narrow Network |
$242.48
|
| Rate for Payer: Priority Health SBD |
$242.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.39
|
| Rate for Payer: UHC Medicare Advantage |
$167.39
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
| Rate for Payer: UMR Bronson Commercial |
$481.16
|
|
|
PR PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN
|
Professional
|
Both
|
$1,841.00
|
|
|
Service Code
|
HCPCS 37187
|
| Min. Negotiated Rate |
$245.59 |
| Max. Negotiated Rate |
$2,507.41 |
| Rate for Payer: Aetna Commercial |
$499.71
|
| Rate for Payer: Aetna Medicare |
$387.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.00
|
| Rate for Payer: BCBS Complete |
$257.87
|
| Rate for Payer: BCBS MAPPO |
$372.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.98
|
| Rate for Payer: BCN Commercial |
$2,507.41
|
| Rate for Payer: BCN Medicare Advantage |
$372.92
|
| Rate for Payer: Cash Price |
$1,472.80
|
| Rate for Payer: Cash Price |
$1,472.80
|
| Rate for Payer: Cofinity Commercial |
$499.71
|
| Rate for Payer: Cofinity Commercial |
$537.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.57
|
| Rate for Payer: Meridian Medicaid |
$257.87
|
| Rate for Payer: Nomi Health Commercial |
$447.50
|
| Rate for Payer: PACE SWMI |
$372.92
|
| Rate for Payer: PHP Commercial |
$522.09
|
| Rate for Payer: PHP Medicare Advantage |
$372.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.94
|
| Rate for Payer: Priority Health Medicare |
$372.92
|
| Rate for Payer: Priority Health Narrow Network |
$608.94
|
| Rate for Payer: Priority Health SBD |
$608.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.92
|
| Rate for Payer: UHC Medicare Advantage |
$372.92
|
| Rate for Payer: UHCCP Medicaid |
$245.59
|
| Rate for Payer: UMR Bronson Commercial |
$846.86
|
|
|
PR PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH
|
Professional
|
Both
|
$2,550.00
|
|
|
Service Code
|
HCPCS 92924
|
| Min. Negotiated Rate |
$350.79 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$803.80
|
| Rate for Payer: Aetna Medicare |
$623.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.78
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: BCBS MAPPO |
$599.85
|
| Rate for Payer: BCBS Trust/PPO |
$350.79
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$599.85
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$803.80
|
| Rate for Payer: Cofinity Commercial |
$863.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.84
|
| Rate for Payer: Meridian Medicaid |
$412.64
|
| Rate for Payer: Nomi Health Commercial |
$719.82
|
| Rate for Payer: PACE SWMI |
$599.85
|
| Rate for Payer: PHP Commercial |
$839.79
|
| Rate for Payer: PHP Medicare Advantage |
$599.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.75
|
| Rate for Payer: Priority Health Medicare |
$599.85
|
| Rate for Payer: Priority Health Narrow Network |
$867.75
|
| Rate for Payer: Priority Health SBD |
$867.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.85
|
| Rate for Payer: UHC Medicare Advantage |
$599.85
|
| Rate for Payer: UHCCP Medicaid |
$392.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,173.00
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 92921
|
| Min. Negotiated Rate |
$203.06 |
| Max. Negotiated Rate |
$700.70 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: Aetna Medicare |
$539.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.69
|
| Rate for Payer: BCBS Complete |
$431.20
|
| Rate for Payer: BCBS Trust/PPO |
$388.83
|
| Rate for Payer: BCN Commercial |
$203.06
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
| Rate for Payer: Priority Health SBD |
$249.00
|
| Rate for Payer: UMR Bronson Commercial |
$495.88
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH
|
Professional
|
Both
|
$1,119.00
|
|
|
Service Code
|
HCPCS 92920
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$3,219.99 |
| Rate for Payer: Aetna Commercial |
$674.85
|
| Rate for Payer: Aetna Medicare |
$523.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.21
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS MAPPO |
$503.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,219.99
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: BCN Medicare Advantage |
$503.62
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$725.21
|
| Rate for Payer: Cofinity Commercial |
$674.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.80
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Nomi Health Commercial |
$604.34
|
| Rate for Payer: PACE SWMI |
$503.62
|
| Rate for Payer: PHP Commercial |
$705.07
|
| Rate for Payer: PHP Medicare Advantage |
$503.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.44
|
| Rate for Payer: Priority Health Medicare |
$503.62
|
| Rate for Payer: Priority Health Narrow Network |
$727.44
|
| Rate for Payer: Priority Health SBD |
$727.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.62
|
| Rate for Payer: UHC Medicare Advantage |
$503.62
|
| Rate for Payer: UHCCP Medicaid |
$329.94
|
| Rate for Payer: UMR Bronson Commercial |
$514.74
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 92938
|
| Min. Negotiated Rate |
$112.40 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$140.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.80
|
| Rate for Payer: BCBS Complete |
$112.40
|
| Rate for Payer: BCBS Trust/PPO |
$151.09
|
| Rate for Payer: BCN Commercial |
$226.15
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
| Rate for Payer: Priority Health SBD |
$249.00
|
| Rate for Payer: UMR Bronson Commercial |
$129.26
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 92937
|
| Min. Negotiated Rate |
$146.34 |
| Max. Negotiated Rate |
$837.60 |
| Rate for Payer: Aetna Commercial |
$749.23
|
| Rate for Payer: Aetna Medicare |
$581.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.15
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$559.13
|
| Rate for Payer: BCBS Trust/PPO |
$146.34
|
| Rate for Payer: BCN Commercial |
$837.60
|
| Rate for Payer: BCN Medicare Advantage |
$559.13
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$805.15
|
| Rate for Payer: Cofinity Commercial |
$749.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.09
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Nomi Health Commercial |
$670.96
|
| Rate for Payer: PACE SWMI |
$559.13
|
| Rate for Payer: PHP Commercial |
$782.78
|
| Rate for Payer: PHP Medicare Advantage |
$559.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.36
|
| Rate for Payer: Priority Health Medicare |
$559.13
|
| Rate for Payer: Priority Health Narrow Network |
$809.36
|
| Rate for Payer: Priority Health SBD |
$809.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$559.13
|
| Rate for Payer: UHC Medicare Advantage |
$559.13
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
| Rate for Payer: UMR Bronson Commercial |
$571.78
|
|
|
PR PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 92934
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Aetna Commercial |
$273.84
|
| Rate for Payer: Aetna Medicare |
$622.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.84
|
| Rate for Payer: BCBS Complete |
$498.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.41
|
| Rate for Payer: BCN Commercial |
$253.73
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.00
|
| Rate for Payer: Priority Health Narrow Network |
$310.00
|
| Rate for Payer: Priority Health SBD |
$310.00
|
| Rate for Payer: UMR Bronson Commercial |
$572.70
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH
|
Professional
|
Both
|
$1,213.00
|
|
|
Service Code
|
HCPCS 92929
|
| Min. Negotiated Rate |
$226.41 |
| Max. Negotiated Rate |
$788.45 |
| Rate for Payer: Aetna Commercial |
$352.65
|
| Rate for Payer: Aetna Medicare |
$606.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.65
|
| Rate for Payer: BCBS Complete |
$485.20
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$226.41
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.00
|
| Rate for Payer: Priority Health Narrow Network |
$275.00
|
| Rate for Payer: Priority Health SBD |
$275.00
|
| Rate for Payer: UMR Bronson Commercial |
$557.98
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 92928
|
| Min. Negotiated Rate |
$334.41 |
| Max. Negotiated Rate |
$838.57 |
| Rate for Payer: Aetna Commercial |
$749.66
|
| Rate for Payer: Aetna Medicare |
$581.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.61
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$559.45
|
| Rate for Payer: BCBS Trust/PPO |
$334.41
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$559.45
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$805.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.42
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Nomi Health Commercial |
$671.34
|
| Rate for Payer: PACE SWMI |
$559.45
|
| Rate for Payer: PHP Commercial |
$783.23
|
| Rate for Payer: PHP Medicare Advantage |
$559.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.36
|
| Rate for Payer: Priority Health Medicare |
$559.45
|
| Rate for Payer: Priority Health Narrow Network |
$809.36
|
| Rate for Payer: Priority Health SBD |
$809.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$559.45
|
| Rate for Payer: UHC Medicare Advantage |
$559.45
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
| Rate for Payer: UMR Bronson Commercial |
$572.24
|
|
|
PR PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL
|
Professional
|
Both
|
$1,392.00
|
|
|
Service Code
|
HCPCS 92943
|
| Min. Negotiated Rate |
$411.94 |
| Max. Negotiated Rate |
$1,794.11 |
| Rate for Payer: Aetna Commercial |
$842.62
|
| Rate for Payer: Aetna Medicare |
$653.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.50
|
| Rate for Payer: BCBS Complete |
$432.54
|
| Rate for Payer: BCBS MAPPO |
$628.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,794.11
|
| Rate for Payer: BCN Commercial |
$941.68
|
| Rate for Payer: BCN Medicare Advantage |
$628.82
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cash Price |
$1,113.60
|
| Rate for Payer: Cofinity Commercial |
$842.62
|
| Rate for Payer: Cofinity Commercial |
$905.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$660.26
|
| Rate for Payer: Meridian Medicaid |
$432.54
|
| Rate for Payer: Nomi Health Commercial |
$754.58
|
| Rate for Payer: PACE SWMI |
$628.82
|
| Rate for Payer: PHP Commercial |
$880.35
|
| Rate for Payer: PHP Medicare Advantage |
$628.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.72
|
| Rate for Payer: Priority Health Medicare |
$628.82
|
| Rate for Payer: Priority Health Narrow Network |
$908.72
|
| Rate for Payer: Priority Health SBD |
$908.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.82
|
| Rate for Payer: UHC Medicare Advantage |
$628.82
|
| Rate for Payer: UHCCP Medicaid |
$411.94
|
| Rate for Payer: UMR Bronson Commercial |
$640.32
|
|
|
PR PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 92933
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$939.73 |
| Rate for Payer: Aetna Commercial |
$841.75
|
| Rate for Payer: Aetna Medicare |
$653.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.56
|
| Rate for Payer: BCBS Complete |
$432.10
|
| Rate for Payer: BCBS MAPPO |
$628.17
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$939.73
|
| Rate for Payer: BCN Medicare Advantage |
$628.17
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$841.75
|
| Rate for Payer: Cofinity Commercial |
$904.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.58
|
| Rate for Payer: Meridian Medicaid |
$432.10
|
| Rate for Payer: Nomi Health Commercial |
$753.80
|
| Rate for Payer: PACE SWMI |
$628.17
|
| Rate for Payer: PHP Commercial |
$879.44
|
| Rate for Payer: PHP Medicare Advantage |
$628.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$907.77
|
| Rate for Payer: Priority Health Medicare |
$628.17
|
| Rate for Payer: Priority Health Narrow Network |
$907.77
|
| Rate for Payer: Priority Health SBD |
$907.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.17
|
| Rate for Payer: UHC Medicare Advantage |
$628.17
|
| Rate for Payer: UHCCP Medicaid |
$411.52
|
| Rate for Payer: UMR Bronson Commercial |
$661.02
|
|
|
PR PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 92941
|
| Min. Negotiated Rate |
$180.15 |
| Max. Negotiated Rate |
$940.71 |
| Rate for Payer: Aetna Commercial |
$842.50
|
| Rate for Payer: Aetna Medicare |
$653.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.37
|
| Rate for Payer: BCBS Complete |
$432.54
|
| Rate for Payer: BCBS MAPPO |
$628.73
|
| Rate for Payer: BCBS Trust/PPO |
$180.15
|
| Rate for Payer: BCN Commercial |
$940.71
|
| Rate for Payer: BCN Medicare Advantage |
$628.73
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cofinity Commercial |
$842.50
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$660.17
|
| Rate for Payer: Meridian Medicaid |
$432.54
|
| Rate for Payer: Nomi Health Commercial |
$754.48
|
| Rate for Payer: PACE SWMI |
$628.73
|
| Rate for Payer: PHP Commercial |
$880.22
|
| Rate for Payer: PHP Medicare Advantage |
$628.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$908.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.72
|
| Rate for Payer: Priority Health Medicare |
$628.73
|
| Rate for Payer: Priority Health Narrow Network |
$908.72
|
| Rate for Payer: Priority Health SBD |
$908.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.73
|
| Rate for Payer: UHC Medicare Advantage |
$628.73
|
| Rate for Payer: UHCCP Medicaid |
$411.94
|
| Rate for Payer: UMR Bronson Commercial |
$643.08
|
|
|
PR PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 37188
|
| Min. Negotiated Rate |
$176.36 |
| Max. Negotiated Rate |
$2,165.33 |
| Rate for Payer: Aetna Commercial |
$359.15
|
| Rate for Payer: Aetna Medicare |
$278.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.95
|
| Rate for Payer: BCBS Complete |
$185.18
|
| Rate for Payer: BCBS MAPPO |
$268.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.28
|
| Rate for Payer: BCN Commercial |
$2,165.33
|
| Rate for Payer: BCN Medicare Advantage |
$268.02
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cofinity Commercial |
$359.15
|
| Rate for Payer: Cofinity Commercial |
$385.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.42
|
| Rate for Payer: Meridian Medicaid |
$185.18
|
| Rate for Payer: Nomi Health Commercial |
$321.62
|
| Rate for Payer: PACE SWMI |
$268.02
|
| Rate for Payer: PHP Commercial |
$375.23
|
| Rate for Payer: PHP Medicare Advantage |
$268.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.56
|
| Rate for Payer: Priority Health Medicare |
$268.02
|
| Rate for Payer: Priority Health Narrow Network |
$435.56
|
| Rate for Payer: Priority Health SBD |
$435.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.02
|
| Rate for Payer: UHC Medicare Advantage |
$268.02
|
| Rate for Payer: UHCCP Medicaid |
$176.36
|
| Rate for Payer: UMR Bronson Commercial |
$249.32
|
|
|
PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF
|
Professional
|
Both
|
$9,458.00
|
|
|
Service Code
|
HCPCS 43116
|
| Min. Negotiated Rate |
$216.60 |
| Max. Negotiated Rate |
$8,719.22 |
| Rate for Payer: Aetna Commercial |
$6,397.70
|
| Rate for Payer: Aetna Medicare |
$4,965.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,397.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,875.14
|
| Rate for Payer: BCBS Complete |
$3,274.24
|
| Rate for Payer: BCBS MAPPO |
$4,774.40
|
| Rate for Payer: BCBS Trust/PPO |
$216.60
|
| Rate for Payer: BCN Commercial |
$7,124.91
|
| Rate for Payer: BCN Medicare Advantage |
$4,774.40
|
| Rate for Payer: Cash Price |
$7,566.40
|
| Rate for Payer: Cash Price |
$7,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,397.70
|
| Rate for Payer: Cofinity Commercial |
$6,875.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,774.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,013.12
|
| Rate for Payer: Meridian Medicaid |
$3,274.24
|
| Rate for Payer: Nomi Health Commercial |
$5,729.28
|
| Rate for Payer: PACE SWMI |
$4,774.40
|
| Rate for Payer: PHP Commercial |
$6,684.16
|
| Rate for Payer: PHP Medicare Advantage |
$4,774.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,118.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,719.22
|
| Rate for Payer: Priority Health Medicare |
$4,774.40
|
| Rate for Payer: Priority Health Narrow Network |
$8,719.22
|
| Rate for Payer: Priority Health SBD |
$8,719.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,774.40
|
| Rate for Payer: UHC Medicare Advantage |
$4,774.40
|
| Rate for Payer: UHCCP Medicaid |
$3,118.32
|
| Rate for Payer: UMR Bronson Commercial |
$4,350.68
|
|
|
PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY
|
Professional
|
Both
|
$6,010.00
|
|
|
Service Code
|
HCPCS 43121
|
| Min. Negotiated Rate |
$86.60 |
| Max. Negotiated Rate |
$5,034.65 |
| Rate for Payer: Aetna Commercial |
$3,681.72
|
| Rate for Payer: Aetna Medicare |
$2,857.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,681.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,956.47
|
| Rate for Payer: BCBS Complete |
$1,892.08
|
| Rate for Payer: BCBS MAPPO |
$2,747.55
|
| Rate for Payer: BCBS Trust/PPO |
$86.60
|
| Rate for Payer: BCN Commercial |
$4,105.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,747.55
|
| Rate for Payer: Cash Price |
$4,808.00
|
| Rate for Payer: Cash Price |
$4,808.00
|
| Rate for Payer: Cofinity Commercial |
$3,681.72
|
| Rate for Payer: Cofinity Commercial |
$3,956.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,747.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,884.93
|
| Rate for Payer: Meridian Medicaid |
$1,892.08
|
| Rate for Payer: Nomi Health Commercial |
$3,297.06
|
| Rate for Payer: PACE SWMI |
$2,747.55
|
| Rate for Payer: PHP Commercial |
$3,846.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,747.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,801.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,906.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,034.65
|
| Rate for Payer: Priority Health Medicare |
$2,747.55
|
| Rate for Payer: Priority Health Narrow Network |
$5,034.65
|
| Rate for Payer: Priority Health SBD |
$5,034.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,747.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,747.55
|
| Rate for Payer: UHCCP Medicaid |
$1,801.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,764.60
|
|
|
PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY
|
Professional
|
Both
|
$6,334.00
|
|
|
Service Code
|
HCPCS 43117
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$5,746.98 |
| Rate for Payer: Aetna Commercial |
$4,197.64
|
| Rate for Payer: Aetna Medicare |
$3,257.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,510.90
|
| Rate for Payer: BCBS Complete |
$2,161.58
|
| Rate for Payer: BCBS MAPPO |
$3,132.57
|
| Rate for Payer: BCBS Trust/PPO |
$147.40
|
| Rate for Payer: BCN Commercial |
$4,684.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,132.57
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cofinity Commercial |
$4,197.64
|
| Rate for Payer: Cofinity Commercial |
$4,510.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,289.20
|
| Rate for Payer: Meridian Medicaid |
$2,161.58
|
| Rate for Payer: Nomi Health Commercial |
$3,759.08
|
| Rate for Payer: PACE SWMI |
$3,132.57
|
| Rate for Payer: PHP Commercial |
$4,385.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,058.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,117.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,746.98
|
| Rate for Payer: Priority Health Medicare |
$3,132.57
|
| Rate for Payer: Priority Health Narrow Network |
$5,746.98
|
| Rate for Payer: Priority Health SBD |
$5,746.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,132.57
|
| Rate for Payer: UHC Medicare Advantage |
$3,132.57
|
| Rate for Payer: UHCCP Medicaid |
$2,058.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,913.64
|
|
