|
PR TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ
|
Professional
|
Both
|
$2,013.00
|
|
|
Service Code
|
HCPCS 69632
|
| Min. Negotiated Rate |
$618.13 |
| Max. Negotiated Rate |
$1,835.00 |
| Rate for Payer: Aetna Commercial |
$1,253.54
|
| Rate for Payer: Aetna Medicare |
$972.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,253.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.09
|
| Rate for Payer: BCBS Complete |
$649.04
|
| Rate for Payer: BCBS MAPPO |
$935.48
|
| Rate for Payer: BCN Commercial |
$1,612.96
|
| Rate for Payer: BCN Medicare Advantage |
$935.48
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Cash Price |
$1,610.40
|
| Rate for Payer: Cofinity Commercial |
$1,253.54
|
| Rate for Payer: Cofinity Commercial |
$1,347.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$935.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$982.25
|
| Rate for Payer: Meridian Medicaid |
$649.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,029.03
|
| Rate for Payer: Nomi Health Commercial |
$1,122.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,509.75
|
| Rate for Payer: PACE SWMI |
$935.48
|
| Rate for Payer: PHP Commercial |
$1,309.67
|
| Rate for Payer: PHP Medicare Advantage |
$935.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,593.76
|
| Rate for Payer: Priority Health Medicare |
$935.48
|
| Rate for Payer: Priority Health SBD |
$1,593.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,593.76
|
| Rate for Payer: Railroad Medicare Medicare |
$935.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,835.00
|
| Rate for Payer: UHC Core |
$1,835.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$935.48
|
| Rate for Payer: UHC Exchange |
$1,835.00
|
| Rate for Payer: UHC Medicaid |
$618.13
|
| Rate for Payer: UHCCP Medicaid |
$618.13
|
| Rate for Payer: UMR Bronson Commercial |
$925.98
|
|
|
PR TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$3,745.00
|
|
|
Service Code
|
HCPCS 69635
|
| Min. Negotiated Rate |
$749.97 |
| Max. Negotiated Rate |
$2,808.75 |
| Rate for Payer: Aetna Commercial |
$1,512.61
|
| Rate for Payer: Aetna Medicare |
$1,173.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.49
|
| Rate for Payer: BCBS Complete |
$787.47
|
| Rate for Payer: BCBS MAPPO |
$1,128.81
|
| Rate for Payer: BCN Commercial |
$1,915.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.81
|
| Rate for Payer: Cash Price |
$2,996.00
|
| Rate for Payer: Cash Price |
$2,996.00
|
| Rate for Payer: Cofinity Commercial |
$1,512.61
|
| Rate for Payer: Cofinity Commercial |
$1,625.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.25
|
| Rate for Payer: Meridian Medicaid |
$787.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,241.69
|
| Rate for Payer: Nomi Health Commercial |
$1,354.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,808.75
|
| Rate for Payer: PACE SWMI |
$1,128.81
|
| Rate for Payer: PHP Commercial |
$1,580.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,892.45
|
| Rate for Payer: Priority Health Medicare |
$1,128.81
|
| Rate for Payer: Priority Health SBD |
$1,892.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,892.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,098.61
|
| Rate for Payer: UHC Core |
$2,098.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,128.81
|
| Rate for Payer: UHC Exchange |
$2,098.61
|
| Rate for Payer: UHC Medicaid |
$749.97
|
| Rate for Payer: UHCCP Medicaid |
$749.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,722.70
|
|
|
PR UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX
|
Professional
|
Both
|
$2,066.00
|
|
|
Service Code
|
HCPCS 49250
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,549.50 |
| Rate for Payer: Aetna Commercial |
$749.57
|
| Rate for Payer: Aetna Medicare |
$581.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.51
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$559.38
|
| Rate for Payer: BCN Commercial |
$902.34
|
| Rate for Payer: BCN Medicare Advantage |
$559.38
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cofinity Commercial |
$749.57
|
| Rate for Payer: Cofinity Commercial |
$805.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.35
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.32
|
| Rate for Payer: Nomi Health Commercial |
$671.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,549.50
|
| Rate for Payer: PACE SWMI |
$559.38
|
| Rate for Payer: PHP Commercial |
$783.13
|
| Rate for Payer: PHP Medicare Advantage |
$559.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,099.45
|
| Rate for Payer: Priority Health Medicare |
$559.38
|
| Rate for Payer: Priority Health SBD |
$1,099.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,099.45
|
| Rate for Payer: Railroad Medicare Medicare |
$559.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.55
|
| Rate for Payer: UHC Core |
$1,040.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.38
|
| Rate for Payer: UHC Exchange |
$1,040.55
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
| Rate for Payer: UMR Bronson Commercial |
$950.36
|
|
|
PR UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 91299
|
| Min. Negotiated Rate |
$149.50 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
PR UNLISTED EVALUATION AND MANAGEMENT SERVICE
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 99499
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
|
|
PR UNLISTED PSYCHIATRIC SERVICE/PROCEDURE
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 90899
|
| Min. Negotiated Rate |
$63.02 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: UMR Bronson Commercial |
$63.02
|
|
|
PR UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 33214
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$847.47 |
| Rate for Payer: Aetna Commercial |
$565.95
|
| Rate for Payer: Aetna Medicare |
$439.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.18
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$422.35
|
| Rate for Payer: BCN Commercial |
$706.64
|
| Rate for Payer: BCN Medicare Advantage |
$422.35
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$565.95
|
| Rate for Payer: Cofinity Commercial |
$608.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.47
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$464.58
|
| Rate for Payer: Nomi Health Commercial |
$506.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$767.25
|
| Rate for Payer: PACE SWMI |
$422.35
|
| Rate for Payer: PHP Commercial |
$591.29
|
| Rate for Payer: PHP Medicare Advantage |
$422.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$759.90
|
| Rate for Payer: Priority Health Medicare |
$422.35
|
| Rate for Payer: Priority Health SBD |
$759.90
|
| Rate for Payer: Priority Health Tiered Network |
$759.90
|
| Rate for Payer: Railroad Medicare Medicare |
$422.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$847.47
|
| Rate for Payer: UHC Core |
$847.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.35
|
| Rate for Payer: UHC Exchange |
$847.47
|
| Rate for Payer: UHC Medicaid |
$271.36
|
| Rate for Payer: UHCCP Medicaid |
$271.36
|
| Rate for Payer: UMR Bronson Commercial |
$470.58
|
|
|
PR UPPER EXT FX ORTHOSIS RAD/UL
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS L3982
|
| Min. Negotiated Rate |
$143.26 |
| Max. Negotiated Rate |
$632.66 |
| Rate for Payer: Aetna Commercial |
$588.73
|
| Rate for Payer: Aetna Medicare |
$456.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.66
|
| Rate for Payer: BCBS Complete |
$144.40
|
| Rate for Payer: BCBS MAPPO |
$439.35
|
| Rate for Payer: BCN Commercial |
$420.64
|
| Rate for Payer: BCN Medicare Advantage |
$439.35
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$632.66
|
| Rate for Payer: Cofinity Commercial |
$588.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.29
|
| Rate for Payer: Nomi Health Commercial |
$527.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.75
|
| Rate for Payer: PACE SWMI |
$439.35
|
| Rate for Payer: PHP Commercial |
$615.09
|
| Rate for Payer: PHP Medicare Advantage |
$439.35
|
| Rate for Payer: Priority Health Medicare |
$439.35
|
| Rate for Payer: Railroad Medicare Medicare |
$439.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.26
|
| Rate for Payer: UHC Core |
$143.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.35
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UMR Bronson Commercial |
$166.06
|
|
|
PR UPPER EXT FX ORTHOSIS WRIST
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS L3984
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$557.32 |
| Rate for Payer: Aetna Commercial |
$518.62
|
| Rate for Payer: Aetna Medicare |
$402.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.32
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS MAPPO |
$387.03
|
| Rate for Payer: BCN Commercial |
$370.55
|
| Rate for Payer: BCN Medicare Advantage |
$387.03
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$518.62
|
| Rate for Payer: Cofinity Commercial |
$557.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.73
|
| Rate for Payer: Nomi Health Commercial |
$464.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.75
|
| Rate for Payer: PACE SWMI |
$387.03
|
| Rate for Payer: PHP Commercial |
$541.84
|
| Rate for Payer: PHP Medicare Advantage |
$387.03
|
| Rate for Payer: Priority Health Medicare |
$387.03
|
| Rate for Payer: Railroad Medicare Medicare |
$387.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.20
|
| Rate for Payer: UHC Core |
$126.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.03
|
| Rate for Payer: UHC Exchange |
$126.20
|
| Rate for Payer: UMR Bronson Commercial |
$145.82
|
|
|
PR UPPER GI ENDOSCOPY,STENT PLACEMENT
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 43256
|
| Min. Negotiated Rate |
$456.80 |
| Max. Negotiated Rate |
$856.50 |
| Rate for Payer: Aetna Medicare |
$571.00
|
| Rate for Payer: BCBS Complete |
$456.80
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$856.50
|
| Rate for Payer: UMR Bronson Commercial |
$525.32
|
|
|
PR UPPER GI ENDOSCOPY,TUMOR ABLATN
|
Professional
|
Both
|
$1,257.00
|
|
|
Service Code
|
HCPCS 43258
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$942.75 |
| Rate for Payer: Aetna Medicare |
$628.50
|
| Rate for Payer: BCBS Complete |
$502.80
|
| Rate for Payer: Cash Price |
$1,005.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$942.75
|
| Rate for Payer: UMR Bronson Commercial |
$578.22
|
|
|
PR UPPER LID BLEPHAROPLASTY
|
Professional
|
Both
|
$2,704.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,081.60 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna Medicare |
$1,352.00
|
| Rate for Payer: BCBS Complete |
$1,081.60
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR URETERAL ENDOSCOPY VIA URETEROSTOMY
|
Professional
|
Both
|
$740.00
|
|
|
Service Code
|
HCPCS 50951
|
| Min. Negotiated Rate |
$171.68 |
| Max. Negotiated Rate |
$555.00 |
| Rate for Payer: Aetna Commercial |
$358.44
|
| Rate for Payer: Aetna Medicare |
$278.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.19
|
| Rate for Payer: BCBS Complete |
$180.26
|
| Rate for Payer: BCBS MAPPO |
$267.49
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$267.49
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cash Price |
$592.00
|
| Rate for Payer: Cofinity Commercial |
$358.44
|
| Rate for Payer: Cofinity Commercial |
$385.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.86
|
| Rate for Payer: Meridian Medicaid |
$180.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$294.24
|
| Rate for Payer: Nomi Health Commercial |
$320.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.00
|
| Rate for Payer: PACE SWMI |
$267.49
|
| Rate for Payer: PHP Commercial |
$374.49
|
| Rate for Payer: PHP Medicare Advantage |
$267.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$493.64
|
| Rate for Payer: Priority Health Medicare |
$267.49
|
| Rate for Payer: Priority Health SBD |
$493.64
|
| Rate for Payer: Priority Health Tiered Network |
$493.64
|
| Rate for Payer: Railroad Medicare Medicare |
$267.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.91
|
| Rate for Payer: UHC Core |
$541.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$267.49
|
| Rate for Payer: UHC Exchange |
$541.91
|
| Rate for Payer: UHC Medicaid |
$171.68
|
| Rate for Payer: UHCCP Medicaid |
$171.68
|
| Rate for Payer: UMR Bronson Commercial |
$340.40
|
|
|
PR URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 50961
|
| Min. Negotiated Rate |
$178.07 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$371.90
|
| Rate for Payer: Aetna Medicare |
$288.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.66
|
| Rate for Payer: BCBS Complete |
$186.97
|
| Rate for Payer: BCBS MAPPO |
$277.54
|
| Rate for Payer: BCN Commercial |
$465.61
|
| Rate for Payer: BCN Medicare Advantage |
$277.54
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$371.90
|
| Rate for Payer: Cofinity Commercial |
$399.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.42
|
| Rate for Payer: Meridian Medicaid |
$186.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.29
|
| Rate for Payer: Nomi Health Commercial |
$333.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: PACE SWMI |
$277.54
|
| Rate for Payer: PHP Commercial |
$388.56
|
| Rate for Payer: PHP Medicare Advantage |
$277.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$507.20
|
| Rate for Payer: Priority Health Medicare |
$277.54
|
| Rate for Payer: Priority Health SBD |
$507.20
|
| Rate for Payer: Priority Health Tiered Network |
$507.20
|
| Rate for Payer: Railroad Medicare Medicare |
$277.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.99
|
| Rate for Payer: UHC Core |
$560.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$277.54
|
| Rate for Payer: UHC Exchange |
$560.99
|
| Rate for Payer: UHC Medicaid |
$178.07
|
| Rate for Payer: UHCCP Medicaid |
$178.07
|
| Rate for Payer: UMR Bronson Commercial |
$364.32
|
|
|
PR URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 50820
|
| Min. Negotiated Rate |
$751.68 |
| Max. Negotiated Rate |
$2,670.75 |
| Rate for Payer: Aetna Commercial |
$1,564.88
|
| Rate for Payer: Aetna Medicare |
$1,214.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,564.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,681.66
|
| Rate for Payer: BCBS Complete |
$789.26
|
| Rate for Payer: BCBS MAPPO |
$1,167.82
|
| Rate for Payer: BCN Commercial |
$1,956.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,167.82
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,564.88
|
| Rate for Payer: Cofinity Commercial |
$1,681.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,167.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,226.21
|
| Rate for Payer: Meridian Medicaid |
$789.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,284.60
|
| Rate for Payer: Nomi Health Commercial |
$1,401.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,670.75
|
| Rate for Payer: PACE SWMI |
$1,167.82
|
| Rate for Payer: PHP Commercial |
$1,634.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,167.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,131.33
|
| Rate for Payer: Priority Health Medicare |
$1,167.82
|
| Rate for Payer: Priority Health SBD |
$2,131.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,131.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,167.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,324.41
|
| Rate for Payer: UHC Core |
$2,324.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,167.82
|
| Rate for Payer: UHC Exchange |
$2,324.41
|
| Rate for Payer: UHC Medicaid |
$751.68
|
| Rate for Payer: UHCCP Medicaid |
$751.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.06
|
|
|
PR URETEROLYSIS FOR OVARIAN VEIN SYNDROME
|
Professional
|
Both
|
$2,712.00
|
|
|
Service Code
|
HCPCS 50722
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$2,034.00 |
| Rate for Payer: Aetna Commercial |
$1,203.39
|
| Rate for Payer: Aetna Medicare |
$933.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,293.19
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$898.05
|
| Rate for Payer: BCN Commercial |
$1,525.82
|
| Rate for Payer: BCN Medicare Advantage |
$898.05
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,203.39
|
| Rate for Payer: Cofinity Commercial |
$1,293.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.95
|
| Rate for Payer: Meridian Medicaid |
$605.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.86
|
| Rate for Payer: Nomi Health Commercial |
$1,077.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,034.00
|
| Rate for Payer: PACE SWMI |
$898.05
|
| Rate for Payer: PHP Commercial |
$1,257.27
|
| Rate for Payer: PHP Medicare Advantage |
$898.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,662.11
|
| Rate for Payer: Priority Health Medicare |
$898.05
|
| Rate for Payer: Priority Health SBD |
$1,662.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,662.11
|
| Rate for Payer: Railroad Medicare Medicare |
$898.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,824.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$898.05
|
| Rate for Payer: UHC Exchange |
$1,824.15
|
| Rate for Payer: UHC Medicaid |
$576.38
|
| Rate for Payer: UHCCP Medicaid |
$576.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,247.52
|
|
|
PR URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 50715
|
| Min. Negotiated Rate |
$713.98 |
| Max. Negotiated Rate |
$2,125.04 |
| Rate for Payer: Aetna Commercial |
$1,489.26
|
| Rate for Payer: Aetna Medicare |
$1,155.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,600.40
|
| Rate for Payer: BCBS Complete |
$749.68
|
| Rate for Payer: BCBS MAPPO |
$1,111.39
|
| Rate for Payer: BCN Commercial |
$1,811.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,111.39
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cofinity Commercial |
$1,489.26
|
| Rate for Payer: Cofinity Commercial |
$1,600.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,111.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,166.96
|
| Rate for Payer: Meridian Medicaid |
$749.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,222.53
|
| Rate for Payer: Nomi Health Commercial |
$1,333.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,753.50
|
| Rate for Payer: PACE SWMI |
$1,111.39
|
| Rate for Payer: PHP Commercial |
$1,555.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,111.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,973.49
|
| Rate for Payer: Priority Health Medicare |
$1,111.39
|
| Rate for Payer: Priority Health SBD |
$1,973.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,973.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,111.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,125.04
|
| Rate for Payer: UHC Core |
$2,125.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,111.39
|
| Rate for Payer: UHC Exchange |
$2,125.04
|
| Rate for Payer: UHC Medicaid |
$713.98
|
| Rate for Payer: UHCCP Medicaid |
$713.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.48
|
|
|
PR URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER
|
Professional
|
Both
|
$2,156.00
|
|
|
Service Code
|
HCPCS 50780
|
| Min. Negotiated Rate |
$641.98 |
| Max. Negotiated Rate |
$1,959.08 |
| Rate for Payer: Aetna Commercial |
$1,336.84
|
| Rate for Payer: Aetna Medicare |
$1,037.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.60
|
| Rate for Payer: BCBS Complete |
$674.08
|
| Rate for Payer: BCBS MAPPO |
$997.64
|
| Rate for Payer: BCN Commercial |
$1,662.76
|
| Rate for Payer: BCN Medicare Advantage |
$997.64
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cash Price |
$1,724.80
|
| Rate for Payer: Cofinity Commercial |
$1,336.84
|
| Rate for Payer: Cofinity Commercial |
$1,436.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,047.52
|
| Rate for Payer: Meridian Medicaid |
$674.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,097.40
|
| Rate for Payer: Nomi Health Commercial |
$1,197.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,617.00
|
| Rate for Payer: PACE SWMI |
$997.64
|
| Rate for Payer: PHP Commercial |
$1,396.70
|
| Rate for Payer: PHP Medicare Advantage |
$997.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,811.29
|
| Rate for Payer: Priority Health Medicare |
$997.64
|
| Rate for Payer: Priority Health SBD |
$1,811.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,811.29
|
| Rate for Payer: Railroad Medicare Medicare |
$997.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,959.08
|
| Rate for Payer: UHC Core |
$1,959.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$997.64
|
| Rate for Payer: UHC Exchange |
$1,959.08
|
| Rate for Payer: UHC Medicaid |
$641.98
|
| Rate for Payer: UHCCP Medicaid |
$641.98
|
| Rate for Payer: UMR Bronson Commercial |
$991.76
|
|
|
PR URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR
|
Professional
|
Both
|
$2,303.00
|
|
|
Service Code
|
HCPCS 50782
|
| Min. Negotiated Rate |
$614.29 |
| Max. Negotiated Rate |
$1,900.31 |
| Rate for Payer: Aetna Commercial |
$1,277.11
|
| Rate for Payer: Aetna Medicare |
$991.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.42
|
| Rate for Payer: BCBS Complete |
$645.00
|
| Rate for Payer: BCBS MAPPO |
$953.07
|
| Rate for Payer: BCN Commercial |
$1,602.51
|
| Rate for Payer: BCN Medicare Advantage |
$953.07
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cash Price |
$1,842.40
|
| Rate for Payer: Cofinity Commercial |
$1,277.11
|
| Rate for Payer: Cofinity Commercial |
$1,372.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.72
|
| Rate for Payer: Meridian Medicaid |
$645.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,048.38
|
| Rate for Payer: Nomi Health Commercial |
$1,143.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.25
|
| Rate for Payer: PACE SWMI |
$953.07
|
| Rate for Payer: PHP Commercial |
$1,334.30
|
| Rate for Payer: PHP Medicare Advantage |
$953.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,745.65
|
| Rate for Payer: Priority Health Medicare |
$953.07
|
| Rate for Payer: Priority Health SBD |
$1,745.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,745.65
|
| Rate for Payer: Railroad Medicare Medicare |
$953.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,900.31
|
| Rate for Payer: UHC Core |
$1,900.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$953.07
|
| Rate for Payer: UHC Exchange |
$1,900.31
|
| Rate for Payer: UHC Medicaid |
$614.29
|
| Rate for Payer: UHCCP Medicaid |
$614.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,059.38
|
|
|
PR URETERONEOCYSTOSTOMY W/URETERAL TAILORING
|
Professional
|
Both
|
$2,415.00
|
|
|
Service Code
|
HCPCS 50783
|
| Min. Negotiated Rate |
$642.83 |
| Max. Negotiated Rate |
$1,993.20 |
| Rate for Payer: Aetna Commercial |
$1,336.97
|
| Rate for Payer: Aetna Medicare |
$1,037.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.75
|
| Rate for Payer: BCBS Complete |
$674.97
|
| Rate for Payer: BCBS MAPPO |
$997.74
|
| Rate for Payer: BCN Commercial |
$1,678.19
|
| Rate for Payer: BCN Medicare Advantage |
$997.74
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cash Price |
$1,932.00
|
| Rate for Payer: Cofinity Commercial |
$1,336.97
|
| Rate for Payer: Cofinity Commercial |
$1,436.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,047.63
|
| Rate for Payer: Meridian Medicaid |
$674.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,097.51
|
| Rate for Payer: Nomi Health Commercial |
$1,197.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,811.25
|
| Rate for Payer: PACE SWMI |
$997.74
|
| Rate for Payer: PHP Commercial |
$1,396.84
|
| Rate for Payer: PHP Medicare Advantage |
$997.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,828.11
|
| Rate for Payer: Priority Health Medicare |
$997.74
|
| Rate for Payer: Priority Health SBD |
$1,828.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,828.11
|
| Rate for Payer: Railroad Medicare Medicare |
$997.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,993.20
|
| Rate for Payer: UHC Core |
$1,993.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$997.74
|
| Rate for Payer: UHC Exchange |
$1,993.20
|
| Rate for Payer: UHC Medicaid |
$642.83
|
| Rate for Payer: UHCCP Medicaid |
$642.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.90
|
|
|
PR URETEROPYELOSTOMY ANAST URETER RENAL PELVIS
|
Professional
|
Both
|
$2,640.00
|
|
|
Service Code
|
HCPCS 50740
|
| Min. Negotiated Rate |
$735.70 |
| Max. Negotiated Rate |
$2,181.14 |
| Rate for Payer: Aetna Commercial |
$1,538.09
|
| Rate for Payer: Aetna Medicare |
$1,193.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,538.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,652.88
|
| Rate for Payer: BCBS Complete |
$772.49
|
| Rate for Payer: BCBS MAPPO |
$1,147.83
|
| Rate for Payer: BCN Commercial |
$1,844.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.83
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cash Price |
$2,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,538.09
|
| Rate for Payer: Cofinity Commercial |
$1,652.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,205.22
|
| Rate for Payer: Meridian Medicaid |
$772.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,262.61
|
| Rate for Payer: Nomi Health Commercial |
$1,377.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,980.00
|
| Rate for Payer: PACE SWMI |
$1,147.83
|
| Rate for Payer: PHP Commercial |
$1,606.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,008.74
|
| Rate for Payer: Priority Health Medicare |
$1,147.83
|
| Rate for Payer: Priority Health SBD |
$2,008.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,008.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,147.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,181.14
|
| Rate for Payer: UHC Core |
$2,181.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,147.83
|
| Rate for Payer: UHC Exchange |
$2,181.14
|
| Rate for Payer: UHC Medicaid |
$735.70
|
| Rate for Payer: UHCCP Medicaid |
$735.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,214.40
|
|
|
PR URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,822.00
|
|
|
Service Code
|
HCPCS 50900
|
| Min. Negotiated Rate |
$485.43 |
| Max. Negotiated Rate |
$1,486.05 |
| Rate for Payer: Aetna Commercial |
$1,006.54
|
| Rate for Payer: Aetna Medicare |
$781.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.66
|
| Rate for Payer: BCBS Complete |
$509.70
|
| Rate for Payer: BCBS MAPPO |
$751.15
|
| Rate for Payer: BCN Commercial |
$1,260.88
|
| Rate for Payer: BCN Medicare Advantage |
$751.15
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cofinity Commercial |
$1,006.54
|
| Rate for Payer: Cofinity Commercial |
$1,081.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.71
|
| Rate for Payer: Meridian Medicaid |
$509.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$826.26
|
| Rate for Payer: Nomi Health Commercial |
$901.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,366.50
|
| Rate for Payer: PACE SWMI |
$751.15
|
| Rate for Payer: PHP Commercial |
$1,051.61
|
| Rate for Payer: PHP Medicare Advantage |
$751.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,373.51
|
| Rate for Payer: Priority Health Medicare |
$751.15
|
| Rate for Payer: Priority Health SBD |
$1,373.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,373.51
|
| Rate for Payer: Railroad Medicare Medicare |
$751.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,486.05
|
| Rate for Payer: UHC Core |
$1,486.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$751.15
|
| Rate for Payer: UHC Exchange |
$1,486.05
|
| Rate for Payer: UHC Medicaid |
$485.43
|
| Rate for Payer: UHCCP Medicaid |
$485.43
|
| Rate for Payer: UMR Bronson Commercial |
$838.12
|
|
|
PR URETEROTOMY INSERTION INDWELLING STENT ALL TYPES
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 50605
|
| Min. Negotiated Rate |
$596.83 |
| Max. Negotiated Rate |
$1,766.43 |
| Rate for Payer: Aetna Commercial |
$1,246.05
|
| Rate for Payer: Aetna Medicare |
$967.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,246.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.04
|
| Rate for Payer: BCBS Complete |
$626.67
|
| Rate for Payer: BCBS MAPPO |
$929.89
|
| Rate for Payer: BCN Commercial |
$1,510.38
|
| Rate for Payer: BCN Medicare Advantage |
$929.89
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cofinity Commercial |
$1,246.05
|
| Rate for Payer: Cofinity Commercial |
$1,339.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.38
|
| Rate for Payer: Meridian Medicaid |
$626.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,022.88
|
| Rate for Payer: Nomi Health Commercial |
$1,115.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,571.25
|
| Rate for Payer: PACE SWMI |
$929.89
|
| Rate for Payer: PHP Commercial |
$1,301.85
|
| Rate for Payer: PHP Medicare Advantage |
$929.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$596.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,645.29
|
| Rate for Payer: Priority Health Medicare |
$929.89
|
| Rate for Payer: Priority Health SBD |
$1,645.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,645.29
|
| Rate for Payer: Railroad Medicare Medicare |
$929.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,766.43
|
| Rate for Payer: UHC Core |
$1,766.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$929.89
|
| Rate for Payer: UHC Exchange |
$1,766.43
|
| Rate for Payer: UHC Medicaid |
$596.83
|
| Rate for Payer: UHCCP Medicaid |
$596.83
|
| Rate for Payer: UMR Bronson Commercial |
$963.70
|
|
|
PR URETEROURETEROSTOMY
|
Professional
|
Both
|
$2,173.00
|
|
|
Service Code
|
HCPCS 50760
|
| Min. Negotiated Rate |
$654.98 |
| Max. Negotiated Rate |
$2,000.74 |
| Rate for Payer: Aetna Commercial |
$1,364.84
|
| Rate for Payer: Aetna Medicare |
$1,059.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,466.70
|
| Rate for Payer: BCBS Complete |
$687.73
|
| Rate for Payer: BCBS MAPPO |
$1,018.54
|
| Rate for Payer: BCN Commercial |
$1,685.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,018.54
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cofinity Commercial |
$1,364.84
|
| Rate for Payer: Cofinity Commercial |
$1,466.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,018.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,069.47
|
| Rate for Payer: Meridian Medicaid |
$687.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,120.39
|
| Rate for Payer: Nomi Health Commercial |
$1,222.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.75
|
| Rate for Payer: PACE SWMI |
$1,018.54
|
| Rate for Payer: PHP Commercial |
$1,425.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,018.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,835.70
|
| Rate for Payer: Priority Health Medicare |
$1,018.54
|
| Rate for Payer: Priority Health SBD |
$1,835.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,835.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,018.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.74
|
| Rate for Payer: UHC Core |
$2,000.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,018.54
|
| Rate for Payer: UHC Exchange |
$2,000.74
|
| Rate for Payer: UHC Medicaid |
$654.98
|
| Rate for Payer: UHCCP Medicaid |
$654.98
|
| Rate for Payer: UMR Bronson Commercial |
$999.58
|
|
|
PR URETHRECTOMY TOT W/CYSTOST MALE
|
Professional
|
Both
|
$1,986.00
|
|
|
Service Code
|
HCPCS 53215
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$1,641.31 |
| Rate for Payer: Aetna Commercial |
$1,103.29
|
| Rate for Payer: Aetna Medicare |
$856.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.62
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCBS MAPPO |
$823.35
|
| Rate for Payer: BCN Commercial |
$1,385.38
|
| Rate for Payer: BCN Medicare Advantage |
$823.35
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cofinity Commercial |
$1,103.29
|
| Rate for Payer: Cofinity Commercial |
$1,185.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.52
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$905.68
|
| Rate for Payer: Nomi Health Commercial |
$988.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,489.50
|
| Rate for Payer: PACE SWMI |
$823.35
|
| Rate for Payer: PHP Commercial |
$1,152.69
|
| Rate for Payer: PHP Medicare Advantage |
$823.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,509.13
|
| Rate for Payer: Priority Health Medicare |
$823.35
|
| Rate for Payer: Priority Health SBD |
$1,509.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,509.13
|
| Rate for Payer: Railroad Medicare Medicare |
$823.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,641.31
|
| Rate for Payer: UHC Core |
$1,641.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$823.35
|
| Rate for Payer: UHC Exchange |
$1,641.31
|
| Rate for Payer: UHC Medicaid |
$531.01
|
| Rate for Payer: UHCCP Medicaid |
$531.01
|
| Rate for Payer: UMR Bronson Commercial |
$913.56
|
|
