|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$811.50 |
| Rate for Payer: Aetna Commercial |
$365.71
|
| Rate for Payer: Aetna Medicare |
$283.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.00
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$272.92
|
| Rate for Payer: BCN Commercial |
$452.17
|
| Rate for Payer: BCN Medicare Advantage |
$272.92
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$365.71
|
| Rate for Payer: Cofinity Commercial |
$393.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.57
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.21
|
| Rate for Payer: Nomi Health Commercial |
$327.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$811.50
|
| Rate for Payer: PACE SWMI |
$272.92
|
| Rate for Payer: PHP Commercial |
$382.09
|
| Rate for Payer: PHP Medicare Advantage |
$272.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$425.81
|
| Rate for Payer: Priority Health Medicare |
$272.92
|
| Rate for Payer: Priority Health SBD |
$425.81
|
| Rate for Payer: Priority Health Tiered Network |
$425.81
|
| Rate for Payer: Railroad Medicare Medicare |
$272.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.80
|
| Rate for Payer: UHC Core |
$545.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.92
|
| Rate for Payer: UHC Exchange |
$545.80
|
| Rate for Payer: UHC Medicaid |
$174.23
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
| Rate for Payer: UMR Bronson Commercial |
$497.72
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,069.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$801.75 |
| Rate for Payer: Aetna Commercial |
$505.60
|
| Rate for Payer: Aetna Medicare |
$392.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.33
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS MAPPO |
$377.31
|
| Rate for Payer: BCN Commercial |
$669.28
|
| Rate for Payer: BCN Medicare Advantage |
$377.31
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cofinity Commercial |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$543.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.18
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.04
|
| Rate for Payer: Nomi Health Commercial |
$452.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.75
|
| Rate for Payer: PACE SWMI |
$377.31
|
| Rate for Payer: PHP Commercial |
$528.23
|
| Rate for Payer: PHP Medicare Advantage |
$377.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$630.27
|
| Rate for Payer: Priority Health Medicare |
$377.31
|
| Rate for Payer: Priority Health SBD |
$630.27
|
| Rate for Payer: Priority Health Tiered Network |
$630.27
|
| Rate for Payer: Railroad Medicare Medicare |
$377.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$790.81
|
| Rate for Payer: UHC Core |
$790.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.31
|
| Rate for Payer: UHC Exchange |
$790.81
|
| Rate for Payer: UHC Medicaid |
$241.97
|
| Rate for Payer: UHCCP Medicaid |
$241.97
|
| Rate for Payer: UMR Bronson Commercial |
$491.74
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$61.98 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$31.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.43
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.18
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48.31
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: Priority Health SBD |
$48.31
|
| Rate for Payer: Priority Health Tiered Network |
$48.31
|
| Rate for Payer: Railroad Medicare Medicare |
$30.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.98
|
| Rate for Payer: UHC Core |
$61.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.16
|
| Rate for Payer: UHC Exchange |
$61.98
|
| Rate for Payer: UHC Medicaid |
$19.38
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,427.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$378.71 |
| Max. Negotiated Rate |
$1,181.55 |
| Rate for Payer: Aetna Commercial |
$800.23
|
| Rate for Payer: Aetna Medicare |
$621.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.95
|
| Rate for Payer: BCBS Complete |
$397.65
|
| Rate for Payer: BCBS MAPPO |
$597.19
|
| Rate for Payer: BCN Commercial |
$957.62
|
| Rate for Payer: BCN Medicare Advantage |
$597.19
|
| Rate for Payer: Cash Price |
$1,141.60
|
| Rate for Payer: Cash Price |
$1,141.60
|
| Rate for Payer: Cofinity Commercial |
$800.23
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.05
|
| Rate for Payer: Meridian Medicaid |
$397.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$656.91
|
| Rate for Payer: Nomi Health Commercial |
$716.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,070.25
|
| Rate for Payer: PACE SWMI |
$597.19
|
| Rate for Payer: PHP Commercial |
$836.07
|
| Rate for Payer: PHP Medicare Advantage |
$597.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,029.79
|
| Rate for Payer: Priority Health Medicare |
$597.19
|
| Rate for Payer: Priority Health SBD |
$1,029.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,029.79
|
| Rate for Payer: Railroad Medicare Medicare |
$597.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.55
|
| Rate for Payer: UHC Core |
$1,181.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$597.19
|
| Rate for Payer: UHC Exchange |
$1,181.55
|
| Rate for Payer: UHC Medicaid |
$378.71
|
| Rate for Payer: UHCCP Medicaid |
$378.71
|
| Rate for Payer: UMR Bronson Commercial |
$656.42
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,835.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$893.11 |
| Max. Negotiated Rate |
$4,376.25 |
| Rate for Payer: Aetna Commercial |
$1,891.16
|
| Rate for Payer: Aetna Medicare |
$1,467.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,891.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,032.29
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS MAPPO |
$1,411.31
|
| Rate for Payer: BCN Commercial |
$2,296.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,411.31
|
| Rate for Payer: Cash Price |
$4,668.00
|
| Rate for Payer: Cash Price |
$4,668.00
|
| Rate for Payer: Cofinity Commercial |
$1,891.16
|
| Rate for Payer: Cofinity Commercial |
$2,032.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,411.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.88
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,552.44
|
| Rate for Payer: Nomi Health Commercial |
$1,693.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,376.25
|
| Rate for Payer: PACE SWMI |
$1,411.31
|
| Rate for Payer: PHP Commercial |
$1,975.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,411.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,469.27
|
| Rate for Payer: Priority Health Medicare |
$1,411.31
|
| Rate for Payer: Priority Health SBD |
$2,469.27
|
| Rate for Payer: Priority Health Tiered Network |
$2,469.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,411.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,818.57
|
| Rate for Payer: UHC Core |
$2,818.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,411.31
|
| Rate for Payer: UHC Exchange |
$2,818.57
|
| Rate for Payer: UHC Medicaid |
$893.11
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,684.10
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$671.60 |
| Max. Negotiated Rate |
$1,259.25 |
| Rate for Payer: Aetna Medicare |
$839.50
|
| Rate for Payer: BCBS Complete |
$671.60
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.25
|
| Rate for Payer: UMR Bronson Commercial |
$772.34
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: Aetna Medicare |
$61.50
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: UMR Bronson Commercial |
$56.58
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,912.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$764.80 |
| Max. Negotiated Rate |
$1,434.00 |
| Rate for Payer: Aetna Medicare |
$956.00
|
| Rate for Payer: BCBS Complete |
$764.80
|
| Rate for Payer: Cash Price |
$1,529.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,434.00
|
| Rate for Payer: UMR Bronson Commercial |
$879.52
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$675.20 |
| Max. Negotiated Rate |
$1,266.00 |
| Rate for Payer: Aetna Medicare |
$844.00
|
| Rate for Payer: BCBS Complete |
$675.20
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,266.00
|
| Rate for Payer: UMR Bronson Commercial |
$776.48
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$382.40 |
| Max. Negotiated Rate |
$717.00 |
| Rate for Payer: Aetna Medicare |
$478.00
|
| Rate for Payer: BCBS Complete |
$382.40
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.00
|
| Rate for Payer: UMR Bronson Commercial |
$439.76
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,771.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$708.40 |
| Max. Negotiated Rate |
$1,328.25 |
| Rate for Payer: Aetna Medicare |
$885.50
|
| Rate for Payer: BCBS Complete |
$708.40
|
| Rate for Payer: Cash Price |
$1,416.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.25
|
| Rate for Payer: UMR Bronson Commercial |
$814.66
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,655.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,332.53 |
| Max. Negotiated Rate |
$4,266.15 |
| Rate for Payer: Aetna Commercial |
$2,760.23
|
| Rate for Payer: Aetna Medicare |
$2,142.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,760.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,966.21
|
| Rate for Payer: BCBS Complete |
$1,399.16
|
| Rate for Payer: BCBS MAPPO |
$2,059.87
|
| Rate for Payer: BCN Commercial |
$3,633.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,059.87
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cash Price |
$3,724.00
|
| Rate for Payer: Cofinity Commercial |
$2,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,760.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,059.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,162.86
|
| Rate for Payer: Meridian Medicaid |
$1,399.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,265.86
|
| Rate for Payer: Nomi Health Commercial |
$2,471.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,491.25
|
| Rate for Payer: PACE SWMI |
$2,059.87
|
| Rate for Payer: PHP Commercial |
$2,883.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,059.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,332.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,219.97
|
| Rate for Payer: Priority Health Medicare |
$2,059.87
|
| Rate for Payer: Priority Health SBD |
$4,219.97
|
| Rate for Payer: Priority Health Tiered Network |
$4,219.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,059.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,266.15
|
| Rate for Payer: UHC Core |
$4,266.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,059.87
|
| Rate for Payer: UHC Exchange |
$4,266.15
|
| Rate for Payer: UHC Medicaid |
$1,332.53
|
| Rate for Payer: UHCCP Medicaid |
$1,332.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,141.30
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$127.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$474.60 |
| Rate for Payer: Aetna Commercial |
$380.14
|
| Rate for Payer: Aetna Medicare |
$295.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.51
|
| Rate for Payer: BCBS MAPPO |
$283.69
|
| Rate for Payer: BCN Commercial |
$436.73
|
| Rate for Payer: BCN Medicare Advantage |
$283.69
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$408.51
|
| Rate for Payer: Cofinity Commercial |
$380.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$312.06
|
| Rate for Payer: Nomi Health Commercial |
$340.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.25
|
| Rate for Payer: PACE SWMI |
$283.69
|
| Rate for Payer: PHP Commercial |
$397.17
|
| Rate for Payer: PHP Medicare Advantage |
$283.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$402.76
|
| Rate for Payer: Priority Health Medicare |
$283.69
|
| Rate for Payer: Priority Health SBD |
$402.76
|
| Rate for Payer: Priority Health Tiered Network |
$402.76
|
| Rate for Payer: Railroad Medicare Medicare |
$283.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.60
|
| Rate for Payer: UHC Core |
$474.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$283.69
|
| Rate for Payer: UHC Exchange |
$474.60
|
| Rate for Payer: UMR Bronson Commercial |
$58.42
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$249.61 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$334.48
|
| Rate for Payer: Aetna Commercial |
$334.48
|
| Rate for Payer: Aetna Medicare |
$259.59
|
| Rate for Payer: Aetna Medicare |
$259.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.48
|
| Rate for Payer: BCBS MAPPO |
$249.61
|
| Rate for Payer: BCBS MAPPO |
$249.61
|
| Rate for Payer: BCN Commercial |
$382.45
|
| Rate for Payer: BCN Commercial |
$382.45
|
| Rate for Payer: BCN Medicare Advantage |
$249.61
|
| Rate for Payer: BCN Medicare Advantage |
$249.61
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$334.48
|
| Rate for Payer: Cofinity Commercial |
$359.44
|
| Rate for Payer: Cofinity Commercial |
$359.44
|
| Rate for Payer: Cofinity Commercial |
$334.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.57
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$488.25
|
| Rate for Payer: PACE SWMI |
$249.61
|
| Rate for Payer: PACE SWMI |
$249.61
|
| Rate for Payer: PHP Commercial |
$349.45
|
| Rate for Payer: PHP Commercial |
$349.45
|
| Rate for Payer: PHP Medicare Advantage |
$249.61
|
| Rate for Payer: PHP Medicare Advantage |
$249.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.70
|
| Rate for Payer: Priority Health Medicare |
$249.61
|
| Rate for Payer: Priority Health Medicare |
$249.61
|
| Rate for Payer: Priority Health SBD |
$352.70
|
| Rate for Payer: Priority Health SBD |
$352.70
|
| Rate for Payer: Priority Health Tiered Network |
$352.70
|
| Rate for Payer: Priority Health Tiered Network |
$352.70
|
| Rate for Payer: Railroad Medicare Medicare |
$249.61
|
| Rate for Payer: Railroad Medicare Medicare |
$249.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.25
|
| Rate for Payer: UHC Core |
$414.25
|
| Rate for Payer: UHC Core |
$414.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.61
|
| Rate for Payer: UHC Exchange |
$414.25
|
| Rate for Payer: UHC Exchange |
$414.25
|
| Rate for Payer: UMR Bronson Commercial |
$299.46
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$158.02 |
| Max. Negotiated Rate |
$284.25 |
| Rate for Payer: Aetna Commercial |
$211.75
|
| Rate for Payer: Aetna Medicare |
$164.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.55
|
| Rate for Payer: BCBS MAPPO |
$158.02
|
| Rate for Payer: BCN Commercial |
$240.53
|
| Rate for Payer: BCN Medicare Advantage |
$158.02
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$211.75
|
| Rate for Payer: Cofinity Commercial |
$227.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.82
|
| Rate for Payer: Nomi Health Commercial |
$189.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.25
|
| Rate for Payer: PACE SWMI |
$158.02
|
| Rate for Payer: PHP Commercial |
$221.23
|
| Rate for Payer: PHP Medicare Advantage |
$158.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.81
|
| Rate for Payer: Priority Health Medicare |
$158.02
|
| Rate for Payer: Priority Health SBD |
$221.81
|
| Rate for Payer: Priority Health Tiered Network |
$221.81
|
| Rate for Payer: Railroad Medicare Medicare |
$158.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.85
|
| Rate for Payer: UHC Core |
$246.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.02
|
| Rate for Payer: UHC Exchange |
$246.85
|
| Rate for Payer: UMR Bronson Commercial |
$174.34
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$906.35 |
| Rate for Payer: Aetna Commercial |
$707.65
|
| Rate for Payer: Aetna Medicare |
$549.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.46
|
| Rate for Payer: BCBS Complete |
$362.99
|
| Rate for Payer: BCBS MAPPO |
$528.10
|
| Rate for Payer: BCN Commercial |
$857.25
|
| Rate for Payer: BCN Medicare Advantage |
$528.10
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$760.46
|
| Rate for Payer: Cofinity Commercial |
$707.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.50
|
| Rate for Payer: Meridian Medicaid |
$362.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.91
|
| Rate for Payer: Nomi Health Commercial |
$633.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.75
|
| Rate for Payer: PACE SWMI |
$528.10
|
| Rate for Payer: PHP Commercial |
$739.34
|
| Rate for Payer: PHP Medicare Advantage |
$528.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$906.35
|
| Rate for Payer: Priority Health Medicare |
$528.10
|
| Rate for Payer: Priority Health SBD |
$906.35
|
| Rate for Payer: Priority Health Tiered Network |
$906.35
|
| Rate for Payer: Railroad Medicare Medicare |
$528.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.12
|
| Rate for Payer: UHC Core |
$862.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$528.10
|
| Rate for Payer: UHC Exchange |
$862.12
|
| Rate for Payer: UHC Medicaid |
$345.70
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
| Rate for Payer: UMR Bronson Commercial |
$410.78
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,009.50 |
| Rate for Payer: Aetna Commercial |
$675.32
|
| Rate for Payer: Aetna Medicare |
$524.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.72
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$503.97
|
| Rate for Payer: BCN Commercial |
$930.57
|
| Rate for Payer: BCN Medicare Advantage |
$503.97
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$675.32
|
| Rate for Payer: Cofinity Commercial |
$725.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.17
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.37
|
| Rate for Payer: Nomi Health Commercial |
$604.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,009.50
|
| Rate for Payer: PACE SWMI |
$503.97
|
| Rate for Payer: PHP Commercial |
$705.56
|
| Rate for Payer: PHP Medicare Advantage |
$503.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$983.84
|
| Rate for Payer: Priority Health Medicare |
$503.97
|
| Rate for Payer: Priority Health SBD |
$983.84
|
| Rate for Payer: Priority Health Tiered Network |
$983.84
|
| Rate for Payer: Railroad Medicare Medicare |
$503.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.61
|
| Rate for Payer: UHC Core |
$984.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.97
|
| Rate for Payer: UHC Exchange |
$984.61
|
| Rate for Payer: UHC Medicaid |
$329.30
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
| Rate for Payer: UMR Bronson Commercial |
$619.16
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,093.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$918.49 |
| Rate for Payer: Aetna Commercial |
$672.76
|
| Rate for Payer: Aetna Medicare |
$522.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.97
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$502.06
|
| Rate for Payer: BCN Commercial |
$790.79
|
| Rate for Payer: BCN Medicare Advantage |
$502.06
|
| Rate for Payer: Cash Price |
$874.40
|
| Rate for Payer: Cash Price |
$874.40
|
| Rate for Payer: Cofinity Commercial |
$672.76
|
| Rate for Payer: Cofinity Commercial |
$722.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.16
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$552.27
|
| Rate for Payer: Nomi Health Commercial |
$602.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.75
|
| Rate for Payer: PACE SWMI |
$502.06
|
| Rate for Payer: PHP Commercial |
$702.88
|
| Rate for Payer: PHP Medicare Advantage |
$502.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$918.49
|
| Rate for Payer: Priority Health Medicare |
$502.06
|
| Rate for Payer: Priority Health SBD |
$918.49
|
| Rate for Payer: Priority Health Tiered Network |
$918.49
|
| Rate for Payer: Railroad Medicare Medicare |
$502.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$913.29
|
| Rate for Payer: UHC Core |
$913.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$502.06
|
| Rate for Payer: UHC Exchange |
$913.29
|
| Rate for Payer: UHC Medicaid |
$325.68
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
| Rate for Payer: UMR Bronson Commercial |
$502.78
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$419.61 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Aetna Commercial |
$859.06
|
| Rate for Payer: Aetna Medicare |
$666.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.17
|
| Rate for Payer: BCBS Complete |
$440.59
|
| Rate for Payer: BCBS MAPPO |
$641.09
|
| Rate for Payer: BCN Commercial |
$1,065.18
|
| Rate for Payer: BCN Medicare Advantage |
$641.09
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$859.06
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.14
|
| Rate for Payer: Meridian Medicaid |
$440.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.20
|
| Rate for Payer: Nomi Health Commercial |
$769.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.75
|
| Rate for Payer: PACE SWMI |
$641.09
|
| Rate for Payer: PHP Commercial |
$897.53
|
| Rate for Payer: PHP Medicare Advantage |
$641.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,138.65
|
| Rate for Payer: Priority Health Medicare |
$641.09
|
| Rate for Payer: Priority Health SBD |
$1,138.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,138.65
|
| Rate for Payer: Railroad Medicare Medicare |
$641.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,210.97
|
| Rate for Payer: UHC Core |
$1,210.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.09
|
| Rate for Payer: UHC Exchange |
$1,210.97
|
| Rate for Payer: UHC Medicaid |
$419.61
|
| Rate for Payer: UHCCP Medicaid |
$419.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.02
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$759.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$244.10 |
| Max. Negotiated Rate |
$656.76 |
| Rate for Payer: Aetna Commercial |
$494.81
|
| Rate for Payer: Aetna Medicare |
$384.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.73
|
| Rate for Payer: BCBS Complete |
$256.31
|
| Rate for Payer: BCBS MAPPO |
$369.26
|
| Rate for Payer: BCN Commercial |
$613.51
|
| Rate for Payer: BCN Medicare Advantage |
$369.26
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cofinity Commercial |
$494.81
|
| Rate for Payer: Cofinity Commercial |
$531.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.72
|
| Rate for Payer: Meridian Medicaid |
$256.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.19
|
| Rate for Payer: Nomi Health Commercial |
$443.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$569.25
|
| Rate for Payer: PACE SWMI |
$369.26
|
| Rate for Payer: PHP Commercial |
$516.96
|
| Rate for Payer: PHP Medicare Advantage |
$369.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$561.52
|
| Rate for Payer: Priority Health Medicare |
$369.26
|
| Rate for Payer: Priority Health SBD |
$561.52
|
| Rate for Payer: Priority Health Tiered Network |
$561.52
|
| Rate for Payer: Railroad Medicare Medicare |
$369.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.76
|
| Rate for Payer: UHC Core |
$656.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$369.26
|
| Rate for Payer: UHC Exchange |
$656.76
|
| Rate for Payer: UHC Medicaid |
$244.10
|
| Rate for Payer: UHCCP Medicaid |
$244.10
|
| Rate for Payer: UMR Bronson Commercial |
$349.14
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$7,157.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$5,367.75 |
| Rate for Payer: Aetna Commercial |
$1,179.99
|
| Rate for Payer: Aetna Medicare |
$915.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,179.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,268.05
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$880.59
|
| Rate for Payer: BCN Commercial |
$1,475.02
|
| Rate for Payer: BCN Medicare Advantage |
$880.59
|
| Rate for Payer: Cash Price |
$5,725.60
|
| Rate for Payer: Cash Price |
$5,725.60
|
| Rate for Payer: Cofinity Commercial |
$1,179.99
|
| Rate for Payer: Cofinity Commercial |
$1,268.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$880.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$924.62
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$968.65
|
| Rate for Payer: Nomi Health Commercial |
$1,056.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,367.75
|
| Rate for Payer: PACE SWMI |
$880.59
|
| Rate for Payer: PHP Commercial |
$1,232.83
|
| Rate for Payer: PHP Medicare Advantage |
$880.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,576.75
|
| Rate for Payer: Priority Health Medicare |
$880.59
|
| Rate for Payer: Priority Health SBD |
$1,576.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,576.75
|
| Rate for Payer: Railroad Medicare Medicare |
$880.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.50
|
| Rate for Payer: UHC Core |
$1,698.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$880.59
|
| Rate for Payer: UHC Exchange |
$1,698.50
|
| Rate for Payer: UHC Medicaid |
$573.40
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
| Rate for Payer: UMR Bronson Commercial |
$3,292.22
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,746.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$2,059.50 |
| Rate for Payer: Aetna Commercial |
$1,031.41
|
| Rate for Payer: Aetna Medicare |
$800.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.38
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$769.71
|
| Rate for Payer: BCN Commercial |
$1,259.89
|
| Rate for Payer: BCN Medicare Advantage |
$769.71
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cash Price |
$2,196.80
|
| Rate for Payer: Cofinity Commercial |
$1,031.41
|
| Rate for Payer: Cofinity Commercial |
$1,108.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$808.20
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$846.68
|
| Rate for Payer: Nomi Health Commercial |
$923.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,059.50
|
| Rate for Payer: PACE SWMI |
$769.71
|
| Rate for Payer: PHP Commercial |
$1,077.59
|
| Rate for Payer: PHP Medicare Advantage |
$769.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.80
|
| Rate for Payer: Priority Health Medicare |
$769.71
|
| Rate for Payer: Priority Health SBD |
$1,346.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.80
|
| Rate for Payer: Railroad Medicare Medicare |
$769.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,396.37
|
| Rate for Payer: UHC Core |
$1,396.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$769.71
|
| Rate for Payer: UHC Exchange |
$1,396.37
|
| Rate for Payer: UHC Medicaid |
$514.61
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,263.16
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$40.02 |
| Max. Negotiated Rate |
$69.09 |
| Rate for Payer: Aetna Commercial |
$58.32
|
| Rate for Payer: Aetna Medicare |
$45.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: BCBS MAPPO |
$43.52
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$43.52
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$58.32
|
| Rate for Payer: Cofinity Commercial |
$62.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.87
|
| Rate for Payer: Nomi Health Commercial |
$52.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$43.52
|
| Rate for Payer: PHP Commercial |
$60.93
|
| Rate for Payer: PHP Medicare Advantage |
$43.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.09
|
| Rate for Payer: Priority Health Medicare |
$43.52
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$69.09
|
| Rate for Payer: Railroad Medicare Medicare |
$43.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.99
|
| Rate for Payer: UHC Core |
$56.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.52
|
| Rate for Payer: UHC Exchange |
$56.99
|
| Rate for Payer: UMR Bronson Commercial |
$40.02
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$400.02
|
| Rate for Payer: Aetna Medicare |
$310.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.87
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$298.52
|
| Rate for Payer: BCN Commercial |
$509.43
|
| Rate for Payer: BCN Medicare Advantage |
$298.52
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$429.87
|
| Rate for Payer: Cofinity Commercial |
$400.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.45
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.37
|
| Rate for Payer: Nomi Health Commercial |
$358.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.50
|
| Rate for Payer: PACE SWMI |
$298.52
|
| Rate for Payer: PHP Commercial |
$417.93
|
| Rate for Payer: PHP Medicare Advantage |
$298.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$547.82
|
| Rate for Payer: Priority Health Medicare |
$298.52
|
| Rate for Payer: Priority Health SBD |
$547.82
|
| Rate for Payer: Priority Health Tiered Network |
$547.82
|
| Rate for Payer: Railroad Medicare Medicare |
$298.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.94
|
| Rate for Payer: UHC Core |
$620.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$298.52
|
| Rate for Payer: UHC Exchange |
$620.94
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
| Rate for Payer: UMR Bronson Commercial |
$670.68
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$273.75 |
| Rate for Payer: Aetna Commercial |
$220.58
|
| Rate for Payer: Aetna Medicare |
$171.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.04
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$164.61
|
| Rate for Payer: BCN Commercial |
$204.87
|
| Rate for Payer: BCN Medicare Advantage |
$164.61
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$220.58
|
| Rate for Payer: Cofinity Commercial |
$237.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.84
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$181.07
|
| Rate for Payer: Nomi Health Commercial |
$197.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.75
|
| Rate for Payer: PACE SWMI |
$164.61
|
| Rate for Payer: PHP Commercial |
$230.45
|
| Rate for Payer: PHP Medicare Advantage |
$164.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$252.63
|
| Rate for Payer: Priority Health Medicare |
$164.61
|
| Rate for Payer: Priority Health SBD |
$252.63
|
| Rate for Payer: Priority Health Tiered Network |
$252.63
|
| Rate for Payer: Railroad Medicare Medicare |
$164.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.56
|
| Rate for Payer: UHC Core |
$229.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$164.61
|
| Rate for Payer: UHC Exchange |
$229.56
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
| Rate for Payer: UMR Bronson Commercial |
$167.90
|
|
