|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$2,575.99 |
| Rate for Payer: Aetna Commercial |
$982.61
|
| Rate for Payer: Aetna Medicare |
$762.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.61
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$733.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.99
|
| Rate for Payer: BCN Commercial |
$1,101.48
|
| Rate for Payer: BCN Medicare Advantage |
$733.29
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,055.94
|
| Rate for Payer: Cofinity Commercial |
$982.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.95
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Nomi Health Commercial |
$879.95
|
| Rate for Payer: PACE SWMI |
$733.29
|
| Rate for Payer: PHP Commercial |
$1,026.61
|
| Rate for Payer: PHP Medicare Advantage |
$733.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,104.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.54
|
| Rate for Payer: Priority Health Medicare |
$733.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.54
|
| Rate for Payer: Priority Health SBD |
$1,209.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.29
|
| Rate for Payer: UHC Medicare Advantage |
$733.29
|
| Rate for Payer: UHCCP Medicaid |
$486.71
|
| Rate for Payer: UMR Bronson Commercial |
$781.54
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$185.74 |
| Max. Negotiated Rate |
$3,748.82 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: Aetna Medicare |
$289.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.37
|
| Rate for Payer: BCBS Complete |
$195.03
|
| Rate for Payer: BCBS MAPPO |
$278.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.82
|
| Rate for Payer: BCN Commercial |
$522.88
|
| Rate for Payer: BCN Medicare Advantage |
$278.73
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$373.50
|
| Rate for Payer: Cofinity Commercial |
$401.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.67
|
| Rate for Payer: Meridian Medicaid |
$195.03
|
| Rate for Payer: Nomi Health Commercial |
$334.48
|
| Rate for Payer: PACE SWMI |
$278.73
|
| Rate for Payer: PHP Commercial |
$390.22
|
| Rate for Payer: PHP Medicare Advantage |
$278.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.23
|
| Rate for Payer: Priority Health Medicare |
$278.73
|
| Rate for Payer: Priority Health Narrow Network |
$461.23
|
| Rate for Payer: Priority Health SBD |
$461.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.73
|
| Rate for Payer: UHC Medicare Advantage |
$278.73
|
| Rate for Payer: UHCCP Medicaid |
$185.74
|
| Rate for Payer: UMR Bronson Commercial |
$333.96
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$452.20 |
| Max. Negotiated Rate |
$3,137.57 |
| Rate for Payer: Aetna Commercial |
$902.37
|
| Rate for Payer: Aetna Medicare |
$700.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.71
|
| Rate for Payer: BCBS Complete |
$474.81
|
| Rate for Payer: BCBS MAPPO |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.57
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: BCN Medicare Advantage |
$673.41
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$902.37
|
| Rate for Payer: Cofinity Commercial |
$969.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.08
|
| Rate for Payer: Meridian Medicaid |
$474.81
|
| Rate for Payer: Nomi Health Commercial |
$808.09
|
| Rate for Payer: PACE SWMI |
$673.41
|
| Rate for Payer: PHP Commercial |
$942.77
|
| Rate for Payer: PHP Medicare Advantage |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,124.32
|
| Rate for Payer: Priority Health Medicare |
$673.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.32
|
| Rate for Payer: Priority Health SBD |
$1,124.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.41
|
| Rate for Payer: UHC Medicare Advantage |
$673.41
|
| Rate for Payer: UHCCP Medicaid |
$452.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,156.44
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$4,030.40 |
| Rate for Payer: Aetna Commercial |
$434.24
|
| Rate for Payer: Aetna Medicare |
$337.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.65
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$324.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.40
|
| Rate for Payer: BCN Commercial |
$595.70
|
| Rate for Payer: BCN Medicare Advantage |
$324.06
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cofinity Commercial |
$434.24
|
| Rate for Payer: Cofinity Commercial |
$466.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.26
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Nomi Health Commercial |
$388.87
|
| Rate for Payer: PACE SWMI |
$324.06
|
| Rate for Payer: PHP Commercial |
$453.68
|
| Rate for Payer: PHP Medicare Advantage |
$324.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.26
|
| Rate for Payer: Priority Health Medicare |
$324.06
|
| Rate for Payer: Priority Health Narrow Network |
$535.26
|
| Rate for Payer: Priority Health SBD |
$535.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.06
|
| Rate for Payer: UHC Medicare Advantage |
$324.06
|
| Rate for Payer: UHCCP Medicaid |
$215.77
|
| Rate for Payer: UMR Bronson Commercial |
$360.64
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$4,171.46 |
| Rate for Payer: Aetna Commercial |
$439.32
|
| Rate for Payer: Aetna Medicare |
$340.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.10
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$327.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.46
|
| Rate for Payer: BCN Commercial |
$606.45
|
| Rate for Payer: BCN Medicare Advantage |
$327.85
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$439.32
|
| Rate for Payer: Cofinity Commercial |
$472.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.24
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Nomi Health Commercial |
$393.42
|
| Rate for Payer: PACE SWMI |
$327.85
|
| Rate for Payer: PHP Commercial |
$458.99
|
| Rate for Payer: PHP Medicare Advantage |
$327.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.19
|
| Rate for Payer: Priority Health Medicare |
$327.85
|
| Rate for Payer: Priority Health Narrow Network |
$542.19
|
| Rate for Payer: Priority Health SBD |
$542.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.85
|
| Rate for Payer: UHC Medicare Advantage |
$327.85
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
| Rate for Payer: UMR Bronson Commercial |
$382.26
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$908.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$687.57 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$388.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.16
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCBS Trust/PPO |
$287.92
|
| Rate for Payer: BCN Commercial |
$687.57
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Commercial |
$523.21
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.41
|
| Rate for Payer: Priority Health Medicare |
$373.72
|
| Rate for Payer: Priority Health Narrow Network |
$619.41
|
| Rate for Payer: Priority Health SBD |
$619.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
| Rate for Payer: UMR Bronson Commercial |
$417.68
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$3,834.93 |
| Rate for Payer: Aetna Commercial |
$398.76
|
| Rate for Payer: Aetna Medicare |
$309.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.52
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$297.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,834.93
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$297.58
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$398.76
|
| Rate for Payer: Cofinity Commercial |
$428.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.46
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Nomi Health Commercial |
$357.10
|
| Rate for Payer: PACE SWMI |
$297.58
|
| Rate for Payer: PHP Commercial |
$416.61
|
| Rate for Payer: PHP Medicare Advantage |
$297.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.18
|
| Rate for Payer: Priority Health Medicare |
$297.58
|
| Rate for Payer: Priority Health Narrow Network |
$493.18
|
| Rate for Payer: Priority Health SBD |
$493.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.58
|
| Rate for Payer: UHC Medicare Advantage |
$297.58
|
| Rate for Payer: UHCCP Medicaid |
$198.30
|
| Rate for Payer: UMR Bronson Commercial |
$333.96
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$770.67 |
| Rate for Payer: Aetna Commercial |
$623.96
|
| Rate for Payer: Aetna Medicare |
$484.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.52
|
| Rate for Payer: BCBS Complete |
$325.18
|
| Rate for Payer: BCBS MAPPO |
$465.64
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$465.64
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$623.96
|
| Rate for Payer: Cofinity Commercial |
$670.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.92
|
| Rate for Payer: Meridian Medicaid |
$325.18
|
| Rate for Payer: Nomi Health Commercial |
$558.77
|
| Rate for Payer: PACE SWMI |
$465.64
|
| Rate for Payer: PHP Commercial |
$651.90
|
| Rate for Payer: PHP Medicare Advantage |
$465.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.67
|
| Rate for Payer: Priority Health Medicare |
$465.64
|
| Rate for Payer: Priority Health Narrow Network |
$770.67
|
| Rate for Payer: Priority Health SBD |
$770.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.64
|
| Rate for Payer: UHC Medicare Advantage |
$465.64
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
| Rate for Payer: UMR Bronson Commercial |
$438.84
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$611.24 |
| Max. Negotiated Rate |
$1,863.76 |
| Rate for Payer: Aetna Commercial |
$1,356.37
|
| Rate for Payer: Aetna Medicare |
$1,052.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,457.60
|
| Rate for Payer: BCBS Complete |
$702.71
|
| Rate for Payer: BCBS MAPPO |
$1,012.22
|
| Rate for Payer: BCBS Trust/PPO |
$611.24
|
| Rate for Payer: BCN Commercial |
$1,518.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.22
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.37
|
| Rate for Payer: Cofinity Commercial |
$1,457.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,062.83
|
| Rate for Payer: Meridian Medicaid |
$702.71
|
| Rate for Payer: Nomi Health Commercial |
$1,214.66
|
| Rate for Payer: PACE SWMI |
$1,012.22
|
| Rate for Payer: PHP Commercial |
$1,417.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,863.76
|
| Rate for Payer: Priority Health Medicare |
$1,012.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,863.76
|
| Rate for Payer: Priority Health SBD |
$1,863.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,012.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,012.22
|
| Rate for Payer: UHCCP Medicaid |
$669.25
|
| Rate for Payer: UMR Bronson Commercial |
$978.42
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$325.15 |
| Rate for Payer: Aetna Commercial |
$234.53
|
| Rate for Payer: Aetna Medicare |
$182.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.03
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS MAPPO |
$175.02
|
| Rate for Payer: BCBS Trust/PPO |
$169.58
|
| Rate for Payer: BCN Commercial |
$262.91
|
| Rate for Payer: BCN Medicare Advantage |
$175.02
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$234.53
|
| Rate for Payer: Cofinity Commercial |
$252.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.77
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Nomi Health Commercial |
$210.02
|
| Rate for Payer: PACE SWMI |
$175.02
|
| Rate for Payer: PHP Commercial |
$245.03
|
| Rate for Payer: PHP Medicare Advantage |
$175.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Medicare |
$175.02
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: Priority Health SBD |
$325.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.02
|
| Rate for Payer: UHC Medicare Advantage |
$175.02
|
| Rate for Payer: UHCCP Medicaid |
$117.58
|
| Rate for Payer: UMR Bronson Commercial |
$156.86
|
|
|
PR REPAIR ANORECTAL FISTULA PLUG
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 46707
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$910.41 |
| Rate for Payer: Aetna Commercial |
$652.96
|
| Rate for Payer: Aetna Medicare |
$506.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$701.68
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$487.28
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$487.28
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cofinity Commercial |
$652.96
|
| Rate for Payer: Cofinity Commercial |
$701.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.64
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Nomi Health Commercial |
$584.74
|
| Rate for Payer: PACE SWMI |
$487.28
|
| Rate for Payer: PHP Commercial |
$682.19
|
| Rate for Payer: PHP Medicare Advantage |
$487.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.41
|
| Rate for Payer: Priority Health Medicare |
$487.28
|
| Rate for Payer: Priority Health Narrow Network |
$910.41
|
| Rate for Payer: Priority Health SBD |
$910.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.28
|
| Rate for Payer: UHC Medicare Advantage |
$487.28
|
| Rate for Payer: UHCCP Medicaid |
$328.87
|
| Rate for Payer: UMR Bronson Commercial |
$477.02
|
|
|
PR REPAIR BIFID EARLOBES - BILATERAL
|
Professional
|
Both
|
$1,020.00
|
|
|
Service Code
|
HCPCS 00535
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$408.00 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Medicare |
$510.00
|
| Rate for Payer: BCBS Complete |
$408.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: UMR Bronson Commercial |
$469.20
|
|
|
PR REPAIR BIFID EARLOBES - UNILATERAL
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 00534
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$244.80 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR REPAIR BLOOD VESSEL DIRECT HAND FINGER
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 35207
|
| Min. Negotiated Rate |
$292.68 |
| Max. Negotiated Rate |
$1,209.90 |
| Rate for Payer: Aetna Commercial |
$972.95
|
| Rate for Payer: Aetna Medicare |
$755.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.95
|
| Rate for Payer: BCBS Complete |
$514.17
|
| Rate for Payer: BCBS MAPPO |
$726.08
|
| Rate for Payer: BCBS Trust/PPO |
$292.68
|
| Rate for Payer: BCN Commercial |
$1,109.79
|
| Rate for Payer: BCN Medicare Advantage |
$726.08
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$972.95
|
| Rate for Payer: Cofinity Commercial |
$1,045.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.38
|
| Rate for Payer: Meridian Medicaid |
$514.17
|
| Rate for Payer: Nomi Health Commercial |
$871.30
|
| Rate for Payer: PACE SWMI |
$726.08
|
| Rate for Payer: PHP Commercial |
$1,016.51
|
| Rate for Payer: PHP Medicare Advantage |
$726.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.90
|
| Rate for Payer: Priority Health Medicare |
$726.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,209.90
|
| Rate for Payer: Priority Health SBD |
$1,209.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$726.08
|
| Rate for Payer: UHC Medicare Advantage |
$726.08
|
| Rate for Payer: UHCCP Medicaid |
$489.69
|
| Rate for Payer: UMR Bronson Commercial |
$622.38
|
|
|
PR REPAIR BLOOD VESSEL DIRECT INTRA-ABDOMINAL
|
Professional
|
Both
|
$5,052.00
|
|
|
Service Code
|
HCPCS 35221
|
| Min. Negotiated Rate |
$926.34 |
| Max. Negotiated Rate |
$3,283.80 |
| Rate for Payer: Aetna Commercial |
$1,893.10
|
| Rate for Payer: Aetna Medicare |
$1,469.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,893.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,034.37
|
| Rate for Payer: BCBS Complete |
$972.66
|
| Rate for Payer: BCBS MAPPO |
$1,412.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.77
|
| Rate for Payer: BCN Commercial |
$2,119.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,412.76
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cofinity Commercial |
$1,893.10
|
| Rate for Payer: Cofinity Commercial |
$2,034.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,412.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,483.40
|
| Rate for Payer: Meridian Medicaid |
$972.66
|
| Rate for Payer: Nomi Health Commercial |
$1,695.31
|
| Rate for Payer: PACE SWMI |
$1,412.76
|
| Rate for Payer: PHP Commercial |
$1,977.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,412.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,283.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,313.97
|
| Rate for Payer: Priority Health Medicare |
$1,412.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,313.97
|
| Rate for Payer: Priority Health SBD |
$2,313.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,412.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,412.76
|
| Rate for Payer: UHCCP Medicaid |
$926.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,323.92
|
|
|
PR REPAIR BLOOD VESSEL DIRECT LOWER EXTREMITY
|
Professional
|
Both
|
$2,660.00
|
|
|
Service Code
|
HCPCS 35226
|
| Min. Negotiated Rate |
$519.51 |
| Max. Negotiated Rate |
$2,526.86 |
| Rate for Payer: Aetna Commercial |
$1,063.89
|
| Rate for Payer: Aetna Medicare |
$825.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.29
|
| Rate for Payer: BCBS Complete |
$545.49
|
| Rate for Payer: BCBS MAPPO |
$793.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,526.86
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| Rate for Payer: BCN Medicare Advantage |
$793.95
|
| Rate for Payer: Cash Price |
$2,128.00
|
| Rate for Payer: Cash Price |
$2,128.00
|
| Rate for Payer: Cofinity Commercial |
$1,063.89
|
| Rate for Payer: Cofinity Commercial |
$1,143.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$833.65
|
| Rate for Payer: Meridian Medicaid |
$545.49
|
| Rate for Payer: Nomi Health Commercial |
$952.74
|
| Rate for Payer: PACE SWMI |
$793.95
|
| Rate for Payer: PHP Commercial |
$1,111.53
|
| Rate for Payer: PHP Medicare Advantage |
$793.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,294.99
|
| Rate for Payer: Priority Health Medicare |
$793.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,294.99
|
| Rate for Payer: Priority Health SBD |
$1,294.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.95
|
| Rate for Payer: UHC Medicare Advantage |
$793.95
|
| Rate for Payer: UHCCP Medicaid |
$519.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,223.60
|
|
|
PR REPAIR BLOOD VESSEL DIRECT NECK
|
Professional
|
Both
|
$4,240.00
|
|
|
Service Code
|
HCPCS 35201
|
| Min. Negotiated Rate |
$584.05 |
| Max. Negotiated Rate |
$2,756.00 |
| Rate for Payer: Aetna Commercial |
$1,192.77
|
| Rate for Payer: Aetna Medicare |
$925.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.79
|
| Rate for Payer: BCBS Complete |
$613.25
|
| Rate for Payer: BCBS MAPPO |
$890.13
|
| Rate for Payer: BCBS Trust/PPO |
$871.17
|
| Rate for Payer: BCN Commercial |
$1,340.94
|
| Rate for Payer: BCN Medicare Advantage |
$890.13
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cofinity Commercial |
$1,192.77
|
| Rate for Payer: Cofinity Commercial |
$1,281.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.64
|
| Rate for Payer: Meridian Medicaid |
$613.25
|
| Rate for Payer: Nomi Health Commercial |
$1,068.16
|
| Rate for Payer: PACE SWMI |
$890.13
|
| Rate for Payer: PHP Commercial |
$1,246.18
|
| Rate for Payer: PHP Medicare Advantage |
$890.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,463.58
|
| Rate for Payer: Priority Health Medicare |
$890.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,463.58
|
| Rate for Payer: Priority Health SBD |
$1,463.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.13
|
| Rate for Payer: UHC Medicare Advantage |
$890.13
|
| Rate for Payer: UHCCP Medicaid |
$584.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,950.40
|
|
|
PR REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 35206
|
| Min. Negotiated Rate |
$503.53 |
| Max. Negotiated Rate |
$1,959.46 |
| Rate for Payer: Aetna Commercial |
$1,022.62
|
| Rate for Payer: Aetna Medicare |
$793.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,022.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.94
|
| Rate for Payer: BCBS Complete |
$528.71
|
| Rate for Payer: BCBS MAPPO |
$763.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.46
|
| Rate for Payer: BCN Commercial |
$1,129.33
|
| Rate for Payer: BCN Medicare Advantage |
$763.15
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,022.62
|
| Rate for Payer: Cofinity Commercial |
$1,098.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.31
|
| Rate for Payer: Meridian Medicaid |
$528.71
|
| Rate for Payer: Nomi Health Commercial |
$915.78
|
| Rate for Payer: PACE SWMI |
$763.15
|
| Rate for Payer: PHP Commercial |
$1,068.41
|
| Rate for Payer: PHP Medicare Advantage |
$763.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,813.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,243.40
|
| Rate for Payer: Priority Health Medicare |
$763.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,243.40
|
| Rate for Payer: Priority Health SBD |
$1,243.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.15
|
| Rate for Payer: UHC Medicare Advantage |
$763.15
|
| Rate for Payer: UHCCP Medicaid |
$503.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,283.40
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL
|
Professional
|
Both
|
$3,839.00
|
|
|
Service Code
|
HCPCS 35251
|
| Min. Negotiated Rate |
$808.30 |
| Max. Negotiated Rate |
$2,725.59 |
| Rate for Payer: Aetna Commercial |
$2,226.45
|
| Rate for Payer: Aetna Medicare |
$1,727.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,226.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,392.60
|
| Rate for Payer: BCBS Complete |
$1,141.74
|
| Rate for Payer: BCBS MAPPO |
$1,661.53
|
| Rate for Payer: BCBS Trust/PPO |
$808.30
|
| Rate for Payer: BCN Commercial |
$2,514.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.53
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cash Price |
$3,071.20
|
| Rate for Payer: Cofinity Commercial |
$2,226.45
|
| Rate for Payer: Cofinity Commercial |
$2,392.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,744.61
|
| Rate for Payer: Meridian Medicaid |
$1,141.74
|
| Rate for Payer: Nomi Health Commercial |
$1,993.84
|
| Rate for Payer: PACE SWMI |
$1,661.53
|
| Rate for Payer: PHP Commercial |
$2,326.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,087.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,495.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,725.59
|
| Rate for Payer: Priority Health Medicare |
$1,661.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,725.59
|
| Rate for Payer: Priority Health SBD |
$2,725.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,661.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,661.53
|
| Rate for Payer: UHCCP Medicaid |
$1,087.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,765.94
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY
|
Professional
|
Both
|
$4,575.00
|
|
|
Service Code
|
HCPCS 35256
|
| Min. Negotiated Rate |
$639.43 |
| Max. Negotiated Rate |
$2,973.75 |
| Rate for Payer: Aetna Commercial |
$1,310.69
|
| Rate for Payer: Aetna Medicare |
$1,017.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.51
|
| Rate for Payer: BCBS Complete |
$671.40
|
| Rate for Payer: BCBS MAPPO |
$978.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,459.19
|
| Rate for Payer: BCN Medicare Advantage |
$978.13
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cash Price |
$3,660.00
|
| Rate for Payer: Cofinity Commercial |
$1,310.69
|
| Rate for Payer: Cofinity Commercial |
$1,408.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.04
|
| Rate for Payer: Meridian Medicaid |
$671.40
|
| Rate for Payer: Nomi Health Commercial |
$1,173.76
|
| Rate for Payer: PACE SWMI |
$978.13
|
| Rate for Payer: PHP Commercial |
$1,369.38
|
| Rate for Payer: PHP Medicare Advantage |
$978.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,973.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,578.99
|
| Rate for Payer: Priority Health Medicare |
$978.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,578.99
|
| Rate for Payer: Priority Health SBD |
$1,578.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.13
|
| Rate for Payer: UHC Medicare Advantage |
$978.13
|
| Rate for Payer: UHCCP Medicaid |
$639.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.50
|
|
|
PR REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK
|
Professional
|
Both
|
$4,692.00
|
|
|
Service Code
|
HCPCS 35261
|
| Min. Negotiated Rate |
$615.36 |
| Max. Negotiated Rate |
$3,049.80 |
| Rate for Payer: Aetna Commercial |
$1,266.84
|
| Rate for Payer: Aetna Medicare |
$983.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.38
|
| Rate for Payer: BCBS Complete |
$646.13
|
| Rate for Payer: BCBS MAPPO |
$945.40
|
| Rate for Payer: BCBS Trust/PPO |
$773.96
|
| Rate for Payer: BCN Commercial |
$1,398.59
|
| Rate for Payer: BCN Medicare Advantage |
$945.40
|
| Rate for Payer: Cash Price |
$3,753.60
|
| Rate for Payer: Cash Price |
$3,753.60
|
| Rate for Payer: Cofinity Commercial |
$1,266.84
|
| Rate for Payer: Cofinity Commercial |
$1,361.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.67
|
| Rate for Payer: Meridian Medicaid |
$646.13
|
| Rate for Payer: Nomi Health Commercial |
$1,134.48
|
| Rate for Payer: PACE SWMI |
$945.40
|
| Rate for Payer: PHP Commercial |
$1,323.56
|
| Rate for Payer: PHP Medicare Advantage |
$945.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,049.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,531.13
|
| Rate for Payer: Priority Health Medicare |
$945.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,531.13
|
| Rate for Payer: Priority Health SBD |
$1,531.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.40
|
| Rate for Payer: UHC Medicare Advantage |
$945.40
|
| Rate for Payer: UHCCP Medicaid |
$615.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,158.32
|
|
|
PR REPAIR BLOOD VESSEL W/VEIN GRAFT NECK
|
Professional
|
Both
|
$1,896.00
|
|
|
Service Code
|
HCPCS 35231
|
| Min. Negotiated Rate |
$794.92 |
| Max. Negotiated Rate |
$2,591.31 |
| Rate for Payer: Aetna Commercial |
$1,599.79
|
| Rate for Payer: Aetna Medicare |
$1,241.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,599.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.17
|
| Rate for Payer: BCBS Complete |
$834.67
|
| Rate for Payer: BCBS MAPPO |
$1,193.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.31
|
| Rate for Payer: BCN Commercial |
$1,810.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.87
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cash Price |
$1,516.80
|
| Rate for Payer: Cofinity Commercial |
$1,599.79
|
| Rate for Payer: Cofinity Commercial |
$1,719.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,253.56
|
| Rate for Payer: Meridian Medicaid |
$834.67
|
| Rate for Payer: Nomi Health Commercial |
$1,432.64
|
| Rate for Payer: PACE SWMI |
$1,193.87
|
| Rate for Payer: PHP Commercial |
$1,671.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,969.88
|
| Rate for Payer: Priority Health Medicare |
$1,193.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,969.88
|
| Rate for Payer: Priority Health SBD |
$1,969.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,193.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.87
|
| Rate for Payer: UHCCP Medicaid |
$794.92
|
| Rate for Payer: UMR Bronson Commercial |
$872.16
|
|
|
PR REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY
|
Professional
|
Both
|
$3,698.00
|
|
|
Service Code
|
HCPCS 35236
|
| Min. Negotiated Rate |
$636.02 |
| Max. Negotiated Rate |
$2,563.84 |
| Rate for Payer: Aetna Commercial |
$1,295.15
|
| Rate for Payer: Aetna Medicare |
$1,005.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,391.80
|
| Rate for Payer: BCBS Complete |
$667.82
|
| Rate for Payer: BCBS MAPPO |
$966.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,563.84
|
| Rate for Payer: BCN Commercial |
$1,427.91
|
| Rate for Payer: BCN Medicare Advantage |
$966.53
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,295.15
|
| Rate for Payer: Cofinity Commercial |
$1,391.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,014.86
|
| Rate for Payer: Meridian Medicaid |
$667.82
|
| Rate for Payer: Nomi Health Commercial |
$1,159.84
|
| Rate for Payer: PACE SWMI |
$966.53
|
| Rate for Payer: PHP Commercial |
$1,353.14
|
| Rate for Payer: PHP Medicare Advantage |
$966.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,403.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,565.69
|
| Rate for Payer: Priority Health Medicare |
$966.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,565.69
|
| Rate for Payer: Priority Health SBD |
$1,565.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$966.53
|
| Rate for Payer: UHC Medicare Advantage |
$966.53
|
| Rate for Payer: UHCCP Medicaid |
$636.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,701.08
|
|
|
PR REPAIR BROW PTOSIS
|
Professional
|
Both
|
$1,326.00
|
|
|
Service Code
|
HCPCS 67900
|
| Min. Negotiated Rate |
$183.32 |
| Max. Negotiated Rate |
$944.61 |
| Rate for Payer: Aetna Commercial |
$627.51
|
| Rate for Payer: Aetna Medicare |
$487.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.34
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$468.29
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$944.61
|
| Rate for Payer: BCN Medicare Advantage |
$468.29
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$627.51
|
| Rate for Payer: Cofinity Commercial |
$674.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.70
|
| Rate for Payer: Meridian Medicaid |
$336.60
|
| Rate for Payer: Nomi Health Commercial |
$561.95
|
| Rate for Payer: PACE SWMI |
$468.29
|
| Rate for Payer: PHP Commercial |
$655.61
|
| Rate for Payer: PHP Medicare Advantage |
$468.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.53
|
| Rate for Payer: Priority Health Medicare |
$468.29
|
| Rate for Payer: Priority Health Narrow Network |
$878.53
|
| Rate for Payer: Priority Health SBD |
$878.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.29
|
| Rate for Payer: UHC Medicare Advantage |
$468.29
|
| Rate for Payer: UHCCP Medicaid |
$320.57
|
| Rate for Payer: UMR Bronson Commercial |
$609.96
|
|
|
PR REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS
|
Professional
|
Both
|
$7,686.00
|
|
|
Service Code
|
HCPCS 33305
|
| Min. Negotiated Rate |
$786.64 |
| Max. Negotiated Rate |
$6,391.47 |
| Rate for Payer: Aetna Commercial |
$5,250.48
|
| Rate for Payer: Aetna Medicare |
$4,075.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,250.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,642.31
|
| Rate for Payer: BCBS Complete |
$2,688.94
|
| Rate for Payer: BCBS MAPPO |
$3,918.27
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$5,839.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,918.27
|
| Rate for Payer: Cash Price |
$6,148.80
|
| Rate for Payer: Cash Price |
$6,148.80
|
| Rate for Payer: Cofinity Commercial |
$5,250.48
|
| Rate for Payer: Cofinity Commercial |
$5,642.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,918.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,114.18
|
| Rate for Payer: Meridian Medicaid |
$2,688.94
|
| Rate for Payer: Nomi Health Commercial |
$4,701.92
|
| Rate for Payer: PACE SWMI |
$3,918.27
|
| Rate for Payer: PHP Commercial |
$5,485.58
|
| Rate for Payer: PHP Medicare Advantage |
$3,918.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,560.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,995.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,391.47
|
| Rate for Payer: Priority Health Medicare |
$3,918.27
|
| Rate for Payer: Priority Health Narrow Network |
$6,391.47
|
| Rate for Payer: Priority Health SBD |
$6,391.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,918.27
|
| Rate for Payer: UHC Medicare Advantage |
$3,918.27
|
| Rate for Payer: UHCCP Medicaid |
$2,560.90
|
| Rate for Payer: UMR Bronson Commercial |
$3,535.56
|
|
