|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Hospital Charge Code |
49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$648.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.91
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$623.55
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: BCN Medicare Advantage |
$623.55
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$835.56
|
| Rate for Payer: Cofinity Commercial |
$897.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.73
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Nomi Health Commercial |
$748.26
|
| Rate for Payer: PACE SWMI |
$623.55
|
| Rate for Payer: PHP Commercial |
$872.97
|
| Rate for Payer: PHP Medicare Advantage |
$623.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.69
|
| Rate for Payer: Priority Health Medicare |
$623.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.69
|
| Rate for Payer: Priority Health SBD |
$1,140.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.55
|
| Rate for Payer: UHC Medicare Advantage |
$623.55
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
| Rate for Payer: UMR Bronson Commercial |
$730.94
|
|
|
PR RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 49615
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,140.69 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$648.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.91
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$623.55
|
| Rate for Payer: BCBS Trust/PPO |
$941.43
|
| Rate for Payer: BCN Commercial |
$931.91
|
| Rate for Payer: BCN Medicare Advantage |
$623.55
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$835.56
|
| Rate for Payer: Cofinity Commercial |
$897.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.73
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Nomi Health Commercial |
$748.26
|
| Rate for Payer: PACE SWMI |
$623.55
|
| Rate for Payer: PHP Commercial |
$872.97
|
| Rate for Payer: PHP Medicare Advantage |
$623.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.69
|
| Rate for Payer: Priority Health Medicare |
$623.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.69
|
| Rate for Payer: Priority Health SBD |
$1,140.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.55
|
| Rate for Payer: UHC Medicare Advantage |
$623.55
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
| Rate for Payer: UMR Bronson Commercial |
$730.94
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$431.05 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$757.25
|
| Rate for Payer: Aetna Commercial |
$990.25
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,923.56
|
| Rate for Payer: BCN Commercial |
$3,923.56
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$815.50
|
| Rate for Payer: Cofinity Commercial |
$1,001.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$815.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,048.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$815.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.75
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.25
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$990.25
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$733.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.92
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$561.75
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$431.05
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.75
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$747.44
|
| Rate for Payer: Aetna Medicare |
$580.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.22
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$557.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: BCN Medicare Advantage |
$557.79
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$747.44
|
| Rate for Payer: Cofinity Commercial |
$803.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.68
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Nomi Health Commercial |
$669.35
|
| Rate for Payer: PACE SWMI |
$557.79
|
| Rate for Payer: PHP Commercial |
$780.91
|
| Rate for Payer: PHP Medicare Advantage |
$557.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.18
|
| Rate for Payer: Priority Health Medicare |
$557.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.18
|
| Rate for Payer: Priority Health SBD |
$1,020.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.79
|
| Rate for Payer: UHC Medicare Advantage |
$557.79
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
| Rate for Payer: UMR Bronson Commercial |
$535.90
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$2,425.95 |
| Rate for Payer: Aetna Commercial |
$747.44
|
| Rate for Payer: Aetna Medicare |
$580.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.22
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$557.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.95
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: BCN Medicare Advantage |
$557.79
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$803.22
|
| Rate for Payer: Cofinity Commercial |
$747.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.68
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Nomi Health Commercial |
$669.35
|
| Rate for Payer: PACE SWMI |
$557.79
|
| Rate for Payer: PHP Commercial |
$780.91
|
| Rate for Payer: PHP Medicare Advantage |
$557.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.18
|
| Rate for Payer: Priority Health Medicare |
$557.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.18
|
| Rate for Payer: Priority Health SBD |
$1,020.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.79
|
| Rate for Payer: UHC Medicare Advantage |
$557.79
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
| Rate for Payer: UMR Bronson Commercial |
$535.90
|
|
|
PR RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED
|
Facility
|
IP
|
$1,165.00
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
49614
|
| Min. Negotiated Rate |
$512.60 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Aetna American Axle |
$757.25
|
| Rate for Payer: Aetna Commercial |
$990.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$757.25
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,001.90
|
| Rate for Payer: Cofinity Commercial |
$815.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$815.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$932.00
|
| Rate for Payer: Healthscope Commercial |
$1,048.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$815.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$990.25
|
| Rate for Payer: PHP Commercial |
$990.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health SBD |
$733.95
|
| Rate for Payer: UMR Bronson Commercial |
$512.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.75
|
|
|
PR RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Professional
|
Both
|
$857.00
|
|
|
Service Code
|
HCPCS 49613
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$2,199.84 |
| Rate for Payer: Aetna Commercial |
$549.76
|
| Rate for Payer: Aetna Medicare |
$426.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.79
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS MAPPO |
$410.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,199.84
|
| Rate for Payer: BCN Commercial |
$614.26
|
| Rate for Payer: BCN Medicare Advantage |
$410.27
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Cash Price |
$685.60
|
| Rate for Payer: Cofinity Commercial |
$549.76
|
| Rate for Payer: Cofinity Commercial |
$590.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.78
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Nomi Health Commercial |
$492.32
|
| Rate for Payer: PACE SWMI |
$410.27
|
| Rate for Payer: PHP Commercial |
$574.38
|
| Rate for Payer: PHP Medicare Advantage |
$410.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.50
|
| Rate for Payer: Priority Health Medicare |
$410.27
|
| Rate for Payer: Priority Health Narrow Network |
$753.50
|
| Rate for Payer: Priority Health SBD |
$753.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.27
|
| Rate for Payer: UHC Medicare Advantage |
$410.27
|
| Rate for Payer: UHCCP Medicaid |
$270.08
|
| Rate for Payer: UMR Bronson Commercial |
$394.22
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA EXTREMITIES
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 35190
|
| Min. Negotiated Rate |
$474.14 |
| Max. Negotiated Rate |
$1,185.44 |
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Aetna Commercial |
$968.34
|
| Rate for Payer: Aetna Medicare |
$751.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.34
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS MAPPO |
$722.64
|
| Rate for Payer: BCBS Trust/PPO |
$706.87
|
| Rate for Payer: BCN Commercial |
$1,095.13
|
| Rate for Payer: BCN Medicare Advantage |
$722.64
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$1,040.60
|
| Rate for Payer: Cofinity Commercial |
$968.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.77
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Nomi Health Commercial |
$867.17
|
| Rate for Payer: PACE SWMI |
$722.64
|
| Rate for Payer: PHP Commercial |
$1,011.70
|
| Rate for Payer: PHP Medicare Advantage |
$722.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,185.44
|
| Rate for Payer: Priority Health Medicare |
$722.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,185.44
|
| Rate for Payer: Priority Health SBD |
$1,185.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.64
|
| Rate for Payer: UHC Medicare Advantage |
$722.64
|
| Rate for Payer: UHCCP Medicaid |
$474.14
|
| Rate for Payer: UMR Bronson Commercial |
$708.86
|
|
|
PR RPR ACQUIRED/TRAUMATIC AV FISTULA HEAD & NECK
|
Professional
|
Both
|
$4,240.00
|
|
|
Service Code
|
HCPCS 35188
|
| Min. Negotiated Rate |
$836.88 |
| Max. Negotiated Rate |
$2,756.00 |
| Rate for Payer: Aetna Commercial |
$1,704.68
|
| Rate for Payer: Aetna Medicare |
$1,323.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,704.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,831.90
|
| Rate for Payer: BCBS Complete |
$878.72
|
| Rate for Payer: BCBS MAPPO |
$1,272.15
|
| Rate for Payer: BCBS Trust/PPO |
$933.51
|
| Rate for Payer: BCN Commercial |
$1,893.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.15
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cash Price |
$3,392.00
|
| Rate for Payer: Cofinity Commercial |
$1,704.68
|
| Rate for Payer: Cofinity Commercial |
$1,831.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.76
|
| Rate for Payer: Meridian Medicaid |
$878.72
|
| Rate for Payer: Nomi Health Commercial |
$1,526.58
|
| Rate for Payer: PACE SWMI |
$1,272.15
|
| Rate for Payer: PHP Commercial |
$1,781.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,080.50
|
| Rate for Payer: Priority Health Medicare |
$1,272.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,080.50
|
| Rate for Payer: Priority Health SBD |
$2,080.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,272.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,272.15
|
| Rate for Payer: UHCCP Medicaid |
$836.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,950.40
|
|
|
PR RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 26350
|
| Min. Negotiated Rate |
$329.13 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Commercial |
$929.13
|
| Rate for Payer: Aetna Medicare |
$721.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$929.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.47
|
| Rate for Payer: BCBS Complete |
$505.23
|
| Rate for Payer: BCBS MAPPO |
$693.38
|
| Rate for Payer: BCBS Trust/PPO |
$329.13
|
| Rate for Payer: BCN Commercial |
$1,111.25
|
| Rate for Payer: BCN Medicare Advantage |
$693.38
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$929.13
|
| Rate for Payer: Cofinity Commercial |
$998.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$728.05
|
| Rate for Payer: Meridian Medicaid |
$505.23
|
| Rate for Payer: Nomi Health Commercial |
$832.06
|
| Rate for Payer: PACE SWMI |
$693.38
|
| Rate for Payer: PHP Commercial |
$970.73
|
| Rate for Payer: PHP Medicare Advantage |
$693.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.13
|
| Rate for Payer: Priority Health Medicare |
$693.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.13
|
| Rate for Payer: Priority Health SBD |
$1,156.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$693.38
|
| Rate for Payer: UHC Medicare Advantage |
$693.38
|
| Rate for Payer: UHCCP Medicaid |
$481.17
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$641.34 |
| Max. Negotiated Rate |
$1,760.85 |
| Rate for Payer: Aetna Commercial |
$1,266.73
|
| Rate for Payer: Aetna Medicare |
$983.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.26
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS MAPPO |
$945.32
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$945.32
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cofinity Commercial |
$1,266.73
|
| Rate for Payer: Cofinity Commercial |
$1,361.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.59
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Nomi Health Commercial |
$1,134.38
|
| Rate for Payer: PACE SWMI |
$945.32
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: PHP Medicare Advantage |
$945.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,522.00
|
| Rate for Payer: Priority Health Medicare |
$945.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,522.00
|
| Rate for Payer: Priority Health SBD |
$1,522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.32
|
| Rate for Payer: UHC Medicare Advantage |
$945.32
|
| Rate for Payer: UHCCP Medicaid |
$641.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.14
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 26357
|
| Min. Negotiated Rate |
$511.92 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,147.04
|
| Rate for Payer: Aetna Medicare |
$890.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,232.64
|
| Rate for Payer: BCBS Complete |
$611.24
|
| Rate for Payer: BCBS MAPPO |
$856.00
|
| Rate for Payer: BCBS Trust/PPO |
$511.92
|
| Rate for Payer: BCN Commercial |
$1,316.50
|
| Rate for Payer: BCN Medicare Advantage |
$856.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,147.04
|
| Rate for Payer: Cofinity Commercial |
$1,232.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$856.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.80
|
| Rate for Payer: Meridian Medicaid |
$611.24
|
| Rate for Payer: Nomi Health Commercial |
$1,027.20
|
| Rate for Payer: PACE SWMI |
$856.00
|
| Rate for Payer: PHP Commercial |
$1,198.40
|
| Rate for Payer: PHP Medicare Advantage |
$856.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.56
|
| Rate for Payer: Priority Health Medicare |
$856.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.56
|
| Rate for Payer: Priority Health SBD |
$1,381.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$856.00
|
| Rate for Payer: UHC Medicare Advantage |
$856.00
|
| Rate for Payer: UHCCP Medicaid |
$582.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.50
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 26356
|
| Min. Negotiated Rate |
$521.21 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$1,023.56
|
| Rate for Payer: Aetna Medicare |
$794.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.94
|
| Rate for Payer: BCBS Complete |
$547.27
|
| Rate for Payer: BCBS MAPPO |
$763.85
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$1,176.25
|
| Rate for Payer: BCN Medicare Advantage |
$763.85
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,023.56
|
| Rate for Payer: Cofinity Commercial |
$1,099.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$802.04
|
| Rate for Payer: Meridian Medicaid |
$547.27
|
| Rate for Payer: Nomi Health Commercial |
$916.62
|
| Rate for Payer: PACE SWMI |
$763.85
|
| Rate for Payer: PHP Commercial |
$1,069.39
|
| Rate for Payer: PHP Medicare Advantage |
$763.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.98
|
| Rate for Payer: Priority Health Medicare |
$763.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.98
|
| Rate for Payer: Priority Health SBD |
$1,233.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.85
|
| Rate for Payer: UHC Medicare Advantage |
$763.85
|
| Rate for Payer: UHCCP Medicaid |
$521.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,222.22
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 26370
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$980.26
|
| Rate for Payer: Aetna Medicare |
$760.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,053.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.26
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$731.54
|
| Rate for Payer: BCBS Trust/PPO |
$732.75
|
| Rate for Payer: BCN Commercial |
$1,166.96
|
| Rate for Payer: BCN Medicare Advantage |
$731.54
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$1,053.42
|
| Rate for Payer: Cofinity Commercial |
$980.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$768.12
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Nomi Health Commercial |
$877.85
|
| Rate for Payer: PACE SWMI |
$731.54
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: PHP Medicare Advantage |
$731.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,210.58
|
| Rate for Payer: Priority Health Medicare |
$731.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,210.58
|
| Rate for Payer: Priority Health SBD |
$1,210.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.54
|
| Rate for Payer: UHC Medicare Advantage |
$731.54
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,076.40
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA
|
Professional
|
Both
|
$3,106.00
|
|
|
Service Code
|
HCPCS 26372
|
| Min. Negotiated Rate |
$588.73 |
| Max. Negotiated Rate |
$2,018.90 |
| Rate for Payer: Aetna Commercial |
$1,147.07
|
| Rate for Payer: Aetna Medicare |
$890.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,232.67
|
| Rate for Payer: BCBS Complete |
$618.17
|
| Rate for Payer: BCBS MAPPO |
$856.02
|
| Rate for Payer: BCN Commercial |
$1,359.50
|
| Rate for Payer: BCN Medicare Advantage |
$856.02
|
| Rate for Payer: Cash Price |
$2,484.80
|
| Rate for Payer: Cash Price |
$2,484.80
|
| Rate for Payer: Cofinity Commercial |
$1,147.07
|
| Rate for Payer: Cofinity Commercial |
$1,232.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$856.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.82
|
| Rate for Payer: Meridian Medicaid |
$618.17
|
| Rate for Payer: Nomi Health Commercial |
$1,027.22
|
| Rate for Payer: PACE SWMI |
$856.02
|
| Rate for Payer: PHP Commercial |
$1,198.43
|
| Rate for Payer: PHP Medicare Advantage |
$856.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,018.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,413.10
|
| Rate for Payer: Priority Health Medicare |
$856.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,413.10
|
| Rate for Payer: Priority Health SBD |
$1,413.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$856.02
|
| Rate for Payer: UHC Medicare Advantage |
$856.02
|
| Rate for Payer: UHCCP Medicaid |
$588.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,428.76
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA
|
Professional
|
Both
|
$2,854.00
|
|
|
Service Code
|
HCPCS 26373
|
| Min. Negotiated Rate |
$250.94 |
| Max. Negotiated Rate |
$1,855.10 |
| Rate for Payer: Aetna Commercial |
$1,102.32
|
| Rate for Payer: Aetna Medicare |
$855.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.59
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$822.63
|
| Rate for Payer: BCBS Trust/PPO |
$250.94
|
| Rate for Payer: BCN Commercial |
$1,309.65
|
| Rate for Payer: BCN Medicare Advantage |
$822.63
|
| Rate for Payer: Cash Price |
$2,283.20
|
| Rate for Payer: Cash Price |
$2,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,102.32
|
| Rate for Payer: Cofinity Commercial |
$1,184.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.76
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Nomi Health Commercial |
$987.16
|
| Rate for Payer: PACE SWMI |
$822.63
|
| Rate for Payer: PHP Commercial |
$1,151.68
|
| Rate for Payer: PHP Medicare Advantage |
$822.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,360.18
|
| Rate for Payer: Priority Health Medicare |
$822.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.18
|
| Rate for Payer: Priority Health SBD |
$1,360.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.63
|
| Rate for Payer: UHC Medicare Advantage |
$822.63
|
| Rate for Payer: UHCCP Medicaid |
$566.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.84
|
|
|
PR RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ
|
Professional
|
Both
|
$3,602.00
|
|
|
Service Code
|
HCPCS 33507
|
| Min. Negotiated Rate |
$724.30 |
| Max. Negotiated Rate |
$2,694.22 |
| Rate for Payer: Aetna Commercial |
$2,214.78
|
| Rate for Payer: Aetna Medicare |
$1,718.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,214.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,380.06
|
| Rate for Payer: BCBS Complete |
$1,136.36
|
| Rate for Payer: BCBS MAPPO |
$1,652.82
|
| Rate for Payer: BCBS Trust/PPO |
$724.30
|
| Rate for Payer: BCN Commercial |
$2,466.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,652.82
|
| Rate for Payer: Cash Price |
$2,881.60
|
| Rate for Payer: Cash Price |
$2,881.60
|
| Rate for Payer: Cofinity Commercial |
$2,214.78
|
| Rate for Payer: Cofinity Commercial |
$2,380.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,652.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,735.46
|
| Rate for Payer: Meridian Medicaid |
$1,136.36
|
| Rate for Payer: Nomi Health Commercial |
$1,983.38
|
| Rate for Payer: PACE SWMI |
$1,652.82
|
| Rate for Payer: PHP Commercial |
$2,313.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,652.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,341.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,694.22
|
| Rate for Payer: Priority Health Medicare |
$1,652.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,694.22
|
| Rate for Payer: Priority Health SBD |
$2,694.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,652.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,652.82
|
| Rate for Payer: UHCCP Medicaid |
$1,082.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,656.92
|
|
|
PR RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP
|
Professional
|
Both
|
$5,041.00
|
|
|
Service Code
|
HCPCS 33504
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$3,276.65 |
| Rate for Payer: Aetna Commercial |
$1,891.09
|
| Rate for Payer: Aetna Medicare |
$1,467.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,891.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,032.21
|
| Rate for Payer: BCBS Complete |
$975.33
|
| Rate for Payer: BCBS MAPPO |
$1,411.26
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$2,109.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,411.26
|
| Rate for Payer: Cash Price |
$4,032.80
|
| Rate for Payer: Cash Price |
$4,032.80
|
| Rate for Payer: Cofinity Commercial |
$1,891.09
|
| Rate for Payer: Cofinity Commercial |
$2,032.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,411.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.82
|
| Rate for Payer: Meridian Medicaid |
$975.33
|
| Rate for Payer: Nomi Health Commercial |
$1,693.51
|
| Rate for Payer: PACE SWMI |
$1,411.26
|
| Rate for Payer: PHP Commercial |
$1,975.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,411.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,276.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,309.18
|
| Rate for Payer: Priority Health Medicare |
$1,411.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.18
|
| Rate for Payer: Priority Health SBD |
$2,309.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,411.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,411.26
|
| Rate for Payer: UHCCP Medicaid |
$928.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,318.86
|
|
|
PR RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH
|
Professional
|
Both
|
$5,071.00
|
|
|
Service Code
|
HCPCS 33641
|
| Min. Negotiated Rate |
$957.28 |
| Max. Negotiated Rate |
$3,296.15 |
| Rate for Payer: Aetna Commercial |
$2,109.17
|
| Rate for Payer: Aetna Medicare |
$1,636.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,109.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,266.57
|
| Rate for Payer: BCBS Complete |
$1,083.36
|
| Rate for Payer: BCBS MAPPO |
$1,574.01
|
| Rate for Payer: BCBS Trust/PPO |
$957.28
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,574.01
|
| Rate for Payer: Cash Price |
$4,056.80
|
| Rate for Payer: Cash Price |
$4,056.80
|
| Rate for Payer: Cofinity Commercial |
$2,109.17
|
| Rate for Payer: Cofinity Commercial |
$2,266.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,574.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,652.71
|
| Rate for Payer: Meridian Medicaid |
$1,083.36
|
| Rate for Payer: Nomi Health Commercial |
$1,888.81
|
| Rate for Payer: PACE SWMI |
$1,574.01
|
| Rate for Payer: PHP Commercial |
$2,203.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,574.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,031.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,296.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,568.72
|
| Rate for Payer: Priority Health Medicare |
$1,574.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,568.72
|
| Rate for Payer: Priority Health SBD |
$2,568.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,574.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,574.01
|
| Rate for Payer: UHCCP Medicaid |
$1,031.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,332.66
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL
|
Professional
|
Both
|
$1,139.00
|
|
|
Service Code
|
HCPCS 67903
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$875.71 |
| Rate for Payer: Aetna Commercial |
$595.28
|
| Rate for Payer: Aetna Medicare |
$462.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.71
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$444.24
|
| Rate for Payer: BCBS Trust/PPO |
$714.79
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: BCN Medicare Advantage |
$444.24
|
| Rate for Payer: Cash Price |
$911.20
|
| Rate for Payer: Cash Price |
$911.20
|
| Rate for Payer: Cofinity Commercial |
$595.28
|
| Rate for Payer: Cofinity Commercial |
$639.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.45
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Nomi Health Commercial |
$533.09
|
| Rate for Payer: PACE SWMI |
$444.24
|
| Rate for Payer: PHP Commercial |
$621.94
|
| Rate for Payer: PHP Medicare Advantage |
$444.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$740.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.08
|
| Rate for Payer: Priority Health Medicare |
$444.24
|
| Rate for Payer: Priority Health Narrow Network |
$834.08
|
| Rate for Payer: Priority Health SBD |
$834.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.24
|
| Rate for Payer: UHC Medicare Advantage |
$444.24
|
| Rate for Payer: UHCCP Medicaid |
$304.38
|
| Rate for Payer: UMR Bronson Commercial |
$523.94
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 67904
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$1,075.09 |
| Rate for Payer: Aetna Commercial |
$737.16
|
| Rate for Payer: Aetna Medicare |
$572.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.17
|
| Rate for Payer: BCBS Complete |
$395.86
|
| Rate for Payer: BCBS MAPPO |
$550.12
|
| Rate for Payer: BCBS Trust/PPO |
$581.13
|
| Rate for Payer: BCN Commercial |
$1,075.09
|
| Rate for Payer: BCN Medicare Advantage |
$550.12
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$737.16
|
| Rate for Payer: Cofinity Commercial |
$792.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.63
|
| Rate for Payer: Meridian Medicaid |
$395.86
|
| Rate for Payer: Nomi Health Commercial |
$660.14
|
| Rate for Payer: PACE SWMI |
$550.12
|
| Rate for Payer: PHP Commercial |
$770.17
|
| Rate for Payer: PHP Medicare Advantage |
$550.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.70
|
| Rate for Payer: Priority Health Medicare |
$550.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.70
|
| Rate for Payer: Priority Health SBD |
$1,034.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.12
|
| Rate for Payer: UHC Medicare Advantage |
$550.12
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS
|
Professional
|
Both
|
$2,893.00
|
|
|
Service Code
|
HCPCS 35211
|
| Min. Negotiated Rate |
$877.35 |
| Max. Negotiated Rate |
$2,185.26 |
| Rate for Payer: Aetna Commercial |
$1,786.80
|
| Rate for Payer: Aetna Medicare |
$1,386.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,786.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,920.14
|
| Rate for Payer: BCBS Complete |
$921.22
|
| Rate for Payer: BCBS MAPPO |
$1,333.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$1,992.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.43
|
| Rate for Payer: Cash Price |
$2,314.40
|
| Rate for Payer: Cash Price |
$2,314.40
|
| Rate for Payer: Cofinity Commercial |
$1,786.80
|
| Rate for Payer: Cofinity Commercial |
$1,920.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,400.10
|
| Rate for Payer: Meridian Medicaid |
$921.22
|
| Rate for Payer: Nomi Health Commercial |
$1,600.12
|
| Rate for Payer: PACE SWMI |
$1,333.43
|
| Rate for Payer: PHP Commercial |
$1,866.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,185.26
|
| Rate for Payer: Priority Health Medicare |
$1,333.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,185.26
|
| Rate for Payer: Priority Health SBD |
$2,185.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.43
|
| Rate for Payer: UHCCP Medicaid |
$877.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,330.78
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS
|
Professional
|
Both
|
$5,326.00
|
|
|
Service Code
|
HCPCS 35216
|
| Min. Negotiated Rate |
$1,312.93 |
| Max. Negotiated Rate |
$3,461.90 |
| Rate for Payer: Aetna Commercial |
$2,673.30
|
| Rate for Payer: Aetna Medicare |
$2,074.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,673.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,872.80
|
| Rate for Payer: BCBS Complete |
$1,378.58
|
| Rate for Payer: BCBS MAPPO |
$1,995.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.69
|
| Rate for Payer: BCN Commercial |
$3,021.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,995.00
|
| Rate for Payer: Cash Price |
$4,260.80
|
| Rate for Payer: Cash Price |
$4,260.80
|
| Rate for Payer: Cofinity Commercial |
$2,673.30
|
| Rate for Payer: Cofinity Commercial |
$2,872.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,995.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,094.75
|
| Rate for Payer: Meridian Medicaid |
$1,378.58
|
| Rate for Payer: Nomi Health Commercial |
$2,394.00
|
| Rate for Payer: PACE SWMI |
$1,995.00
|
| Rate for Payer: PHP Commercial |
$2,793.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,995.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,312.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,461.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,305.29
|
| Rate for Payer: Priority Health Medicare |
$1,995.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,305.29
|
| Rate for Payer: Priority Health SBD |
$3,305.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,995.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,995.00
|
| Rate for Payer: UHCCP Medicaid |
$1,312.93
|
| Rate for Payer: UMR Bronson Commercial |
$2,449.96
|
|
|
PR RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP
|
Professional
|
Both
|
$6,519.00
|
|
|
Service Code
|
HCPCS 35241
|
| Min. Negotiated Rate |
$902.69 |
| Max. Negotiated Rate |
$4,237.35 |
| Rate for Payer: Aetna Commercial |
$1,838.44
|
| Rate for Payer: Aetna Medicare |
$1,426.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,838.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,975.64
|
| Rate for Payer: BCBS Complete |
$947.82
|
| Rate for Payer: BCBS MAPPO |
$1,371.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,986.94
|
| Rate for Payer: BCN Commercial |
$2,057.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,371.97
|
| Rate for Payer: Cash Price |
$5,215.20
|
| Rate for Payer: Cash Price |
$5,215.20
|
| Rate for Payer: Cofinity Commercial |
$1,838.44
|
| Rate for Payer: Cofinity Commercial |
$1,975.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,371.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,440.57
|
| Rate for Payer: Meridian Medicaid |
$947.82
|
| Rate for Payer: Nomi Health Commercial |
$1,646.36
|
| Rate for Payer: PACE SWMI |
$1,371.97
|
| Rate for Payer: PHP Commercial |
$1,920.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,371.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$902.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,237.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.77
|
| Rate for Payer: Priority Health Medicare |
$1,371.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,243.77
|
| Rate for Payer: Priority Health SBD |
$2,243.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,371.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,371.97
|
| Rate for Payer: UHCCP Medicaid |
$902.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,998.74
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP
|
Professional
|
Both
|
$6,744.00
|
|
|
Service Code
|
HCPCS 35271
|
| Min. Negotiated Rate |
$650.87 |
| Max. Negotiated Rate |
$4,383.60 |
| Rate for Payer: Aetna Commercial |
$1,774.00
|
| Rate for Payer: Aetna Medicare |
$1,376.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,906.39
|
| Rate for Payer: BCBS Complete |
$913.38
|
| Rate for Payer: BCBS MAPPO |
$1,323.88
|
| Rate for Payer: BCBS Trust/PPO |
$650.87
|
| Rate for Payer: BCN Commercial |
$1,987.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,323.88
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,774.00
|
| Rate for Payer: Cofinity Commercial |
$1,906.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,323.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,390.07
|
| Rate for Payer: Meridian Medicaid |
$913.38
|
| Rate for Payer: Nomi Health Commercial |
$1,588.66
|
| Rate for Payer: PACE SWMI |
$1,323.88
|
| Rate for Payer: PHP Commercial |
$1,853.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,323.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,383.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,173.57
|
| Rate for Payer: Priority Health Medicare |
$1,323.88
|
| Rate for Payer: Priority Health Narrow Network |
$2,173.57
|
| Rate for Payer: Priority Health SBD |
$2,173.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,323.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,323.88
|
| Rate for Payer: UHCCP Medicaid |
$869.89
|
| Rate for Payer: UMR Bronson Commercial |
$3,102.24
|
|
