|
PR PVB THORACIC CONT CATHETER INFUSION W/IMG GID
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 64463
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$788.75 |
| Rate for Payer: Aetna Commercial |
$104.71
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.71
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$788.75
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Cofinity Commercial |
$104.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$93.77
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$109.40
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.06
|
| Rate for Payer: Priority Health Medicare |
$78.14
|
| Rate for Payer: Priority Health Narrow Network |
$137.06
|
| Rate for Payer: Priority Health SBD |
$137.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.14
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
| Rate for Payer: UMR Bronson Commercial |
$145.82
|
|
|
PR PYELOPLASTY COMPLICATED
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 50405
|
| Min. Negotiated Rate |
$888.00 |
| Max. Negotiated Rate |
$2,206.56 |
| Rate for Payer: Aetna Commercial |
$1,781.38
|
| Rate for Payer: Aetna Medicare |
$1,382.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,914.32
|
| Rate for Payer: BCBS Complete |
$932.40
|
| Rate for Payer: BCBS MAPPO |
$1,329.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,085.73
|
| Rate for Payer: BCN Commercial |
$2,003.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,329.39
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,781.38
|
| Rate for Payer: Cofinity Commercial |
$1,914.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,329.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,395.86
|
| Rate for Payer: Meridian Medicaid |
$932.40
|
| Rate for Payer: Nomi Health Commercial |
$1,595.27
|
| Rate for Payer: PACE SWMI |
$1,329.39
|
| Rate for Payer: PHP Commercial |
$1,861.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,329.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,206.56
|
| Rate for Payer: Priority Health Medicare |
$1,329.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,206.56
|
| Rate for Payer: Priority Health SBD |
$2,206.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,329.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,329.39
|
| Rate for Payer: UHCCP Medicaid |
$888.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,227.28
|
|
|
PR PYELOPLASTY SIMPLE
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 50400
|
| Min. Negotiated Rate |
$736.13 |
| Max. Negotiated Rate |
$2,368.90 |
| Rate for Payer: Aetna Commercial |
$1,475.78
|
| Rate for Payer: Aetna Medicare |
$1,145.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,475.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.92
|
| Rate for Payer: BCBS Complete |
$772.94
|
| Rate for Payer: BCBS MAPPO |
$1,101.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,368.90
|
| Rate for Payer: BCN Commercial |
$1,659.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.33
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,475.78
|
| Rate for Payer: Cofinity Commercial |
$1,585.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,156.40
|
| Rate for Payer: Meridian Medicaid |
$772.94
|
| Rate for Payer: Nomi Health Commercial |
$1,321.60
|
| Rate for Payer: PACE SWMI |
$1,101.33
|
| Rate for Payer: PHP Commercial |
$1,541.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,829.49
|
| Rate for Payer: Priority Health Medicare |
$1,101.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,829.49
|
| Rate for Payer: Priority Health SBD |
$1,829.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,101.33
|
| Rate for Payer: UHCCP Medicaid |
$736.13
|
| Rate for Payer: UMR Bronson Commercial |
$825.70
|
|
|
PR PYLOROMYOTOMY CUTTING PYLORIC MUSC
|
Professional
|
Both
|
$2,256.00
|
|
|
Service Code
|
HCPCS 43520
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,466.40 |
| Rate for Payer: Aetna Commercial |
$930.47
|
| Rate for Payer: Aetna Medicare |
$722.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$930.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.91
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$694.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.39
|
| Rate for Payer: BCN Commercial |
$1,007.65
|
| Rate for Payer: BCN Medicare Advantage |
$694.38
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cofinity Commercial |
$930.47
|
| Rate for Payer: Cofinity Commercial |
$999.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.10
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Nomi Health Commercial |
$833.26
|
| Rate for Payer: PACE SWMI |
$694.38
|
| Rate for Payer: PHP Commercial |
$972.13
|
| Rate for Payer: PHP Medicare Advantage |
$694.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,240.92
|
| Rate for Payer: Priority Health Medicare |
$694.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.92
|
| Rate for Payer: Priority Health SBD |
$1,240.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.38
|
| Rate for Payer: UHC Medicare Advantage |
$694.38
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,037.76
|
|
|
PR PYLOROPLASTY
|
Professional
|
Both
|
$2,557.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$598.32 |
| Max. Negotiated Rate |
$1,667.49 |
| Rate for Payer: Aetna Commercial |
$1,212.20
|
| Rate for Payer: Aetna Medicare |
$940.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.67
|
| Rate for Payer: BCBS Complete |
$628.24
|
| Rate for Payer: BCBS MAPPO |
$904.63
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$1,357.06
|
| Rate for Payer: BCN Medicare Advantage |
$904.63
|
| Rate for Payer: Cash Price |
$2,045.60
|
| Rate for Payer: Cash Price |
$2,045.60
|
| Rate for Payer: Cofinity Commercial |
$1,212.20
|
| Rate for Payer: Cofinity Commercial |
$1,302.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.86
|
| Rate for Payer: Meridian Medicaid |
$628.24
|
| Rate for Payer: Nomi Health Commercial |
$1,085.56
|
| Rate for Payer: PACE SWMI |
$904.63
|
| Rate for Payer: PHP Commercial |
$1,266.48
|
| Rate for Payer: PHP Medicare Advantage |
$904.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,667.49
|
| Rate for Payer: Priority Health Medicare |
$904.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,667.49
|
| Rate for Payer: Priority Health SBD |
$1,667.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.63
|
| Rate for Payer: UHC Medicare Advantage |
$904.63
|
| Rate for Payer: UHCCP Medicaid |
$598.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,176.22
|
|
|
PR QUADRICEPSPLASTY
|
Professional
|
Both
|
$2,049.00
|
|
|
Service Code
|
HCPCS 27430
|
| Min. Negotiated Rate |
$484.36 |
| Max. Negotiated Rate |
$1,331.85 |
| Rate for Payer: Aetna Commercial |
$960.51
|
| Rate for Payer: Aetna Medicare |
$745.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.51
|
| Rate for Payer: BCBS Complete |
$508.58
|
| Rate for Payer: BCBS MAPPO |
$716.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,093.66
|
| Rate for Payer: BCN Medicare Advantage |
$716.80
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cofinity Commercial |
$960.51
|
| Rate for Payer: Cofinity Commercial |
$1,032.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.64
|
| Rate for Payer: Meridian Medicaid |
$508.58
|
| Rate for Payer: Nomi Health Commercial |
$860.16
|
| Rate for Payer: PACE SWMI |
$716.80
|
| Rate for Payer: PHP Commercial |
$1,003.52
|
| Rate for Payer: PHP Medicare Advantage |
$716.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,149.51
|
| Rate for Payer: Priority Health Medicare |
$716.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.51
|
| Rate for Payer: Priority Health SBD |
$1,149.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.80
|
| Rate for Payer: UHC Medicare Advantage |
$716.80
|
| Rate for Payer: UHCCP Medicaid |
$484.36
|
| Rate for Payer: UMR Bronson Commercial |
$942.54
|
|
|
PR QUAL NONMD EST PT 11-20M
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2062
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$24.64 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.64
|
| Rate for Payer: Priority Health Narrow Network |
$24.64
|
| Rate for Payer: Priority Health SBD |
$24.64
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR QUAL NONMD EST PT 21>MIN
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2063
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$38.19 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.19
|
| Rate for Payer: Priority Health Narrow Network |
$38.19
|
| Rate for Payer: Priority Health SBD |
$38.19
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR QUAL NONMD EST PT 5-10M
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2061
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.96
|
| Rate for Payer: Priority Health Narrow Network |
$13.96
|
| Rate for Payer: Priority Health SBD |
$13.96
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 90375
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$383.67 |
| Rate for Payer: Aetna Commercial |
$357.02
|
| Rate for Payer: Aetna Medicare |
$277.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.02
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: BCBS MAPPO |
$266.44
|
| Rate for Payer: BCBS Trust/PPO |
$298.09
|
| Rate for Payer: BCN Commercial |
$345.60
|
| Rate for Payer: BCN Medicare Advantage |
$266.44
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$383.67
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.76
|
| Rate for Payer: Nomi Health Commercial |
$319.72
|
| Rate for Payer: PACE SWMI |
$266.44
|
| Rate for Payer: PHP Commercial |
$373.01
|
| Rate for Payer: PHP Medicare Advantage |
$266.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health Medicare |
$266.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.44
|
| Rate for Payer: UHC Medicare Advantage |
$266.44
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
|
|
PR RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 90675
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$449.32 |
| Rate for Payer: Aetna Commercial |
$418.12
|
| Rate for Payer: Aetna Medicare |
$324.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.32
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$312.03
|
| Rate for Payer: BCBS Trust/PPO |
$345.74
|
| Rate for Payer: BCN Commercial |
$364.50
|
| Rate for Payer: BCN Medicare Advantage |
$312.03
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$418.12
|
| Rate for Payer: Cofinity Commercial |
$449.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$374.44
|
| Rate for Payer: PACE SWMI |
$312.03
|
| Rate for Payer: PHP Commercial |
$436.84
|
| Rate for Payer: PHP Medicare Advantage |
$312.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health Medicare |
$312.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.03
|
| Rate for Payer: UHC Medicare Advantage |
$312.03
|
| Rate for Payer: UMR Bronson Commercial |
$95.68
|
|
|
PR RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY
|
Professional
|
Both
|
$6,028.00
|
|
|
Service Code
|
HCPCS 58210
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$3,918.20 |
| Rate for Payer: Aetna Commercial |
$2,344.97
|
| Rate for Payer: Aetna Medicare |
$1,819.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,519.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.97
|
| Rate for Payer: BCBS Complete |
$1,227.39
|
| Rate for Payer: BCBS MAPPO |
$1,749.98
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$2,658.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,749.98
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cofinity Commercial |
$2,344.97
|
| Rate for Payer: Cofinity Commercial |
$2,519.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,749.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,837.48
|
| Rate for Payer: Meridian Medicaid |
$1,227.39
|
| Rate for Payer: Nomi Health Commercial |
$2,099.98
|
| Rate for Payer: PACE SWMI |
$1,749.98
|
| Rate for Payer: PHP Commercial |
$2,449.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,749.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,168.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,918.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,719.82
|
| Rate for Payer: Priority Health Medicare |
$1,749.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,719.82
|
| Rate for Payer: Priority Health SBD |
$2,719.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,749.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,749.98
|
| Rate for Payer: UHCCP Medicaid |
$1,168.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,772.88
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS
|
Professional
|
Both
|
$2,719.00
|
|
|
Service Code
|
HCPCS 25115
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$1,767.35 |
| Rate for Payer: Aetna Commercial |
$982.01
|
| Rate for Payer: Aetna Medicare |
$762.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.01
|
| Rate for Payer: BCBS Complete |
$522.00
|
| Rate for Payer: BCBS MAPPO |
$732.84
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$1,116.14
|
| Rate for Payer: BCN Medicare Advantage |
$732.84
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cofinity Commercial |
$1,055.29
|
| Rate for Payer: Cofinity Commercial |
$982.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.48
|
| Rate for Payer: Meridian Medicaid |
$522.00
|
| Rate for Payer: Nomi Health Commercial |
$879.41
|
| Rate for Payer: PACE SWMI |
$732.84
|
| Rate for Payer: PHP Commercial |
$1,025.98
|
| Rate for Payer: PHP Medicare Advantage |
$732.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,767.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,173.43
|
| Rate for Payer: Priority Health Medicare |
$732.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,173.43
|
| Rate for Payer: Priority Health SBD |
$1,173.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.84
|
| Rate for Payer: UHC Medicare Advantage |
$732.84
|
| Rate for Payer: UHCCP Medicaid |
$497.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,250.74
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS
|
Professional
|
Both
|
$2,330.00
|
|
|
Service Code
|
HCPCS 25116
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$1,514.50 |
| Rate for Payer: Aetna Commercial |
$783.97
|
| Rate for Payer: Aetna Medicare |
$608.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.47
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$585.05
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: BCN Medicare Advantage |
$585.05
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cofinity Commercial |
$783.97
|
| Rate for Payer: Cofinity Commercial |
$842.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.30
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$702.06
|
| Rate for Payer: PACE SWMI |
$585.05
|
| Rate for Payer: PHP Commercial |
$819.07
|
| Rate for Payer: PHP Medicare Advantage |
$585.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$941.90
|
| Rate for Payer: Priority Health Medicare |
$585.05
|
| Rate for Payer: Priority Health Narrow Network |
$941.90
|
| Rate for Payer: Priority Health SBD |
$941.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.05
|
| Rate for Payer: UHC Medicare Advantage |
$585.05
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.80
|
|
|
PR RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 69150
|
| Min. Negotiated Rate |
$642.41 |
| Max. Negotiated Rate |
$2,143.84 |
| Rate for Payer: Aetna Commercial |
$1,266.35
|
| Rate for Payer: Aetna Medicare |
$982.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,360.86
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: BCBS MAPPO |
$945.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,143.84
|
| Rate for Payer: BCN Commercial |
$1,486.07
|
| Rate for Payer: BCN Medicare Advantage |
$945.04
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,266.35
|
| Rate for Payer: Cofinity Commercial |
$1,360.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.29
|
| Rate for Payer: Meridian Medicaid |
$674.53
|
| Rate for Payer: Nomi Health Commercial |
$1,134.05
|
| Rate for Payer: PACE SWMI |
$945.04
|
| Rate for Payer: PHP Commercial |
$1,323.06
|
| Rate for Payer: PHP Medicare Advantage |
$945.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,474.69
|
| Rate for Payer: Priority Health Medicare |
$945.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,474.69
|
| Rate for Payer: Priority Health SBD |
$1,474.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.04
|
| Rate for Payer: UHC Medicare Advantage |
$945.04
|
| Rate for Payer: UHCCP Medicaid |
$642.41
|
| Rate for Payer: UMR Bronson Commercial |
$874.92
|
|
|
PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 42844
|
| Min. Negotiated Rate |
$526.72 |
| Max. Negotiated Rate |
$2,462.15 |
| Rate for Payer: Aetna Commercial |
$1,725.81
|
| Rate for Payer: Aetna Medicare |
$1,339.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,725.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,854.60
|
| Rate for Payer: BCBS Complete |
$922.11
|
| Rate for Payer: BCBS MAPPO |
$1,287.92
|
| Rate for Payer: BCBS Trust/PPO |
$526.72
|
| Rate for Payer: BCN Commercial |
$2,018.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,287.92
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cofinity Commercial |
$1,725.81
|
| Rate for Payer: Cofinity Commercial |
$1,854.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,287.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,352.32
|
| Rate for Payer: Meridian Medicaid |
$922.11
|
| Rate for Payer: Nomi Health Commercial |
$1,545.50
|
| Rate for Payer: PACE SWMI |
$1,287.92
|
| Rate for Payer: PHP Commercial |
$1,803.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,287.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,462.15
|
| Rate for Payer: Priority Health Medicare |
$1,287.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,462.15
|
| Rate for Payer: Priority Health SBD |
$2,462.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,287.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,287.92
|
| Rate for Payer: UHCCP Medicaid |
$878.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,398.40
|
|
|
PR RADICAL RESECTION STERNUM
|
Professional
|
Both
|
$2,674.00
|
|
|
Service Code
|
HCPCS 21630
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,006.44 |
| Rate for Payer: Aetna Commercial |
$1,684.51
|
| Rate for Payer: Aetna Medicare |
$1,307.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,684.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,810.22
|
| Rate for Payer: BCBS Complete |
$889.68
|
| Rate for Payer: BCBS MAPPO |
$1,257.10
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,920.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.10
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,684.51
|
| Rate for Payer: Cofinity Commercial |
$1,810.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.96
|
| Rate for Payer: Meridian Medicaid |
$889.68
|
| Rate for Payer: Nomi Health Commercial |
$1,508.52
|
| Rate for Payer: PACE SWMI |
$1,257.10
|
| Rate for Payer: PHP Commercial |
$1,759.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.44
|
| Rate for Payer: Priority Health Medicare |
$1,257.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,006.44
|
| Rate for Payer: Priority Health SBD |
$2,006.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.10
|
| Rate for Payer: UHCCP Medicaid |
$847.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,230.04
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$645.39 |
| Max. Negotiated Rate |
$1,810.67 |
| Rate for Payer: Aetna Commercial |
$1,264.06
|
| Rate for Payer: Aetna Medicare |
$981.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,264.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,358.40
|
| Rate for Payer: BCBS Complete |
$677.66
|
| Rate for Payer: BCBS MAPPO |
$943.33
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$1,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$943.33
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,264.06
|
| Rate for Payer: Cofinity Commercial |
$1,358.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$990.50
|
| Rate for Payer: Meridian Medicaid |
$677.66
|
| Rate for Payer: Nomi Health Commercial |
$1,132.00
|
| Rate for Payer: PACE SWMI |
$943.33
|
| Rate for Payer: PHP Commercial |
$1,320.66
|
| Rate for Payer: PHP Medicare Advantage |
$943.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.67
|
| Rate for Payer: Priority Health Medicare |
$943.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,810.67
|
| Rate for Payer: Priority Health SBD |
$1,810.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.33
|
| Rate for Payer: UHC Medicare Advantage |
$943.33
|
| Rate for Payer: UHCCP Medicaid |
$645.39
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$2,630.00
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$42.87 |
| Max. Negotiated Rate |
$2,302.60 |
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Aetna Commercial |
$1,941.97
|
| Rate for Payer: Aetna Medicare |
$1,507.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,941.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,086.89
|
| Rate for Payer: BCBS Complete |
$1,020.52
|
| Rate for Payer: BCBS MAPPO |
$1,449.23
|
| Rate for Payer: BCBS Trust/PPO |
$42.87
|
| Rate for Payer: BCN Commercial |
$2,197.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,449.23
|
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Cofinity Commercial |
$1,941.97
|
| Rate for Payer: Cofinity Commercial |
$2,086.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,449.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,521.69
|
| Rate for Payer: Meridian Medicaid |
$1,020.52
|
| Rate for Payer: Nomi Health Commercial |
$1,739.08
|
| Rate for Payer: PACE SWMI |
$1,449.23
|
| Rate for Payer: PHP Commercial |
$2,028.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,449.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$971.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,709.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,302.60
|
| Rate for Payer: Priority Health Medicare |
$1,449.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,302.60
|
| Rate for Payer: Priority Health SBD |
$2,302.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,449.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,449.23
|
| Rate for Payer: UHCCP Medicaid |
$971.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,209.80
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$5,511.00
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,321.03 |
| Max. Negotiated Rate |
$3,832.29 |
| Rate for Payer: Aetna Commercial |
$2,648.39
|
| Rate for Payer: Aetna Medicare |
$2,055.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,648.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,846.03
|
| Rate for Payer: BCBS Complete |
$1,387.08
|
| Rate for Payer: BCBS MAPPO |
$1,976.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,832.29
|
| Rate for Payer: BCN Commercial |
$2,988.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,976.41
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cofinity Commercial |
$2,648.39
|
| Rate for Payer: Cofinity Commercial |
$2,846.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,976.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,075.23
|
| Rate for Payer: Meridian Medicaid |
$1,387.08
|
| Rate for Payer: Nomi Health Commercial |
$2,371.69
|
| Rate for Payer: PACE SWMI |
$1,976.41
|
| Rate for Payer: PHP Commercial |
$2,766.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,976.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,321.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,129.49
|
| Rate for Payer: Priority Health Medicare |
$1,976.41
|
| Rate for Payer: Priority Health Narrow Network |
$3,129.49
|
| Rate for Payer: Priority Health SBD |
$3,129.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,976.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,976.41
|
| Rate for Payer: UHCCP Medicaid |
$1,321.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,535.06
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$3,029.00
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$1,968.85 |
| Rate for Payer: Aetna Commercial |
$1,377.31
|
| Rate for Payer: Aetna Medicare |
$1,068.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,480.09
|
| Rate for Payer: BCBS Complete |
$726.86
|
| Rate for Payer: BCBS MAPPO |
$1,027.84
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$1,561.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.84
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Cofinity Commercial |
$1,377.31
|
| Rate for Payer: Cofinity Commercial |
$1,480.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,079.23
|
| Rate for Payer: Meridian Medicaid |
$726.86
|
| Rate for Payer: Nomi Health Commercial |
$1,233.41
|
| Rate for Payer: PACE SWMI |
$1,027.84
|
| Rate for Payer: PHP Commercial |
$1,438.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.06
|
| Rate for Payer: Priority Health Medicare |
$1,027.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,640.06
|
| Rate for Payer: Priority Health SBD |
$1,640.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.84
|
| Rate for Payer: UHCCP Medicaid |
$692.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.34
|
|
|
PR RADICAL RESECTION TUMOR METATARSAL
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 28173
|
| Min. Negotiated Rate |
$466.04 |
| Max. Negotiated Rate |
$1,110.49 |
| Rate for Payer: Aetna Commercial |
$931.31
|
| Rate for Payer: Aetna Medicare |
$722.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.31
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS MAPPO |
$695.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: BCN Commercial |
$1,049.68
|
| Rate for Payer: BCN Medicare Advantage |
$695.01
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cofinity Commercial |
$1,000.81
|
| Rate for Payer: Cofinity Commercial |
$931.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.76
|
| Rate for Payer: Meridian Medicaid |
$489.34
|
| Rate for Payer: Nomi Health Commercial |
$834.01
|
| Rate for Payer: PACE SWMI |
$695.01
|
| Rate for Payer: PHP Commercial |
$973.01
|
| Rate for Payer: PHP Medicare Advantage |
$695.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$896.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,106.77
|
| Rate for Payer: Priority Health Medicare |
$695.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,106.77
|
| Rate for Payer: Priority Health SBD |
$1,106.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.01
|
| Rate for Payer: UHC Medicare Advantage |
$695.01
|
| Rate for Payer: UHCCP Medicaid |
$466.04
|
| Rate for Payer: UMR Bronson Commercial |
$634.34
|
|
|
PR RADICAL RESECTION TUMOR RADIUS OR ULNA
|
Professional
|
Both
|
$2,595.00
|
|
|
Service Code
|
HCPCS 25170
|
| Min. Negotiated Rate |
$542.04 |
| Max. Negotiated Rate |
$2,246.11 |
| Rate for Payer: Aetna Commercial |
$1,893.89
|
| Rate for Payer: Aetna Medicare |
$1,469.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,893.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,035.22
|
| Rate for Payer: BCBS Complete |
$995.02
|
| Rate for Payer: BCBS MAPPO |
$1,413.35
|
| Rate for Payer: BCBS Trust/PPO |
$542.04
|
| Rate for Payer: BCN Commercial |
$2,143.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.35
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Cofinity Commercial |
$1,893.89
|
| Rate for Payer: Cofinity Commercial |
$2,035.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.02
|
| Rate for Payer: Meridian Medicaid |
$995.02
|
| Rate for Payer: Nomi Health Commercial |
$1,696.02
|
| Rate for Payer: PACE SWMI |
$1,413.35
|
| Rate for Payer: PHP Commercial |
$1,978.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$947.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,686.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,246.11
|
| Rate for Payer: Priority Health Medicare |
$1,413.35
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.11
|
| Rate for Payer: Priority Health SBD |
$2,246.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,413.35
|
| Rate for Payer: UHCCP Medicaid |
$947.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,193.70
|
|
|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,314.00
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$145.81 |
| Max. Negotiated Rate |
$2,362.64 |
| Rate for Payer: Aetna Commercial |
$1,992.47
|
| Rate for Payer: Aetna Medicare |
$1,546.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,992.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,141.16
|
| Rate for Payer: BCBS Complete |
$1,046.46
|
| Rate for Payer: BCBS MAPPO |
$1,486.92
|
| Rate for Payer: BCBS Trust/PPO |
$145.81
|
| Rate for Payer: BCN Commercial |
$2,253.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,486.92
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cofinity Commercial |
$1,992.47
|
| Rate for Payer: Cofinity Commercial |
$2,141.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,486.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,561.27
|
| Rate for Payer: Meridian Medicaid |
$1,046.46
|
| Rate for Payer: Nomi Health Commercial |
$1,784.30
|
| Rate for Payer: PACE SWMI |
$1,486.92
|
| Rate for Payer: PHP Commercial |
$2,081.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,486.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,362.64
|
| Rate for Payer: Priority Health Medicare |
$1,486.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,362.64
|
| Rate for Payer: Priority Health SBD |
$2,362.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,486.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.92
|
| Rate for Payer: UHCCP Medicaid |
$996.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,064.44
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,539.00
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$286.91 |
| Max. Negotiated Rate |
$1,572.75 |
| Rate for Payer: Aetna Commercial |
$564.18
|
| Rate for Payer: Aetna Medicare |
$437.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.28
|
| Rate for Payer: BCBS Complete |
$301.26
|
| Rate for Payer: BCBS MAPPO |
$421.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.75
|
| Rate for Payer: BCN Commercial |
$642.61
|
| Rate for Payer: BCN Medicare Advantage |
$421.03
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cofinity Commercial |
$564.18
|
| Rate for Payer: Cofinity Commercial |
$606.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.08
|
| Rate for Payer: Meridian Medicaid |
$301.26
|
| Rate for Payer: Nomi Health Commercial |
$505.24
|
| Rate for Payer: PACE SWMI |
$421.03
|
| Rate for Payer: PHP Commercial |
$589.44
|
| Rate for Payer: PHP Medicare Advantage |
$421.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,000.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$677.30
|
| Rate for Payer: Priority Health Medicare |
$421.03
|
| Rate for Payer: Priority Health Narrow Network |
$677.30
|
| Rate for Payer: Priority Health SBD |
$677.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.03
|
| Rate for Payer: UHC Medicare Advantage |
$421.03
|
| Rate for Payer: UHCCP Medicaid |
$286.91
|
| Rate for Payer: UMR Bronson Commercial |
$707.94
|
|
