|
PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 33992
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$1,321.81 |
| Rate for Payer: Aetna Commercial |
$240.46
|
| Rate for Payer: Aetna Medicare |
$186.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.41
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS MAPPO |
$179.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.81
|
| Rate for Payer: BCN Commercial |
$267.31
|
| 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 |
$240.46
|
| Rate for Payer: Cofinity Commercial |
$258.41
|
| 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: Meridian Medicaid |
$123.23
|
| 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 Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.50
|
| Rate for Payer: Priority Health Medicare |
$179.45
|
| Rate for Payer: Priority Health Narrow Network |
$292.50
|
| Rate for Payer: Priority Health SBD |
$292.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.45
|
| Rate for Payer: UHC Medicare Advantage |
$179.45
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
| 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 |
$89.99 |
| 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) |
$1,036.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.24
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS MAPPO |
$719.58
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| 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 |
$1,036.20
|
| Rate for Payer: Cofinity Commercial |
$964.24
|
| 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: Meridian Medicaid |
$505.45
|
| 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 Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.82
|
| Rate for Payer: Priority Health Medicare |
$719.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,138.82
|
| Rate for Payer: Priority Health SBD |
$1,138.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.58
|
| Rate for Payer: UHC Medicare Advantage |
$719.58
|
| Rate for Payer: UHCCP Medicaid |
$481.38
|
| 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 |
$463.28 |
| 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) |
$927.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$996.19
|
| Rate for Payer: BCBS Complete |
$486.44
|
| Rate for Payer: BCBS MAPPO |
$691.80
|
| Rate for Payer: BCBS Trust/PPO |
$648.97
|
| Rate for Payer: BCN Commercial |
$1,042.35
|
| 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 |
$927.01
|
| Rate for Payer: Cofinity Commercial |
$996.19
|
| 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: Meridian Medicaid |
$486.44
|
| 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 Choice Medicaid |
$463.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,098.11
|
| Rate for Payer: Priority Health Medicare |
$691.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,098.11
|
| Rate for Payer: Priority Health SBD |
$1,098.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.80
|
| Rate for Payer: UHC Medicare Advantage |
$691.80
|
| Rate for Payer: UHCCP Medicaid |
$463.28
|
| 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 |
$75.14 |
| Max. Negotiated Rate |
$737.35 |
| Rate for Payer: Aetna Commercial |
$616.49
|
| Rate for Payer: Aetna Medicare |
$478.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.50
|
| Rate for Payer: BCBS Complete |
$328.09
|
| Rate for Payer: BCBS MAPPO |
$460.07
|
| Rate for Payer: BCBS Trust/PPO |
$75.14
|
| Rate for Payer: BCN Commercial |
$699.30
|
| 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 |
$616.49
|
| Rate for Payer: Cofinity Commercial |
$662.50
|
| 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: Meridian Medicaid |
$328.09
|
| 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 Choice Medicaid |
$312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.35
|
| Rate for Payer: Priority Health Medicare |
$460.07
|
| Rate for Payer: Priority Health Narrow Network |
$737.35
|
| Rate for Payer: Priority Health SBD |
$737.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.07
|
| Rate for Payer: UHC Medicare Advantage |
$460.07
|
| Rate for Payer: UHCCP Medicaid |
$312.47
|
| 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 |
$53.89 |
| Max. Negotiated Rate |
$2,454.48 |
| Rate for Payer: Aetna Commercial |
$109.54
|
| Rate for Payer: Aetna Medicare |
$85.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.72
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$81.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.48
|
| Rate for Payer: BCN Commercial |
$192.54
|
| 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 |
$109.54
|
| Rate for Payer: Cofinity Commercial |
$117.72
|
| 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: Meridian Medicaid |
$56.58
|
| 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 Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.01
|
| Rate for Payer: Priority Health Medicare |
$81.75
|
| Rate for Payer: Priority Health Narrow Network |
$134.01
|
| Rate for Payer: Priority Health SBD |
$134.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.75
|
| Rate for Payer: UHC Medicare Advantage |
$81.75
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| 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 |
$452.03 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.37
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCBS Trust/PPO |
$452.03
|
| Rate for Payer: BCN Commercial |
$23.46
|
| 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 |
$17.10
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| 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 HMO/PPO/Tiered Network |
$21.68
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow Network |
$21.68
|
| Rate for Payer: Priority Health SBD |
$21.68
|
| 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 |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.54
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$10.10
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$16.61
|
| 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 |
$10.60
|
| 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 HMO/PPO/Tiered Network |
$15.80
|
| Rate for Payer: Priority Health Medicare |
$10.10
|
| Rate for Payer: Priority Health Narrow Network |
$15.80
|
| Rate for Payer: Priority Health SBD |
$15.80
|
| 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 |
$41.96 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$83.51
|
| Rate for Payer: Aetna Medicare |
$64.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.74
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$62.32
|
| Rate for Payer: BCBS Trust/PPO |
$272.27
|
| Rate for Payer: BCN Commercial |
$82.58
|
| 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 |
$83.51
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| 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: Meridian Medicaid |
$44.06
|
| 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 Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.04
|
| Rate for Payer: Priority Health Medicare |
$62.32
|
| Rate for Payer: Priority Health Narrow Network |
$88.04
|
| Rate for Payer: Priority Health SBD |
$88.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.32
|
| Rate for Payer: UHCCP Medicaid |
$41.96
|
| 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 |
$359.12 |
| Max. Negotiated Rate |
$807.78 |
| 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 |
$377.08
|
| Rate for Payer: BCBS MAPPO |
$527.97
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$807.78
|
| 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: Meridian Medicaid |
$377.08
|
| 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 Choice Medicaid |
$359.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.58
|
| Rate for Payer: Priority Health Medicare |
$527.97
|
| Rate for Payer: Priority Health Narrow Network |
$753.58
|
| Rate for Payer: Priority Health SBD |
$753.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.97
|
| Rate for Payer: UHC Medicare Advantage |
$527.97
|
| Rate for Payer: UHCCP Medicaid |
$359.12
|
| Rate for Payer: UMR Bronson Commercial |
$427.80
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$140.37 |
| Max. Negotiated Rate |
$906.56 |
| Rate for Payer: Aetna Commercial |
$286.09
|
| Rate for Payer: Aetna Medicare |
$222.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.44
|
| Rate for Payer: BCBS Complete |
$147.39
|
| Rate for Payer: BCBS MAPPO |
$213.50
|
| Rate for Payer: BCBS Trust/PPO |
$906.56
|
| Rate for Payer: BCN Commercial |
$320.09
|
| Rate for Payer: BCN Medicare Advantage |
$213.50
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$286.09
|
| Rate for Payer: Cofinity Commercial |
$307.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.18
|
| Rate for Payer: Meridian Medicaid |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$256.20
|
| Rate for Payer: PACE SWMI |
$213.50
|
| Rate for Payer: PHP Commercial |
$298.90
|
| Rate for Payer: PHP Medicare Advantage |
$213.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.56
|
| Rate for Payer: Priority Health Medicare |
$213.50
|
| Rate for Payer: Priority Health Narrow Network |
$392.56
|
| Rate for Payer: Priority Health SBD |
$392.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.50
|
| Rate for Payer: UHC Medicare Advantage |
$213.50
|
| Rate for Payer: UHCCP Medicaid |
$140.37
|
| Rate for Payer: UMR Bronson Commercial |
$451.26
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,380.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$107.24 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna Commercial |
$1,443.35
|
| Rate for Payer: Aetna Medicare |
$1,120.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.07
|
| Rate for Payer: BCBS Complete |
$740.28
|
| Rate for Payer: BCBS MAPPO |
$1,077.13
|
| Rate for Payer: BCBS Trust/PPO |
$107.24
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.13
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cofinity Commercial |
$1,443.35
|
| Rate for Payer: Cofinity Commercial |
$1,551.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,130.99
|
| Rate for Payer: Meridian Medicaid |
$740.28
|
| Rate for Payer: Nomi Health Commercial |
$1,292.56
|
| Rate for Payer: PACE SWMI |
$1,077.13
|
| Rate for Payer: PHP Commercial |
$1,507.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,197.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,750.76
|
| Rate for Payer: Priority Health Medicare |
$1,077.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,750.76
|
| Rate for Payer: Priority Health SBD |
$1,750.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.13
|
| Rate for Payer: UHCCP Medicaid |
$705.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,554.80
|
|
|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,352.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$470.73 |
| Max. Negotiated Rate |
$2,000.67 |
| Rate for Payer: Aetna Commercial |
$933.26
|
| Rate for Payer: Aetna Medicare |
$724.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.26
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS MAPPO |
$696.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.67
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: BCN Medicare Advantage |
$696.46
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Cofinity Commercial |
$1,002.90
|
| Rate for Payer: Cofinity Commercial |
$933.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.28
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Nomi Health Commercial |
$835.75
|
| Rate for Payer: PACE SWMI |
$696.46
|
| Rate for Payer: PHP Commercial |
$975.04
|
| Rate for Payer: PHP Medicare Advantage |
$696.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$878.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.42
|
| Rate for Payer: Priority Health Medicare |
$696.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.42
|
| Rate for Payer: Priority Health SBD |
$1,115.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.46
|
| Rate for Payer: UHC Medicare Advantage |
$696.46
|
| Rate for Payer: UHCCP Medicaid |
$470.73
|
| Rate for Payer: UMR Bronson Commercial |
$621.92
|
|
|
PR REMOVE BILE DUCT STONE, PERCUT
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 47630
|
| Min. Negotiated Rate |
$361.60 |
| Max. Negotiated Rate |
$587.60 |
| Rate for Payer: Aetna Medicare |
$452.00
|
| Rate for Payer: BCBS Complete |
$361.60
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.60
|
| Rate for Payer: UMR Bronson Commercial |
$415.84
|
|
|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Medicare |
$519.50
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
| Rate for Payer: UMR Bronson Commercial |
$477.94
|
|
|
PR REMOVE INT DWELL URETERAL STENT TRANSURETHRAL
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 50386
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$1,103.43 |
| Rate for Payer: Aetna Commercial |
$207.19
|
| Rate for Payer: Aetna Medicare |
$160.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.65
|
| Rate for Payer: BCBS Complete |
$108.24
|
| Rate for Payer: BCBS MAPPO |
$154.62
|
| Rate for Payer: BCN Commercial |
$1,103.43
|
| Rate for Payer: BCN Medicare Advantage |
$154.62
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Cofinity Commercial |
$222.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.35
|
| Rate for Payer: Meridian Medicaid |
$108.24
|
| Rate for Payer: Nomi Health Commercial |
$185.54
|
| Rate for Payer: PACE SWMI |
$154.62
|
| Rate for Payer: PHP Commercial |
$216.47
|
| Rate for Payer: PHP Medicare Advantage |
$154.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.12
|
| Rate for Payer: Priority Health Medicare |
$154.62
|
| Rate for Payer: Priority Health Narrow Network |
$255.12
|
| Rate for Payer: Priority Health SBD |
$255.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.62
|
| Rate for Payer: UHC Medicare Advantage |
$154.62
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
| Rate for Payer: UMR Bronson Commercial |
$727.72
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$344.50 |
| Rate for Payer: Aetna Medicare |
$265.00
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
| Rate for Payer: UMR Bronson Commercial |
$243.80
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,093.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$136.11 |
| Max. Negotiated Rate |
$2,060.90 |
| Rate for Payer: Aetna Commercial |
$274.16
|
| Rate for Payer: Aetna Medicare |
$212.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.62
|
| Rate for Payer: BCBS Complete |
$142.92
|
| Rate for Payer: BCBS MAPPO |
$204.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,060.90
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$204.60
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cofinity Commercial |
$294.62
|
| Rate for Payer: Cofinity Commercial |
$274.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.83
|
| Rate for Payer: Meridian Medicaid |
$142.92
|
| Rate for Payer: Nomi Health Commercial |
$245.52
|
| Rate for Payer: PACE SWMI |
$204.60
|
| Rate for Payer: PHP Commercial |
$286.44
|
| Rate for Payer: PHP Medicare Advantage |
$204.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.06
|
| Rate for Payer: Priority Health Medicare |
$204.60
|
| Rate for Payer: Priority Health Narrow Network |
$336.06
|
| Rate for Payer: Priority Health SBD |
$336.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.60
|
| Rate for Payer: UHC Medicare Advantage |
$204.60
|
| Rate for Payer: UHCCP Medicaid |
$136.11
|
| Rate for Payer: UMR Bronson Commercial |
$962.78
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,924.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$413.01 |
| Max. Negotiated Rate |
$1,250.60 |
| Rate for Payer: Aetna Commercial |
$823.38
|
| Rate for Payer: Aetna Medicare |
$639.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.82
|
| Rate for Payer: BCBS Complete |
$433.66
|
| Rate for Payer: BCBS MAPPO |
$614.46
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$928.00
|
| Rate for Payer: BCN Medicare Advantage |
$614.46
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cofinity Commercial |
$823.38
|
| Rate for Payer: Cofinity Commercial |
$884.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.18
|
| Rate for Payer: Meridian Medicaid |
$433.66
|
| Rate for Payer: Nomi Health Commercial |
$737.35
|
| Rate for Payer: PACE SWMI |
$614.46
|
| Rate for Payer: PHP Commercial |
$860.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.79
|
| Rate for Payer: Priority Health Medicare |
$614.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.79
|
| Rate for Payer: Priority Health SBD |
$1,025.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.46
|
| Rate for Payer: UHC Medicare Advantage |
$614.46
|
| Rate for Payer: UHCCP Medicaid |
$413.01
|
| Rate for Payer: UMR Bronson Commercial |
$885.04
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$1,104.68 |
| Rate for Payer: Aetna Commercial |
$430.49
|
| Rate for Payer: Aetna Medicare |
$334.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.61
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$321.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.68
|
| Rate for Payer: BCN Commercial |
$490.63
|
| Rate for Payer: BCN Medicare Advantage |
$321.26
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$430.49
|
| Rate for Payer: Cofinity Commercial |
$462.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.32
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Nomi Health Commercial |
$385.51
|
| Rate for Payer: PACE SWMI |
$321.26
|
| Rate for Payer: PHP Commercial |
$449.76
|
| Rate for Payer: PHP Medicare Advantage |
$321.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.41
|
| Rate for Payer: Priority Health Medicare |
$321.26
|
| Rate for Payer: Priority Health Narrow Network |
$533.41
|
| Rate for Payer: Priority Health SBD |
$533.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.26
|
| Rate for Payer: UHC Medicare Advantage |
$321.26
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
| Rate for Payer: UMR Bronson Commercial |
$322.92
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$864.30 |
| Rate for Payer: Aetna Commercial |
$451.00
|
| Rate for Payer: Aetna Medicare |
$350.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.66
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$336.57
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$336.57
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$451.00
|
| Rate for Payer: Cofinity Commercial |
$484.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.40
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Nomi Health Commercial |
$403.88
|
| Rate for Payer: PACE SWMI |
$336.57
|
| Rate for Payer: PHP Commercial |
$471.20
|
| Rate for Payer: PHP Medicare Advantage |
$336.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.82
|
| Rate for Payer: Priority Health Medicare |
$336.57
|
| Rate for Payer: Priority Health Narrow Network |
$556.82
|
| Rate for Payer: Priority Health SBD |
$556.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.57
|
| Rate for Payer: UHC Medicare Advantage |
$336.57
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
| Rate for Payer: UMR Bronson Commercial |
$334.42
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$1,010.11 |
| Rate for Payer: Aetna Commercial |
$472.63
|
| Rate for Payer: Aetna Medicare |
$366.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.90
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$352.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.11
|
| Rate for Payer: BCN Commercial |
$541.46
|
| Rate for Payer: BCN Medicare Advantage |
$352.71
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cofinity Commercial |
$472.63
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.35
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Nomi Health Commercial |
$423.25
|
| Rate for Payer: PACE SWMI |
$352.71
|
| Rate for Payer: PHP Commercial |
$493.79
|
| Rate for Payer: PHP Medicare Advantage |
$352.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$585.55
|
| Rate for Payer: Priority Health Medicare |
$352.71
|
| Rate for Payer: Priority Health Narrow Network |
$585.55
|
| Rate for Payer: Priority Health SBD |
$585.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.71
|
| Rate for Payer: UHC Medicare Advantage |
$352.71
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
| Rate for Payer: UMR Bronson Commercial |
$265.88
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$532.35 |
| Rate for Payer: Aetna Medicare |
$409.50
|
| Rate for Payer: BCBS Complete |
$327.60
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
| Rate for Payer: UMR Bronson Commercial |
$376.74
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.40 |
| 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: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$760.38 |
| Rate for Payer: Aetna Commercial |
$159.47
|
| Rate for Payer: Aetna Medicare |
$123.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.37
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$119.01
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$119.01
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$159.47
|
| Rate for Payer: Cofinity Commercial |
$171.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.96
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Nomi Health Commercial |
$142.81
|
| Rate for Payer: PACE SWMI |
$119.01
|
| Rate for Payer: PHP Commercial |
$166.61
|
| Rate for Payer: PHP Medicare Advantage |
$119.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.13
|
| Rate for Payer: Priority Health Medicare |
$119.01
|
| Rate for Payer: Priority Health Narrow Network |
$198.13
|
| Rate for Payer: Priority Health SBD |
$198.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.01
|
| Rate for Payer: UHC Medicare Advantage |
$119.01
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
| Rate for Payer: UMR Bronson Commercial |
$484.38
|
|
