|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Min. Negotiated Rate |
$137.77 |
| Max. Negotiated Rate |
$597.35 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.61
|
| Rate for Payer: BCBS Complete |
$367.60
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Commercial |
$192.88
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health Medicare |
$137.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
IP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$404.36 |
| Max. Negotiated Rate |
$827.10 |
| Rate for Payer: Aetna American Axle |
$597.35
|
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.35
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$643.30
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.15
|
| Rate for Payer: PHP Commercial |
$781.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health SBD |
$578.97
|
| Rate for Payer: UMR Bronson Commercial |
$404.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$137.77 |
| Max. Negotiated Rate |
$597.35 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.61
|
| Rate for Payer: BCBS Complete |
$367.60
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Commercial |
$192.88
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health Medicare |
$137.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
OP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$340.03 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$597.35
|
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Cofinity Commercial |
$643.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.15
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$781.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$578.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$340.03
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL INDWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$1,695.00
|
|
|
Service Code
|
HCPCS 50384
|
| Min. Negotiated Rate |
$214.55 |
| Max. Negotiated Rate |
$1,101.75 |
| Rate for Payer: Aetna Commercial |
$287.50
|
| Rate for Payer: Aetna Medicare |
$223.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.50
|
| Rate for Payer: BCBS Complete |
$678.00
|
| Rate for Payer: BCBS MAPPO |
$214.55
|
| Rate for Payer: BCN Medicare Advantage |
$214.55
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cofinity Commercial |
$308.95
|
| Rate for Payer: Cofinity Commercial |
$287.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.28
|
| Rate for Payer: Nomi Health Commercial |
$257.46
|
| Rate for Payer: PACE SWMI |
$214.55
|
| Rate for Payer: PHP Commercial |
$300.37
|
| Rate for Payer: PHP Medicare Advantage |
$214.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.75
|
| Rate for Payer: Priority Health Medicare |
$214.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.55
|
| Rate for Payer: UHC Medicare Advantage |
$214.55
|
| Rate for Payer: UMR Bronson Commercial |
$779.70
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 19328
|
| Min. Negotiated Rate |
$531.46 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Commercial |
$712.16
|
| Rate for Payer: Aetna Medicare |
$552.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.16
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS MAPPO |
$531.46
|
| Rate for Payer: BCN Medicare Advantage |
$531.46
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$765.30
|
| Rate for Payer: Cofinity Commercial |
$712.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.03
|
| Rate for Payer: Nomi Health Commercial |
$637.75
|
| Rate for Payer: PACE SWMI |
$531.46
|
| Rate for Payer: PHP Commercial |
$744.04
|
| Rate for Payer: PHP Medicare Advantage |
$531.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health Medicare |
$531.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.46
|
| Rate for Payer: UHC Medicare Advantage |
$531.46
|
| Rate for Payer: UMR Bronson Commercial |
$703.80
|
|
|
PR REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 33968
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$62.40 |
| Rate for Payer: Aetna Commercial |
$43.66
|
| Rate for Payer: Aetna Medicare |
$33.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$32.58
|
| Rate for Payer: BCN Medicare Advantage |
$32.58
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.21
|
| Rate for Payer: Nomi Health Commercial |
$39.10
|
| Rate for Payer: PACE SWMI |
$32.58
|
| Rate for Payer: PHP Commercial |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$32.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.58
|
| Rate for Payer: UHC Medicare Advantage |
$32.58
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 20705
|
| Min. Negotiated Rate |
$102.40 |
| Max. Negotiated Rate |
$172.14 |
| Rate for Payer: Aetna Commercial |
$160.18
|
| Rate for Payer: Aetna Medicare |
$124.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.18
|
| Rate for Payer: BCBS Complete |
$102.40
|
| Rate for Payer: BCBS MAPPO |
$119.54
|
| Rate for Payer: BCN Medicare Advantage |
$119.54
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$172.14
|
| Rate for Payer: Cofinity Commercial |
$160.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.52
|
| Rate for Payer: Nomi Health Commercial |
$143.45
|
| Rate for Payer: PACE SWMI |
$119.54
|
| Rate for Payer: PHP Commercial |
$167.36
|
| Rate for Payer: PHP Medicare Advantage |
$119.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.40
|
| Rate for Payer: Priority Health Medicare |
$119.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.54
|
| Rate for Payer: UHC Medicare Advantage |
$119.54
|
| Rate for Payer: UMR Bronson Commercial |
$117.76
|
|
|
PR REMOVAL INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 58301
|
| Min. Negotiated Rate |
$63.78 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$85.47
|
| Rate for Payer: Aetna Medicare |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.47
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$63.78
|
| Rate for Payer: BCN Medicare Advantage |
$63.78
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Cofinity Commercial |
$85.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.97
|
| Rate for Payer: Nomi Health Commercial |
$76.54
|
| Rate for Payer: PACE SWMI |
$63.78
|
| Rate for Payer: PHP Commercial |
$89.29
|
| Rate for Payer: PHP Medicare Advantage |
$63.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$63.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.78
|
| Rate for Payer: UHC Medicare Advantage |
$63.78
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA
|
Professional
|
Both
|
$6,102.00
|
|
|
Service Code
|
HCPCS 32442
|
| Min. Negotiated Rate |
$2,440.80 |
| Max. Negotiated Rate |
$4,222.48 |
| Rate for Payer: Aetna Commercial |
$3,929.26
|
| Rate for Payer: Aetna Medicare |
$3,049.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,222.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,929.26
|
| Rate for Payer: BCBS Complete |
$2,440.80
|
| Rate for Payer: BCBS MAPPO |
$2,932.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,932.28
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cofinity Commercial |
$4,222.48
|
| Rate for Payer: Cofinity Commercial |
$3,929.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,932.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,078.89
|
| Rate for Payer: Nomi Health Commercial |
$3,518.74
|
| Rate for Payer: PACE SWMI |
$2,932.28
|
| Rate for Payer: PHP Commercial |
$4,105.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,932.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,966.30
|
| Rate for Payer: Priority Health Medicare |
$2,932.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,932.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,932.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,806.92
|
|
|
PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11982
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$165.10 |
| Rate for Payer: Aetna Commercial |
$93.87
|
| Rate for Payer: Aetna Medicare |
$72.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.87
|
| Rate for Payer: BCBS Complete |
$101.60
|
| Rate for Payer: BCBS MAPPO |
$70.05
|
| Rate for Payer: BCN Medicare Advantage |
$70.05
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$93.87
|
| Rate for Payer: Cofinity Commercial |
$100.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.55
|
| Rate for Payer: Nomi Health Commercial |
$84.06
|
| Rate for Payer: PACE SWMI |
$70.05
|
| Rate for Payer: PHP Commercial |
$98.07
|
| Rate for Payer: PHP Medicare Advantage |
$70.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health Medicare |
$70.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.05
|
| Rate for Payer: UHC Medicare Advantage |
$70.05
|
| Rate for Payer: UMR Bronson Commercial |
$116.84
|
|
|
PR REMOVAL OF LUNG PNEUMONECTOMY
|
Professional
|
Both
|
$5,503.00
|
|
|
Service Code
|
HCPCS 32440
|
| Min. Negotiated Rate |
$1,507.49 |
| Max. Negotiated Rate |
$3,576.95 |
| Rate for Payer: Aetna Commercial |
$2,020.04
|
| Rate for Payer: Aetna Medicare |
$1,567.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,170.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,020.04
|
| Rate for Payer: BCBS Complete |
$2,201.20
|
| Rate for Payer: BCBS MAPPO |
$1,507.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,507.49
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Cofinity Commercial |
$2,170.79
|
| Rate for Payer: Cofinity Commercial |
$2,020.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,507.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,582.86
|
| Rate for Payer: Nomi Health Commercial |
$1,808.99
|
| Rate for Payer: PACE SWMI |
$1,507.49
|
| Rate for Payer: PHP Commercial |
$2,110.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,507.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,576.95
|
| Rate for Payer: Priority Health Medicare |
$1,507.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,507.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,507.49
|
| Rate for Payer: UMR Bronson Commercial |
$2,531.38
|
|
|
PR REMOVAL OF SUTURES
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS S0630
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 49402
|
| Min. Negotiated Rate |
$832.38 |
| Max. Negotiated Rate |
$1,467.05 |
| Rate for Payer: Aetna Commercial |
$1,115.39
|
| Rate for Payer: Aetna Medicare |
$865.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.63
|
| Rate for Payer: BCBS Complete |
$902.80
|
| Rate for Payer: BCBS MAPPO |
$832.38
|
| Rate for Payer: BCN Medicare Advantage |
$832.38
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.39
|
| Rate for Payer: Cofinity Commercial |
$1,198.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.00
|
| Rate for Payer: Nomi Health Commercial |
$998.86
|
| Rate for Payer: PACE SWMI |
$832.38
|
| Rate for Payer: PHP Commercial |
$1,165.33
|
| Rate for Payer: PHP Medicare Advantage |
$832.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health Medicare |
$832.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.38
|
| Rate for Payer: UHC Medicare Advantage |
$832.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,038.22
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 33233
|
| Min. Negotiated Rate |
$219.56 |
| Max. Negotiated Rate |
$412.75 |
| Rate for Payer: Aetna Commercial |
$294.21
|
| Rate for Payer: Aetna Medicare |
$228.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.21
|
| Rate for Payer: BCBS Complete |
$254.00
|
| Rate for Payer: BCBS MAPPO |
$219.56
|
| Rate for Payer: BCN Medicare Advantage |
$219.56
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$316.17
|
| Rate for Payer: Cofinity Commercial |
$294.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.54
|
| Rate for Payer: Nomi Health Commercial |
$263.47
|
| Rate for Payer: PACE SWMI |
$219.56
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: PHP Medicare Advantage |
$219.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health Medicare |
$219.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.56
|
| Rate for Payer: UHC Medicare Advantage |
$219.56
|
| Rate for Payer: UMR Bronson Commercial |
$292.10
|
|
|
PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 33992
|
| Min. Negotiated Rate |
$179.45 |
| Max. Negotiated Rate |
$365.95 |
| Rate for Payer: Aetna Commercial |
$240.46
|
| Rate for Payer: Aetna Medicare |
$186.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.46
|
| Rate for Payer: BCBS Complete |
$225.20
|
| Rate for Payer: BCBS MAPPO |
$179.45
|
| Rate for Payer: BCN Medicare Advantage |
$179.45
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$258.41
|
| Rate for Payer: Cofinity Commercial |
$240.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.42
|
| Rate for Payer: Nomi Health Commercial |
$215.34
|
| Rate for Payer: PACE SWMI |
$179.45
|
| Rate for Payer: PHP Commercial |
$251.23
|
| Rate for Payer: PHP Medicare Advantage |
$179.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health Medicare |
$179.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.45
|
| Rate for Payer: UHC Medicare Advantage |
$179.45
|
| Rate for Payer: UMR Bronson Commercial |
$258.98
|
|
|
PR REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,102.00
|
|
|
Service Code
|
HCPCS 22850
|
| Min. Negotiated Rate |
$719.58 |
| Max. Negotiated Rate |
$1,366.30 |
| Rate for Payer: Aetna Commercial |
$964.24
|
| Rate for Payer: Aetna Medicare |
$748.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,036.20
|
| Rate for Payer: BCBS Complete |
$840.80
|
| Rate for Payer: BCBS MAPPO |
$719.58
|
| Rate for Payer: BCN Medicare Advantage |
$719.58
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$964.24
|
| Rate for Payer: Cofinity Commercial |
$1,036.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.56
|
| Rate for Payer: Nomi Health Commercial |
$863.50
|
| Rate for Payer: PACE SWMI |
$719.58
|
| Rate for Payer: PHP Commercial |
$1,007.41
|
| Rate for Payer: PHP Medicare Advantage |
$719.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.30
|
| Rate for Payer: Priority Health Medicare |
$719.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.58
|
| Rate for Payer: UHC Medicare Advantage |
$719.58
|
| Rate for Payer: UMR Bronson Commercial |
$966.92
|
|
|
PR REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 22852
|
| Min. Negotiated Rate |
$691.80 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$927.01
|
| Rate for Payer: Aetna Medicare |
$719.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$996.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$927.01
|
| Rate for Payer: BCBS Complete |
$892.80
|
| Rate for Payer: BCBS MAPPO |
$691.80
|
| Rate for Payer: BCN Medicare Advantage |
$691.80
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cofinity Commercial |
$996.19
|
| Rate for Payer: Cofinity Commercial |
$927.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.39
|
| Rate for Payer: Nomi Health Commercial |
$830.16
|
| Rate for Payer: PACE SWMI |
$691.80
|
| Rate for Payer: PHP Commercial |
$968.52
|
| Rate for Payer: PHP Medicare Advantage |
$691.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health Medicare |
$691.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.80
|
| Rate for Payer: UHC Medicare Advantage |
$691.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,026.72
|
|
|
PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 23333
|
| Min. Negotiated Rate |
$379.20 |
| Max. Negotiated Rate |
$662.50 |
| Rate for Payer: Aetna Commercial |
$616.49
|
| Rate for Payer: Aetna Medicare |
$478.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.49
|
| Rate for Payer: BCBS Complete |
$379.20
|
| Rate for Payer: BCBS MAPPO |
$460.07
|
| Rate for Payer: BCN Medicare Advantage |
$460.07
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$662.50
|
| Rate for Payer: Cofinity Commercial |
$616.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.07
|
| Rate for Payer: Nomi Health Commercial |
$552.08
|
| Rate for Payer: PACE SWMI |
$460.07
|
| Rate for Payer: PHP Commercial |
$644.10
|
| Rate for Payer: PHP Medicare Advantage |
$460.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health Medicare |
$460.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.07
|
| Rate for Payer: UHC Medicare Advantage |
$460.07
|
| Rate for Payer: UMR Bronson Commercial |
$436.08
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 33286
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$174.20 |
| Rate for Payer: Aetna Commercial |
$109.55
|
| Rate for Payer: Aetna Medicare |
$85.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.55
|
| Rate for Payer: BCBS Complete |
$107.20
|
| Rate for Payer: BCBS MAPPO |
$81.75
|
| Rate for Payer: BCN Medicare Advantage |
$81.75
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$117.72
|
| Rate for Payer: Cofinity Commercial |
$109.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.84
|
| Rate for Payer: Nomi Health Commercial |
$98.10
|
| Rate for Payer: PACE SWMI |
$81.75
|
| Rate for Payer: PHP Commercial |
$114.45
|
| Rate for Payer: PHP Medicare Advantage |
$81.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$81.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.75
|
| Rate for Payer: UHC Medicare Advantage |
$81.75
|
| Rate for Payer: UMR Bronson Commercial |
$123.28
|
|
|
PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 15854
|
| Min. Negotiated Rate |
$12.76 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.10
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Commercial |
$17.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: Nomi Health Commercial |
$15.31
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$17.86
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.76
|
| Rate for Payer: UHC Medicare Advantage |
$12.76
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$20.80 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$10.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.10
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$13.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: PACE SWMI |
$10.10
|
| Rate for Payer: PHP Commercial |
$14.14
|
| Rate for Payer: PHP Medicare Advantage |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$10.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.10
|
| Rate for Payer: UHC Medicare Advantage |
$10.10
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$62.32 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Commercial |
$83.51
|
| Rate for Payer: Aetna Medicare |
$64.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.51
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS MAPPO |
$62.32
|
| Rate for Payer: BCN Medicare Advantage |
$62.32
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$74.78
|
| Rate for Payer: PACE SWMI |
$62.32
|
| Rate for Payer: PHP Commercial |
$87.25
|
| Rate for Payer: PHP Medicare Advantage |
$62.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health Medicare |
$62.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.32
|
| Rate for Payer: UMR Bronson Commercial |
$73.60
|
|
|
PR REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 15850
|
| Min. Negotiated Rate |
$90.40 |
| Max. Negotiated Rate |
$146.90 |
| Rate for Payer: Aetna Medicare |
$113.00
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: UMR Bronson Commercial |
$103.96
|
|
|
PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11971
|
| Min. Negotiated Rate |
$372.00 |
| Max. Negotiated Rate |
$760.28 |
| Rate for Payer: Aetna Commercial |
$707.48
|
| Rate for Payer: Aetna Medicare |
$549.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.28
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$527.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.97
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$707.48
|
| Rate for Payer: Cofinity Commercial |
$760.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.37
|
| Rate for Payer: Nomi Health Commercial |
$633.56
|
| Rate for Payer: PACE SWMI |
$527.97
|
| Rate for Payer: PHP Commercial |
$739.16
|
| Rate for Payer: PHP Medicare Advantage |
$527.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$527.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.97
|
| Rate for Payer: UHC Medicare Advantage |
$527.97
|
| Rate for Payer: UMR Bronson Commercial |
$427.80
|
|
