|
PR SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,747.00
|
|
|
Service Code
|
HCPCS 31085
|
| Min. Negotiated Rate |
$710.36 |
| Max. Negotiated Rate |
$2,084.50 |
| Rate for Payer: Aetna Commercial |
$1,443.54
|
| Rate for Payer: Aetna Medicare |
$1,120.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.27
|
| Rate for Payer: BCBS Complete |
$745.88
|
| Rate for Payer: BCBS MAPPO |
$1,077.27
|
| Rate for Payer: BCN Commercial |
$1,859.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.27
|
| Rate for Payer: Cash Price |
$2,197.60
|
| Rate for Payer: Cash Price |
$2,197.60
|
| Rate for Payer: Cofinity Commercial |
$1,443.54
|
| Rate for Payer: Cofinity Commercial |
$1,551.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.13
|
| Rate for Payer: Meridian Medicaid |
$745.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,185.00
|
| Rate for Payer: Nomi Health Commercial |
$1,292.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,060.25
|
| Rate for Payer: PACE SWMI |
$1,077.27
|
| Rate for Payer: PHP Commercial |
$1,508.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$710.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,751.53
|
| Rate for Payer: Priority Health Medicare |
$1,077.27
|
| Rate for Payer: Priority Health SBD |
$1,751.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,751.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,077.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,084.50
|
| Rate for Payer: UHC Core |
$2,084.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,077.27
|
| Rate for Payer: UHC Exchange |
$2,084.50
|
| Rate for Payer: UHC Medicaid |
$710.36
|
| Rate for Payer: UHCCP Medicaid |
$710.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,263.62
|
|
|
PR SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS
|
Professional
|
Both
|
$1,158.00
|
|
|
Service Code
|
HCPCS 31032
|
| Min. Negotiated Rate |
$351.88 |
| Max. Negotiated Rate |
$989.92 |
| Rate for Payer: Aetna Commercial |
$709.44
|
| Rate for Payer: Aetna Medicare |
$550.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.38
|
| Rate for Payer: BCBS Complete |
$369.47
|
| Rate for Payer: BCBS MAPPO |
$529.43
|
| Rate for Payer: BCN Commercial |
$893.88
|
| Rate for Payer: BCN Medicare Advantage |
$529.43
|
| Rate for Payer: Cash Price |
$926.40
|
| Rate for Payer: Cash Price |
$926.40
|
| Rate for Payer: Cofinity Commercial |
$709.44
|
| Rate for Payer: Cofinity Commercial |
$762.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.90
|
| Rate for Payer: Meridian Medicaid |
$369.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.37
|
| Rate for Payer: Nomi Health Commercial |
$635.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$868.50
|
| Rate for Payer: PACE SWMI |
$529.43
|
| Rate for Payer: PHP Commercial |
$741.20
|
| Rate for Payer: PHP Medicare Advantage |
$529.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$841.77
|
| Rate for Payer: Priority Health Medicare |
$529.43
|
| Rate for Payer: Priority Health SBD |
$841.77
|
| Rate for Payer: Priority Health Tiered Network |
$841.77
|
| Rate for Payer: Railroad Medicare Medicare |
$529.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$989.92
|
| Rate for Payer: UHC Core |
$989.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.43
|
| Rate for Payer: UHC Exchange |
$989.92
|
| Rate for Payer: UHC Medicaid |
$351.88
|
| Rate for Payer: UHCCP Medicaid |
$351.88
|
| Rate for Payer: UMR Bronson Commercial |
$532.68
|
|
|
PR SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC
|
Professional
|
Both
|
$2,332.00
|
|
|
Service Code
|
HCPCS 31080
|
| Min. Negotiated Rate |
$626.65 |
| Max. Negotiated Rate |
$1,806.05 |
| Rate for Payer: Aetna Commercial |
$1,267.96
|
| Rate for Payer: Aetna Medicare |
$984.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.59
|
| Rate for Payer: BCBS Complete |
$657.98
|
| Rate for Payer: BCBS MAPPO |
$946.24
|
| Rate for Payer: BCN Commercial |
$1,626.90
|
| Rate for Payer: BCN Medicare Advantage |
$946.24
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Cash Price |
$1,865.60
|
| Rate for Payer: Cofinity Commercial |
$1,267.96
|
| Rate for Payer: Cofinity Commercial |
$1,362.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.55
|
| Rate for Payer: Meridian Medicaid |
$657.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,040.86
|
| Rate for Payer: Nomi Health Commercial |
$1,135.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.00
|
| Rate for Payer: PACE SWMI |
$946.24
|
| Rate for Payer: PHP Commercial |
$1,324.74
|
| Rate for Payer: PHP Medicare Advantage |
$946.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,532.06
|
| Rate for Payer: Priority Health Medicare |
$946.24
|
| Rate for Payer: Priority Health SBD |
$1,532.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,532.06
|
| Rate for Payer: Railroad Medicare Medicare |
$946.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,806.05
|
| Rate for Payer: UHC Core |
$1,806.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$946.24
|
| Rate for Payer: UHC Exchange |
$1,806.05
|
| Rate for Payer: UHC Medicaid |
$626.65
|
| Rate for Payer: UHCCP Medicaid |
$626.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,072.72
|
|
|
PR SINUSOTOMY FRONTAL EXTERNAL SIMPLE
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 31070
|
| Min. Negotiated Rate |
$282.44 |
| Max. Negotiated Rate |
$769.01 |
| Rate for Payer: Aetna Commercial |
$564.54
|
| Rate for Payer: Aetna Medicare |
$438.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.67
|
| Rate for Payer: BCBS Complete |
$296.56
|
| Rate for Payer: BCBS MAPPO |
$421.30
|
| Rate for Payer: BCN Commercial |
$712.11
|
| Rate for Payer: BCN Medicare Advantage |
$421.30
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$564.54
|
| Rate for Payer: Cofinity Commercial |
$606.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.37
|
| Rate for Payer: Meridian Medicaid |
$296.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.43
|
| Rate for Payer: Nomi Health Commercial |
$505.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$421.30
|
| Rate for Payer: PHP Commercial |
$589.82
|
| Rate for Payer: PHP Medicare Advantage |
$421.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$670.59
|
| Rate for Payer: Priority Health Medicare |
$421.30
|
| Rate for Payer: Priority Health SBD |
$670.59
|
| Rate for Payer: Priority Health Tiered Network |
$670.59
|
| Rate for Payer: Railroad Medicare Medicare |
$421.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.01
|
| Rate for Payer: UHC Core |
$769.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$421.30
|
| Rate for Payer: UHC Exchange |
$769.01
|
| Rate for Payer: UHC Medicaid |
$282.44
|
| Rate for Payer: UHCCP Medicaid |
$282.44
|
| Rate for Payer: UMR Bronson Commercial |
$419.98
|
|
|
PR SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 31020
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$627.60 |
| Rate for Payer: Aetna Commercial |
$415.27
|
| Rate for Payer: Aetna Medicare |
$322.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.26
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS MAPPO |
$309.90
|
| Rate for Payer: BCN Commercial |
$516.91
|
| Rate for Payer: BCN Medicare Advantage |
$309.90
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$415.27
|
| Rate for Payer: Cofinity Commercial |
$446.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.39
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.89
|
| Rate for Payer: Nomi Health Commercial |
$371.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$309.90
|
| Rate for Payer: PHP Commercial |
$433.86
|
| Rate for Payer: PHP Medicare Advantage |
$309.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$486.78
|
| Rate for Payer: Priority Health Medicare |
$309.90
|
| Rate for Payer: Priority Health SBD |
$486.78
|
| Rate for Payer: Priority Health Tiered Network |
$486.78
|
| Rate for Payer: Railroad Medicare Medicare |
$309.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.60
|
| Rate for Payer: UHC Core |
$627.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.90
|
| Rate for Payer: UHC Exchange |
$627.60
|
| Rate for Payer: UHC Medicaid |
$208.53
|
| Rate for Payer: UHCCP Medicaid |
$208.53
|
| Rate for Payer: UMR Bronson Commercial |
$338.10
|
|
|
PR SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS
|
Professional
|
Both
|
$1,191.00
|
|
|
Service Code
|
HCPCS 31030
|
| Min. Negotiated Rate |
$302.46 |
| Max. Negotiated Rate |
$893.25 |
| Rate for Payer: Aetna Commercial |
$610.62
|
| Rate for Payer: Aetna Medicare |
$473.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.19
|
| Rate for Payer: BCBS Complete |
$317.58
|
| Rate for Payer: BCBS MAPPO |
$455.69
|
| Rate for Payer: BCN Commercial |
$774.86
|
| Rate for Payer: BCN Medicare Advantage |
$455.69
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cofinity Commercial |
$610.62
|
| Rate for Payer: Cofinity Commercial |
$656.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.47
|
| Rate for Payer: Meridian Medicaid |
$317.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.26
|
| Rate for Payer: Nomi Health Commercial |
$546.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$893.25
|
| Rate for Payer: PACE SWMI |
$455.69
|
| Rate for Payer: PHP Commercial |
$637.97
|
| Rate for Payer: PHP Medicare Advantage |
$455.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$729.68
|
| Rate for Payer: Priority Health Medicare |
$455.69
|
| Rate for Payer: Priority Health SBD |
$729.68
|
| Rate for Payer: Priority Health Tiered Network |
$729.68
|
| Rate for Payer: Railroad Medicare Medicare |
$455.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.09
|
| Rate for Payer: UHC Core |
$880.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$455.69
|
| Rate for Payer: UHC Exchange |
$880.09
|
| Rate for Payer: UHC Medicaid |
$302.46
|
| Rate for Payer: UHCCP Medicaid |
$302.46
|
| Rate for Payer: UMR Bronson Commercial |
$547.86
|
|
|
PR SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP
|
Professional
|
Both
|
$1,923.00
|
|
|
Service Code
|
HCPCS 31051
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,442.25 |
| Rate for Payer: Aetna Commercial |
$814.91
|
| Rate for Payer: Aetna Medicare |
$632.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.72
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS MAPPO |
$608.14
|
| Rate for Payer: BCN Commercial |
$1,034.80
|
| Rate for Payer: BCN Medicare Advantage |
$608.14
|
| Rate for Payer: Cash Price |
$1,538.40
|
| Rate for Payer: Cash Price |
$1,538.40
|
| Rate for Payer: Cofinity Commercial |
$814.91
|
| Rate for Payer: Cofinity Commercial |
$875.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$608.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.55
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.95
|
| Rate for Payer: Nomi Health Commercial |
$729.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,442.25
|
| Rate for Payer: PACE SWMI |
$608.14
|
| Rate for Payer: PHP Commercial |
$851.40
|
| Rate for Payer: PHP Medicare Advantage |
$608.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$974.48
|
| Rate for Payer: Priority Health Medicare |
$608.14
|
| Rate for Payer: Priority Health SBD |
$974.48
|
| Rate for Payer: Priority Health Tiered Network |
$974.48
|
| Rate for Payer: Railroad Medicare Medicare |
$608.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.63
|
| Rate for Payer: UHC Core |
$1,135.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$608.14
|
| Rate for Payer: UHC Exchange |
$1,135.63
|
| Rate for Payer: UHC Medicaid |
$405.13
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
| Rate for Payer: UMR Bronson Commercial |
$884.58
|
|
|
PR SKIN LESION SHAVE/EXCISION (15 MIN)
|
Professional
|
Both
|
$450.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Medicare |
$225.00
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.50
|
| Rate for Payer: UMR Bronson Commercial |
$207.00
|
|
|
PR SKIN LESION SHAVE/EXCISION (30 MIN)
|
Professional
|
Both
|
$525.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Medicare |
$262.50
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: UMR Bronson Commercial |
$241.50
|
|
|
PR SKYLA, 13.5 MG
|
Professional
|
Both
|
$1,506.00
|
|
|
Service Code
|
HCPCS J7301
|
| Min. Negotiated Rate |
$692.76 |
| Max. Negotiated Rate |
$1,129.50 |
| Rate for Payer: Aetna Commercial |
$917.35
|
| Rate for Payer: Aetna Medicare |
$753.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.35
|
| Rate for Payer: BCBS Complete |
$1,125.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.71
|
| Rate for Payer: BCN Commercial |
$1,020.68
|
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Meridian Medicaid |
$1,125.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,129.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,072.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.52
|
| Rate for Payer: UHC Core |
$1,059.52
|
| Rate for Payer: UHC Exchange |
$1,059.52
|
| Rate for Payer: UHC Medicaid |
$1,072.06
|
| Rate for Payer: UHCCP Medicaid |
$1,072.06
|
| Rate for Payer: UMR Bronson Commercial |
$692.76
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 36251
|
| Min. Negotiated Rate |
$143.14 |
| Max. Negotiated Rate |
$463.33 |
| Rate for Payer: Aetna Commercial |
$303.13
|
| Rate for Payer: Aetna Medicare |
$235.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.13
|
| Rate for Payer: BCBS Complete |
$150.30
|
| Rate for Payer: BCBS MAPPO |
$226.22
|
| Rate for Payer: BCN Commercial |
$371.49
|
| Rate for Payer: BCN Medicare Advantage |
$226.22
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cofinity Commercial |
$325.76
|
| Rate for Payer: Cofinity Commercial |
$303.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.53
|
| Rate for Payer: Meridian Medicaid |
$150.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.84
|
| Rate for Payer: Nomi Health Commercial |
$271.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.75
|
| Rate for Payer: PACE SWMI |
$226.22
|
| Rate for Payer: PHP Commercial |
$316.71
|
| Rate for Payer: PHP Medicare Advantage |
$226.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$399.49
|
| Rate for Payer: Priority Health Medicare |
$226.22
|
| Rate for Payer: Priority Health SBD |
$399.49
|
| Rate for Payer: Priority Health Tiered Network |
$399.49
|
| Rate for Payer: Railroad Medicare Medicare |
$226.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.33
|
| Rate for Payer: UHC Core |
$463.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.22
|
| Rate for Payer: UHC Exchange |
$463.33
|
| Rate for Payer: UHC Medicaid |
$143.14
|
| Rate for Payer: UHCCP Medicaid |
$143.14
|
| Rate for Payer: UMR Bronson Commercial |
$243.34
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 36252
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$642.76 |
| Rate for Payer: Aetna Commercial |
$418.70
|
| Rate for Payer: Aetna Medicare |
$324.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.94
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$312.46
|
| Rate for Payer: BCN Commercial |
$520.39
|
| Rate for Payer: BCN Medicare Advantage |
$312.46
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$418.70
|
| Rate for Payer: Cofinity Commercial |
$449.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.08
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.71
|
| Rate for Payer: Nomi Health Commercial |
$374.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.75
|
| Rate for Payer: PACE SWMI |
$312.46
|
| Rate for Payer: PHP Commercial |
$437.44
|
| Rate for Payer: PHP Medicare Advantage |
$312.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$559.61
|
| Rate for Payer: Priority Health Medicare |
$312.46
|
| Rate for Payer: Priority Health SBD |
$559.61
|
| Rate for Payer: Priority Health Tiered Network |
$559.61
|
| Rate for Payer: Railroad Medicare Medicare |
$312.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.76
|
| Rate for Payer: UHC Core |
$642.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.46
|
| Rate for Payer: UHC Exchange |
$642.76
|
| Rate for Payer: UHC Medicaid |
$197.45
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
| Rate for Payer: UMR Bronson Commercial |
$316.94
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 36223
|
| Min. Negotiated Rate |
$189.57 |
| Max. Negotiated Rate |
$1,391.25 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: Aetna Medicare |
$312.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.06
|
| Rate for Payer: BCBS Complete |
$199.05
|
| Rate for Payer: BCBS MAPPO |
$300.04
|
| Rate for Payer: BCN Commercial |
$489.52
|
| Rate for Payer: BCN Medicare Advantage |
$300.04
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$402.05
|
| Rate for Payer: Cofinity Commercial |
$432.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.04
|
| Rate for Payer: Meridian Medicaid |
$199.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.04
|
| Rate for Payer: Nomi Health Commercial |
$360.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,391.25
|
| Rate for Payer: PACE SWMI |
$300.04
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: PHP Medicare Advantage |
$300.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$526.42
|
| Rate for Payer: Priority Health Medicare |
$300.04
|
| Rate for Payer: Priority Health SBD |
$526.42
|
| Rate for Payer: Priority Health Tiered Network |
$526.42
|
| Rate for Payer: Railroad Medicare Medicare |
$300.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.01
|
| Rate for Payer: UHC Core |
$565.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.04
|
| Rate for Payer: UHC Exchange |
$565.01
|
| Rate for Payer: UHC Medicaid |
$189.57
|
| Rate for Payer: UHCCP Medicaid |
$189.57
|
| Rate for Payer: UMR Bronson Commercial |
$853.30
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 36222
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$341.65
|
| Rate for Payer: Aetna Medicare |
$265.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.14
|
| Rate for Payer: BCBS Complete |
$169.08
|
| Rate for Payer: BCBS MAPPO |
$254.96
|
| Rate for Payer: BCN Commercial |
$420.80
|
| Rate for Payer: BCN Medicare Advantage |
$254.96
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$341.65
|
| Rate for Payer: Cofinity Commercial |
$367.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.71
|
| Rate for Payer: Meridian Medicaid |
$169.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$280.46
|
| Rate for Payer: Nomi Health Commercial |
$305.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$254.96
|
| Rate for Payer: PHP Commercial |
$356.94
|
| Rate for Payer: PHP Medicare Advantage |
$254.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$452.51
|
| Rate for Payer: Priority Health Medicare |
$254.96
|
| Rate for Payer: Priority Health SBD |
$452.51
|
| Rate for Payer: Priority Health Tiered Network |
$452.51
|
| Rate for Payer: Railroad Medicare Medicare |
$254.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.88
|
| Rate for Payer: UHC Core |
$504.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$254.96
|
| Rate for Payer: UHC Exchange |
$504.88
|
| Rate for Payer: UHC Medicaid |
$161.03
|
| Rate for Payer: UHCCP Medicaid |
$161.03
|
| Rate for Payer: UMR Bronson Commercial |
$784.30
|
|
|
PR SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 36014
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$779.25 |
| Rate for Payer: Aetna Commercial |
$175.86
|
| Rate for Payer: Aetna Medicare |
$136.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.99
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$131.24
|
| Rate for Payer: BCN Commercial |
$222.10
|
| Rate for Payer: BCN Medicare Advantage |
$131.24
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cofinity Commercial |
$175.86
|
| Rate for Payer: Cofinity Commercial |
$188.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.80
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.36
|
| Rate for Payer: Nomi Health Commercial |
$157.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$779.25
|
| Rate for Payer: PACE SWMI |
$131.24
|
| Rate for Payer: PHP Commercial |
$183.74
|
| Rate for Payer: PHP Medicare Advantage |
$131.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$238.85
|
| Rate for Payer: Priority Health Medicare |
$131.24
|
| Rate for Payer: Priority Health SBD |
$238.85
|
| Rate for Payer: Priority Health Tiered Network |
$238.85
|
| Rate for Payer: Railroad Medicare Medicare |
$131.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.84
|
| Rate for Payer: UHC Core |
$271.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.24
|
| Rate for Payer: UHC Exchange |
$271.84
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
| Rate for Payer: UMR Bronson Commercial |
$477.94
|
|
|
PR SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 36228
|
| Min. Negotiated Rate |
$143.35 |
| Max. Negotiated Rate |
$1,050.75 |
| Rate for Payer: Aetna Commercial |
$304.96
|
| Rate for Payer: Aetna Medicare |
$236.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.72
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: BCBS MAPPO |
$227.58
|
| Rate for Payer: BCN Commercial |
$372.49
|
| Rate for Payer: BCN Medicare Advantage |
$227.58
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Cofinity Commercial |
$327.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.96
|
| Rate for Payer: Meridian Medicaid |
$150.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.34
|
| Rate for Payer: Nomi Health Commercial |
$273.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,050.75
|
| Rate for Payer: PACE SWMI |
$227.58
|
| Rate for Payer: PHP Commercial |
$318.61
|
| Rate for Payer: PHP Medicare Advantage |
$227.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$400.56
|
| Rate for Payer: Priority Health Medicare |
$227.58
|
| Rate for Payer: Priority Health SBD |
$400.56
|
| Rate for Payer: Priority Health Tiered Network |
$400.56
|
| Rate for Payer: Railroad Medicare Medicare |
$227.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.38
|
| Rate for Payer: UHC Core |
$429.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.58
|
| Rate for Payer: UHC Exchange |
$429.38
|
| Rate for Payer: UHC Medicaid |
$143.35
|
| Rate for Payer: UHCCP Medicaid |
$143.35
|
| Rate for Payer: UMR Bronson Commercial |
$644.46
|
|
|
PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART
|
Professional
|
Both
|
$1,296.00
|
|
|
Service Code
|
HCPCS 36224
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$972.00 |
| Rate for Payer: Aetna Commercial |
$448.85
|
| Rate for Payer: Aetna Medicare |
$348.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.34
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$334.96
|
| Rate for Payer: BCN Commercial |
$549.77
|
| Rate for Payer: BCN Medicare Advantage |
$334.96
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cofinity Commercial |
$448.85
|
| Rate for Payer: Cofinity Commercial |
$482.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.71
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.46
|
| Rate for Payer: Nomi Health Commercial |
$401.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.00
|
| Rate for Payer: PACE SWMI |
$334.96
|
| Rate for Payer: PHP Commercial |
$468.94
|
| Rate for Payer: PHP Medicare Advantage |
$334.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$591.22
|
| Rate for Payer: Priority Health Medicare |
$334.96
|
| Rate for Payer: Priority Health SBD |
$591.22
|
| Rate for Payer: Priority Health Tiered Network |
$591.22
|
| Rate for Payer: Railroad Medicare Medicare |
$334.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.93
|
| Rate for Payer: UHC Core |
$640.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$334.96
|
| Rate for Payer: UHC Exchange |
$640.93
|
| Rate for Payer: UHC Medicaid |
$211.72
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
| Rate for Payer: UMR Bronson Commercial |
$596.16
|
|
|
PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$2,414.00
|
|
|
Service Code
|
HCPCS 36216
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$1,810.50 |
| Rate for Payer: Aetna Commercial |
$328.84
|
| Rate for Payer: Aetna Medicare |
$255.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.38
|
| Rate for Payer: BCBS Complete |
$163.04
|
| Rate for Payer: BCBS MAPPO |
$245.40
|
| Rate for Payer: BCN Commercial |
$399.39
|
| Rate for Payer: BCN Medicare Advantage |
$245.40
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$328.84
|
| Rate for Payer: Cofinity Commercial |
$353.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.67
|
| Rate for Payer: Meridian Medicaid |
$163.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$269.94
|
| Rate for Payer: Nomi Health Commercial |
$294.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,810.50
|
| Rate for Payer: PACE SWMI |
$245.40
|
| Rate for Payer: PHP Commercial |
$343.56
|
| Rate for Payer: PHP Medicare Advantage |
$245.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$429.49
|
| Rate for Payer: Priority Health Medicare |
$245.40
|
| Rate for Payer: Priority Health SBD |
$429.49
|
| Rate for Payer: Priority Health Tiered Network |
$429.49
|
| Rate for Payer: Railroad Medicare Medicare |
$245.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.06
|
| Rate for Payer: UHC Core |
$487.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.40
|
| Rate for Payer: UHC Exchange |
$487.06
|
| Rate for Payer: UHC Medicaid |
$155.28
|
| Rate for Payer: UHCCP Medicaid |
$155.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.44
|
|
|
PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,073.00
|
|
|
Service Code
|
HCPCS 36246
|
| Min. Negotiated Rate |
$141.22 |
| Max. Negotiated Rate |
$804.75 |
| Rate for Payer: Aetna Commercial |
$300.12
|
| Rate for Payer: Aetna Medicare |
$232.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.52
|
| Rate for Payer: BCBS Complete |
$148.28
|
| Rate for Payer: BCBS MAPPO |
$223.97
|
| Rate for Payer: BCN Commercial |
$367.51
|
| Rate for Payer: BCN Medicare Advantage |
$223.97
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Commercial |
$300.12
|
| Rate for Payer: Cofinity Commercial |
$322.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.17
|
| Rate for Payer: Meridian Medicaid |
$148.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$246.37
|
| Rate for Payer: Nomi Health Commercial |
$268.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PACE SWMI |
$223.97
|
| Rate for Payer: PHP Commercial |
$313.56
|
| Rate for Payer: PHP Medicare Advantage |
$223.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$395.22
|
| Rate for Payer: Priority Health Medicare |
$223.97
|
| Rate for Payer: Priority Health SBD |
$395.22
|
| Rate for Payer: Priority Health Tiered Network |
$395.22
|
| Rate for Payer: Railroad Medicare Medicare |
$223.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.17
|
| Rate for Payer: UHC Core |
$454.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.97
|
| Rate for Payer: UHC Exchange |
$454.17
|
| Rate for Payer: UHC Medicaid |
$141.22
|
| Rate for Payer: UHCCP Medicaid |
$141.22
|
| Rate for Payer: UMR Bronson Commercial |
$493.58
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 36247
|
| Min. Negotiated Rate |
$165.08 |
| Max. Negotiated Rate |
$1,007.25 |
| Rate for Payer: Aetna Commercial |
$349.19
|
| Rate for Payer: Aetna Medicare |
$271.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.25
|
| Rate for Payer: BCBS Complete |
$173.33
|
| Rate for Payer: BCBS MAPPO |
$260.59
|
| Rate for Payer: BCN Commercial |
$433.74
|
| Rate for Payer: BCN Medicare Advantage |
$260.59
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$349.19
|
| Rate for Payer: Cofinity Commercial |
$375.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.62
|
| Rate for Payer: Meridian Medicaid |
$173.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.65
|
| Rate for Payer: Nomi Health Commercial |
$312.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.25
|
| Rate for Payer: PACE SWMI |
$260.59
|
| Rate for Payer: PHP Commercial |
$364.83
|
| Rate for Payer: PHP Medicare Advantage |
$260.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$466.44
|
| Rate for Payer: Priority Health Medicare |
$260.59
|
| Rate for Payer: Priority Health SBD |
$466.44
|
| Rate for Payer: Priority Health Tiered Network |
$466.44
|
| Rate for Payer: Railroad Medicare Medicare |
$260.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.37
|
| Rate for Payer: UHC Core |
$540.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$260.59
|
| Rate for Payer: UHC Exchange |
$540.37
|
| Rate for Payer: UHC Medicaid |
$165.08
|
| Rate for Payer: UHCCP Medicaid |
$165.08
|
| Rate for Payer: UMR Bronson Commercial |
$617.78
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 36217
|
| Min. Negotiated Rate |
$192.34 |
| Max. Negotiated Rate |
$1,063.50 |
| Rate for Payer: Aetna Commercial |
$407.65
|
| Rate for Payer: Aetna Medicare |
$316.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.08
|
| Rate for Payer: BCBS Complete |
$201.96
|
| Rate for Payer: BCBS MAPPO |
$304.22
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$304.22
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$407.65
|
| Rate for Payer: Cofinity Commercial |
$438.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.43
|
| Rate for Payer: Meridian Medicaid |
$201.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.64
|
| Rate for Payer: Nomi Health Commercial |
$365.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,063.50
|
| Rate for Payer: PACE SWMI |
$304.22
|
| Rate for Payer: PHP Commercial |
$425.91
|
| Rate for Payer: PHP Medicare Advantage |
$304.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$533.90
|
| Rate for Payer: Priority Health Medicare |
$304.22
|
| Rate for Payer: Priority Health SBD |
$533.90
|
| Rate for Payer: Priority Health Tiered Network |
$533.90
|
| Rate for Payer: Railroad Medicare Medicare |
$304.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.95
|
| Rate for Payer: UHC Core |
$586.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.22
|
| Rate for Payer: UHC Exchange |
$586.95
|
| Rate for Payer: UHC Medicaid |
$192.34
|
| Rate for Payer: UHCCP Medicaid |
$192.34
|
| Rate for Payer: UMR Bronson Commercial |
$652.28
|
|
|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$132.06 |
| Max. Negotiated Rate |
$645.00 |
| Rate for Payer: Aetna Commercial |
$279.31
|
| Rate for Payer: Aetna Medicare |
$216.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.15
|
| Rate for Payer: BCBS Complete |
$138.66
|
| Rate for Payer: BCBS MAPPO |
$208.44
|
| Rate for Payer: BCN Commercial |
$345.10
|
| Rate for Payer: BCN Medicare Advantage |
$208.44
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$279.31
|
| Rate for Payer: Cofinity Commercial |
$300.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.86
|
| Rate for Payer: Meridian Medicaid |
$138.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.28
|
| Rate for Payer: Nomi Health Commercial |
$250.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
| Rate for Payer: PACE SWMI |
$208.44
|
| Rate for Payer: PHP Commercial |
$291.82
|
| Rate for Payer: PHP Medicare Advantage |
$208.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.11
|
| Rate for Payer: Priority Health Medicare |
$208.44
|
| Rate for Payer: Priority Health SBD |
$371.11
|
| Rate for Payer: Priority Health Tiered Network |
$371.11
|
| Rate for Payer: Railroad Medicare Medicare |
$208.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.82
|
| Rate for Payer: UHC Core |
$424.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.44
|
| Rate for Payer: UHC Exchange |
$424.82
|
| Rate for Payer: UHC Medicaid |
$132.06
|
| Rate for Payer: UHCCP Medicaid |
$132.06
|
| Rate for Payer: UMR Bronson Commercial |
$395.60
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$709.50 |
| Rate for Payer: Aetna Commercial |
$251.91
|
| Rate for Payer: Aetna Medicare |
$195.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.71
|
| Rate for Payer: BCBS Complete |
$125.92
|
| Rate for Payer: BCBS MAPPO |
$187.99
|
| Rate for Payer: BCN Commercial |
$312.73
|
| Rate for Payer: BCN Medicare Advantage |
$187.99
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$251.91
|
| Rate for Payer: Cofinity Commercial |
$270.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.39
|
| Rate for Payer: Meridian Medicaid |
$125.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$206.79
|
| Rate for Payer: Nomi Health Commercial |
$225.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$187.99
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: PHP Medicare Advantage |
$187.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.31
|
| Rate for Payer: Priority Health Medicare |
$187.99
|
| Rate for Payer: Priority Health SBD |
$336.31
|
| Rate for Payer: Priority Health Tiered Network |
$336.31
|
| Rate for Payer: Railroad Medicare Medicare |
$187.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.32
|
| Rate for Payer: UHC Core |
$377.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$187.99
|
| Rate for Payer: UHC Exchange |
$377.32
|
| Rate for Payer: UHC Medicaid |
$119.92
|
| Rate for Payer: UHCCP Medicaid |
$119.92
|
| Rate for Payer: UMR Bronson Commercial |
$435.16
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$55.65
|
| Rate for Payer: Aetna Medicare |
$43.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.80
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$41.53
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.53
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$55.65
|
| Rate for Payer: Cofinity Commercial |
$59.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.61
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.68
|
| Rate for Payer: Nomi Health Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: PACE SWMI |
$41.53
|
| Rate for Payer: PHP Commercial |
$58.14
|
| Rate for Payer: PHP Medicare Advantage |
$41.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.04
|
| Rate for Payer: Priority Health Medicare |
$41.53
|
| Rate for Payer: Priority Health SBD |
$76.04
|
| Rate for Payer: Priority Health Tiered Network |
$76.04
|
| Rate for Payer: Railroad Medicare Medicare |
$41.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.53
|
| Rate for Payer: UHC Exchange |
$86.98
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$62.65
|
| Rate for Payer: Aetna Medicare |
$48.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.32
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$46.75
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$46.75
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$62.65
|
| Rate for Payer: Cofinity Commercial |
$67.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.09
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$56.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$46.75
|
| Rate for Payer: PHP Commercial |
$65.45
|
| Rate for Payer: PHP Medicare Advantage |
$46.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.01
|
| Rate for Payer: Priority Health Medicare |
$46.75
|
| Rate for Payer: Priority Health SBD |
$83.01
|
| Rate for Payer: Priority Health Tiered Network |
$83.01
|
| Rate for Payer: Railroad Medicare Medicare |
$46.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.53
|
| Rate for Payer: UHC Core |
$92.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.75
|
| Rate for Payer: UHC Exchange |
$92.53
|
| Rate for Payer: UHC Medicaid |
$29.61
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UMR Bronson Commercial |
$155.48
|
|
