|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,619.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$774.47 |
| Max. Negotiated Rate |
$1,929.99 |
| Rate for Payer: Aetna Commercial |
$1,599.64
|
| Rate for Payer: Aetna Medicare |
$1,241.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,599.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,719.01
|
| Rate for Payer: BCBS Complete |
$813.19
|
| Rate for Payer: BCBS MAPPO |
$1,193.76
|
| Rate for Payer: BCBS Trust/PPO |
$926.64
|
| Rate for Payer: BCN Commercial |
$1,765.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,193.76
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cash Price |
$2,095.20
|
| Rate for Payer: Cofinity Commercial |
$1,599.64
|
| Rate for Payer: Cofinity Commercial |
$1,719.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,193.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,253.45
|
| Rate for Payer: Meridian Medicaid |
$813.19
|
| Rate for Payer: Nomi Health Commercial |
$1,432.51
|
| Rate for Payer: PACE SWMI |
$1,193.76
|
| Rate for Payer: PHP Commercial |
$1,671.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,193.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,929.99
|
| Rate for Payer: Priority Health Medicare |
$1,193.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,929.99
|
| Rate for Payer: Priority Health SBD |
$1,929.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,193.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.76
|
| Rate for Payer: UHCCP Medicaid |
$774.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,204.74
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,362.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$745.07 |
| Max. Negotiated Rate |
$1,861.38 |
| Rate for Payer: Aetna Commercial |
$1,535.51
|
| Rate for Payer: Aetna Medicare |
$1,191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,535.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,650.10
|
| Rate for Payer: BCBS Complete |
$782.32
|
| Rate for Payer: BCBS MAPPO |
$1,145.90
|
| Rate for Payer: BCBS Trust/PPO |
$876.98
|
| Rate for Payer: BCN Commercial |
$1,707.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.90
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cash Price |
$1,889.60
|
| Rate for Payer: Cofinity Commercial |
$1,535.51
|
| Rate for Payer: Cofinity Commercial |
$1,650.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.20
|
| Rate for Payer: Meridian Medicaid |
$782.32
|
| Rate for Payer: Nomi Health Commercial |
$1,375.08
|
| Rate for Payer: PACE SWMI |
$1,145.90
|
| Rate for Payer: PHP Commercial |
$1,604.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,535.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,861.38
|
| Rate for Payer: Priority Health Medicare |
$1,145.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,861.38
|
| Rate for Payer: Priority Health SBD |
$1,861.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,145.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,145.90
|
| Rate for Payer: UHCCP Medicaid |
$745.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.52
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,384.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$163.77 |
| Max. Negotiated Rate |
$3,499.60 |
| Rate for Payer: Aetna Commercial |
$2,132.30
|
| Rate for Payer: Aetna Medicare |
$1,654.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,291.43
|
| Rate for Payer: BCBS Complete |
$1,102.59
|
| Rate for Payer: BCBS MAPPO |
$1,591.27
|
| Rate for Payer: BCBS Trust/PPO |
$163.77
|
| Rate for Payer: BCN Commercial |
$2,385.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.27
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cash Price |
$4,307.20
|
| Rate for Payer: Cofinity Commercial |
$2,132.30
|
| Rate for Payer: Cofinity Commercial |
$2,291.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,670.83
|
| Rate for Payer: Meridian Medicaid |
$1,102.59
|
| Rate for Payer: Nomi Health Commercial |
$1,909.52
|
| Rate for Payer: PACE SWMI |
$1,591.27
|
| Rate for Payer: PHP Commercial |
$2,227.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,499.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,923.91
|
| Rate for Payer: Priority Health Medicare |
$1,591.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,923.91
|
| Rate for Payer: Priority Health SBD |
$2,923.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,591.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,591.27
|
| Rate for Payer: UHCCP Medicaid |
$1,050.09
|
| Rate for Payer: UMR Bronson Commercial |
$2,476.64
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$1,794.56 |
| Rate for Payer: Aetna Commercial |
$1,292.68
|
| Rate for Payer: Aetna Medicare |
$1,003.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,389.15
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$964.69
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$1,462.12
|
| Rate for Payer: BCN Medicare Advantage |
$964.69
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$1,292.68
|
| Rate for Payer: Cofinity Commercial |
$1,389.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.92
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,157.63
|
| Rate for Payer: PACE SWMI |
$964.69
|
| Rate for Payer: PHP Commercial |
$1,350.57
|
| Rate for Payer: PHP Medicare Advantage |
$964.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,794.56
|
| Rate for Payer: Priority Health Medicare |
$964.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,794.56
|
| Rate for Payer: Priority Health SBD |
$1,794.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.69
|
| Rate for Payer: UHC Medicare Advantage |
$964.69
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,190.02
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$1,072.68 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare |
$598.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.58
|
| Rate for Payer: BCBS Complete |
$403.69
|
| Rate for Payer: BCBS MAPPO |
$575.40
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$575.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$771.04
|
| Rate for Payer: Cofinity Commercial |
$828.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.17
|
| Rate for Payer: Meridian Medicaid |
$403.69
|
| Rate for Payer: Nomi Health Commercial |
$690.48
|
| Rate for Payer: PACE SWMI |
$575.40
|
| Rate for Payer: PHP Commercial |
$805.56
|
| Rate for Payer: PHP Medicare Advantage |
$575.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.68
|
| Rate for Payer: Priority Health Medicare |
$575.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.68
|
| Rate for Payer: Priority Health SBD |
$1,072.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.40
|
| Rate for Payer: UHC Medicare Advantage |
$575.40
|
| Rate for Payer: UHCCP Medicaid |
$384.47
|
| Rate for Payer: UMR Bronson Commercial |
$569.48
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,128.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$580.21 |
| Max. Negotiated Rate |
$2,683.20 |
| Rate for Payer: Aetna Commercial |
$1,166.62
|
| Rate for Payer: Aetna Medicare |
$905.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,253.68
|
| Rate for Payer: BCBS Complete |
$609.22
|
| Rate for Payer: BCBS MAPPO |
$870.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$1,305.75
|
| Rate for Payer: BCN Medicare Advantage |
$870.61
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cash Price |
$3,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,166.62
|
| Rate for Payer: Cofinity Commercial |
$1,253.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.14
|
| Rate for Payer: Meridian Medicaid |
$609.22
|
| Rate for Payer: Nomi Health Commercial |
$1,044.73
|
| Rate for Payer: PACE SWMI |
$870.61
|
| Rate for Payer: PHP Commercial |
$1,218.85
|
| Rate for Payer: PHP Medicare Advantage |
$870.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,683.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,538.38
|
| Rate for Payer: Priority Health Medicare |
$870.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,538.38
|
| Rate for Payer: Priority Health SBD |
$1,538.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.61
|
| Rate for Payer: UHC Medicare Advantage |
$870.61
|
| Rate for Payer: UHCCP Medicaid |
$580.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,898.88
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,817.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$3,131.05 |
| Rate for Payer: Aetna Commercial |
$578.84
|
| Rate for Payer: Aetna Medicare |
$449.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.04
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$431.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.26
|
| Rate for Payer: BCN Commercial |
$1,321.38
|
| Rate for Payer: BCN Medicare Advantage |
$431.97
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cash Price |
$3,853.60
|
| Rate for Payer: Cofinity Commercial |
$578.84
|
| Rate for Payer: Cofinity Commercial |
$622.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.57
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Nomi Health Commercial |
$518.36
|
| Rate for Payer: PACE SWMI |
$431.97
|
| Rate for Payer: PHP Commercial |
$604.76
|
| Rate for Payer: PHP Medicare Advantage |
$431.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.18
|
| Rate for Payer: Priority Health Medicare |
$431.97
|
| Rate for Payer: Priority Health Narrow Network |
$771.18
|
| Rate for Payer: Priority Health SBD |
$771.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.97
|
| Rate for Payer: UHC Medicare Advantage |
$431.97
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
| Rate for Payer: UMR Bronson Commercial |
$2,215.82
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,825.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$576.80 |
| Max. Negotiated Rate |
$1,898.71 |
| Rate for Payer: Aetna Commercial |
$1,185.40
|
| Rate for Payer: Aetna Medicare |
$920.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.87
|
| Rate for Payer: BCBS Complete |
$605.64
|
| Rate for Payer: BCBS MAPPO |
$884.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.71
|
| Rate for Payer: BCN Commercial |
$1,316.01
|
| Rate for Payer: BCN Medicare Advantage |
$884.63
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cash Price |
$1,460.00
|
| Rate for Payer: Cofinity Commercial |
$1,185.40
|
| Rate for Payer: Cofinity Commercial |
$1,273.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.86
|
| Rate for Payer: Meridian Medicaid |
$605.64
|
| Rate for Payer: Nomi Health Commercial |
$1,061.56
|
| Rate for Payer: PACE SWMI |
$884.63
|
| Rate for Payer: PHP Commercial |
$1,238.48
|
| Rate for Payer: PHP Medicare Advantage |
$884.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,435.40
|
| Rate for Payer: Priority Health Medicare |
$884.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,435.40
|
| Rate for Payer: Priority Health SBD |
$1,435.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$884.63
|
| Rate for Payer: UHC Medicare Advantage |
$884.63
|
| Rate for Payer: UHCCP Medicaid |
$576.80
|
| Rate for Payer: UMR Bronson Commercial |
$839.50
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,119.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$639.85 |
| Max. Negotiated Rate |
$1,789.35 |
| Rate for Payer: Aetna Commercial |
$1,314.77
|
| Rate for Payer: Aetna Medicare |
$1,020.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.88
|
| Rate for Payer: BCBS Complete |
$671.84
|
| Rate for Payer: BCBS MAPPO |
$981.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,460.66
|
| Rate for Payer: BCN Medicare Advantage |
$981.17
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cash Price |
$1,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,314.77
|
| Rate for Payer: Cofinity Commercial |
$1,412.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.23
|
| Rate for Payer: Meridian Medicaid |
$671.84
|
| Rate for Payer: Nomi Health Commercial |
$1,177.40
|
| Rate for Payer: PACE SWMI |
$981.17
|
| Rate for Payer: PHP Commercial |
$1,373.64
|
| Rate for Payer: PHP Medicare Advantage |
$981.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$639.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,604.51
|
| Rate for Payer: Priority Health Medicare |
$981.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,604.51
|
| Rate for Payer: Priority Health SBD |
$1,604.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.17
|
| Rate for Payer: UHC Medicare Advantage |
$981.17
|
| Rate for Payer: UHCCP Medicaid |
$639.85
|
| Rate for Payer: UMR Bronson Commercial |
$974.74
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,087.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$650.08 |
| Max. Negotiated Rate |
$2,276.44 |
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Aetna Commercial |
$1,279.16
|
| Rate for Payer: Aetna Medicare |
$992.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.62
|
| Rate for Payer: BCBS Complete |
$682.58
|
| Rate for Payer: BCBS MAPPO |
$954.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.44
|
| Rate for Payer: BCN Commercial |
$1,503.17
|
| Rate for Payer: BCN Medicare Advantage |
$954.60
|
| Rate for Payer: Cash Price |
$1,669.60
|
| Rate for Payer: Cofinity Commercial |
$1,279.16
|
| Rate for Payer: Cofinity Commercial |
$1,374.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.33
|
| Rate for Payer: Meridian Medicaid |
$682.58
|
| Rate for Payer: Nomi Health Commercial |
$1,145.52
|
| Rate for Payer: PACE SWMI |
$954.60
|
| Rate for Payer: PHP Commercial |
$1,336.44
|
| Rate for Payer: PHP Medicare Advantage |
$954.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,356.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,493.17
|
| Rate for Payer: Priority Health Medicare |
$954.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.17
|
| Rate for Payer: Priority Health SBD |
$1,493.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$954.60
|
| Rate for Payer: UHC Medicare Advantage |
$954.60
|
| Rate for Payer: UHCCP Medicaid |
$650.08
|
| Rate for Payer: UMR Bronson Commercial |
$960.02
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,239.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$709.50 |
| Max. Negotiated Rate |
$1,642.45 |
| Rate for Payer: Aetna Commercial |
$1,393.48
|
| Rate for Payer: Aetna Medicare |
$1,081.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,497.47
|
| Rate for Payer: BCBS Complete |
$744.98
|
| Rate for Payer: BCBS MAPPO |
$1,039.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.15
|
| Rate for Payer: BCN Commercial |
$1,642.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.91
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cash Price |
$1,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,393.48
|
| Rate for Payer: Cofinity Commercial |
$1,497.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.91
|
| Rate for Payer: Meridian Medicaid |
$744.98
|
| Rate for Payer: Nomi Health Commercial |
$1,247.89
|
| Rate for Payer: PACE SWMI |
$1,039.91
|
| Rate for Payer: PHP Commercial |
$1,455.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.79
|
| Rate for Payer: Priority Health Medicare |
$1,039.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,631.79
|
| Rate for Payer: Priority Health SBD |
$1,631.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,039.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,039.91
|
| Rate for Payer: UHCCP Medicaid |
$709.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.94
|
|
|
PR REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 36832
|
| Min. Negotiated Rate |
$473.93 |
| Max. Negotiated Rate |
$1,757.65 |
| Rate for Payer: Aetna Commercial |
$968.02
|
| Rate for Payer: Aetna Medicare |
$751.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.02
|
| Rate for Payer: BCBS Complete |
$497.63
|
| Rate for Payer: BCBS MAPPO |
$722.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.65
|
| Rate for Payer: BCN Commercial |
$1,081.45
|
| Rate for Payer: BCN Medicare Advantage |
$722.40
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$1,040.26
|
| Rate for Payer: Cofinity Commercial |
$968.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.52
|
| Rate for Payer: Meridian Medicaid |
$497.63
|
| Rate for Payer: Nomi Health Commercial |
$866.88
|
| Rate for Payer: PACE SWMI |
$722.40
|
| Rate for Payer: PHP Commercial |
$1,011.36
|
| Rate for Payer: PHP Medicare Advantage |
$722.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,182.24
|
| Rate for Payer: Priority Health Medicare |
$722.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.24
|
| Rate for Payer: Priority Health SBD |
$1,182.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.40
|
| Rate for Payer: UHC Medicare Advantage |
$722.40
|
| Rate for Payer: UHCCP Medicaid |
$473.93
|
| Rate for Payer: UMR Bronson Commercial |
$563.04
|
|
|
PR REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 36833
|
| Min. Negotiated Rate |
$505.66 |
| Max. Negotiated Rate |
$1,516.45 |
| Rate for Payer: Aetna Commercial |
$1,033.56
|
| Rate for Payer: Aetna Medicare |
$802.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.69
|
| Rate for Payer: BCBS Complete |
$530.94
|
| Rate for Payer: BCBS MAPPO |
$771.31
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$1,155.23
|
| Rate for Payer: BCN Medicare Advantage |
$771.31
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,033.56
|
| Rate for Payer: Cofinity Commercial |
$1,110.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.88
|
| Rate for Payer: Meridian Medicaid |
$530.94
|
| Rate for Payer: Nomi Health Commercial |
$925.57
|
| Rate for Payer: PACE SWMI |
$771.31
|
| Rate for Payer: PHP Commercial |
$1,079.83
|
| Rate for Payer: PHP Medicare Advantage |
$771.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.96
|
| Rate for Payer: Priority Health Medicare |
$771.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.96
|
| Rate for Payer: Priority Health SBD |
$1,260.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.31
|
| Rate for Payer: UHC Medicare Advantage |
$771.31
|
| Rate for Payer: UHCCP Medicaid |
$505.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.18
|
|
|
PR REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA
|
Professional
|
Both
|
$1,819.00
|
|
|
Service Code
|
HCPCS 63688
|
| Min. Negotiated Rate |
$193.83 |
| Max. Negotiated Rate |
$1,182.35 |
| Rate for Payer: Aetna Commercial |
$387.23
|
| Rate for Payer: Aetna Medicare |
$300.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.13
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$288.98
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$547.80
|
| Rate for Payer: BCN Medicare Advantage |
$288.98
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cash Price |
$1,455.20
|
| Rate for Payer: Cofinity Commercial |
$387.23
|
| Rate for Payer: Cofinity Commercial |
$416.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.43
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Nomi Health Commercial |
$346.78
|
| Rate for Payer: PACE SWMI |
$288.98
|
| Rate for Payer: PHP Commercial |
$404.57
|
| Rate for Payer: PHP Medicare Advantage |
$288.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,182.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$516.96
|
| Rate for Payer: Priority Health Medicare |
$288.98
|
| Rate for Payer: Priority Health Narrow Network |
$516.96
|
| Rate for Payer: Priority Health SBD |
$516.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.98
|
| Rate for Payer: UHC Medicare Advantage |
$288.98
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
| Rate for Payer: UMR Bronson Commercial |
$836.74
|
|
|
PR REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS
|
Professional
|
Both
|
$3,184.00
|
|
|
Service Code
|
HCPCS 61880
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$2,069.60 |
| Rate for Payer: Aetna Commercial |
$776.65
|
| Rate for Payer: Aetna Medicare |
$602.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.61
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$579.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.32
|
| Rate for Payer: BCN Commercial |
$871.31
|
| Rate for Payer: BCN Medicare Advantage |
$579.59
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cofinity Commercial |
$776.65
|
| Rate for Payer: Cofinity Commercial |
$834.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.57
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Nomi Health Commercial |
$695.51
|
| Rate for Payer: PACE SWMI |
$579.59
|
| Rate for Payer: PHP Commercial |
$811.43
|
| Rate for Payer: PHP Medicare Advantage |
$579.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.97
|
| Rate for Payer: Priority Health Medicare |
$579.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.97
|
| Rate for Payer: Priority Health SBD |
$1,025.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.59
|
| Rate for Payer: UHC Medicare Advantage |
$579.59
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,464.64
|
|
|
PR REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR
|
Professional
|
Both
|
$1,048.00
|
|
|
Service Code
|
HCPCS 61888
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$1,422.71 |
| Rate for Payer: Aetna Commercial |
$525.59
|
| Rate for Payer: Aetna Medicare |
$407.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.81
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$392.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
| Rate for Payer: BCN Commercial |
$818.26
|
| Rate for Payer: BCN Medicare Advantage |
$392.23
|
| Rate for Payer: Cash Price |
$838.40
|
| Rate for Payer: Cash Price |
$838.40
|
| Rate for Payer: Cofinity Commercial |
$525.59
|
| Rate for Payer: Cofinity Commercial |
$564.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.84
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Nomi Health Commercial |
$470.68
|
| Rate for Payer: PACE SWMI |
$392.23
|
| Rate for Payer: PHP Commercial |
$549.12
|
| Rate for Payer: PHP Medicare Advantage |
$392.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$681.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.13
|
| Rate for Payer: Priority Health Medicare |
$392.23
|
| Rate for Payer: Priority Health Narrow Network |
$692.13
|
| Rate for Payer: Priority Health SBD |
$692.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.23
|
| Rate for Payer: UHC Medicare Advantage |
$392.23
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
| Rate for Payer: UMR Bronson Commercial |
$482.08
|
|
|
PR REVJ/RMVL PERPH NEUROSTIMULATOR ELECTRODE ARRAY
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 64585
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$869.70 |
| Rate for Payer: Aetna Commercial |
$183.20
|
| Rate for Payer: Aetna Medicare |
$142.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.88
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$136.72
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$136.72
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cofinity Commercial |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$196.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.56
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Nomi Health Commercial |
$164.06
|
| Rate for Payer: PACE SWMI |
$136.72
|
| Rate for Payer: PHP Commercial |
$191.41
|
| Rate for Payer: PHP Medicare Advantage |
$136.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.25
|
| Rate for Payer: Priority Health Medicare |
$136.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.25
|
| Rate for Payer: Priority Health SBD |
$246.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.72
|
| Rate for Payer: UHC Medicare Advantage |
$136.72
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: UMR Bronson Commercial |
$615.48
|
|
|
PR REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 57295
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$1,461.28 |
| Rate for Payer: Aetna Commercial |
$641.74
|
| Rate for Payer: Aetna Medicare |
$498.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.63
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS MAPPO |
$478.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.28
|
| Rate for Payer: BCN Commercial |
$1,021.64
|
| Rate for Payer: BCN Medicare Advantage |
$478.91
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$641.74
|
| Rate for Payer: Cofinity Commercial |
$689.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.86
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Nomi Health Commercial |
$574.69
|
| Rate for Payer: PACE SWMI |
$478.91
|
| Rate for Payer: PHP Commercial |
$670.47
|
| Rate for Payer: PHP Medicare Advantage |
$478.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.01
|
| Rate for Payer: Priority Health Medicare |
$478.91
|
| Rate for Payer: Priority Health Narrow Network |
$752.01
|
| Rate for Payer: Priority Health SBD |
$752.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.91
|
| Rate for Payer: UHC Medicare Advantage |
$478.91
|
| Rate for Payer: UHCCP Medicaid |
$322.48
|
| Rate for Payer: UMR Bronson Commercial |
$653.20
|
|
|
PR REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
HCPCS 64583
|
| Min. Negotiated Rate |
$315.92 |
| Max. Negotiated Rate |
$1,475.25 |
| Rate for Payer: Aetna Commercial |
$1,108.53
|
| Rate for Payer: Aetna Medicare |
$860.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.25
|
| Rate for Payer: BCBS Complete |
$582.61
|
| Rate for Payer: BCBS MAPPO |
$827.26
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$1,262.26
|
| Rate for Payer: BCN Medicare Advantage |
$827.26
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cofinity Commercial |
$1,108.53
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.62
|
| Rate for Payer: Meridian Medicaid |
$582.61
|
| Rate for Payer: Nomi Health Commercial |
$992.71
|
| Rate for Payer: PACE SWMI |
$827.26
|
| Rate for Payer: PHP Commercial |
$1,158.16
|
| Rate for Payer: PHP Medicare Advantage |
$827.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,475.25
|
| Rate for Payer: Priority Health Medicare |
$827.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,475.25
|
| Rate for Payer: Priority Health SBD |
$1,475.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$827.26
|
| Rate for Payer: UHC Medicare Advantage |
$827.26
|
| Rate for Payer: UHCCP Medicaid |
$554.87
|
| Rate for Payer: UMR Bronson Commercial |
$806.84
|
|
|
PR REVJ/RPLMNT CH WAL RESPIR ELTRD & CONJ PULSE GEN
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 0467T
|
| Min. Negotiated Rate |
$326.40 |
| Max. Negotiated Rate |
$530.40 |
| Rate for Payer: Aetna Medicare |
$408.00
|
| Rate for Payer: BCBS Complete |
$326.40
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.40
|
| Rate for Payer: UMR Bronson Commercial |
$375.36
|
|
|
PR REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT
|
Professional
|
Both
|
$4,568.00
|
|
|
Service Code
|
HCPCS 27486
|
| Min. Negotiated Rate |
$907.38 |
| Max. Negotiated Rate |
$2,969.20 |
| Rate for Payer: Aetna Commercial |
$1,812.44
|
| Rate for Payer: Aetna Medicare |
$1,406.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,812.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.70
|
| Rate for Payer: BCBS Complete |
$952.75
|
| Rate for Payer: BCBS MAPPO |
$1,352.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.05
|
| Rate for Payer: BCN Commercial |
$2,050.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.57
|
| Rate for Payer: Cash Price |
$3,654.40
|
| Rate for Payer: Cash Price |
$3,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,812.44
|
| Rate for Payer: Cofinity Commercial |
$1,947.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.20
|
| Rate for Payer: Meridian Medicaid |
$952.75
|
| Rate for Payer: Nomi Health Commercial |
$1,623.08
|
| Rate for Payer: PACE SWMI |
$1,352.57
|
| Rate for Payer: PHP Commercial |
$1,893.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$907.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,969.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,149.42
|
| Rate for Payer: Priority Health Medicare |
$1,352.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,149.42
|
| Rate for Payer: Priority Health SBD |
$2,149.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,352.57
|
| Rate for Payer: UHCCP Medicaid |
$907.38
|
| Rate for Payer: UMR Bronson Commercial |
$2,101.28
|
|
|
PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,038.00
|
|
|
Service Code
|
HCPCS 27137
|
| Min. Negotiated Rate |
$944.44 |
| Max. Negotiated Rate |
$2,238.48 |
| Rate for Payer: Aetna Commercial |
$1,890.98
|
| Rate for Payer: Aetna Medicare |
$1,467.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,032.10
|
| Rate for Payer: BCBS Complete |
$991.66
|
| Rate for Payer: BCBS MAPPO |
$1,411.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
| Rate for Payer: BCN Commercial |
$2,136.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,411.18
|
| Rate for Payer: Cash Price |
$2,430.40
|
| Rate for Payer: Cash Price |
$2,430.40
|
| Rate for Payer: Cofinity Commercial |
$1,890.98
|
| Rate for Payer: Cofinity Commercial |
$2,032.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,411.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.74
|
| Rate for Payer: Meridian Medicaid |
$991.66
|
| Rate for Payer: Nomi Health Commercial |
$1,693.42
|
| Rate for Payer: PACE SWMI |
$1,411.18
|
| Rate for Payer: PHP Commercial |
$1,975.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,411.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,238.48
|
| Rate for Payer: Priority Health Medicare |
$1,411.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,238.48
|
| Rate for Payer: Priority Health SBD |
$2,238.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,411.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,411.18
|
| Rate for Payer: UHCCP Medicaid |
$944.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,397.48
|
|
|
PR REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,958.00
|
|
|
Service Code
|
HCPCS 27134
|
| Min. Negotiated Rate |
$409.96 |
| Max. Negotiated Rate |
$3,054.10 |
| Rate for Payer: Aetna Commercial |
$2,455.78
|
| Rate for Payer: Aetna Medicare |
$1,905.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,455.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,639.04
|
| Rate for Payer: BCBS Complete |
$1,285.10
|
| Rate for Payer: BCBS MAPPO |
$1,832.67
|
| Rate for Payer: BCBS Trust/PPO |
$409.96
|
| Rate for Payer: BCN Commercial |
$3,054.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,832.67
|
| Rate for Payer: Cash Price |
$3,166.40
|
| Rate for Payer: Cash Price |
$3,166.40
|
| Rate for Payer: Cofinity Commercial |
$2,455.78
|
| Rate for Payer: Cofinity Commercial |
$2,639.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,832.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,924.30
|
| Rate for Payer: Meridian Medicaid |
$1,285.10
|
| Rate for Payer: Nomi Health Commercial |
$2,199.20
|
| Rate for Payer: PACE SWMI |
$1,832.67
|
| Rate for Payer: PHP Commercial |
$2,565.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,832.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,223.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,572.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,902.54
|
| Rate for Payer: Priority Health Medicare |
$1,832.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,902.54
|
| Rate for Payer: Priority Health SBD |
$2,902.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,832.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,832.67
|
| Rate for Payer: UHCCP Medicaid |
$1,223.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,820.68
|
|
|
PR REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT
|
Professional
|
Both
|
$3,157.00
|
|
|
Service Code
|
HCPCS 27138
|
| Min. Negotiated Rate |
$573.73 |
| Max. Negotiated Rate |
$2,324.47 |
| Rate for Payer: Aetna Commercial |
$1,964.64
|
| Rate for Payer: Aetna Medicare |
$1,524.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,111.26
|
| Rate for Payer: BCBS Complete |
$1,029.91
|
| Rate for Payer: BCBS MAPPO |
$1,466.15
|
| Rate for Payer: BCBS Trust/PPO |
$573.73
|
| Rate for Payer: BCN Commercial |
$2,219.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,466.15
|
| Rate for Payer: Cash Price |
$2,525.60
|
| Rate for Payer: Cash Price |
$2,525.60
|
| Rate for Payer: Cofinity Commercial |
$1,964.64
|
| Rate for Payer: Cofinity Commercial |
$2,111.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,466.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,539.46
|
| Rate for Payer: Meridian Medicaid |
$1,029.91
|
| Rate for Payer: Nomi Health Commercial |
$1,759.38
|
| Rate for Payer: PACE SWMI |
$1,466.15
|
| Rate for Payer: PHP Commercial |
$2,052.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,466.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$980.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,052.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,324.47
|
| Rate for Payer: Priority Health Medicare |
$1,466.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,324.47
|
| Rate for Payer: Priority Health SBD |
$2,324.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,466.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.15
|
| Rate for Payer: UHCCP Medicaid |
$980.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,452.22
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Professional
|
Both
|
$6,003.00
|
|
|
Service Code
|
HCPCS 27487
|
| Hospital Charge Code |
27487
|
| Min. Negotiated Rate |
$861.66 |
| Max. Negotiated Rate |
$3,901.95 |
| Rate for Payer: BCBS Trust/PPO |
$861.66
|
| Rate for Payer: BCN Commercial |
$2,813.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,686.61
|
| Rate for Payer: Cash Price |
$4,802.40
|
| Rate for Payer: Cash Price |
$4,802.40
|
| Rate for Payer: Cofinity Commercial |
$2,260.06
|
| Rate for Payer: Cofinity Commercial |
$2,428.72
|
| Rate for Payer: Aetna Commercial |
$2,260.06
|
| Rate for Payer: Aetna Medicare |
$1,754.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,260.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,428.72
|
| Rate for Payer: BCBS Complete |
$1,185.34
|
| Rate for Payer: BCBS MAPPO |
$1,686.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,686.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,770.94
|
| Rate for Payer: Meridian Medicaid |
$1,185.34
|
| Rate for Payer: Nomi Health Commercial |
$2,023.93
|
| Rate for Payer: PACE SWMI |
$1,686.61
|
| Rate for Payer: PHP Commercial |
$2,361.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,686.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,128.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,901.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,677.12
|
| Rate for Payer: Priority Health Medicare |
$1,686.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,677.12
|
| Rate for Payer: Priority Health SBD |
$2,677.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,686.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,686.61
|
| Rate for Payer: UHCCP Medicaid |
$1,128.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,761.38
|
|
