|
PR RPR CLOACAL ANOMALY SACROPERINEAL
|
Professional
|
Both
|
$6,780.00
|
|
|
Service Code
|
HCPCS 46744
|
| Min. Negotiated Rate |
$2,107.00 |
| Max. Negotiated Rate |
$6,461.36 |
| Rate for Payer: Aetna Commercial |
$4,414.76
|
| Rate for Payer: Aetna Medicare |
$3,426.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,414.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,744.22
|
| Rate for Payer: BCBS Complete |
$2,212.35
|
| Rate for Payer: BCBS MAPPO |
$3,294.60
|
| Rate for Payer: BCN Commercial |
$5,303.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,294.60
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Cofinity Commercial |
$4,414.76
|
| Rate for Payer: Cofinity Commercial |
$4,744.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,294.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,459.33
|
| Rate for Payer: Meridian Medicaid |
$2,212.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,624.06
|
| Rate for Payer: Nomi Health Commercial |
$3,953.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,085.00
|
| Rate for Payer: PACE SWMI |
$3,294.60
|
| Rate for Payer: PHP Commercial |
$4,612.44
|
| Rate for Payer: PHP Medicare Advantage |
$3,294.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,107.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,461.36
|
| Rate for Payer: Priority Health Medicare |
$3,294.60
|
| Rate for Payer: Priority Health SBD |
$6,461.36
|
| Rate for Payer: Priority Health Tiered Network |
$6,461.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,294.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,312.63
|
| Rate for Payer: UHC Core |
$6,312.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,294.60
|
| Rate for Payer: UHC Exchange |
$6,312.63
|
| Rate for Payer: UHC Medicaid |
$2,107.00
|
| Rate for Payer: UHCCP Medicaid |
$2,107.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,118.80
|
|
|
PR RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26540
|
| Min. Negotiated Rate |
$433.24 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$868.23
|
| Rate for Payer: Aetna Medicare |
$673.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.02
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCBS MAPPO |
$647.93
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: BCN Medicare Advantage |
$647.93
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$868.23
|
| Rate for Payer: Cofinity Commercial |
$933.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.33
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.72
|
| Rate for Payer: Nomi Health Commercial |
$777.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$647.93
|
| Rate for Payer: PHP Commercial |
$907.10
|
| Rate for Payer: PHP Medicare Advantage |
$647.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,130.14
|
| Rate for Payer: Priority Health Medicare |
$647.93
|
| Rate for Payer: Priority Health SBD |
$1,130.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,130.14
|
| Rate for Payer: Railroad Medicare Medicare |
$647.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,151.60
|
| Rate for Payer: UHC Core |
$1,151.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$647.93
|
| Rate for Payer: UHC Exchange |
$1,151.60
|
| Rate for Payer: UHC Medicaid |
$433.24
|
| Rate for Payer: UHCCP Medicaid |
$433.24
|
| Rate for Payer: UMR Bronson Commercial |
$939.32
|
|
|
PR RPR COMPONENT INFLATABLE PENILE PROSTHESIS
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 54408
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,394.51 |
| Rate for Payer: Aetna Commercial |
$948.28
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.28
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$707.67
|
| Rate for Payer: BCN Commercial |
$1,186.69
|
| Rate for Payer: BCN Medicare Advantage |
$707.67
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.04
|
| Rate for Payer: Cofinity Commercial |
$948.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.05
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.44
|
| Rate for Payer: Nomi Health Commercial |
$849.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,162.50
|
| Rate for Payer: PACE SWMI |
$707.67
|
| Rate for Payer: PHP Commercial |
$990.74
|
| Rate for Payer: PHP Medicare Advantage |
$707.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,292.69
|
| Rate for Payer: Priority Health Medicare |
$707.67
|
| Rate for Payer: Priority Health SBD |
$1,292.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,292.69
|
| Rate for Payer: Railroad Medicare Medicare |
$707.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,394.51
|
| Rate for Payer: UHC Core |
$1,394.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.67
|
| Rate for Payer: UHC Exchange |
$1,394.51
|
| Rate for Payer: UHC Medicaid |
$457.95
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
| Rate for Payer: UMR Bronson Commercial |
$713.00
|
|
|
PR RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS
|
Professional
|
Both
|
$5,983.00
|
|
|
Service Code
|
HCPCS 33500
|
| Min. Negotiated Rate |
$948.92 |
| Max. Negotiated Rate |
$4,487.25 |
| Rate for Payer: Aetna Commercial |
$1,989.66
|
| Rate for Payer: Aetna Medicare |
$1,544.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,989.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,138.14
|
| Rate for Payer: BCBS Complete |
$996.37
|
| Rate for Payer: BCBS MAPPO |
$1,484.82
|
| Rate for Payer: BCN Commercial |
$2,294.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.82
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cofinity Commercial |
$1,989.66
|
| Rate for Payer: Cofinity Commercial |
$2,138.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.06
|
| Rate for Payer: Meridian Medicaid |
$996.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,633.30
|
| Rate for Payer: Nomi Health Commercial |
$1,781.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,487.25
|
| Rate for Payer: PACE SWMI |
$1,484.82
|
| Rate for Payer: PHP Commercial |
$2,078.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$948.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,467.11
|
| Rate for Payer: Priority Health Medicare |
$1,484.82
|
| Rate for Payer: Priority Health SBD |
$2,467.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,467.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,484.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.48
|
| Rate for Payer: UHC Core |
$2,779.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,484.82
|
| Rate for Payer: UHC Exchange |
$2,779.48
|
| Rate for Payer: UHC Medicaid |
$948.92
|
| Rate for Payer: UHCCP Medicaid |
$948.92
|
| Rate for Payer: UMR Bronson Commercial |
$2,752.18
|
|
|
PR RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 36576
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$658.50 |
| Rate for Payer: Aetna Commercial |
$225.70
|
| Rate for Payer: Aetna Medicare |
$175.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.54
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$168.43
|
| Rate for Payer: BCN Commercial |
$270.90
|
| Rate for Payer: BCN Medicare Advantage |
$168.43
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$225.70
|
| Rate for Payer: Cofinity Commercial |
$242.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.85
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.27
|
| Rate for Payer: Nomi Health Commercial |
$202.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.50
|
| Rate for Payer: PACE SWMI |
$168.43
|
| Rate for Payer: PHP Commercial |
$235.80
|
| Rate for Payer: PHP Medicare Advantage |
$168.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$291.31
|
| Rate for Payer: Priority Health Medicare |
$168.43
|
| Rate for Payer: Priority Health SBD |
$291.31
|
| Rate for Payer: Priority Health Tiered Network |
$291.31
|
| Rate for Payer: Railroad Medicare Medicare |
$168.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.32
|
| Rate for Payer: UHC Core |
$326.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.43
|
| Rate for Payer: UHC Exchange |
$326.32
|
| Rate for Payer: UHC Medicaid |
$108.84
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
| Rate for Payer: UMR Bronson Commercial |
$403.88
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT
|
Professional
|
Both
|
$6,173.00
|
|
|
Service Code
|
HCPCS 39540
|
| Min. Negotiated Rate |
$521.85 |
| Max. Negotiated Rate |
$4,629.75 |
| Rate for Payer: Aetna Commercial |
$1,091.39
|
| Rate for Payer: Aetna Medicare |
$847.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,172.84
|
| Rate for Payer: BCBS Complete |
$547.94
|
| Rate for Payer: BCBS MAPPO |
$814.47
|
| Rate for Payer: BCN Commercial |
$1,290.77
|
| Rate for Payer: BCN Medicare Advantage |
$814.47
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cofinity Commercial |
$1,091.39
|
| Rate for Payer: Cofinity Commercial |
$1,172.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$814.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$855.19
|
| Rate for Payer: Meridian Medicaid |
$547.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$895.92
|
| Rate for Payer: Nomi Health Commercial |
$977.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,629.75
|
| Rate for Payer: PACE SWMI |
$814.47
|
| Rate for Payer: PHP Commercial |
$1,140.26
|
| Rate for Payer: PHP Medicare Advantage |
$814.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,388.05
|
| Rate for Payer: Priority Health Medicare |
$814.47
|
| Rate for Payer: Priority Health SBD |
$1,388.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,388.05
|
| Rate for Payer: Railroad Medicare Medicare |
$814.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.66
|
| Rate for Payer: UHC Core |
$1,549.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$814.47
|
| Rate for Payer: UHC Exchange |
$1,549.66
|
| Rate for Payer: UHC Medicaid |
$521.85
|
| Rate for Payer: UHCCP Medicaid |
$521.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,839.58
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC
|
Professional
|
Both
|
$1,763.00
|
|
|
Service Code
|
HCPCS 39541
|
| Min. Negotiated Rate |
$566.37 |
| Max. Negotiated Rate |
$1,673.71 |
| Rate for Payer: Aetna Commercial |
$1,184.84
|
| Rate for Payer: Aetna Medicare |
$919.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.26
|
| Rate for Payer: BCBS Complete |
$594.69
|
| Rate for Payer: BCBS MAPPO |
$884.21
|
| Rate for Payer: BCN Commercial |
$1,401.82
|
| Rate for Payer: BCN Medicare Advantage |
$884.21
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cofinity Commercial |
$1,184.84
|
| Rate for Payer: Cofinity Commercial |
$1,273.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.42
|
| Rate for Payer: Meridian Medicaid |
$594.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$972.63
|
| Rate for Payer: Nomi Health Commercial |
$1,061.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,322.25
|
| Rate for Payer: PACE SWMI |
$884.21
|
| Rate for Payer: PHP Commercial |
$1,237.89
|
| Rate for Payer: PHP Medicare Advantage |
$884.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,507.47
|
| Rate for Payer: Priority Health Medicare |
$884.21
|
| Rate for Payer: Priority Health SBD |
$1,507.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,507.47
|
| Rate for Payer: Railroad Medicare Medicare |
$884.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,673.71
|
| Rate for Payer: UHC Core |
$1,673.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$884.21
|
| Rate for Payer: UHC Exchange |
$1,673.71
|
| Rate for Payer: UHC Medicaid |
$566.37
|
| Rate for Payer: UHCCP Medicaid |
$566.37
|
| Rate for Payer: UMR Bronson Commercial |
$810.98
|
|
|
PR RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27675
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$612.39
|
| Rate for Payer: Aetna Medicare |
$475.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.09
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$457.01
|
| Rate for Payer: BCN Commercial |
$756.93
|
| Rate for Payer: BCN Medicare Advantage |
$457.01
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$612.39
|
| Rate for Payer: Cofinity Commercial |
$658.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.86
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.71
|
| Rate for Payer: Nomi Health Commercial |
$548.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$457.01
|
| Rate for Payer: PHP Commercial |
$639.81
|
| Rate for Payer: PHP Medicare Advantage |
$457.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$809.14
|
| Rate for Payer: Priority Health Medicare |
$457.01
|
| Rate for Payer: Priority Health SBD |
$809.14
|
| Rate for Payer: Priority Health Tiered Network |
$809.14
|
| Rate for Payer: Railroad Medicare Medicare |
$457.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$856.81
|
| Rate for Payer: UHC Core |
$856.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.01
|
| Rate for Payer: UHC Exchange |
$856.81
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
| Rate for Payer: UMR Bronson Commercial |
$616.40
|
|
|
PR RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM
|
Professional
|
Both
|
$1,986.00
|
|
|
Service Code
|
HCPCS 63707
|
| Min. Negotiated Rate |
$591.71 |
| Max. Negotiated Rate |
$1,678.51 |
| Rate for Payer: Aetna Commercial |
$1,225.15
|
| Rate for Payer: Aetna Medicare |
$950.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,316.58
|
| Rate for Payer: BCBS Complete |
$621.30
|
| Rate for Payer: BCBS MAPPO |
$914.29
|
| Rate for Payer: BCN Commercial |
$1,587.59
|
| Rate for Payer: BCN Medicare Advantage |
$914.29
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cofinity Commercial |
$1,225.15
|
| Rate for Payer: Cofinity Commercial |
$1,316.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.00
|
| Rate for Payer: Meridian Medicaid |
$621.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,005.72
|
| Rate for Payer: Nomi Health Commercial |
$1,097.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,489.50
|
| Rate for Payer: PACE SWMI |
$914.29
|
| Rate for Payer: PHP Commercial |
$1,280.01
|
| Rate for Payer: PHP Medicare Advantage |
$914.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,678.51
|
| Rate for Payer: Priority Health Medicare |
$914.29
|
| Rate for Payer: Priority Health SBD |
$1,678.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,678.51
|
| Rate for Payer: Railroad Medicare Medicare |
$914.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,628.59
|
| Rate for Payer: UHC Core |
$1,628.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$914.29
|
| Rate for Payer: UHC Exchange |
$1,628.59
|
| Rate for Payer: UHC Medicaid |
$591.71
|
| Rate for Payer: UHCCP Medicaid |
$591.71
|
| Rate for Payer: UMR Bronson Commercial |
$913.56
|
|
|
PR RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM
|
Professional
|
Both
|
$6,209.00
|
|
|
Service Code
|
HCPCS 63709
|
| Min. Negotiated Rate |
$691.82 |
| Max. Negotiated Rate |
$4,656.75 |
| Rate for Payer: Aetna Commercial |
$1,437.22
|
| Rate for Payer: Aetna Medicare |
$1,115.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,544.47
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCBS MAPPO |
$1,072.55
|
| Rate for Payer: BCN Commercial |
$1,866.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.55
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cofinity Commercial |
$1,437.22
|
| Rate for Payer: Cofinity Commercial |
$1,544.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,126.18
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,179.81
|
| Rate for Payer: Nomi Health Commercial |
$1,287.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,656.75
|
| Rate for Payer: PACE SWMI |
$1,072.55
|
| Rate for Payer: PHP Commercial |
$1,501.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,972.91
|
| Rate for Payer: Priority Health Medicare |
$1,072.55
|
| Rate for Payer: Priority Health SBD |
$1,972.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,972.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,072.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,948.56
|
| Rate for Payer: UHC Core |
$1,948.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,072.55
|
| Rate for Payer: UHC Exchange |
$1,948.56
|
| Rate for Payer: UHC Medicaid |
$691.82
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,856.14
|
|
|
PR RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY
|
Professional
|
Both
|
$6,019.00
|
|
|
Service Code
|
HCPCS 62120
|
| Min. Negotiated Rate |
$1,367.67 |
| Max. Negotiated Rate |
$4,514.25 |
| Rate for Payer: Aetna Commercial |
$2,815.14
|
| Rate for Payer: Aetna Medicare |
$2,184.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,815.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,025.22
|
| Rate for Payer: BCBS Complete |
$1,436.05
|
| Rate for Payer: BCBS MAPPO |
$2,100.85
|
| Rate for Payer: BCN Commercial |
$3,146.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,100.85
|
| Rate for Payer: Cash Price |
$4,815.20
|
| Rate for Payer: Cash Price |
$4,815.20
|
| Rate for Payer: Cofinity Commercial |
$2,815.14
|
| Rate for Payer: Cofinity Commercial |
$3,025.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,100.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,205.89
|
| Rate for Payer: Meridian Medicaid |
$1,436.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,310.93
|
| Rate for Payer: Nomi Health Commercial |
$2,521.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,514.25
|
| Rate for Payer: PACE SWMI |
$2,100.85
|
| Rate for Payer: PHP Commercial |
$2,941.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,100.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,367.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,654.30
|
| Rate for Payer: Priority Health Medicare |
$2,100.85
|
| Rate for Payer: Priority Health SBD |
$3,654.30
|
| Rate for Payer: Priority Health Tiered Network |
$3,654.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,100.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.84
|
| Rate for Payer: UHC Core |
$3,662.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,100.85
|
| Rate for Payer: UHC Exchange |
$3,662.84
|
| Rate for Payer: UHC Medicaid |
$1,367.67
|
| Rate for Payer: UHCCP Medicaid |
$1,367.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,768.74
|
|
|
PR RPR EPIGASTRIC HERNIA INCARCERATED
|
Professional
|
Both
|
$1,533.00
|
|
|
Service Code
|
HCPCS 49572
|
| Min. Negotiated Rate |
$613.20 |
| Max. Negotiated Rate |
$1,149.75 |
| Rate for Payer: Aetna Medicare |
$766.50
|
| Rate for Payer: BCBS Complete |
$613.20
|
| Rate for Payer: Cash Price |
$1,226.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,149.75
|
| Rate for Payer: UMR Bronson Commercial |
$705.18
|
|
|
PR RPR EPIGASTRIC HERNIA REDUCIBLE SPX
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 49570
|
| Min. Negotiated Rate |
$482.40 |
| Max. Negotiated Rate |
$904.50 |
| Rate for Payer: Aetna Medicare |
$603.00
|
| Rate for Payer: BCBS Complete |
$482.40
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$904.50
|
| Rate for Payer: UMR Bronson Commercial |
$554.76
|
|
|
PR RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH
|
Professional
|
Both
|
$625.00
|
|
|
Service Code
|
HCPCS 27664
|
| Min. Negotiated Rate |
$219.39 |
| Max. Negotiated Rate |
$625.46 |
| Rate for Payer: Aetna Commercial |
$445.71
|
| Rate for Payer: Aetna Medicare |
$345.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.97
|
| Rate for Payer: BCBS Complete |
$230.36
|
| Rate for Payer: BCBS MAPPO |
$332.62
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: BCN Medicare Advantage |
$332.62
|
| Rate for Payer: Cash Price |
$500.00
|
| Rate for Payer: Cash Price |
$500.00
|
| Rate for Payer: Cofinity Commercial |
$445.71
|
| Rate for Payer: Cofinity Commercial |
$478.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.25
|
| Rate for Payer: Meridian Medicaid |
$230.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.88
|
| Rate for Payer: Nomi Health Commercial |
$399.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.75
|
| Rate for Payer: PACE SWMI |
$332.62
|
| Rate for Payer: PHP Commercial |
$465.67
|
| Rate for Payer: PHP Medicare Advantage |
$332.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$583.44
|
| Rate for Payer: Priority Health Medicare |
$332.62
|
| Rate for Payer: Priority Health SBD |
$583.44
|
| Rate for Payer: Priority Health Tiered Network |
$583.44
|
| Rate for Payer: Railroad Medicare Medicare |
$332.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.46
|
| Rate for Payer: UHC Core |
$625.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.62
|
| Rate for Payer: UHC Exchange |
$625.46
|
| Rate for Payer: UHC Medicaid |
$219.39
|
| Rate for Payer: UHCCP Medicaid |
$219.39
|
| Rate for Payer: UMR Bronson Commercial |
$287.50
|
|
|
PR RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH
|
Professional
|
Both
|
$885.00
|
|
|
Service Code
|
HCPCS 27665
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$720.22 |
| Rate for Payer: Aetna Commercial |
$518.29
|
| Rate for Payer: Aetna Medicare |
$402.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.96
|
| Rate for Payer: BCBS Complete |
$267.49
|
| Rate for Payer: BCBS MAPPO |
$386.78
|
| Rate for Payer: BCN Commercial |
$636.42
|
| Rate for Payer: BCN Medicare Advantage |
$386.78
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$518.29
|
| Rate for Payer: Cofinity Commercial |
$556.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.12
|
| Rate for Payer: Meridian Medicaid |
$267.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.46
|
| Rate for Payer: Nomi Health Commercial |
$464.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.75
|
| Rate for Payer: PACE SWMI |
$386.78
|
| Rate for Payer: PHP Commercial |
$541.49
|
| Rate for Payer: PHP Medicare Advantage |
$386.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$680.32
|
| Rate for Payer: Priority Health Medicare |
$386.78
|
| Rate for Payer: Priority Health SBD |
$680.32
|
| Rate for Payer: Priority Health Tiered Network |
$680.32
|
| Rate for Payer: Railroad Medicare Medicare |
$386.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.22
|
| Rate for Payer: UHC Core |
$720.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$386.78
|
| Rate for Payer: UHC Exchange |
$720.22
|
| Rate for Payer: UHC Medicaid |
$254.75
|
| Rate for Payer: UHCCP Medicaid |
$254.75
|
| Rate for Payer: UMR Bronson Commercial |
$407.10
|
|
|
PR RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 27659
|
| Min. Negotiated Rate |
$284.78 |
| Max. Negotiated Rate |
$840.75 |
| Rate for Payer: Aetna Commercial |
$582.86
|
| Rate for Payer: Aetna Medicare |
$452.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.36
|
| Rate for Payer: BCBS Complete |
$299.02
|
| Rate for Payer: BCBS MAPPO |
$434.97
|
| Rate for Payer: BCN Commercial |
$719.08
|
| Rate for Payer: BCN Medicare Advantage |
$434.97
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cofinity Commercial |
$582.86
|
| Rate for Payer: Cofinity Commercial |
$626.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.72
|
| Rate for Payer: Meridian Medicaid |
$299.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$478.47
|
| Rate for Payer: Nomi Health Commercial |
$521.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$840.75
|
| Rate for Payer: PACE SWMI |
$434.97
|
| Rate for Payer: PHP Commercial |
$608.96
|
| Rate for Payer: PHP Medicare Advantage |
$434.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.68
|
| Rate for Payer: Priority Health Medicare |
$434.97
|
| Rate for Payer: Priority Health SBD |
$768.68
|
| Rate for Payer: Priority Health Tiered Network |
$768.68
|
| Rate for Payer: Railroad Medicare Medicare |
$434.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.64
|
| Rate for Payer: UHC Core |
$820.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$434.97
|
| Rate for Payer: UHC Exchange |
$820.64
|
| Rate for Payer: UHC Medicaid |
$284.78
|
| Rate for Payer: UHCCP Medicaid |
$284.78
|
| Rate for Payer: UMR Bronson Commercial |
$515.66
|
|
|
PR RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$5,724.00
|
|
|
Service Code
|
HCPCS 46740
|
| Min. Negotiated Rate |
$1,321.45 |
| Max. Negotiated Rate |
$4,293.00 |
| Rate for Payer: Aetna Commercial |
$2,749.41
|
| Rate for Payer: Aetna Medicare |
$2,133.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,749.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,954.59
|
| Rate for Payer: BCBS Complete |
$1,387.52
|
| Rate for Payer: BCBS MAPPO |
$2,051.80
|
| Rate for Payer: BCN Commercial |
$3,269.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,051.80
|
| Rate for Payer: Cash Price |
$4,579.20
|
| Rate for Payer: Cash Price |
$4,579.20
|
| Rate for Payer: Cofinity Commercial |
$2,749.41
|
| Rate for Payer: Cofinity Commercial |
$2,954.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,051.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,154.39
|
| Rate for Payer: Meridian Medicaid |
$1,387.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,256.98
|
| Rate for Payer: Nomi Health Commercial |
$2,462.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,293.00
|
| Rate for Payer: PACE SWMI |
$2,051.80
|
| Rate for Payer: PHP Commercial |
$2,872.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,051.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,321.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,983.37
|
| Rate for Payer: Priority Health Medicare |
$2,051.80
|
| Rate for Payer: Priority Health SBD |
$3,983.37
|
| Rate for Payer: Priority Health Tiered Network |
$3,983.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,051.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,830.44
|
| Rate for Payer: UHC Core |
$3,830.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,051.80
|
| Rate for Payer: UHC Exchange |
$3,830.44
|
| Rate for Payer: UHC Medicaid |
$1,321.45
|
| Rate for Payer: UHCCP Medicaid |
$1,321.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,633.04
|
|
|
PR RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL
|
Professional
|
Both
|
$5,301.00
|
|
|
Service Code
|
HCPCS 46742
|
| Min. Negotiated Rate |
$1,514.43 |
| Max. Negotiated Rate |
$4,591.93 |
| Rate for Payer: Aetna Commercial |
$3,159.20
|
| Rate for Payer: Aetna Medicare |
$2,451.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,159.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,394.96
|
| Rate for Payer: BCBS Complete |
$1,590.15
|
| Rate for Payer: BCBS MAPPO |
$2,357.61
|
| Rate for Payer: BCN Commercial |
$3,768.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,357.61
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cofinity Commercial |
$3,159.20
|
| Rate for Payer: Cofinity Commercial |
$3,394.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,357.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,475.49
|
| Rate for Payer: Meridian Medicaid |
$1,590.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,593.37
|
| Rate for Payer: Nomi Health Commercial |
$2,829.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,975.75
|
| Rate for Payer: PACE SWMI |
$2,357.61
|
| Rate for Payer: PHP Commercial |
$3,300.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,357.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,514.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,591.93
|
| Rate for Payer: Priority Health Medicare |
$2,357.61
|
| Rate for Payer: Priority Health SBD |
$4,591.93
|
| Rate for Payer: Priority Health Tiered Network |
$4,591.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,357.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,443.00
|
| Rate for Payer: UHC Core |
$4,443.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,357.61
|
| Rate for Payer: UHC Exchange |
$4,443.00
|
| Rate for Payer: UHC Medicaid |
$1,514.43
|
| Rate for Payer: UHCCP Medicaid |
$1,514.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,438.46
|
|
|
PR RPR HI IMPRF ANUS W/O FISTULA CMBN APPR
|
Professional
|
Both
|
$4,903.00
|
|
|
Service Code
|
HCPCS 46735
|
| Min. Negotiated Rate |
$1,388.33 |
| Max. Negotiated Rate |
$4,198.77 |
| Rate for Payer: Aetna Commercial |
$2,891.76
|
| Rate for Payer: Aetna Medicare |
$2,244.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,891.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,107.56
|
| Rate for Payer: BCBS Complete |
$1,457.75
|
| Rate for Payer: BCBS MAPPO |
$2,158.03
|
| Rate for Payer: BCN Commercial |
$3,446.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,158.03
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Cofinity Commercial |
$2,891.76
|
| Rate for Payer: Cofinity Commercial |
$3,107.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,158.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,265.93
|
| Rate for Payer: Meridian Medicaid |
$1,457.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,373.83
|
| Rate for Payer: Nomi Health Commercial |
$2,589.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,677.25
|
| Rate for Payer: PACE SWMI |
$2,158.03
|
| Rate for Payer: PHP Commercial |
$3,021.24
|
| Rate for Payer: PHP Medicare Advantage |
$2,158.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,388.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,198.77
|
| Rate for Payer: Priority Health Medicare |
$2,158.03
|
| Rate for Payer: Priority Health SBD |
$4,198.77
|
| Rate for Payer: Priority Health Tiered Network |
$4,198.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,158.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,047.66
|
| Rate for Payer: UHC Core |
$4,047.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,158.03
|
| Rate for Payer: UHC Exchange |
$4,047.66
|
| Rate for Payer: UHC Medicaid |
$1,388.33
|
| Rate for Payer: UHCCP Medicaid |
$1,388.33
|
| Rate for Payer: UMR Bronson Commercial |
$2,255.38
|
|
|
PR RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$3,995.00
|
|
|
Service Code
|
HCPCS 46730
|
| Min. Negotiated Rate |
$1,216.44 |
| Max. Negotiated Rate |
$3,653.90 |
| Rate for Payer: Aetna Commercial |
$2,527.40
|
| Rate for Payer: Aetna Medicare |
$1,961.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,527.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,716.01
|
| Rate for Payer: BCBS Complete |
$1,277.26
|
| Rate for Payer: BCBS MAPPO |
$1,886.12
|
| Rate for Payer: BCN Commercial |
$2,998.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,886.12
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Cash Price |
$3,196.00
|
| Rate for Payer: Cofinity Commercial |
$2,527.40
|
| Rate for Payer: Cofinity Commercial |
$2,716.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,886.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,980.43
|
| Rate for Payer: Meridian Medicaid |
$1,277.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,074.73
|
| Rate for Payer: Nomi Health Commercial |
$2,263.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,996.25
|
| Rate for Payer: PACE SWMI |
$1,886.12
|
| Rate for Payer: PHP Commercial |
$2,640.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,886.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,216.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,653.90
|
| Rate for Payer: Priority Health Medicare |
$1,886.12
|
| Rate for Payer: Priority Health SBD |
$3,653.90
|
| Rate for Payer: Priority Health Tiered Network |
$3,653.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,886.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,505.70
|
| Rate for Payer: UHC Core |
$3,505.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,886.12
|
| Rate for Payer: UHC Exchange |
$3,505.70
|
| Rate for Payer: UHC Medicaid |
$1,216.44
|
| Rate for Payer: UHCCP Medicaid |
$1,216.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.70
|
|
|
PR RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 54340
|
| Min. Negotiated Rate |
$332.07 |
| Max. Negotiated Rate |
$1,533.75 |
| Rate for Payer: Aetna Commercial |
$685.73
|
| Rate for Payer: Aetna Medicare |
$532.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: BCBS Complete |
$348.67
|
| Rate for Payer: BCBS MAPPO |
$511.74
|
| Rate for Payer: BCN Commercial |
$855.53
|
| Rate for Payer: BCN Medicare Advantage |
$511.74
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cofinity Commercial |
$685.73
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.33
|
| Rate for Payer: Meridian Medicaid |
$348.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$562.91
|
| Rate for Payer: Nomi Health Commercial |
$614.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: PACE SWMI |
$511.74
|
| Rate for Payer: PHP Commercial |
$716.44
|
| Rate for Payer: PHP Medicare Advantage |
$511.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$931.95
|
| Rate for Payer: Priority Health Medicare |
$511.74
|
| Rate for Payer: Priority Health SBD |
$931.95
|
| Rate for Payer: Priority Health Tiered Network |
$931.95
|
| Rate for Payer: Railroad Medicare Medicare |
$511.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.34
|
| Rate for Payer: UHC Core |
$1,002.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$511.74
|
| Rate for Payer: UHC Exchange |
$1,002.34
|
| Rate for Payer: UHC Medicaid |
$332.07
|
| Rate for Payer: UHCCP Medicaid |
$332.07
|
| Rate for Payer: UMR Bronson Commercial |
$940.70
|
|
|
PR RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR
|
Professional
|
Both
|
$7,774.00
|
|
|
Service Code
|
HCPCS 33660
|
| Min. Negotiated Rate |
$1,046.04 |
| Max. Negotiated Rate |
$5,830.50 |
| Rate for Payer: Aetna Commercial |
$2,203.32
|
| Rate for Payer: Aetna Medicare |
$1,710.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,203.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.75
|
| Rate for Payer: BCBS Complete |
$1,098.34
|
| Rate for Payer: BCBS MAPPO |
$1,644.27
|
| Rate for Payer: BCN Commercial |
$2,582.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,644.27
|
| Rate for Payer: Cash Price |
$6,219.20
|
| Rate for Payer: Cash Price |
$6,219.20
|
| Rate for Payer: Cofinity Commercial |
$2,203.32
|
| Rate for Payer: Cofinity Commercial |
$2,367.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,644.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,726.48
|
| Rate for Payer: Meridian Medicaid |
$1,098.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,808.70
|
| Rate for Payer: Nomi Health Commercial |
$1,973.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,830.50
|
| Rate for Payer: PACE SWMI |
$1,644.27
|
| Rate for Payer: PHP Commercial |
$2,301.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,644.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,777.18
|
| Rate for Payer: Priority Health Medicare |
$1,644.27
|
| Rate for Payer: Priority Health SBD |
$2,777.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,777.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,644.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,131.15
|
| Rate for Payer: UHC Core |
$3,131.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,644.27
|
| Rate for Payer: UHC Exchange |
$3,131.15
|
| Rate for Payer: UHC Medicaid |
$1,046.04
|
| Rate for Payer: UHCCP Medicaid |
$1,046.04
|
| Rate for Payer: UMR Bronson Commercial |
$3,576.04
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
IP
|
$1,685.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$741.40 |
| Max. Negotiated Rate |
$1,516.50 |
| Rate for Payer: Aetna American Axle |
$1,095.25
|
| Rate for Payer: Aetna Commercial |
$1,432.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.25
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cofinity Advantage |
$1,179.50
|
| Rate for Payer: Cofinity Commercial |
$1,449.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,348.00
|
| Rate for Payer: Healthscope Commercial |
$1,516.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,179.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.75
|
| Rate for Payer: PHP Commercial |
$1,432.25
|
| Rate for Payer: Priority Health SBD |
$1,061.55
|
| Rate for Payer: UMR Bronson Commercial |
$741.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.75
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
OP
|
$1,685.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$623.45 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$1,095.25
|
| Rate for Payer: Aetna Commercial |
$1,432.25
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,191.89
|
| Rate for Payer: BCN Commercial |
$3,191.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cofinity Advantage |
$1,179.50
|
| Rate for Payer: Cofinity Commercial |
$1,449.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,348.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,516.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,179.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.75
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.25
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.75
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$1,432.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$1,061.55
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$623.45
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.75
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,685.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,263.75 |
| Rate for Payer: Aetna Commercial |
$734.29
|
| Rate for Payer: Aetna Medicare |
$569.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.09
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$547.98
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$547.98
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Cofinity Commercial |
$734.29
|
| Rate for Payer: Cofinity Commercial |
$789.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.38
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.78
|
| Rate for Payer: Nomi Health Commercial |
$657.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.75
|
| Rate for Payer: PACE SWMI |
$547.98
|
| Rate for Payer: PHP Commercial |
$767.17
|
| Rate for Payer: PHP Medicare Advantage |
$547.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,061.22
|
| Rate for Payer: Priority Health Medicare |
$547.98
|
| Rate for Payer: Priority Health SBD |
$1,061.22
|
| Rate for Payer: Priority Health Tiered Network |
$1,061.22
|
| Rate for Payer: Railroad Medicare Medicare |
$547.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.03
|
| Rate for Payer: UHC Core |
$1,019.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.98
|
| Rate for Payer: UHC Exchange |
$1,019.03
|
| Rate for Payer: UHC Medicaid |
$353.58
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
| Rate for Payer: UMR Bronson Commercial |
$775.10
|
|
