|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$258.58 |
| Max. Negotiated Rate |
$775.90 |
| Rate for Payer: Aetna Commercial |
$533.49
|
| Rate for Payer: Aetna Medicare |
$414.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.31
|
| Rate for Payer: BCBS Complete |
$271.51
|
| Rate for Payer: BCBS MAPPO |
$398.13
|
| Rate for Payer: BCN Commercial |
$666.30
|
| Rate for Payer: BCN Medicare Advantage |
$398.13
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$533.49
|
| Rate for Payer: Cofinity Commercial |
$573.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.04
|
| Rate for Payer: Meridian Medicaid |
$271.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.94
|
| Rate for Payer: Nomi Health Commercial |
$477.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.00
|
| Rate for Payer: PACE SWMI |
$398.13
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$398.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$725.82
|
| Rate for Payer: Priority Health Medicare |
$398.13
|
| Rate for Payer: Priority Health SBD |
$725.82
|
| Rate for Payer: Priority Health Tiered Network |
$725.82
|
| Rate for Payer: Railroad Medicare Medicare |
$398.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.90
|
| Rate for Payer: UHC Core |
$775.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.13
|
| Rate for Payer: UHC Exchange |
$775.90
|
| Rate for Payer: UHC Medicaid |
$258.58
|
| Rate for Payer: UHCCP Medicaid |
$258.58
|
| Rate for Payer: UMR Bronson Commercial |
$391.92
|
|
|
PR TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY
|
Professional
|
Both
|
$3,657.00
|
|
|
Service Code
|
HCPCS 53854
|
| Min. Negotiated Rate |
$225.78 |
| Max. Negotiated Rate |
$2,742.75 |
| Rate for Payer: Aetna Commercial |
$462.90
|
| Rate for Payer: Aetna Medicare |
$359.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.45
|
| Rate for Payer: BCBS Complete |
$237.07
|
| Rate for Payer: BCBS MAPPO |
$345.45
|
| Rate for Payer: BCN Commercial |
$575.67
|
| Rate for Payer: BCN Medicare Advantage |
$345.45
|
| Rate for Payer: Cash Price |
$2,925.60
|
| Rate for Payer: Cash Price |
$2,925.60
|
| Rate for Payer: Cofinity Commercial |
$462.90
|
| Rate for Payer: Cofinity Commercial |
$497.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.72
|
| Rate for Payer: Meridian Medicaid |
$237.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$380.00
|
| Rate for Payer: Nomi Health Commercial |
$414.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,742.75
|
| Rate for Payer: PACE SWMI |
$345.45
|
| Rate for Payer: PHP Commercial |
$483.63
|
| Rate for Payer: PHP Medicare Advantage |
$345.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$627.09
|
| Rate for Payer: Priority Health Medicare |
$345.45
|
| Rate for Payer: Priority Health SBD |
$627.09
|
| Rate for Payer: Priority Health Tiered Network |
$627.09
|
| Rate for Payer: Railroad Medicare Medicare |
$345.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.21
|
| Rate for Payer: UHC Core |
$656.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$345.45
|
| Rate for Payer: UHC Exchange |
$656.21
|
| Rate for Payer: UHC Medicaid |
$225.78
|
| Rate for Payer: UHCCP Medicaid |
$225.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,682.22
|
|
|
PR TRURL DSTRJ PRSTATE TISS RF THERMOTH
|
Professional
|
Both
|
$3,023.00
|
|
|
Service Code
|
HCPCS 53852
|
| Min. Negotiated Rate |
$225.57 |
| Max. Negotiated Rate |
$2,267.25 |
| Rate for Payer: Aetna Commercial |
$462.50
|
| Rate for Payer: Aetna Medicare |
$358.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.02
|
| Rate for Payer: BCBS Complete |
$236.85
|
| Rate for Payer: BCBS MAPPO |
$345.15
|
| Rate for Payer: BCN Commercial |
$575.67
|
| Rate for Payer: BCN Medicare Advantage |
$345.15
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Cash Price |
$2,418.40
|
| Rate for Payer: Cofinity Commercial |
$462.50
|
| Rate for Payer: Cofinity Commercial |
$497.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.41
|
| Rate for Payer: Meridian Medicaid |
$236.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.67
|
| Rate for Payer: Nomi Health Commercial |
$414.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,267.25
|
| Rate for Payer: PACE SWMI |
$345.15
|
| Rate for Payer: PHP Commercial |
$483.21
|
| Rate for Payer: PHP Medicare Advantage |
$345.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$627.09
|
| Rate for Payer: Priority Health Medicare |
$345.15
|
| Rate for Payer: Priority Health SBD |
$627.09
|
| Rate for Payer: Priority Health Tiered Network |
$627.09
|
| Rate for Payer: Railroad Medicare Medicare |
$345.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.83
|
| Rate for Payer: UHC Core |
$656.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$345.15
|
| Rate for Payer: UHC Exchange |
$656.83
|
| Rate for Payer: UHC Medicaid |
$225.57
|
| Rate for Payer: UHCCP Medicaid |
$225.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,390.58
|
|
|
PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$1,638.00
|
|
|
Service Code
|
HCPCS 52601
|
| Min. Negotiated Rate |
$335.48 |
| Max. Negotiated Rate |
$1,287.65 |
| Rate for Payer: Aetna Commercial |
$693.74
|
| Rate for Payer: Aetna Medicare |
$538.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.52
|
| Rate for Payer: BCBS Complete |
$352.25
|
| Rate for Payer: BCBS MAPPO |
$517.72
|
| Rate for Payer: BCN Commercial |
$1,088.58
|
| Rate for Payer: BCN Medicare Advantage |
$517.72
|
| Rate for Payer: Cash Price |
$1,310.40
|
| Rate for Payer: Cash Price |
$1,310.40
|
| Rate for Payer: Cofinity Commercial |
$693.74
|
| Rate for Payer: Cofinity Commercial |
$745.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.61
|
| Rate for Payer: Meridian Medicaid |
$352.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$569.49
|
| Rate for Payer: Nomi Health Commercial |
$621.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,228.50
|
| Rate for Payer: PACE SWMI |
$517.72
|
| Rate for Payer: PHP Commercial |
$724.81
|
| Rate for Payer: PHP Medicare Advantage |
$517.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,185.82
|
| Rate for Payer: Priority Health Medicare |
$517.72
|
| Rate for Payer: Priority Health SBD |
$1,185.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,185.82
|
| Rate for Payer: Railroad Medicare Medicare |
$517.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.65
|
| Rate for Payer: UHC Core |
$1,287.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$517.72
|
| Rate for Payer: UHC Exchange |
$1,287.65
|
| Rate for Payer: UHC Medicaid |
$335.48
|
| Rate for Payer: UHCCP Medicaid |
$335.48
|
| Rate for Payer: UMR Bronson Commercial |
$753.48
|
|
|
PR TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE
|
Professional
|
Both
|
$746.00
|
|
|
Service Code
|
HCPCS 52640
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$559.50 |
| Rate for Payer: Aetna Commercial |
$393.71
|
| Rate for Payer: Aetna Medicare |
$305.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.09
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$293.81
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$293.81
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cofinity Commercial |
$393.71
|
| Rate for Payer: Cofinity Commercial |
$423.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.50
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$323.19
|
| Rate for Payer: Nomi Health Commercial |
$352.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$559.50
|
| Rate for Payer: PACE SWMI |
$293.81
|
| Rate for Payer: PHP Commercial |
$411.33
|
| Rate for Payer: PHP Medicare Advantage |
$293.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$533.78
|
| Rate for Payer: Priority Health Medicare |
$293.81
|
| Rate for Payer: Priority Health SBD |
$533.78
|
| Rate for Payer: Priority Health Tiered Network |
$533.78
|
| Rate for Payer: Railroad Medicare Medicare |
$293.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.43
|
| Rate for Payer: UHC Core |
$552.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.81
|
| Rate for Payer: UHC Exchange |
$552.43
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
| Rate for Payer: UMR Bronson Commercial |
$343.16
|
|
|
PR TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 52630
|
| Min. Negotiated Rate |
$239.84 |
| Max. Negotiated Rate |
$705.48 |
| Rate for Payer: Aetna Commercial |
$493.03
|
| Rate for Payer: Aetna Medicare |
$382.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.82
|
| Rate for Payer: BCBS Complete |
$251.83
|
| Rate for Payer: BCBS MAPPO |
$367.93
|
| Rate for Payer: BCN Commercial |
$613.01
|
| Rate for Payer: BCN Medicare Advantage |
$367.93
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$493.03
|
| Rate for Payer: Cofinity Commercial |
$529.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.33
|
| Rate for Payer: Meridian Medicaid |
$251.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$404.72
|
| Rate for Payer: Nomi Health Commercial |
$441.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$609.75
|
| Rate for Payer: PACE SWMI |
$367.93
|
| Rate for Payer: PHP Commercial |
$515.10
|
| Rate for Payer: PHP Medicare Advantage |
$367.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$667.78
|
| Rate for Payer: Priority Health Medicare |
$367.93
|
| Rate for Payer: Priority Health SBD |
$667.78
|
| Rate for Payer: Priority Health Tiered Network |
$667.78
|
| Rate for Payer: Railroad Medicare Medicare |
$367.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.48
|
| Rate for Payer: UHC Core |
$705.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$367.93
|
| Rate for Payer: UHC Exchange |
$705.48
|
| Rate for Payer: UHC Medicaid |
$239.84
|
| Rate for Payer: UHCCP Medicaid |
$239.84
|
| Rate for Payer: UMR Bronson Commercial |
$373.98
|
|
|
PR TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 95921
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$133.84 |
| Rate for Payer: Aetna Commercial |
$114.14
|
| Rate for Payer: Aetna Medicare |
$88.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.66
|
| Rate for Payer: BCBS MAPPO |
$85.18
|
| Rate for Payer: BCN Commercial |
$128.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.18
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$114.14
|
| Rate for Payer: Cofinity Commercial |
$122.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.70
|
| Rate for Payer: Nomi Health Commercial |
$102.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: PACE SWMI |
$85.18
|
| Rate for Payer: PHP Commercial |
$119.25
|
| Rate for Payer: PHP Medicare Advantage |
$85.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$118.95
|
| Rate for Payer: Priority Health Medicare |
$85.18
|
| Rate for Payer: Priority Health SBD |
$118.95
|
| Rate for Payer: Priority Health Tiered Network |
$118.95
|
| Rate for Payer: Railroad Medicare Medicare |
$85.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.84
|
| Rate for Payer: UHC Core |
$133.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.18
|
| Rate for Payer: UHC Exchange |
$133.84
|
| Rate for Payer: UMR Bronson Commercial |
$73.14
|
|
|
PR TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 95924
|
| Min. Negotiated Rate |
$85.56 |
| Max. Negotiated Rate |
$235.56 |
| Rate for Payer: Aetna Commercial |
$196.90
|
| Rate for Payer: Aetna Medicare |
$152.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.59
|
| Rate for Payer: BCBS MAPPO |
$146.94
|
| Rate for Payer: BCN Commercial |
$219.61
|
| Rate for Payer: BCN Medicare Advantage |
$146.94
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Commercial |
$211.59
|
| Rate for Payer: Cofinity Commercial |
$196.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.63
|
| Rate for Payer: Nomi Health Commercial |
$176.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: PACE SWMI |
$146.94
|
| Rate for Payer: PHP Commercial |
$205.72
|
| Rate for Payer: PHP Medicare Advantage |
$146.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.53
|
| Rate for Payer: Priority Health Medicare |
$146.94
|
| Rate for Payer: Priority Health SBD |
$202.53
|
| Rate for Payer: Priority Health Tiered Network |
$202.53
|
| Rate for Payer: Railroad Medicare Medicare |
$146.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.56
|
| Rate for Payer: UHC Core |
$235.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.94
|
| Rate for Payer: UHC Exchange |
$235.56
|
| Rate for Payer: UMR Bronson Commercial |
$85.56
|
|
|
PR TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 95922
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$153.42 |
| Rate for Payer: Aetna Commercial |
$115.78
|
| Rate for Payer: Aetna Medicare |
$89.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.42
|
| Rate for Payer: BCBS MAPPO |
$86.40
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$86.40
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$115.78
|
| Rate for Payer: Cofinity Commercial |
$124.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.04
|
| Rate for Payer: Nomi Health Commercial |
$103.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.25
|
| Rate for Payer: PACE SWMI |
$86.40
|
| Rate for Payer: PHP Commercial |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$86.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.16
|
| Rate for Payer: Priority Health Medicare |
$86.40
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: Priority Health Tiered Network |
$122.16
|
| Rate for Payer: Railroad Medicare Medicare |
$86.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.42
|
| Rate for Payer: UHC Core |
$153.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.40
|
| Rate for Payer: UHC Exchange |
$153.42
|
| Rate for Payer: UMR Bronson Commercial |
$87.86
|
|
|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$125.60 |
| Max. Negotiated Rate |
$266.79 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.56
|
| Rate for Payer: BCBS Complete |
$125.60
|
| Rate for Payer: BCBS MAPPO |
$133.72
|
| Rate for Payer: BCN Commercial |
$221.60
|
| Rate for Payer: BCN Medicare Advantage |
$133.72
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Cofinity Commercial |
$179.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.09
|
| Rate for Payer: Nomi Health Commercial |
$160.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$133.72
|
| Rate for Payer: PHP Commercial |
$187.21
|
| Rate for Payer: PHP Medicare Advantage |
$133.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.68
|
| Rate for Payer: Priority Health Medicare |
$133.72
|
| Rate for Payer: Priority Health SBD |
$208.68
|
| Rate for Payer: Priority Health Tiered Network |
$208.68
|
| Rate for Payer: Railroad Medicare Medicare |
$133.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.79
|
| Rate for Payer: UHC Core |
$266.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.72
|
| Rate for Payer: UHC Exchange |
$266.79
|
| Rate for Payer: UMR Bronson Commercial |
$144.44
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$1,280.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$960.00 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna Medicare |
$132.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.54
|
| Rate for Payer: BCBS Complete |
$84.77
|
| Rate for Payer: BCBS MAPPO |
$127.46
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$127.46
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$183.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.83
|
| Rate for Payer: Meridian Medicaid |
$84.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.21
|
| Rate for Payer: Nomi Health Commercial |
$152.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.00
|
| Rate for Payer: PACE SWMI |
$127.46
|
| Rate for Payer: PHP Commercial |
$178.44
|
| Rate for Payer: PHP Medicare Advantage |
$127.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$127.46
|
| Rate for Payer: Priority Health SBD |
$254.85
|
| Rate for Payer: Priority Health Tiered Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$127.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.71
|
| Rate for Payer: UHC Core |
$255.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.46
|
| Rate for Payer: UHC Exchange |
$255.71
|
| Rate for Payer: UHC Medicaid |
$80.73
|
| Rate for Payer: UHCCP Medicaid |
$80.73
|
| Rate for Payer: UMR Bronson Commercial |
$588.80
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Medicare |
$148.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.05
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$465.00
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PHP Commercial |
$200.33
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$216.19
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health SBD |
$216.19
|
| Rate for Payer: Priority Health Tiered Network |
$216.19
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.03
|
| Rate for Payer: UHC Core |
$281.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Exchange |
$281.03
|
| Rate for Payer: UHC Medicaid |
$91.16
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
| Rate for Payer: UMR Bronson Commercial |
$285.20
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,703.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$681.20 |
| Max. Negotiated Rate |
$1,611.05 |
| Rate for Payer: Aetna Commercial |
$1,066.32
|
| Rate for Payer: Aetna Medicare |
$827.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.89
|
| Rate for Payer: BCBS Complete |
$681.20
|
| Rate for Payer: BCBS MAPPO |
$795.76
|
| Rate for Payer: BCN Commercial |
$1,362.98
|
| Rate for Payer: BCN Medicare Advantage |
$795.76
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,145.89
|
| Rate for Payer: Cofinity Commercial |
$1,066.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$875.34
|
| Rate for Payer: Nomi Health Commercial |
$954.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,277.25
|
| Rate for Payer: PACE SWMI |
$795.76
|
| Rate for Payer: PHP Commercial |
$1,114.06
|
| Rate for Payer: PHP Medicare Advantage |
$795.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,380.39
|
| Rate for Payer: Priority Health Medicare |
$795.76
|
| Rate for Payer: Priority Health SBD |
$1,380.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,380.39
|
| Rate for Payer: Railroad Medicare Medicare |
$795.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,611.05
|
| Rate for Payer: UHC Core |
$1,611.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$795.76
|
| Rate for Payer: UHC Exchange |
$1,611.05
|
| Rate for Payer: UMR Bronson Commercial |
$783.38
|
|
|
PR TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA
|
Professional
|
Both
|
$4,027.00
|
|
|
Service Code
|
HCPCS 61108
|
| Min. Negotiated Rate |
$592.35 |
| Max. Negotiated Rate |
$3,020.25 |
| Rate for Payer: PHP Medicare Advantage |
$914.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.87
|
| Rate for Payer: Priority Health Medicare |
$914.09
|
| Rate for Payer: Priority Health SBD |
$1,614.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.87
|
| Rate for Payer: Railroad Medicare Medicare |
$914.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.64
|
| Rate for Payer: UHC Core |
$1,567.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$914.09
|
| Rate for Payer: UHC Exchange |
$1,567.64
|
| Rate for Payer: UHC Medicaid |
$592.35
|
| Rate for Payer: UHCCP Medicaid |
$592.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,852.42
|
| Rate for Payer: Aetna Commercial |
$1,224.88
|
| Rate for Payer: Aetna Medicare |
$950.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,224.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,316.29
|
| Rate for Payer: BCBS Complete |
$621.97
|
| Rate for Payer: BCBS MAPPO |
$914.09
|
| Rate for Payer: BCN Commercial |
$1,920.82
|
| Rate for Payer: BCN Medicare Advantage |
$914.09
|
| Rate for Payer: Cash Price |
$3,221.60
|
| Rate for Payer: Cash Price |
$3,221.60
|
| Rate for Payer: Cofinity Commercial |
$1,316.29
|
| Rate for Payer: Cofinity Commercial |
$1,224.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$959.79
|
| Rate for Payer: Meridian Medicaid |
$621.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,005.50
|
| Rate for Payer: Nomi Health Commercial |
$1,096.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,020.25
|
| Rate for Payer: PACE SWMI |
$914.09
|
| Rate for Payer: PHP Commercial |
$1,279.73
|
|
|
PR TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Professional
|
Both
|
$2,553.00
|
|
|
Service Code
|
HCPCS 61107
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,914.75 |
| Rate for Payer: Aetna Commercial |
$390.52
|
| Rate for Payer: Aetna Medicare |
$303.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.66
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$291.43
|
| Rate for Payer: BCN Commercial |
$649.45
|
| Rate for Payer: BCN Medicare Advantage |
$291.43
|
| Rate for Payer: Cash Price |
$2,042.40
|
| Rate for Payer: Cash Price |
$2,042.40
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Cofinity Commercial |
$419.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.00
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$320.57
|
| Rate for Payer: Nomi Health Commercial |
$349.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.75
|
| Rate for Payer: PACE SWMI |
$291.43
|
| Rate for Payer: PHP Commercial |
$408.00
|
| Rate for Payer: PHP Medicare Advantage |
$291.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$546.00
|
| Rate for Payer: Priority Health Medicare |
$291.43
|
| Rate for Payer: Priority Health SBD |
$546.00
|
| Rate for Payer: Priority Health Tiered Network |
$546.00
|
| Rate for Payer: Railroad Medicare Medicare |
$291.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.84
|
| Rate for Payer: UHC Core |
$557.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$291.43
|
| Rate for Payer: UHC Exchange |
$557.84
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,174.38
|
|
|
PR TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 61105
|
| Min. Negotiated Rate |
$317.80 |
| Max. Negotiated Rate |
$1,659.75 |
| Rate for Payer: Aetna Commercial |
$651.91
|
| Rate for Payer: Aetna Medicare |
$505.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.56
|
| Rate for Payer: BCBS Complete |
$333.69
|
| Rate for Payer: BCBS MAPPO |
$486.50
|
| Rate for Payer: BCN Commercial |
$992.05
|
| Rate for Payer: BCN Medicare Advantage |
$486.50
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$651.91
|
| Rate for Payer: Cofinity Commercial |
$700.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.82
|
| Rate for Payer: Meridian Medicaid |
$333.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$535.15
|
| Rate for Payer: Nomi Health Commercial |
$583.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,659.75
|
| Rate for Payer: PACE SWMI |
$486.50
|
| Rate for Payer: PHP Commercial |
$681.10
|
| Rate for Payer: PHP Medicare Advantage |
$486.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$834.05
|
| Rate for Payer: Priority Health Medicare |
$486.50
|
| Rate for Payer: Priority Health SBD |
$834.05
|
| Rate for Payer: Priority Health Tiered Network |
$834.05
|
| Rate for Payer: Railroad Medicare Medicare |
$486.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.90
|
| Rate for Payer: UHC Core |
$800.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$486.50
|
| Rate for Payer: UHC Exchange |
$800.90
|
| Rate for Payer: UHC Medicaid |
$317.80
|
| Rate for Payer: UHCCP Medicaid |
$317.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.98
|
|
|
PR TWO AREA LIPOSUCTION - 2 AREA 2.0 HR
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,658.30
|
|
|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$1,509.00
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$1,131.75 |
| Rate for Payer: Aetna Commercial |
$625.95
|
| Rate for Payer: Aetna Medicare |
$485.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.67
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$467.13
|
| Rate for Payer: BCN Commercial |
$730.53
|
| Rate for Payer: BCN Medicare Advantage |
$467.13
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Cash Price |
$1,207.20
|
| Rate for Payer: Cofinity Commercial |
$672.67
|
| Rate for Payer: Cofinity Commercial |
$625.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.49
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.84
|
| Rate for Payer: Nomi Health Commercial |
$560.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.75
|
| Rate for Payer: PACE SWMI |
$467.13
|
| Rate for Payer: PHP Commercial |
$653.98
|
| Rate for Payer: PHP Medicare Advantage |
$467.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$890.11
|
| Rate for Payer: Priority Health Medicare |
$467.13
|
| Rate for Payer: Priority Health SBD |
$890.11
|
| Rate for Payer: Priority Health Tiered Network |
$890.11
|
| Rate for Payer: Railroad Medicare Medicare |
$467.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.51
|
| Rate for Payer: UHC Core |
$827.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.13
|
| Rate for Payer: UHC Exchange |
$827.51
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
| Rate for Payer: UMR Bronson Commercial |
$694.14
|
|
|
PR TX ECTOPIC PREGNANCY ABDL PREGNANCY
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 59130
|
| Min. Negotiated Rate |
$543.58 |
| Max. Negotiated Rate |
$1,675.64 |
| Rate for Payer: Aetna Commercial |
$1,145.70
|
| Rate for Payer: Aetna Medicare |
$889.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.20
|
| Rate for Payer: BCBS Complete |
$570.76
|
| Rate for Payer: BCBS MAPPO |
$855.00
|
| Rate for Payer: BCN Commercial |
$1,426.22
|
| Rate for Payer: BCN Medicare Advantage |
$855.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,145.70
|
| Rate for Payer: Cofinity Commercial |
$1,231.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.75
|
| Rate for Payer: Meridian Medicaid |
$570.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$940.50
|
| Rate for Payer: Nomi Health Commercial |
$1,026.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,162.50
|
| Rate for Payer: PACE SWMI |
$855.00
|
| Rate for Payer: PHP Commercial |
$1,197.00
|
| Rate for Payer: PHP Medicare Advantage |
$855.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$543.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.35
|
| Rate for Payer: Priority Health Medicare |
$855.00
|
| Rate for Payer: Priority Health SBD |
$1,346.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.35
|
| Rate for Payer: Railroad Medicare Medicare |
$855.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.64
|
| Rate for Payer: UHC Core |
$1,675.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.00
|
| Rate for Payer: UHC Exchange |
$1,675.64
|
| Rate for Payer: UHC Medicaid |
$543.58
|
| Rate for Payer: UHCCP Medicaid |
$543.58
|
| Rate for Payer: UMR Bronson Commercial |
$713.00
|
|
|
PR TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 59120
|
| Min. Negotiated Rate |
$468.60 |
| Max. Negotiated Rate |
$1,435.73 |
| Rate for Payer: Aetna Commercial |
$985.28
|
| Rate for Payer: Aetna Medicare |
$764.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.28
|
| Rate for Payer: BCBS Complete |
$492.03
|
| Rate for Payer: BCBS MAPPO |
$735.28
|
| Rate for Payer: BCN Commercial |
$1,229.02
|
| Rate for Payer: BCN Medicare Advantage |
$735.28
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,058.80
|
| Rate for Payer: Cofinity Commercial |
$985.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.04
|
| Rate for Payer: Meridian Medicaid |
$492.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$808.81
|
| Rate for Payer: Nomi Health Commercial |
$882.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: PACE SWMI |
$735.28
|
| Rate for Payer: PHP Commercial |
$1,029.39
|
| Rate for Payer: PHP Medicare Advantage |
$735.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,160.19
|
| Rate for Payer: Priority Health Medicare |
$735.28
|
| Rate for Payer: Priority Health SBD |
$1,160.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,160.19
|
| Rate for Payer: Railroad Medicare Medicare |
$735.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,435.73
|
| Rate for Payer: UHC Core |
$1,435.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$735.28
|
| Rate for Payer: UHC Exchange |
$1,435.73
|
| Rate for Payer: UHC Medicaid |
$468.60
|
| Rate for Payer: UHCCP Medicaid |
$468.60
|
| Rate for Payer: UMR Bronson Commercial |
$819.26
|
|
|
PR TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 59136
|
| Min. Negotiated Rate |
$515.25 |
| Max. Negotiated Rate |
$1,588.46 |
| Rate for Payer: Aetna Commercial |
$1,085.68
|
| Rate for Payer: Aetna Medicare |
$842.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,166.70
|
| Rate for Payer: BCBS Complete |
$541.01
|
| Rate for Payer: BCBS MAPPO |
$810.21
|
| Rate for Payer: BCN Commercial |
$1,354.01
|
| Rate for Payer: BCN Medicare Advantage |
$810.21
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$1,085.68
|
| Rate for Payer: Cofinity Commercial |
$1,166.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.72
|
| Rate for Payer: Meridian Medicaid |
$541.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$891.23
|
| Rate for Payer: Nomi Health Commercial |
$972.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,404.00
|
| Rate for Payer: PACE SWMI |
$810.21
|
| Rate for Payer: PHP Commercial |
$1,134.29
|
| Rate for Payer: PHP Medicare Advantage |
$810.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,278.19
|
| Rate for Payer: Priority Health Medicare |
$810.21
|
| Rate for Payer: Priority Health SBD |
$1,278.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,278.19
|
| Rate for Payer: Railroad Medicare Medicare |
$810.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.46
|
| Rate for Payer: UHC Core |
$1,588.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$810.21
|
| Rate for Payer: UHC Exchange |
$1,588.46
|
| Rate for Payer: UHC Medicaid |
$515.25
|
| Rate for Payer: UHCCP Medicaid |
$515.25
|
| Rate for Payer: UMR Bronson Commercial |
$861.12
|
|
|
PR TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,511.00
|
|
|
Service Code
|
HCPCS 59121
|
| Min. Negotiated Rate |
$468.81 |
| Max. Negotiated Rate |
$1,437.94 |
| Rate for Payer: Aetna Commercial |
$986.24
|
| Rate for Payer: Aetna Medicare |
$765.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.24
|
| Rate for Payer: BCBS Complete |
$492.25
|
| Rate for Payer: BCBS MAPPO |
$736.00
|
| Rate for Payer: BCN Commercial |
$1,229.52
|
| Rate for Payer: BCN Medicare Advantage |
$736.00
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cash Price |
$1,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,059.84
|
| Rate for Payer: Cofinity Commercial |
$986.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.80
|
| Rate for Payer: Meridian Medicaid |
$492.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$809.60
|
| Rate for Payer: Nomi Health Commercial |
$883.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,133.25
|
| Rate for Payer: PACE SWMI |
$736.00
|
| Rate for Payer: PHP Commercial |
$1,030.40
|
| Rate for Payer: PHP Medicare Advantage |
$736.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,160.67
|
| Rate for Payer: Priority Health Medicare |
$736.00
|
| Rate for Payer: Priority Health SBD |
$1,160.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,160.67
|
| Rate for Payer: Railroad Medicare Medicare |
$736.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,437.94
|
| Rate for Payer: UHC Core |
$1,437.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.00
|
| Rate for Payer: UHC Exchange |
$1,437.94
|
| Rate for Payer: UHC Medicaid |
$468.81
|
| Rate for Payer: UHCCP Medicaid |
$468.81
|
| Rate for Payer: UMR Bronson Commercial |
$695.06
|
|
|
PR TX HUMRL SHFT FX W/INSJ IMED IMPLT W/WO CERCLAGE
|
Professional
|
Both
|
$3,619.00
|
|
|
Service Code
|
HCPCS 24516
|
| Min. Negotiated Rate |
$508.64 |
| Max. Negotiated Rate |
$2,714.25 |
| Rate for Payer: Aetna Commercial |
$1,046.29
|
| Rate for Payer: Aetna Medicare |
$812.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.37
|
| Rate for Payer: BCBS Complete |
$534.07
|
| Rate for Payer: BCBS MAPPO |
$780.81
|
| Rate for Payer: BCN Commercial |
$1,306.20
|
| Rate for Payer: BCN Medicare Advantage |
$780.81
|
| Rate for Payer: Cash Price |
$2,895.20
|
| Rate for Payer: Cash Price |
$2,895.20
|
| Rate for Payer: Cofinity Commercial |
$1,046.29
|
| Rate for Payer: Cofinity Commercial |
$1,124.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.85
|
| Rate for Payer: Meridian Medicaid |
$534.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$858.89
|
| Rate for Payer: Nomi Health Commercial |
$936.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,714.25
|
| Rate for Payer: PACE SWMI |
$780.81
|
| Rate for Payer: PHP Commercial |
$1,093.13
|
| Rate for Payer: PHP Medicare Advantage |
$780.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,396.30
|
| Rate for Payer: Priority Health Medicare |
$780.81
|
| Rate for Payer: Priority Health SBD |
$1,396.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,396.30
|
| Rate for Payer: Railroad Medicare Medicare |
$780.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,502.52
|
| Rate for Payer: UHC Core |
$1,502.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$780.81
|
| Rate for Payer: UHC Exchange |
$1,502.52
|
| Rate for Payer: UHC Medicaid |
$508.64
|
| Rate for Payer: UHCCP Medicaid |
$508.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,664.74
|
|
|
PR TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 59812
|
| Min. Negotiated Rate |
$178.28 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$372.13
|
| Rate for Payer: Aetna Medicare |
$288.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.90
|
| Rate for Payer: BCBS Complete |
$187.19
|
| Rate for Payer: BCBS MAPPO |
$277.71
|
| Rate for Payer: BCN Commercial |
$464.62
|
| Rate for Payer: BCN Medicare Advantage |
$277.71
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$372.13
|
| Rate for Payer: Cofinity Commercial |
$399.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.60
|
| Rate for Payer: Meridian Medicaid |
$187.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.48
|
| Rate for Payer: Nomi Health Commercial |
$333.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$277.71
|
| Rate for Payer: PHP Commercial |
$388.79
|
| Rate for Payer: PHP Medicare Advantage |
$277.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$438.60
|
| Rate for Payer: Priority Health Medicare |
$277.71
|
| Rate for Payer: Priority Health SBD |
$438.60
|
| Rate for Payer: Priority Health Tiered Network |
$438.60
|
| Rate for Payer: Railroad Medicare Medicare |
$277.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.19
|
| Rate for Payer: UHC Core |
$535.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$277.71
|
| Rate for Payer: UHC Exchange |
$535.19
|
| Rate for Payer: UHC Medicaid |
$178.28
|
| Rate for Payer: UHCCP Medicaid |
$178.28
|
| Rate for Payer: UMR Bronson Commercial |
$362.48
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
|
Professional
|
Both
|
$4,229.00
|
|
|
Service Code
|
HCPCS 27245
|
| Min. Negotiated Rate |
$713.12 |
| Max. Negotiated Rate |
$3,171.75 |
| Rate for Payer: Aetna Commercial |
$1,473.01
|
| Rate for Payer: Aetna Medicare |
$1,143.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.93
|
| Rate for Payer: BCBS Complete |
$748.78
|
| Rate for Payer: BCBS MAPPO |
$1,099.26
|
| Rate for Payer: BCN Commercial |
$1,854.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.26
|
| Rate for Payer: Cash Price |
$3,383.20
|
| Rate for Payer: Cash Price |
$3,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,473.01
|
| Rate for Payer: Cofinity Commercial |
$1,582.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.22
|
| Rate for Payer: Meridian Medicaid |
$748.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,209.19
|
| Rate for Payer: Nomi Health Commercial |
$1,319.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,171.75
|
| Rate for Payer: PACE SWMI |
$1,099.26
|
| Rate for Payer: PHP Commercial |
$1,538.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,982.93
|
| Rate for Payer: Priority Health Medicare |
$1,099.26
|
| Rate for Payer: Priority Health SBD |
$1,982.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,982.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,099.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,155.53
|
| Rate for Payer: UHC Core |
$2,155.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,099.26
|
| Rate for Payer: UHC Exchange |
$2,155.53
|
| Rate for Payer: UHC Medicaid |
$713.12
|
| Rate for Payer: UHCCP Medicaid |
$713.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,945.34
|
|
