|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$573.73 |
| Max. Negotiated Rate |
$1,995.94 |
| Rate for Payer: Aetna Commercial |
$1,625.41
|
| Rate for Payer: Aetna Medicare |
$1,261.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,746.71
|
| Rate for Payer: BCBS Complete |
$846.07
|
| Rate for Payer: BCBS MAPPO |
$1,212.99
|
| Rate for Payer: BCBS Trust/PPO |
$573.73
|
| Rate for Payer: BCN Commercial |
$1,817.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.99
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,625.41
|
| Rate for Payer: Cofinity Commercial |
$1,746.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.64
|
| Rate for Payer: Meridian Medicaid |
$846.07
|
| Rate for Payer: Nomi Health Commercial |
$1,455.59
|
| Rate for Payer: PACE SWMI |
$1,212.99
|
| Rate for Payer: PHP Commercial |
$1,698.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,995.94
|
| Rate for Payer: Priority Health Medicare |
$1,212.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.94
|
| Rate for Payer: Priority Health SBD |
$1,995.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,212.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,212.99
|
| Rate for Payer: UHCCP Medicaid |
$805.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,040.06
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,676.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$479.70 |
| Max. Negotiated Rate |
$2,389.40 |
| Rate for Payer: Aetna Commercial |
$1,039.29
|
| Rate for Payer: Aetna Medicare |
$806.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.85
|
| Rate for Payer: BCBS Complete |
$541.45
|
| Rate for Payer: BCBS MAPPO |
$775.59
|
| Rate for Payer: BCBS Trust/PPO |
$479.70
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$775.59
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cofinity Commercial |
$1,039.29
|
| Rate for Payer: Cofinity Commercial |
$1,116.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.37
|
| Rate for Payer: Meridian Medicaid |
$541.45
|
| Rate for Payer: Nomi Health Commercial |
$930.71
|
| Rate for Payer: PACE SWMI |
$775.59
|
| Rate for Payer: PHP Commercial |
$1,085.83
|
| Rate for Payer: PHP Medicare Advantage |
$775.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,389.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,279.03
|
| Rate for Payer: Priority Health Medicare |
$775.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,279.03
|
| Rate for Payer: Priority Health SBD |
$1,279.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.59
|
| Rate for Payer: UHC Medicare Advantage |
$775.59
|
| Rate for Payer: UHCCP Medicaid |
$515.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,690.96
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,417.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$410.49 |
| Max. Negotiated Rate |
$3,634.65 |
| Rate for Payer: Aetna Commercial |
$2,700.09
|
| Rate for Payer: Aetna Medicare |
$2,095.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,700.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,901.59
|
| Rate for Payer: BCBS Complete |
$1,422.19
|
| Rate for Payer: BCBS MAPPO |
$2,014.99
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$3,131.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.99
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cofinity Commercial |
$2,700.09
|
| Rate for Payer: Cofinity Commercial |
$2,901.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.74
|
| Rate for Payer: Meridian Medicaid |
$1,422.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.99
|
| Rate for Payer: PACE SWMI |
$2,014.99
|
| Rate for Payer: PHP Commercial |
$2,820.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,634.65
|
| Rate for Payer: Priority Health Medicare |
$2,014.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,634.65
|
| Rate for Payer: Priority Health SBD |
$3,634.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.99
|
| Rate for Payer: UHCCP Medicaid |
$1,354.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,491.82
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,464.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$1,560.44 |
| Max. Negotiated Rate |
$4,982.12 |
| Rate for Payer: Aetna Commercial |
$3,147.04
|
| Rate for Payer: Aetna Medicare |
$2,442.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,147.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.90
|
| Rate for Payer: BCBS Complete |
$1,638.46
|
| Rate for Payer: BCBS MAPPO |
$2,348.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$4,982.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,348.54
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cofinity Commercial |
$3,147.04
|
| Rate for Payer: Cofinity Commercial |
$3,381.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,348.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,465.97
|
| Rate for Payer: Meridian Medicaid |
$1,638.46
|
| Rate for Payer: Nomi Health Commercial |
$2,818.25
|
| Rate for Payer: PACE SWMI |
$2,348.54
|
| Rate for Payer: PHP Commercial |
$3,287.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,348.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,560.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,851.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,196.54
|
| Rate for Payer: Priority Health Medicare |
$2,348.54
|
| Rate for Payer: Priority Health Narrow Network |
$4,196.54
|
| Rate for Payer: Priority Health SBD |
$4,196.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,348.54
|
| Rate for Payer: UHC Medicare Advantage |
$2,348.54
|
| Rate for Payer: UHCCP Medicaid |
$1,560.44
|
| Rate for Payer: UMR Bronson Commercial |
$3,433.44
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$6,974.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$6,824.07 |
| Rate for Payer: Aetna Commercial |
$4,342.20
|
| Rate for Payer: Aetna Medicare |
$3,370.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,342.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,666.25
|
| Rate for Payer: BCBS Complete |
$2,249.47
|
| Rate for Payer: BCBS MAPPO |
$3,240.45
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$6,824.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,240.45
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cofinity Commercial |
$4,342.20
|
| Rate for Payer: Cofinity Commercial |
$4,666.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,240.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,402.47
|
| Rate for Payer: Meridian Medicaid |
$2,249.47
|
| Rate for Payer: Nomi Health Commercial |
$3,888.54
|
| Rate for Payer: PACE SWMI |
$3,240.45
|
| Rate for Payer: PHP Commercial |
$4,536.63
|
| Rate for Payer: PHP Medicare Advantage |
$3,240.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,142.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,533.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,752.55
|
| Rate for Payer: Priority Health Medicare |
$3,240.45
|
| Rate for Payer: Priority Health Narrow Network |
$5,752.55
|
| Rate for Payer: Priority Health SBD |
$5,752.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,240.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,240.45
|
| Rate for Payer: UHCCP Medicaid |
$2,142.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,208.04
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,225.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$129.96 |
| Max. Negotiated Rate |
$4,857.41 |
| Rate for Payer: Aetna Commercial |
$3,674.04
|
| Rate for Payer: Aetna Medicare |
$2,851.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,674.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,948.22
|
| Rate for Payer: BCBS Complete |
$1,908.19
|
| Rate for Payer: BCBS MAPPO |
$2,741.82
|
| Rate for Payer: BCBS Trust/PPO |
$129.96
|
| Rate for Payer: BCN Commercial |
$4,161.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,741.82
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cofinity Commercial |
$3,674.04
|
| Rate for Payer: Cofinity Commercial |
$3,948.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,741.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,878.91
|
| Rate for Payer: Meridian Medicaid |
$1,908.19
|
| Rate for Payer: Nomi Health Commercial |
$3,290.18
|
| Rate for Payer: PACE SWMI |
$2,741.82
|
| Rate for Payer: PHP Commercial |
$3,838.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,741.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,817.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,696.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,857.41
|
| Rate for Payer: Priority Health Medicare |
$2,741.82
|
| Rate for Payer: Priority Health Narrow Network |
$4,857.41
|
| Rate for Payer: Priority Health SBD |
$4,857.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,741.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,741.82
|
| Rate for Payer: UHCCP Medicaid |
$1,817.32
|
| Rate for Payer: UMR Bronson Commercial |
$3,323.50
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,724.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,389.19 |
| Max. Negotiated Rate |
$3,700.05 |
| Rate for Payer: Aetna Commercial |
$2,763.20
|
| Rate for Payer: Aetna Medicare |
$2,144.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,763.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,969.41
|
| Rate for Payer: BCBS Complete |
$1,458.65
|
| Rate for Payer: BCBS MAPPO |
$2,062.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$3,188.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,062.09
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Cofinity Commercial |
$2,763.20
|
| Rate for Payer: Cofinity Commercial |
$2,969.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,062.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,165.19
|
| Rate for Payer: Meridian Medicaid |
$1,458.65
|
| Rate for Payer: Nomi Health Commercial |
$2,474.51
|
| Rate for Payer: PACE SWMI |
$2,062.09
|
| Rate for Payer: PHP Commercial |
$2,886.93
|
| Rate for Payer: PHP Medicare Advantage |
$2,062.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,389.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,070.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,700.05
|
| Rate for Payer: Priority Health Medicare |
$2,062.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,700.05
|
| Rate for Payer: Priority Health SBD |
$3,700.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,062.09
|
| Rate for Payer: UHC Medicare Advantage |
$2,062.09
|
| Rate for Payer: UHCCP Medicaid |
$1,389.19
|
| Rate for Payer: UMR Bronson Commercial |
$2,173.04
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,219.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$202.34 |
| Max. Negotiated Rate |
$6,642.35 |
| Rate for Payer: Aetna Commercial |
$3,795.98
|
| Rate for Payer: Aetna Medicare |
$2,946.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,795.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,079.26
|
| Rate for Payer: BCBS Complete |
$1,967.90
|
| Rate for Payer: BCBS MAPPO |
$2,832.82
|
| Rate for Payer: BCBS Trust/PPO |
$202.34
|
| Rate for Payer: BCN Commercial |
$5,966.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,832.82
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Cofinity Commercial |
$3,795.98
|
| Rate for Payer: Cofinity Commercial |
$4,079.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,832.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,974.46
|
| Rate for Payer: Meridian Medicaid |
$1,967.90
|
| Rate for Payer: Nomi Health Commercial |
$3,399.38
|
| Rate for Payer: PACE SWMI |
$2,832.82
|
| Rate for Payer: PHP Commercial |
$3,965.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,832.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,874.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,642.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,995.03
|
| Rate for Payer: Priority Health Medicare |
$2,832.82
|
| Rate for Payer: Priority Health Narrow Network |
$4,995.03
|
| Rate for Payer: Priority Health SBD |
$4,995.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,832.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,832.82
|
| Rate for Payer: UHCCP Medicaid |
$1,874.19
|
| Rate for Payer: UMR Bronson Commercial |
$4,700.74
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL
|
Professional
|
Both
|
$10,653.00
|
|
|
Service Code
|
HCPCS 61608
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$6,924.45 |
| Rate for Payer: Aetna Commercial |
$4,302.03
|
| Rate for Payer: Aetna Medicare |
$3,338.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,302.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,623.08
|
| Rate for Payer: BCBS Complete |
$2,220.39
|
| Rate for Payer: BCBS MAPPO |
$3,210.47
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$6,712.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,210.47
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Cofinity Commercial |
$4,302.03
|
| Rate for Payer: Cofinity Commercial |
$4,623.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,210.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,370.99
|
| Rate for Payer: Meridian Medicaid |
$2,220.39
|
| Rate for Payer: Nomi Health Commercial |
$3,852.56
|
| Rate for Payer: PACE SWMI |
$3,210.47
|
| Rate for Payer: PHP Commercial |
$4,494.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,210.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,924.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,653.60
|
| Rate for Payer: Priority Health Medicare |
$3,210.47
|
| Rate for Payer: Priority Health Narrow Network |
$5,653.60
|
| Rate for Payer: Priority Health SBD |
$5,653.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,210.47
|
| Rate for Payer: UHC Medicare Advantage |
$3,210.47
|
| Rate for Payer: UHCCP Medicaid |
$2,114.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,900.38
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL
|
Professional
|
Both
|
$6,021.00
|
|
|
Service Code
|
HCPCS 61607
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$5,239.58 |
| Rate for Payer: Aetna Commercial |
$3,987.44
|
| Rate for Payer: Aetna Medicare |
$3,094.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,987.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,285.01
|
| Rate for Payer: BCBS Complete |
$2,060.71
|
| Rate for Payer: BCBS MAPPO |
$2,975.70
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$3,905.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,975.70
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cofinity Commercial |
$3,987.44
|
| Rate for Payer: Cofinity Commercial |
$4,285.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,975.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,124.48
|
| Rate for Payer: Meridian Medicaid |
$2,060.71
|
| Rate for Payer: Nomi Health Commercial |
$3,570.84
|
| Rate for Payer: PACE SWMI |
$2,975.70
|
| Rate for Payer: PHP Commercial |
$4,165.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,975.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,962.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,913.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,239.58
|
| Rate for Payer: Priority Health Medicare |
$2,975.70
|
| Rate for Payer: Priority Health Narrow Network |
$5,239.58
|
| Rate for Payer: Priority Health SBD |
$5,239.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,975.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,975.70
|
| Rate for Payer: UHCCP Medicaid |
$1,962.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,769.66
|
|
|
PR RESCJ PALATE/EXTENSIVE RESCJ LESION
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 42120
|
| Min. Negotiated Rate |
$418.41 |
| Max. Negotiated Rate |
$1,793.97 |
| Rate for Payer: Aetna Commercial |
$1,256.14
|
| Rate for Payer: Aetna Medicare |
$974.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.88
|
| Rate for Payer: BCBS Complete |
$674.31
|
| Rate for Payer: BCBS MAPPO |
$937.42
|
| Rate for Payer: BCBS Trust/PPO |
$418.41
|
| Rate for Payer: BCN Commercial |
$1,474.34
|
| Rate for Payer: BCN Medicare Advantage |
$937.42
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$1,256.14
|
| Rate for Payer: Cofinity Commercial |
$1,349.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.29
|
| Rate for Payer: Meridian Medicaid |
$674.31
|
| Rate for Payer: Nomi Health Commercial |
$1,124.90
|
| Rate for Payer: PACE SWMI |
$937.42
|
| Rate for Payer: PHP Commercial |
$1,312.39
|
| Rate for Payer: PHP Medicare Advantage |
$937.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.97
|
| Rate for Payer: Priority Health Medicare |
$937.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,793.97
|
| Rate for Payer: Priority Health SBD |
$1,793.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.42
|
| Rate for Payer: UHC Medicare Advantage |
$937.42
|
| Rate for Payer: UHCCP Medicaid |
$642.20
|
| Rate for Payer: UMR Bronson Commercial |
$943.92
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 58952
|
| Min. Negotiated Rate |
$1,056.69 |
| Max. Negotiated Rate |
$2,463.86 |
| Rate for Payer: Aetna Commercial |
$2,116.78
|
| Rate for Payer: Aetna Medicare |
$1,642.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,116.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.75
|
| Rate for Payer: BCBS Complete |
$1,109.52
|
| Rate for Payer: BCBS MAPPO |
$1,579.69
|
| Rate for Payer: BCN Commercial |
$2,406.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,579.69
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.78
|
| Rate for Payer: Cofinity Commercial |
$2,274.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,579.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,658.67
|
| Rate for Payer: Meridian Medicaid |
$1,109.52
|
| Rate for Payer: Nomi Health Commercial |
$1,895.63
|
| Rate for Payer: PACE SWMI |
$1,579.69
|
| Rate for Payer: PHP Commercial |
$2,211.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,579.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,056.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,463.86
|
| Rate for Payer: Priority Health Medicare |
$1,579.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,463.86
|
| Rate for Payer: Priority Health SBD |
$2,463.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,579.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,579.69
|
| Rate for Payer: UHCCP Medicaid |
$1,056.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,595.28
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD
|
Professional
|
Both
|
$4,936.00
|
|
|
Service Code
|
HCPCS 58951
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$3,208.40 |
| Rate for Payer: Aetna Commercial |
$1,858.10
|
| Rate for Payer: Aetna Medicare |
$1,442.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,996.76
|
| Rate for Payer: BCBS Complete |
$973.10
|
| Rate for Payer: BCBS MAPPO |
$1,386.64
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$2,107.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,386.64
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Cofinity Commercial |
$1,858.10
|
| Rate for Payer: Cofinity Commercial |
$1,996.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,386.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,455.97
|
| Rate for Payer: Meridian Medicaid |
$973.10
|
| Rate for Payer: Nomi Health Commercial |
$1,663.97
|
| Rate for Payer: PACE SWMI |
$1,386.64
|
| Rate for Payer: PHP Commercial |
$1,941.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,386.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,208.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,156.32
|
| Rate for Payer: Priority Health Medicare |
$1,386.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,156.32
|
| Rate for Payer: Priority Health SBD |
$2,156.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,386.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,386.64
|
| Rate for Payer: UHCCP Medicaid |
$926.76
|
| Rate for Payer: UMR Bronson Commercial |
$2,270.56
|
|
|
PR RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS
|
Professional
|
Both
|
$6,636.00
|
|
|
Service Code
|
HCPCS 48105
|
| Min. Negotiated Rate |
$1,805.39 |
| Max. Negotiated Rate |
$5,018.54 |
| Rate for Payer: Aetna Commercial |
$3,660.48
|
| Rate for Payer: Aetna Medicare |
$2,840.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,660.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,933.65
|
| Rate for Payer: BCBS Complete |
$1,895.66
|
| Rate for Payer: BCBS MAPPO |
$2,731.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,408.52
|
| Rate for Payer: BCN Commercial |
$4,107.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,731.70
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Cofinity Commercial |
$3,933.65
|
| Rate for Payer: Cofinity Commercial |
$3,660.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,731.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,868.28
|
| Rate for Payer: Meridian Medicaid |
$1,895.66
|
| Rate for Payer: Nomi Health Commercial |
$3,278.04
|
| Rate for Payer: PACE SWMI |
$2,731.70
|
| Rate for Payer: PHP Commercial |
$3,824.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,731.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,805.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,313.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,018.54
|
| Rate for Payer: Priority Health Medicare |
$2,731.70
|
| Rate for Payer: Priority Health Narrow Network |
$5,018.54
|
| Rate for Payer: Priority Health SBD |
$5,018.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,731.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,731.70
|
| Rate for Payer: UHCCP Medicaid |
$1,805.39
|
| Rate for Payer: UMR Bronson Commercial |
$3,052.56
|
|
|
PR RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY
|
Professional
|
Both
|
$3,325.00
|
|
|
Service Code
|
HCPCS 58957
|
| Min. Negotiated Rate |
$404.15 |
| Max. Negotiated Rate |
$2,319.75 |
| Rate for Payer: Aetna Commercial |
$1,889.07
|
| Rate for Payer: Aetna Medicare |
$1,662.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,889.07
|
| Rate for Payer: BCBS Complete |
$1,330.00
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: BCN Commercial |
$2,319.75
|
| Rate for Payer: Cash Price |
$2,660.00
|
| Rate for Payer: Cash Price |
$2,660.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,161.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,529.50
|
|
|
PR RESEC RECURRENT LARYNX NERVE
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 31595
|
| Min. Negotiated Rate |
$550.80 |
| Max. Negotiated Rate |
$895.05 |
| Rate for Payer: Aetna Medicare |
$688.50
|
| Rate for Payer: BCBS Complete |
$550.80
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UMR Bronson Commercial |
$633.42
|
|
|
PR RESECTION CONDYLE DISTAL END PHALANX EACH TOE
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 28153
|
| Min. Negotiated Rate |
$171.47 |
| Max. Negotiated Rate |
$988.45 |
| Rate for Payer: Aetna Commercial |
$336.39
|
| Rate for Payer: Aetna Medicare |
$261.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.50
|
| Rate for Payer: BCBS Complete |
$180.04
|
| Rate for Payer: BCBS MAPPO |
$251.04
|
| Rate for Payer: BCBS Trust/PPO |
$988.45
|
| Rate for Payer: BCN Commercial |
$588.86
|
| Rate for Payer: BCN Medicare Advantage |
$251.04
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Cofinity Commercial |
$336.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.59
|
| Rate for Payer: Meridian Medicaid |
$180.04
|
| Rate for Payer: Nomi Health Commercial |
$301.25
|
| Rate for Payer: PACE SWMI |
$251.04
|
| Rate for Payer: PHP Commercial |
$351.46
|
| Rate for Payer: PHP Medicare Advantage |
$251.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.59
|
| Rate for Payer: Priority Health Medicare |
$251.04
|
| Rate for Payer: Priority Health Narrow Network |
$407.59
|
| Rate for Payer: Priority Health SBD |
$407.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.04
|
| Rate for Payer: UHC Medicare Advantage |
$251.04
|
| Rate for Payer: UHCCP Medicaid |
$171.47
|
| Rate for Payer: UMR Bronson Commercial |
$300.84
|
|
|
PR RESECTION EXTERNAL CARDIAC TUMOR
|
Professional
|
Both
|
$4,644.00
|
|
|
Service Code
|
HCPCS 33130
|
| Min. Negotiated Rate |
$860.52 |
| Max. Negotiated Rate |
$3,018.60 |
| Rate for Payer: Aetna Commercial |
$1,751.30
|
| Rate for Payer: Aetna Medicare |
$1,359.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,751.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.99
|
| Rate for Payer: BCBS Complete |
$903.55
|
| Rate for Payer: BCBS MAPPO |
$1,306.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.28
|
| Rate for Payer: BCN Commercial |
$1,958.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.94
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,751.30
|
| Rate for Payer: Cofinity Commercial |
$1,881.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,372.29
|
| Rate for Payer: Meridian Medicaid |
$903.55
|
| Rate for Payer: Nomi Health Commercial |
$1,568.33
|
| Rate for Payer: PACE SWMI |
$1,306.94
|
| Rate for Payer: PHP Commercial |
$1,829.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.87
|
| Rate for Payer: Priority Health Medicare |
$1,306.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,136.87
|
| Rate for Payer: Priority Health SBD |
$2,136.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.94
|
| Rate for Payer: UHCCP Medicaid |
$860.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,136.24
|
|
|
PR RESECTION HUMERAL HEAD
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 23195
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$1,156.63 |
| Rate for Payer: Aetna Commercial |
$969.87
|
| Rate for Payer: Aetna Medicare |
$752.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.87
|
| Rate for Payer: BCBS Complete |
$513.50
|
| Rate for Payer: BCBS MAPPO |
$723.78
|
| Rate for Payer: BCBS Trust/PPO |
$20.80
|
| Rate for Payer: BCN Commercial |
$1,094.15
|
| Rate for Payer: BCN Medicare Advantage |
$723.78
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$1,042.24
|
| Rate for Payer: Cofinity Commercial |
$969.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.97
|
| Rate for Payer: Meridian Medicaid |
$513.50
|
| Rate for Payer: Nomi Health Commercial |
$868.54
|
| Rate for Payer: PACE SWMI |
$723.78
|
| Rate for Payer: PHP Commercial |
$1,013.29
|
| Rate for Payer: PHP Medicare Advantage |
$723.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.63
|
| Rate for Payer: Priority Health Medicare |
$723.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.63
|
| Rate for Payer: Priority Health SBD |
$1,156.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$723.78
|
| Rate for Payer: UHC Medicare Advantage |
$723.78
|
| Rate for Payer: UHCCP Medicaid |
$489.05
|
| Rate for Payer: UMR Bronson Commercial |
$756.70
|
|
|
PR RESECTION/INCISION SUBVALVULAR TISSUE
|
Professional
|
Both
|
$6,220.00
|
|
|
Service Code
|
HCPCS 33415
|
| Min. Negotiated Rate |
$642.41 |
| Max. Negotiated Rate |
$4,043.00 |
| Rate for Payer: Aetna Commercial |
$2,605.46
|
| Rate for Payer: Aetna Medicare |
$2,022.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,605.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,799.89
|
| Rate for Payer: BCBS Complete |
$1,338.32
|
| Rate for Payer: BCBS MAPPO |
$1,944.37
|
| Rate for Payer: BCBS Trust/PPO |
$642.41
|
| Rate for Payer: BCN Commercial |
$2,902.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,944.37
|
| Rate for Payer: Cash Price |
$4,976.00
|
| Rate for Payer: Cash Price |
$4,976.00
|
| Rate for Payer: Cofinity Commercial |
$2,605.46
|
| Rate for Payer: Cofinity Commercial |
$2,799.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,944.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,041.59
|
| Rate for Payer: Meridian Medicaid |
$1,338.32
|
| Rate for Payer: Nomi Health Commercial |
$2,333.24
|
| Rate for Payer: PACE SWMI |
$1,944.37
|
| Rate for Payer: PHP Commercial |
$2,722.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,944.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,274.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,043.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,170.74
|
| Rate for Payer: Priority Health Medicare |
$1,944.37
|
| Rate for Payer: Priority Health Narrow Network |
$3,170.74
|
| Rate for Payer: Priority Health SBD |
$3,170.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,944.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,944.37
|
| Rate for Payer: UHCCP Medicaid |
$1,274.59
|
| Rate for Payer: UMR Bronson Commercial |
$2,861.20
|
|
|
PR RESECTION MEDIASTINAL TUMOR
|
Professional
|
Both
|
$5,782.00
|
|
|
Service Code
|
HCPCS 39220
|
| Min. Negotiated Rate |
$723.14 |
| Max. Negotiated Rate |
$3,758.30 |
| Rate for Payer: Aetna Commercial |
$1,465.96
|
| Rate for Payer: Aetna Medicare |
$1,137.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,575.36
|
| Rate for Payer: BCBS Complete |
$759.30
|
| Rate for Payer: BCBS MAPPO |
$1,094.00
|
| Rate for Payer: BCBS Trust/PPO |
$735.39
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.00
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,465.96
|
| Rate for Payer: Cofinity Commercial |
$1,575.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.70
|
| Rate for Payer: Meridian Medicaid |
$759.30
|
| Rate for Payer: Nomi Health Commercial |
$1,312.80
|
| Rate for Payer: PACE SWMI |
$1,094.00
|
| Rate for Payer: PHP Commercial |
$1,531.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,758.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,792.78
|
| Rate for Payer: Priority Health Medicare |
$1,094.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.78
|
| Rate for Payer: Priority Health SBD |
$1,792.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,094.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.00
|
| Rate for Payer: UHCCP Medicaid |
$723.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,659.72
|
|
|
PR RESECTION OF MEDIASTINAL CYST
|
Professional
|
Both
|
$5,041.00
|
|
|
Service Code
|
HCPCS 39200
|
| Min. Negotiated Rate |
$551.67 |
| Max. Negotiated Rate |
$3,276.65 |
| Rate for Payer: Aetna Commercial |
$1,122.71
|
| Rate for Payer: Aetna Medicare |
$871.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,122.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.49
|
| Rate for Payer: BCBS Complete |
$579.25
|
| Rate for Payer: BCBS MAPPO |
$837.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.79
|
| Rate for Payer: BCN Commercial |
$1,253.95
|
| Rate for Payer: BCN Medicare Advantage |
$837.84
|
| Rate for Payer: Cash Price |
$4,032.80
|
| Rate for Payer: Cash Price |
$4,032.80
|
| Rate for Payer: Cofinity Commercial |
$1,122.71
|
| Rate for Payer: Cofinity Commercial |
$1,206.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$879.73
|
| Rate for Payer: Meridian Medicaid |
$579.25
|
| Rate for Payer: Nomi Health Commercial |
$1,005.41
|
| Rate for Payer: PACE SWMI |
$837.84
|
| Rate for Payer: PHP Commercial |
$1,172.98
|
| Rate for Payer: PHP Medicare Advantage |
$837.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,276.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,372.11
|
| Rate for Payer: Priority Health Medicare |
$837.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,372.11
|
| Rate for Payer: Priority Health SBD |
$1,372.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$837.84
|
| Rate for Payer: UHC Medicare Advantage |
$837.84
|
| Rate for Payer: UHCCP Medicaid |
$551.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,318.86
|
|
|
PR RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 28126
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$319.75
|
| Rate for Payer: Aetna Medicare |
$248.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.61
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$238.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: BCN Medicare Advantage |
$238.62
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$319.75
|
| Rate for Payer: Cofinity Commercial |
$343.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.55
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Nomi Health Commercial |
$286.34
|
| Rate for Payer: PACE SWMI |
$238.62
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicare Advantage |
$238.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.25
|
| Rate for Payer: Priority Health Medicare |
$238.62
|
| Rate for Payer: Priority Health Narrow Network |
$387.25
|
| Rate for Payer: Priority Health SBD |
$387.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.62
|
| Rate for Payer: UHC Medicare Advantage |
$238.62
|
| Rate for Payer: UHCCP Medicaid |
$162.52
|
| Rate for Payer: UMR Bronson Commercial |
$318.78
|
|
|
PR RESECTION PERICARDIAL CYST/TUMOR
|
Professional
|
Both
|
$2,869.00
|
|
|
Service Code
|
HCPCS 33050
|
| Min. Negotiated Rate |
$639.00 |
| Max. Negotiated Rate |
$1,864.85 |
| Rate for Payer: Aetna Commercial |
$1,297.19
|
| Rate for Payer: Aetna Medicare |
$1,006.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.99
|
| Rate for Payer: BCBS Complete |
$670.95
|
| Rate for Payer: BCBS MAPPO |
$968.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$1,448.93
|
| Rate for Payer: BCN Medicare Advantage |
$968.05
|
| Rate for Payer: Cash Price |
$2,295.20
|
| Rate for Payer: Cash Price |
$2,295.20
|
| Rate for Payer: Cofinity Commercial |
$1,297.19
|
| Rate for Payer: Cofinity Commercial |
$1,393.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,016.45
|
| Rate for Payer: Meridian Medicaid |
$670.95
|
| Rate for Payer: Nomi Health Commercial |
$1,161.66
|
| Rate for Payer: PACE SWMI |
$968.05
|
| Rate for Payer: PHP Commercial |
$1,355.27
|
| Rate for Payer: PHP Medicare Advantage |
$968.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,864.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.56
|
| Rate for Payer: Priority Health Medicare |
$968.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,588.56
|
| Rate for Payer: Priority Health SBD |
$1,588.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$968.05
|
| Rate for Payer: UHC Medicare Advantage |
$968.05
|
| Rate for Payer: UHCCP Medicaid |
$639.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,319.74
|
|
|
PR RESECTION RIBS EXTRAPLEURAL ALL STAGES
|
Professional
|
Both
|
$3,144.00
|
|
|
Service Code
|
HCPCS 32900
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$2,061.73 |
| Rate for Payer: Aetna Commercial |
$1,878.52
|
| Rate for Payer: Aetna Medicare |
$1,457.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,878.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,018.71
|
| Rate for Payer: BCBS Complete |
$976.46
|
| Rate for Payer: BCBS MAPPO |
$1,401.88
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$2,061.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,401.88
|
| Rate for Payer: Cash Price |
$2,515.20
|
| Rate for Payer: Cash Price |
$2,515.20
|
| Rate for Payer: Cofinity Commercial |
$1,878.52
|
| Rate for Payer: Cofinity Commercial |
$2,018.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,401.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,471.97
|
| Rate for Payer: Meridian Medicaid |
$976.46
|
| Rate for Payer: Nomi Health Commercial |
$1,682.26
|
| Rate for Payer: PACE SWMI |
$1,401.88
|
| Rate for Payer: PHP Commercial |
$1,962.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,401.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$929.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,866.84
|
| Rate for Payer: Priority Health Medicare |
$1,401.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,866.84
|
| Rate for Payer: Priority Health SBD |
$1,866.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,401.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,401.88
|
| Rate for Payer: UHCCP Medicaid |
$929.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,446.24
|
|
