|
PR URETHROLSS TRVG SEC OPN W/CSTO
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS 53500
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,322.28 |
| Rate for Payer: Aetna Commercial |
$891.02
|
| Rate for Payer: Aetna Medicare |
$691.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.51
|
| Rate for Payer: BCBS Complete |
$450.43
|
| Rate for Payer: BCBS MAPPO |
$664.94
|
| Rate for Payer: BCN Commercial |
$1,120.46
|
| Rate for Payer: BCN Medicare Advantage |
$664.94
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cofinity Commercial |
$891.02
|
| Rate for Payer: Cofinity Commercial |
$957.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.19
|
| Rate for Payer: Meridian Medicaid |
$450.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$731.43
|
| Rate for Payer: Nomi Health Commercial |
$797.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: PACE SWMI |
$664.94
|
| Rate for Payer: PHP Commercial |
$930.92
|
| Rate for Payer: PHP Medicare Advantage |
$664.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,220.55
|
| Rate for Payer: Priority Health Medicare |
$664.94
|
| Rate for Payer: Priority Health SBD |
$1,220.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,220.55
|
| Rate for Payer: Railroad Medicare Medicare |
$664.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.28
|
| Rate for Payer: UHC Core |
$1,322.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$664.94
|
| Rate for Payer: UHC Exchange |
$1,322.28
|
| Rate for Payer: UHC Medicaid |
$428.98
|
| Rate for Payer: UHCCP Medicaid |
$428.98
|
| Rate for Payer: UMR Bronson Commercial |
$645.84
|
|
|
PR URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 53450
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$718.31 |
| Rate for Payer: Aetna Commercial |
$497.81
|
| Rate for Payer: Aetna Medicare |
$386.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.96
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$371.50
|
| Rate for Payer: BCN Commercial |
$618.00
|
| Rate for Payer: BCN Medicare Advantage |
$371.50
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cofinity Commercial |
$497.81
|
| Rate for Payer: Cofinity Commercial |
$534.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.07
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$408.65
|
| Rate for Payer: Nomi Health Commercial |
$445.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$597.75
|
| Rate for Payer: PACE SWMI |
$371.50
|
| Rate for Payer: PHP Commercial |
$520.10
|
| Rate for Payer: PHP Medicare Advantage |
$371.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$673.20
|
| Rate for Payer: Priority Health Medicare |
$371.50
|
| Rate for Payer: Priority Health SBD |
$673.20
|
| Rate for Payer: Priority Health Tiered Network |
$673.20
|
| Rate for Payer: Railroad Medicare Medicare |
$371.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.31
|
| Rate for Payer: UHC Core |
$718.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.50
|
| Rate for Payer: UHC Exchange |
$718.31
|
| Rate for Payer: UHC Medicaid |
$241.76
|
| Rate for Payer: UHCCP Medicaid |
$241.76
|
| Rate for Payer: UMR Bronson Commercial |
$366.62
|
|
|
PR URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 53460
|
| Min. Negotiated Rate |
$268.81 |
| Max. Negotiated Rate |
$1,216.50 |
| Rate for Payer: Aetna Commercial |
$554.71
|
| Rate for Payer: Aetna Medicare |
$430.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.10
|
| Rate for Payer: BCBS Complete |
$282.25
|
| Rate for Payer: BCBS MAPPO |
$413.96
|
| Rate for Payer: BCN Commercial |
$688.71
|
| Rate for Payer: BCN Medicare Advantage |
$413.96
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cofinity Commercial |
$554.71
|
| Rate for Payer: Cofinity Commercial |
$596.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.66
|
| Rate for Payer: Meridian Medicaid |
$282.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.36
|
| Rate for Payer: Nomi Health Commercial |
$496.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,216.50
|
| Rate for Payer: PACE SWMI |
$413.96
|
| Rate for Payer: PHP Commercial |
$579.54
|
| Rate for Payer: PHP Medicare Advantage |
$413.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$750.22
|
| Rate for Payer: Priority Health Medicare |
$413.96
|
| Rate for Payer: Priority Health SBD |
$750.22
|
| Rate for Payer: Priority Health Tiered Network |
$750.22
|
| Rate for Payer: Railroad Medicare Medicare |
$413.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.45
|
| Rate for Payer: UHC Core |
$804.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$413.96
|
| Rate for Payer: UHC Exchange |
$804.45
|
| Rate for Payer: UHC Medicaid |
$268.81
|
| Rate for Payer: UHCCP Medicaid |
$268.81
|
| Rate for Payer: UMR Bronson Commercial |
$746.12
|
|
|
PR URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 53410
|
| Min. Negotiated Rate |
$560.83 |
| Max. Negotiated Rate |
$1,728.79 |
| Rate for Payer: Aetna Commercial |
$1,164.53
|
| Rate for Payer: Aetna Medicare |
$903.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.43
|
| Rate for Payer: BCBS Complete |
$588.87
|
| Rate for Payer: BCBS MAPPO |
$869.05
|
| Rate for Payer: BCN Commercial |
$1,461.57
|
| Rate for Payer: BCN Medicare Advantage |
$869.05
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$1,164.53
|
| Rate for Payer: Cofinity Commercial |
$1,251.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.50
|
| Rate for Payer: Meridian Medicaid |
$588.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$955.96
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,570.50
|
| Rate for Payer: PACE SWMI |
$869.05
|
| Rate for Payer: PHP Commercial |
$1,216.67
|
| Rate for Payer: PHP Medicare Advantage |
$869.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,592.13
|
| Rate for Payer: Priority Health Medicare |
$869.05
|
| Rate for Payer: Priority Health SBD |
$1,592.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.13
|
| Rate for Payer: Railroad Medicare Medicare |
$869.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,728.79
|
| Rate for Payer: UHC Core |
$1,728.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$869.05
|
| Rate for Payer: UHC Exchange |
$1,728.79
|
| Rate for Payer: UHC Medicaid |
$560.83
|
| Rate for Payer: UHCCP Medicaid |
$560.83
|
| Rate for Payer: UMR Bronson Commercial |
$963.24
|
|
|
PR URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 53400
|
| Min. Negotiated Rate |
$461.57 |
| Max. Negotiated Rate |
$1,414.81 |
| Rate for Payer: Aetna Commercial |
$956.85
|
| Rate for Payer: Aetna Medicare |
$742.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.85
|
| Rate for Payer: BCBS Complete |
$484.65
|
| Rate for Payer: BCBS MAPPO |
$714.07
|
| Rate for Payer: BCN Commercial |
$1,200.63
|
| Rate for Payer: BCN Medicare Advantage |
$714.07
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$1,028.26
|
| Rate for Payer: Cofinity Commercial |
$956.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$749.77
|
| Rate for Payer: Meridian Medicaid |
$484.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$785.48
|
| Rate for Payer: Nomi Health Commercial |
$856.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.50
|
| Rate for Payer: PACE SWMI |
$714.07
|
| Rate for Payer: PHP Commercial |
$999.70
|
| Rate for Payer: PHP Medicare Advantage |
$714.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,307.87
|
| Rate for Payer: Priority Health Medicare |
$714.07
|
| Rate for Payer: Priority Health SBD |
$1,307.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,307.87
|
| Rate for Payer: Railroad Medicare Medicare |
$714.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.81
|
| Rate for Payer: UHC Core |
$1,414.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$714.07
|
| Rate for Payer: UHC Exchange |
$1,414.81
|
| Rate for Payer: UHC Medicaid |
$461.57
|
| Rate for Payer: UHCCP Medicaid |
$461.57
|
| Rate for Payer: UMR Bronson Commercial |
$722.20
|
|
|
PR URETHROPLASTY 2ND STAGE W/URINARY DIVERSION
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 53405
|
| Min. Negotiated Rate |
$502.04 |
| Max. Negotiated Rate |
$1,542.18 |
| Rate for Payer: Aetna Commercial |
$1,041.56
|
| Rate for Payer: Aetna Medicare |
$808.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,041.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.28
|
| Rate for Payer: BCBS Complete |
$527.14
|
| Rate for Payer: BCBS MAPPO |
$777.28
|
| Rate for Payer: BCN Commercial |
$1,306.20
|
| Rate for Payer: BCN Medicare Advantage |
$777.28
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cofinity Commercial |
$1,041.56
|
| Rate for Payer: Cofinity Commercial |
$1,119.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.14
|
| Rate for Payer: Meridian Medicaid |
$527.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$855.01
|
| Rate for Payer: Nomi Health Commercial |
$932.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.00
|
| Rate for Payer: PACE SWMI |
$777.28
|
| Rate for Payer: PHP Commercial |
$1,088.19
|
| Rate for Payer: PHP Medicare Advantage |
$777.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,422.88
|
| Rate for Payer: Priority Health Medicare |
$777.28
|
| Rate for Payer: Priority Health SBD |
$1,422.88
|
| Rate for Payer: Priority Health Tiered Network |
$1,422.88
|
| Rate for Payer: Railroad Medicare Medicare |
$777.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.18
|
| Rate for Payer: UHC Core |
$1,542.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$777.28
|
| Rate for Payer: UHC Exchange |
$1,542.18
|
| Rate for Payer: UHC Medicaid |
$502.04
|
| Rate for Payer: UHCCP Medicaid |
$502.04
|
| Rate for Payer: UMR Bronson Commercial |
$859.28
|
|
|
PR URETHROPLASTY RCNSTJ FEMALE URETHRA
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 53430
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$1,717.66 |
| Rate for Payer: Aetna Commercial |
$1,157.91
|
| Rate for Payer: Aetna Medicare |
$898.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.32
|
| Rate for Payer: BCBS Complete |
$584.62
|
| Rate for Payer: BCBS MAPPO |
$864.11
|
| Rate for Payer: BCN Commercial |
$1,454.60
|
| Rate for Payer: BCN Medicare Advantage |
$864.11
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$1,157.91
|
| Rate for Payer: Cofinity Commercial |
$1,244.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.32
|
| Rate for Payer: Meridian Medicaid |
$584.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$950.52
|
| Rate for Payer: Nomi Health Commercial |
$1,036.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,362.75
|
| Rate for Payer: PACE SWMI |
$864.11
|
| Rate for Payer: PHP Commercial |
$1,209.75
|
| Rate for Payer: PHP Medicare Advantage |
$864.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,584.53
|
| Rate for Payer: Priority Health Medicare |
$864.11
|
| Rate for Payer: Priority Health SBD |
$1,584.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,584.53
|
| Rate for Payer: Railroad Medicare Medicare |
$864.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,717.66
|
| Rate for Payer: UHC Core |
$1,717.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$864.11
|
| Rate for Payer: UHC Exchange |
$1,717.66
|
| Rate for Payer: UHC Medicaid |
$556.78
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
| Rate for Payer: UMR Bronson Commercial |
$835.82
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 53502
|
| Min. Negotiated Rate |
$284.99 |
| Max. Negotiated Rate |
$853.99 |
| Rate for Payer: Aetna Commercial |
$588.25
|
| Rate for Payer: Aetna Medicare |
$456.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.15
|
| Rate for Payer: BCBS Complete |
$299.24
|
| Rate for Payer: BCBS MAPPO |
$438.99
|
| Rate for Payer: BCN Commercial |
$732.53
|
| Rate for Payer: BCN Medicare Advantage |
$438.99
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cofinity Commercial |
$588.25
|
| Rate for Payer: Cofinity Commercial |
$632.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.94
|
| Rate for Payer: Meridian Medicaid |
$299.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$482.89
|
| Rate for Payer: Nomi Health Commercial |
$526.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$754.50
|
| Rate for Payer: PACE SWMI |
$438.99
|
| Rate for Payer: PHP Commercial |
$614.59
|
| Rate for Payer: PHP Medicare Advantage |
$438.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$797.97
|
| Rate for Payer: Priority Health Medicare |
$438.99
|
| Rate for Payer: Priority Health SBD |
$797.97
|
| Rate for Payer: Priority Health Tiered Network |
$797.97
|
| Rate for Payer: Railroad Medicare Medicare |
$438.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.99
|
| Rate for Payer: UHC Core |
$853.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.99
|
| Rate for Payer: UHC Exchange |
$853.99
|
| Rate for Payer: UHC Medicaid |
$284.99
|
| Rate for Payer: UHCCP Medicaid |
$284.99
|
| Rate for Payer: UMR Bronson Commercial |
$462.76
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 53505
|
| Min. Negotiated Rate |
$284.78 |
| Max. Negotiated Rate |
$853.42 |
| Rate for Payer: Aetna Commercial |
$587.84
|
| Rate for Payer: Aetna Medicare |
$456.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.71
|
| Rate for Payer: BCBS Complete |
$299.02
|
| Rate for Payer: BCBS MAPPO |
$438.69
|
| Rate for Payer: BCN Commercial |
$732.03
|
| Rate for Payer: BCN Medicare Advantage |
$438.69
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Cofinity Commercial |
$631.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.62
|
| Rate for Payer: Meridian Medicaid |
$299.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$482.56
|
| Rate for Payer: Nomi Health Commercial |
$526.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.25
|
| Rate for Payer: PACE SWMI |
$438.69
|
| Rate for Payer: PHP Commercial |
$614.17
|
| Rate for Payer: PHP Medicare Advantage |
$438.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$797.41
|
| Rate for Payer: Priority Health Medicare |
$438.69
|
| Rate for Payer: Priority Health SBD |
$797.41
|
| Rate for Payer: Priority Health Tiered Network |
$797.41
|
| Rate for Payer: Railroad Medicare Medicare |
$438.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.42
|
| Rate for Payer: UHC Core |
$853.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.69
|
| Rate for Payer: UHC Exchange |
$853.42
|
| Rate for Payer: UHC Medicaid |
$284.78
|
| Rate for Payer: UHCCP Medicaid |
$284.78
|
| Rate for Payer: UMR Bronson Commercial |
$437.46
|
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 53010
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$514.26 |
| Rate for Payer: Aetna Commercial |
$366.48
|
| Rate for Payer: Aetna Medicare |
$284.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.83
|
| Rate for Payer: BCBS Complete |
$188.32
|
| Rate for Payer: BCBS MAPPO |
$273.49
|
| Rate for Payer: BCN Commercial |
$451.17
|
| Rate for Payer: BCN Medicare Advantage |
$273.49
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$366.48
|
| Rate for Payer: Cofinity Commercial |
$393.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.16
|
| Rate for Payer: Meridian Medicaid |
$188.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.84
|
| Rate for Payer: Nomi Health Commercial |
$328.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$427.50
|
| Rate for Payer: PACE SWMI |
$273.49
|
| Rate for Payer: PHP Commercial |
$382.89
|
| Rate for Payer: PHP Medicare Advantage |
$273.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$491.47
|
| Rate for Payer: Priority Health Medicare |
$273.49
|
| Rate for Payer: Priority Health SBD |
$491.47
|
| Rate for Payer: Priority Health Tiered Network |
$491.47
|
| Rate for Payer: Railroad Medicare Medicare |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.26
|
| Rate for Payer: UHC Core |
$514.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$273.49
|
| Rate for Payer: UHC Exchange |
$514.26
|
| Rate for Payer: UHC Medicaid |
$179.35
|
| Rate for Payer: UHCCP Medicaid |
$179.35
|
| Rate for Payer: UMR Bronson Commercial |
$262.20
|
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,451.00
|
|
|
Service Code
|
HCPCS 50650
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$2,588.25 |
| Rate for Payer: Aetna Commercial |
$1,234.80
|
| Rate for Payer: Aetna Medicare |
$958.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.95
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$921.49
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: BCN Medicare Advantage |
$921.49
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Cofinity Commercial |
$1,234.80
|
| Rate for Payer: Cofinity Commercial |
$1,326.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.56
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,013.64
|
| Rate for Payer: Nomi Health Commercial |
$1,105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,588.25
|
| Rate for Payer: PACE SWMI |
$921.49
|
| Rate for Payer: PHP Commercial |
$1,290.09
|
| Rate for Payer: PHP Medicare Advantage |
$921.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,687.07
|
| Rate for Payer: Priority Health Medicare |
$921.49
|
| Rate for Payer: Priority Health SBD |
$1,687.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,687.07
|
| Rate for Payer: Railroad Medicare Medicare |
$921.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,836.22
|
| Rate for Payer: UHC Core |
$1,836.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$921.49
|
| Rate for Payer: UHC Exchange |
$1,836.22
|
| Rate for Payer: UHC Medicaid |
$593.84
|
| Rate for Payer: UHCCP Medicaid |
$593.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,587.46
|
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4358
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$12.02 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna Medicare |
$8.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.02
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$8.35
|
| Rate for Payer: BCN Commercial |
$8.00
|
| Rate for Payer: BCN Medicare Advantage |
$8.35
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$12.02
|
| Rate for Payer: Cofinity Commercial |
$11.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.19
|
| Rate for Payer: Nomi Health Commercial |
$10.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$8.35
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: PHP Medicare Advantage |
$8.35
|
| Rate for Payer: Priority Health Medicare |
$8.35
|
| Rate for Payer: Railroad Medicare Medicare |
$8.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.73
|
| Rate for Payer: UHC Core |
$2.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.35
|
| Rate for Payer: UHC Exchange |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
|
PR URINARY SUSPENSORY
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS A5105
|
| Min. Negotiated Rate |
$18.95 |
| Max. Negotiated Rate |
$83.68 |
| Rate for Payer: Aetna Commercial |
$77.87
|
| Rate for Payer: Aetna Medicare |
$60.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.68
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$55.63
|
| Rate for Payer: BCN Medicare Advantage |
$58.11
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$77.87
|
| Rate for Payer: Cofinity Commercial |
$83.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.92
|
| Rate for Payer: Nomi Health Commercial |
$69.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: PACE SWMI |
$58.11
|
| Rate for Payer: PHP Commercial |
$81.35
|
| Rate for Payer: PHP Medicare Advantage |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$58.11
|
| Rate for Payer: Railroad Medicare Medicare |
$58.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.95
|
| Rate for Payer: UHC Core |
$18.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.11
|
| Rate for Payer: UHC Exchange |
$18.95
|
| Rate for Payer: UMR Bronson Commercial |
$31.28
|
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 53431
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$2,040.32 |
| Rate for Payer: Aetna Commercial |
$1,366.67
|
| Rate for Payer: Aetna Medicare |
$1,060.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.66
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCBS MAPPO |
$1,019.90
|
| Rate for Payer: BCN Commercial |
$1,717.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cofinity Commercial |
$1,366.67
|
| Rate for Payer: Cofinity Commercial |
$1,468.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,019.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.89
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,121.89
|
| Rate for Payer: Nomi Health Commercial |
$1,223.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,704.00
|
| Rate for Payer: PACE SWMI |
$1,019.90
|
| Rate for Payer: PHP Commercial |
$1,427.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,019.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,870.95
|
| Rate for Payer: Priority Health Medicare |
$1,019.90
|
| Rate for Payer: Priority Health SBD |
$1,870.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,870.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,019.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,040.32
|
| Rate for Payer: UHC Core |
$2,040.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,019.90
|
| Rate for Payer: UHC Exchange |
$2,040.32
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,045.12
|
|
|
PR URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 50620
|
| Min. Negotiated Rate |
$517.38 |
| Max. Negotiated Rate |
$1,597.32 |
| Rate for Payer: Aetna Commercial |
$1,074.87
|
| Rate for Payer: Aetna Medicare |
$834.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.08
|
| Rate for Payer: BCBS Complete |
$543.25
|
| Rate for Payer: BCBS MAPPO |
$802.14
|
| Rate for Payer: BCN Commercial |
$1,348.04
|
| Rate for Payer: BCN Medicare Advantage |
$802.14
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cofinity Commercial |
$1,074.87
|
| Rate for Payer: Cofinity Commercial |
$1,155.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.25
|
| Rate for Payer: Meridian Medicaid |
$543.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.35
|
| Rate for Payer: Nomi Health Commercial |
$962.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.25
|
| Rate for Payer: PACE SWMI |
$802.14
|
| Rate for Payer: PHP Commercial |
$1,123.00
|
| Rate for Payer: PHP Medicare Advantage |
$802.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,468.45
|
| Rate for Payer: Priority Health Medicare |
$802.14
|
| Rate for Payer: Priority Health SBD |
$1,468.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,468.45
|
| Rate for Payer: Railroad Medicare Medicare |
$802.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,597.32
|
| Rate for Payer: UHC Core |
$1,597.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.14
|
| Rate for Payer: UHC Exchange |
$1,597.32
|
| Rate for Payer: UHC Medicaid |
$517.38
|
| Rate for Payer: UHCCP Medicaid |
$517.38
|
| Rate for Payer: UMR Bronson Commercial |
$770.50
|
|
|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 50785
|
| Min. Negotiated Rate |
$691.82 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$1,440.34
|
| Rate for Payer: Aetna Medicare |
$1,117.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.83
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCBS MAPPO |
$1,074.88
|
| Rate for Payer: BCN Commercial |
$1,812.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.88
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cofinity Commercial |
$1,440.34
|
| Rate for Payer: Cofinity Commercial |
$1,547.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,128.62
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,182.37
|
| Rate for Payer: Nomi Health Commercial |
$1,289.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: PACE SWMI |
$1,074.88
|
| Rate for Payer: PHP Commercial |
$1,504.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,974.03
|
| Rate for Payer: Priority Health Medicare |
$1,074.88
|
| Rate for Payer: Priority Health SBD |
$1,974.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,974.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,074.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,146.86
|
| Rate for Payer: UHC Core |
$2,146.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,074.88
|
| Rate for Payer: UHC Exchange |
$2,146.86
|
| Rate for Payer: UHC Medicaid |
$691.82
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,204.32
|
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 53000
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$259.21 |
| Rate for Payer: Aetna Commercial |
$181.13
|
| Rate for Payer: Aetna Medicare |
$140.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.64
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$135.17
|
| Rate for Payer: BCN Commercial |
$223.60
|
| Rate for Payer: BCN Medicare Advantage |
$135.17
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$181.13
|
| Rate for Payer: Cofinity Commercial |
$194.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.93
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.69
|
| Rate for Payer: Nomi Health Commercial |
$162.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: PACE SWMI |
$135.17
|
| Rate for Payer: PHP Commercial |
$189.24
|
| Rate for Payer: PHP Medicare Advantage |
$135.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$243.57
|
| Rate for Payer: Priority Health Medicare |
$135.17
|
| Rate for Payer: Priority Health SBD |
$243.57
|
| Rate for Payer: Priority Health Tiered Network |
$243.57
|
| Rate for Payer: Railroad Medicare Medicare |
$135.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.21
|
| Rate for Payer: UHC Core |
$259.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.17
|
| Rate for Payer: UHC Exchange |
$259.21
|
| Rate for Payer: UHC Medicaid |
$88.40
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 93352
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Aetna Commercial |
$44.66
|
| Rate for Payer: Aetna Medicare |
$34.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$33.33
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$33.33
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.66
|
| Rate for Payer: Nomi Health Commercial |
$40.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: PACE SWMI |
$33.33
|
| Rate for Payer: PHP Commercial |
$46.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.69
|
| Rate for Payer: Priority Health Medicare |
$33.33
|
| Rate for Payer: Priority Health SBD |
$49.69
|
| Rate for Payer: Priority Health Tiered Network |
$49.69
|
| Rate for Payer: Railroad Medicare Medicare |
$33.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.54
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.33
|
| Rate for Payer: UHC Exchange |
$51.54
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Aetna Commercial |
$13.48
|
| Rate for Payer: Aetna Medicare |
$10.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.49
|
| Rate for Payer: BCBS MAPPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$15.44
|
| Rate for Payer: BCN Medicare Advantage |
$10.06
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$13.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.07
|
| Rate for Payer: Nomi Health Commercial |
$12.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: PACE SWMI |
$10.06
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.24
|
| Rate for Payer: Priority Health Medicare |
$10.06
|
| Rate for Payer: Priority Health SBD |
$14.24
|
| Rate for Payer: Priority Health Tiered Network |
$14.24
|
| Rate for Payer: Railroad Medicare Medicare |
$10.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.77
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.06
|
| Rate for Payer: UHC Exchange |
$12.77
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$889.82 |
| Rate for Payer: Aetna Commercial |
$635.25
|
| Rate for Payer: Aetna Medicare |
$493.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$635.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.66
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$474.07
|
| Rate for Payer: BCN Commercial |
$806.23
|
| Rate for Payer: BCN Medicare Advantage |
$474.07
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$635.25
|
| Rate for Payer: Cofinity Commercial |
$682.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.77
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.48
|
| Rate for Payer: Nomi Health Commercial |
$568.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.75
|
| Rate for Payer: PACE SWMI |
$474.07
|
| Rate for Payer: PHP Commercial |
$663.70
|
| Rate for Payer: PHP Medicare Advantage |
$474.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$761.09
|
| Rate for Payer: Priority Health Medicare |
$474.07
|
| Rate for Payer: Priority Health SBD |
$761.09
|
| Rate for Payer: Priority Health Tiered Network |
$761.09
|
| Rate for Payer: Railroad Medicare Medicare |
$474.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.82
|
| Rate for Payer: UHC Core |
$889.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.07
|
| Rate for Payer: UHC Exchange |
$889.82
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
| Rate for Payer: UMR Bronson Commercial |
$372.14
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$798.59 |
| Rate for Payer: Aetna Commercial |
$546.77
|
| Rate for Payer: Aetna Medicare |
$424.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.58
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$408.04
|
| Rate for Payer: BCN Commercial |
$693.19
|
| Rate for Payer: BCN Medicare Advantage |
$408.04
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$546.77
|
| Rate for Payer: Cofinity Commercial |
$587.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.44
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$448.84
|
| Rate for Payer: Nomi Health Commercial |
$489.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$408.04
|
| Rate for Payer: PHP Commercial |
$571.26
|
| Rate for Payer: PHP Medicare Advantage |
$408.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$702.05
|
| Rate for Payer: Priority Health Medicare |
$408.04
|
| Rate for Payer: Priority Health SBD |
$702.05
|
| Rate for Payer: Priority Health Tiered Network |
$702.05
|
| Rate for Payer: Railroad Medicare Medicare |
$408.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.59
|
| Rate for Payer: UHC Core |
$798.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$408.04
|
| Rate for Payer: UHC Exchange |
$798.59
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
| Rate for Payer: UMR Bronson Commercial |
$409.40
|
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,253.40 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,068.89
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCN Commercial |
$2,253.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,112.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.36
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Commercial |
$194.62
|
| Rate for Payer: Aetna Medicare |
$151.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.15
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCBS MAPPO |
$145.24
|
| Rate for Payer: BCN Commercial |
$247.99
|
| Rate for Payer: BCN Medicare Advantage |
$145.24
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$209.15
|
| Rate for Payer: Cofinity Commercial |
$194.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.50
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.76
|
| Rate for Payer: Nomi Health Commercial |
$174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: PACE SWMI |
$145.24
|
| Rate for Payer: PHP Commercial |
$203.34
|
| Rate for Payer: PHP Medicare Advantage |
$145.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$302.17
|
| Rate for Payer: Priority Health Medicare |
$145.24
|
| Rate for Payer: Priority Health SBD |
$302.17
|
| Rate for Payer: Priority Health Tiered Network |
$302.17
|
| Rate for Payer: Railroad Medicare Medicare |
$145.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.60
|
| Rate for Payer: UHC Core |
$266.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$145.24
|
| Rate for Payer: UHC Exchange |
$266.60
|
| Rate for Payer: UHC Medicaid |
$96.92
|
| Rate for Payer: UHCCP Medicaid |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$271.40
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,218.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,456.85
|
| Rate for Payer: Aetna Medicare |
$1,130.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,456.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,565.57
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,087.20
|
| Rate for Payer: BCN Commercial |
$1,859.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.20
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Cofinity Commercial |
$1,456.85
|
| Rate for Payer: Cofinity Commercial |
$1,565.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,141.56
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,195.92
|
| Rate for Payer: Nomi Health Commercial |
$1,304.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,413.50
|
| Rate for Payer: PACE SWMI |
$1,087.20
|
| Rate for Payer: PHP Commercial |
$1,522.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,883.23
|
| Rate for Payer: Priority Health Medicare |
$1,087.20
|
| Rate for Payer: Priority Health SBD |
$1,883.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,883.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,087.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,218.50
|
| Rate for Payer: UHC Core |
$2,218.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,087.20
|
| Rate for Payer: UHC Exchange |
$2,218.50
|
| Rate for Payer: UHC Medicaid |
$696.72
|
| Rate for Payer: UHCCP Medicaid |
$696.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,480.28
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$2,670.75 |
| Rate for Payer: Aetna Commercial |
$1,534.98
|
| Rate for Payer: Aetna Medicare |
$1,191.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,534.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,649.53
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS MAPPO |
$1,145.51
|
| Rate for Payer: BCN Commercial |
$1,958.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.51
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,534.98
|
| Rate for Payer: Cofinity Commercial |
$1,649.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,202.79
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.06
|
| Rate for Payer: Nomi Health Commercial |
$1,374.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,670.75
|
| Rate for Payer: PACE SWMI |
$1,145.51
|
| Rate for Payer: PHP Commercial |
$1,603.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,983.60
|
| Rate for Payer: Priority Health Medicare |
$1,145.51
|
| Rate for Payer: Priority Health SBD |
$1,983.60
|
| Rate for Payer: Priority Health Tiered Network |
$1,983.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,145.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,339.52
|
| Rate for Payer: UHC Core |
$2,339.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,145.51
|
| Rate for Payer: UHC Exchange |
$2,339.52
|
| Rate for Payer: UHC Medicaid |
$733.79
|
| Rate for Payer: UHCCP Medicaid |
$733.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.06
|
|
