|
PR VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I
|
Professional
|
Both
|
$1,560.00
|
|
|
Service Code
|
HCPCS 37242
|
| Min. Negotiated Rate |
$263.69 |
| Max. Negotiated Rate |
$1,170.00 |
| Rate for Payer: Aetna Commercial |
$557.43
|
| Rate for Payer: Aetna Medicare |
$432.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.03
|
| Rate for Payer: BCBS Complete |
$276.87
|
| Rate for Payer: BCBS MAPPO |
$415.99
|
| Rate for Payer: BCN Commercial |
$691.69
|
| Rate for Payer: BCN Medicare Advantage |
$415.99
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Cofinity Commercial |
$599.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.79
|
| Rate for Payer: Meridian Medicaid |
$276.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.59
|
| Rate for Payer: Nomi Health Commercial |
$499.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.00
|
| Rate for Payer: PACE SWMI |
$415.99
|
| Rate for Payer: PHP Commercial |
$582.39
|
| Rate for Payer: PHP Medicare Advantage |
$415.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$743.83
|
| Rate for Payer: Priority Health Medicare |
$415.99
|
| Rate for Payer: Priority Health SBD |
$743.83
|
| Rate for Payer: Priority Health Tiered Network |
$743.83
|
| Rate for Payer: Railroad Medicare Medicare |
$415.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.28
|
| Rate for Payer: UHC Core |
$855.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$415.99
|
| Rate for Payer: UHC Exchange |
$855.28
|
| Rate for Payer: UHC Medicaid |
$263.69
|
| Rate for Payer: UHCCP Medicaid |
$263.69
|
| Rate for Payer: UMR Bronson Commercial |
$717.60
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE
|
Professional
|
Both
|
$9,993.00
|
|
|
Service Code
|
HCPCS 37244
|
| Min. Negotiated Rate |
$361.04 |
| Max. Negotiated Rate |
$7,494.75 |
| Rate for Payer: Aetna Commercial |
$759.65
|
| Rate for Payer: Aetna Medicare |
$589.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.34
|
| Rate for Payer: BCBS Complete |
$379.09
|
| Rate for Payer: BCBS MAPPO |
$566.90
|
| Rate for Payer: BCN Commercial |
$960.61
|
| Rate for Payer: BCN Medicare Advantage |
$566.90
|
| Rate for Payer: Cash Price |
$7,994.40
|
| Rate for Payer: Cash Price |
$7,994.40
|
| Rate for Payer: Cofinity Commercial |
$759.65
|
| Rate for Payer: Cofinity Commercial |
$816.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.25
|
| Rate for Payer: Meridian Medicaid |
$379.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$623.59
|
| Rate for Payer: Nomi Health Commercial |
$680.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,494.75
|
| Rate for Payer: PACE SWMI |
$566.90
|
| Rate for Payer: PHP Commercial |
$793.66
|
| Rate for Payer: PHP Medicare Advantage |
$566.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,033.00
|
| Rate for Payer: Priority Health Medicare |
$566.90
|
| Rate for Payer: Priority Health SBD |
$1,033.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,033.00
|
| Rate for Payer: Railroad Medicare Medicare |
$566.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.92
|
| Rate for Payer: UHC Core |
$1,188.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$566.90
|
| Rate for Payer: UHC Exchange |
$1,188.92
|
| Rate for Payer: UHC Medicaid |
$361.04
|
| Rate for Payer: UHCCP Medicaid |
$361.04
|
| Rate for Payer: UMR Bronson Commercial |
$4,596.78
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 37241
|
| Min. Negotiated Rate |
$236.64 |
| Max. Negotiated Rate |
$783.49 |
| Rate for Payer: Aetna Commercial |
$499.49
|
| Rate for Payer: Aetna Medicare |
$387.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.76
|
| Rate for Payer: BCBS Complete |
$248.47
|
| Rate for Payer: BCBS MAPPO |
$372.75
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: BCN Medicare Advantage |
$372.75
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$499.49
|
| Rate for Payer: Cofinity Commercial |
$536.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.39
|
| Rate for Payer: Meridian Medicaid |
$248.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.02
|
| Rate for Payer: Nomi Health Commercial |
$447.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$534.00
|
| Rate for Payer: PACE SWMI |
$372.75
|
| Rate for Payer: PHP Commercial |
$521.85
|
| Rate for Payer: PHP Medicare Advantage |
$372.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$668.32
|
| Rate for Payer: Priority Health Medicare |
$372.75
|
| Rate for Payer: Priority Health SBD |
$668.32
|
| Rate for Payer: Priority Health Tiered Network |
$668.32
|
| Rate for Payer: Railroad Medicare Medicare |
$372.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.49
|
| Rate for Payer: UHC Core |
$783.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.75
|
| Rate for Payer: UHC Exchange |
$783.49
|
| Rate for Payer: UHC Medicaid |
$236.64
|
| Rate for Payer: UHCCP Medicaid |
$236.64
|
| Rate for Payer: UMR Bronson Commercial |
$327.52
|
|
|
PR VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT
|
Professional
|
Both
|
$1,254.00
|
|
|
Service Code
|
HCPCS 37243
|
| Min. Negotiated Rate |
$307.57 |
| Max. Negotiated Rate |
$1,004.71 |
| Rate for Payer: Aetna Commercial |
$647.22
|
| Rate for Payer: Aetna Medicare |
$502.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.52
|
| Rate for Payer: BCBS Complete |
$322.95
|
| Rate for Payer: BCBS MAPPO |
$483.00
|
| Rate for Payer: BCN Commercial |
$816.69
|
| Rate for Payer: BCN Medicare Advantage |
$483.00
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cofinity Commercial |
$647.22
|
| Rate for Payer: Cofinity Commercial |
$695.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$507.15
|
| Rate for Payer: Meridian Medicaid |
$322.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$531.30
|
| Rate for Payer: Nomi Health Commercial |
$579.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.50
|
| Rate for Payer: PACE SWMI |
$483.00
|
| Rate for Payer: PHP Commercial |
$676.20
|
| Rate for Payer: PHP Medicare Advantage |
$483.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$878.24
|
| Rate for Payer: Priority Health Medicare |
$483.00
|
| Rate for Payer: Priority Health SBD |
$878.24
|
| Rate for Payer: Priority Health Tiered Network |
$878.24
|
| Rate for Payer: Railroad Medicare Medicare |
$483.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.71
|
| Rate for Payer: UHC Core |
$1,004.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$483.00
|
| Rate for Payer: UHC Exchange |
$1,004.71
|
| Rate for Payer: UHC Medicaid |
$307.57
|
| Rate for Payer: UHCCP Medicaid |
$307.57
|
| Rate for Payer: UMR Bronson Commercial |
$576.84
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$404.80 |
| Max. Negotiated Rate |
$828.00 |
| Rate for Payer: Aetna American Axle |
$598.00
|
| Rate for Payer: Aetna Commercial |
$782.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Advantage |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$791.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$736.00
|
| Rate for Payer: Healthscope Commercial |
$828.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$644.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$690.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$782.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: PHP Commercial |
$782.00
|
| Rate for Payer: Priority Health SBD |
$579.60
|
| Rate for Payer: UMR Bronson Commercial |
$404.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$690.00
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 55250
|
| Min. Negotiated Rate |
$139.09 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Aetna Commercial |
$283.70
|
| Rate for Payer: Aetna Medicare |
$220.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.88
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS MAPPO |
$211.72
|
| Rate for Payer: BCN Commercial |
$274.50
|
| Rate for Payer: BCN Medicare Advantage |
$211.72
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$283.70
|
| Rate for Payer: Cofinity Commercial |
$304.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.31
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$232.89
|
| Rate for Payer: Nomi Health Commercial |
$254.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: PACE SWMI |
$211.72
|
| Rate for Payer: PHP Commercial |
$296.41
|
| Rate for Payer: PHP Medicare Advantage |
$211.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$379.18
|
| Rate for Payer: Priority Health Medicare |
$211.72
|
| Rate for Payer: Priority Health SBD |
$379.18
|
| Rate for Payer: Priority Health Tiered Network |
$379.18
|
| Rate for Payer: Railroad Medicare Medicare |
$211.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.39
|
| Rate for Payer: UHC Core |
$396.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.72
|
| Rate for Payer: UHC Exchange |
$396.39
|
| Rate for Payer: UHC Medicaid |
$139.09
|
| Rate for Payer: UHCCP Medicaid |
$139.09
|
| Rate for Payer: UMR Bronson Commercial |
$423.20
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
OP
|
$920.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$340.40 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$598.00
|
| Rate for Payer: Aetna Commercial |
$782.00
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.93
|
| Rate for Payer: BCN Commercial |
$1,654.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Advantage |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$791.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$736.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$828.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$644.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$690.00
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$782.00
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$782.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$579.60
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$340.40
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$690.00
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 55250
|
| Hospital Charge Code |
55250
|
| Min. Negotiated Rate |
$139.09 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Aetna Commercial |
$283.70
|
| Rate for Payer: Aetna Medicare |
$220.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.88
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS MAPPO |
$211.72
|
| Rate for Payer: BCN Commercial |
$274.50
|
| Rate for Payer: BCN Medicare Advantage |
$211.72
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$283.70
|
| Rate for Payer: Cofinity Commercial |
$304.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.31
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$232.89
|
| Rate for Payer: Nomi Health Commercial |
$254.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: PACE SWMI |
$211.72
|
| Rate for Payer: PHP Commercial |
$296.41
|
| Rate for Payer: PHP Medicare Advantage |
$211.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$379.18
|
| Rate for Payer: Priority Health Medicare |
$211.72
|
| Rate for Payer: Priority Health SBD |
$379.18
|
| Rate for Payer: Priority Health Tiered Network |
$379.18
|
| Rate for Payer: Railroad Medicare Medicare |
$211.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.39
|
| Rate for Payer: UHC Core |
$396.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.72
|
| Rate for Payer: UHC Exchange |
$396.39
|
| Rate for Payer: UHC Medicaid |
$139.09
|
| Rate for Payer: UHCCP Medicaid |
$139.09
|
| Rate for Payer: UMR Bronson Commercial |
$423.20
|
|
|
PR VASOVASOSTOMY VASOVASORRHAPHY
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 55400
|
| Min. Negotiated Rate |
$392.40 |
| Max. Negotiated Rate |
$879.73 |
| Rate for Payer: Aetna Commercial |
$601.71
|
| Rate for Payer: Aetna Medicare |
$467.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.62
|
| Rate for Payer: BCBS Complete |
$392.40
|
| Rate for Payer: BCBS MAPPO |
$449.04
|
| Rate for Payer: BCN Commercial |
$751.45
|
| Rate for Payer: BCN Medicare Advantage |
$449.04
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$646.62
|
| Rate for Payer: Cofinity Commercial |
$601.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$493.94
|
| Rate for Payer: Nomi Health Commercial |
$538.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.75
|
| Rate for Payer: PACE SWMI |
$449.04
|
| Rate for Payer: PHP Commercial |
$628.66
|
| Rate for Payer: PHP Medicare Advantage |
$449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$818.58
|
| Rate for Payer: Priority Health Medicare |
$449.04
|
| Rate for Payer: Priority Health SBD |
$818.58
|
| Rate for Payer: Priority Health Tiered Network |
$818.58
|
| Rate for Payer: Railroad Medicare Medicare |
$449.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$879.73
|
| Rate for Payer: UHC Core |
$879.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$449.04
|
| Rate for Payer: UHC Exchange |
$879.73
|
| Rate for Payer: UMR Bronson Commercial |
$451.26
|
|
|
PR VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG
|
Professional
|
Both
|
$2,853.00
|
|
|
Service Code
|
HCPCS 63103
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$2,139.75 |
| Rate for Payer: Aetna Commercial |
$355.26
|
| Rate for Payer: Aetna Medicare |
$275.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.77
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$265.12
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$265.12
|
| Rate for Payer: Cash Price |
$2,282.40
|
| Rate for Payer: Cash Price |
$2,282.40
|
| Rate for Payer: Cofinity Commercial |
$381.77
|
| Rate for Payer: Cofinity Commercial |
$355.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.38
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$291.63
|
| Rate for Payer: Nomi Health Commercial |
$318.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,139.75
|
| Rate for Payer: PACE SWMI |
$265.12
|
| Rate for Payer: PHP Commercial |
$371.17
|
| Rate for Payer: PHP Medicare Advantage |
$265.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$508.99
|
| Rate for Payer: Priority Health Medicare |
$265.12
|
| Rate for Payer: Priority Health SBD |
$508.99
|
| Rate for Payer: Priority Health Tiered Network |
$508.99
|
| Rate for Payer: Railroad Medicare Medicare |
$265.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.34
|
| Rate for Payer: UHC Core |
$523.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.12
|
| Rate for Payer: UHC Exchange |
$523.34
|
| Rate for Payer: UHC Medicaid |
$167.63
|
| Rate for Payer: UHCCP Medicaid |
$167.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.38
|
|
|
PR VCRPEC LES 1 SGM XDRL CERVICAL
|
Professional
|
Both
|
$4,846.00
|
|
|
Service Code
|
HCPCS 63300
|
| Min. Negotiated Rate |
$1,110.37 |
| Max. Negotiated Rate |
$3,634.50 |
| Rate for Payer: Aetna Commercial |
$2,324.08
|
| Rate for Payer: Aetna Medicare |
$1,803.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,324.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.52
|
| Rate for Payer: BCBS Complete |
$1,165.89
|
| Rate for Payer: BCBS MAPPO |
$1,734.39
|
| Rate for Payer: BCN Commercial |
$3,036.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,734.39
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,324.08
|
| Rate for Payer: Cofinity Commercial |
$2,497.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,821.11
|
| Rate for Payer: Meridian Medicaid |
$1,165.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,907.83
|
| Rate for Payer: Nomi Health Commercial |
$2,081.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,634.50
|
| Rate for Payer: PACE SWMI |
$1,734.39
|
| Rate for Payer: PHP Commercial |
$2,428.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,734.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,110.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,210.67
|
| Rate for Payer: Priority Health Medicare |
$1,734.39
|
| Rate for Payer: Priority Health SBD |
$3,210.67
|
| Rate for Payer: Priority Health Tiered Network |
$3,210.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,734.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,243.74
|
| Rate for Payer: UHC Core |
$3,243.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,734.39
|
| Rate for Payer: UHC Exchange |
$3,243.74
|
| Rate for Payer: UHC Medicaid |
$1,110.37
|
| Rate for Payer: UHCCP Medicaid |
$1,110.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,229.16
|
|
|
PR VCRPEC LES 1 SGM XDRL THORACIC TTHRC
|
Professional
|
Both
|
$4,795.00
|
|
|
Service Code
|
HCPCS 63301
|
| Min. Negotiated Rate |
$1,370.87 |
| Max. Negotiated Rate |
$3,890.88 |
| Rate for Payer: Aetna Commercial |
$2,875.40
|
| Rate for Payer: Aetna Medicare |
$2,231.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,875.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,089.98
|
| Rate for Payer: BCBS Complete |
$1,439.41
|
| Rate for Payer: BCBS MAPPO |
$2,145.82
|
| Rate for Payer: BCN Commercial |
$3,541.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,145.82
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$2,875.40
|
| Rate for Payer: Cofinity Commercial |
$3,089.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,145.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,253.11
|
| Rate for Payer: Meridian Medicaid |
$1,439.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,360.40
|
| Rate for Payer: Nomi Health Commercial |
$2,574.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,596.25
|
| Rate for Payer: PACE SWMI |
$2,145.82
|
| Rate for Payer: PHP Commercial |
$3,004.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,370.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,743.96
|
| Rate for Payer: Priority Health Medicare |
$2,145.82
|
| Rate for Payer: Priority Health SBD |
$3,743.96
|
| Rate for Payer: Priority Health Tiered Network |
$3,743.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,890.88
|
| Rate for Payer: UHC Core |
$3,890.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,145.82
|
| Rate for Payer: UHC Exchange |
$3,890.88
|
| Rate for Payer: UHC Medicaid |
$1,370.87
|
| Rate for Payer: UHCCP Medicaid |
$1,370.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,205.70
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG
|
Professional
|
Both
|
$9,500.00
|
|
|
Service Code
|
HCPCS 63087
|
| Min. Negotiated Rate |
$1,443.93 |
| Max. Negotiated Rate |
$7,125.00 |
| Rate for Payer: Aetna Commercial |
$3,029.97
|
| Rate for Payer: Aetna Medicare |
$2,351.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,029.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,256.08
|
| Rate for Payer: BCBS Complete |
$1,516.13
|
| Rate for Payer: BCBS MAPPO |
$2,261.17
|
| Rate for Payer: BCN Commercial |
$4,027.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,261.17
|
| Rate for Payer: Cash Price |
$7,600.00
|
| Rate for Payer: Cash Price |
$7,600.00
|
| Rate for Payer: Cofinity Commercial |
$3,029.97
|
| Rate for Payer: Cofinity Commercial |
$3,256.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,261.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,374.23
|
| Rate for Payer: Meridian Medicaid |
$1,516.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,487.29
|
| Rate for Payer: Nomi Health Commercial |
$2,713.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,125.00
|
| Rate for Payer: PACE SWMI |
$2,261.17
|
| Rate for Payer: PHP Commercial |
$3,165.64
|
| Rate for Payer: PHP Medicare Advantage |
$2,261.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,443.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,258.15
|
| Rate for Payer: Priority Health Medicare |
$2,261.17
|
| Rate for Payer: Priority Health SBD |
$4,258.15
|
| Rate for Payer: Priority Health Tiered Network |
$4,258.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,261.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,267.66
|
| Rate for Payer: UHC Core |
$4,267.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,261.17
|
| Rate for Payer: UHC Exchange |
$4,267.66
|
| Rate for Payer: UHC Medicaid |
$1,443.93
|
| Rate for Payer: UHCCP Medicaid |
$1,443.93
|
| Rate for Payer: UMR Bronson Commercial |
$4,370.00
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 63088
|
| Min. Negotiated Rate |
$149.53 |
| Max. Negotiated Rate |
$2,442.75 |
| Rate for Payer: Aetna Commercial |
$317.18
|
| Rate for Payer: Aetna Medicare |
$246.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.85
|
| Rate for Payer: BCBS Complete |
$157.01
|
| Rate for Payer: BCBS MAPPO |
$236.70
|
| Rate for Payer: BCN Commercial |
$386.44
|
| Rate for Payer: BCN Medicare Advantage |
$236.70
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cofinity Commercial |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.53
|
| Rate for Payer: Meridian Medicaid |
$157.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$260.37
|
| Rate for Payer: Nomi Health Commercial |
$284.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.75
|
| Rate for Payer: PACE SWMI |
$236.70
|
| Rate for Payer: PHP Commercial |
$331.38
|
| Rate for Payer: PHP Medicare Advantage |
$236.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$448.84
|
| Rate for Payer: Priority Health Medicare |
$236.70
|
| Rate for Payer: Priority Health SBD |
$448.84
|
| Rate for Payer: Priority Health Tiered Network |
$448.84
|
| Rate for Payer: Railroad Medicare Medicare |
$236.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.09
|
| Rate for Payer: UHC Core |
$456.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.70
|
| Rate for Payer: UHC Exchange |
$456.09
|
| Rate for Payer: UHC Medicaid |
$149.53
|
| Rate for Payer: UHCCP Medicaid |
$149.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,498.22
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG
|
Professional
|
Both
|
$7,492.00
|
|
|
Service Code
|
HCPCS 63090
|
| Min. Negotiated Rate |
$1,161.92 |
| Max. Negotiated Rate |
$5,619.00 |
| Rate for Payer: Aetna Commercial |
$2,430.93
|
| Rate for Payer: Aetna Medicare |
$1,886.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,430.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,612.35
|
| Rate for Payer: BCBS Complete |
$1,220.02
|
| Rate for Payer: BCBS MAPPO |
$1,814.13
|
| Rate for Payer: BCN Commercial |
$3,218.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,814.13
|
| Rate for Payer: Cash Price |
$5,993.60
|
| Rate for Payer: Cash Price |
$5,993.60
|
| Rate for Payer: Cofinity Commercial |
$2,430.93
|
| Rate for Payer: Cofinity Commercial |
$2,612.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,814.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,904.84
|
| Rate for Payer: Meridian Medicaid |
$1,220.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,995.54
|
| Rate for Payer: Nomi Health Commercial |
$2,176.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,619.00
|
| Rate for Payer: PACE SWMI |
$1,814.13
|
| Rate for Payer: PHP Commercial |
$2,539.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,814.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,161.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,403.28
|
| Rate for Payer: Priority Health Medicare |
$1,814.13
|
| Rate for Payer: Priority Health SBD |
$3,403.28
|
| Rate for Payer: Priority Health Tiered Network |
$3,403.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,814.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,473.51
|
| Rate for Payer: UHC Core |
$3,473.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,814.13
|
| Rate for Payer: UHC Exchange |
$3,473.51
|
| Rate for Payer: UHC Medicaid |
$1,161.92
|
| Rate for Payer: UHCCP Medicaid |
$1,161.92
|
| Rate for Payer: UMR Bronson Commercial |
$3,446.32
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG
|
Professional
|
Both
|
$2,552.00
|
|
|
Service Code
|
HCPCS 63091
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$1,914.00 |
| Rate for Payer: Aetna Commercial |
$212.99
|
| Rate for Payer: Aetna Medicare |
$165.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.89
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$158.95
|
| Rate for Payer: BCN Commercial |
$286.66
|
| Rate for Payer: BCN Medicare Advantage |
$158.95
|
| Rate for Payer: Cash Price |
$2,041.60
|
| Rate for Payer: Cash Price |
$2,041.60
|
| Rate for Payer: Cofinity Commercial |
$212.99
|
| Rate for Payer: Cofinity Commercial |
$228.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.90
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.84
|
| Rate for Payer: Nomi Health Commercial |
$190.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.00
|
| Rate for Payer: PACE SWMI |
$158.95
|
| Rate for Payer: PHP Commercial |
$222.53
|
| Rate for Payer: PHP Medicare Advantage |
$158.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$303.09
|
| Rate for Payer: Priority Health Medicare |
$158.95
|
| Rate for Payer: Priority Health SBD |
$303.09
|
| Rate for Payer: Priority Health Tiered Network |
$303.09
|
| Rate for Payer: Railroad Medicare Medicare |
$158.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.71
|
| Rate for Payer: UHC Core |
$317.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.95
|
| Rate for Payer: UHC Exchange |
$317.71
|
| Rate for Payer: UHC Medicaid |
$100.75
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,173.92
|
|
|
PR VEIN SCREEN
|
Professional
|
Both
|
$21.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
PR VEN CATHJ SLCTV ORGAN BLD SAMPLING
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 36500
|
| Min. Negotiated Rate |
$102.24 |
| Max. Negotiated Rate |
$325.85 |
| Rate for Payer: Aetna Commercial |
$215.94
|
| Rate for Payer: Aetna Medicare |
$167.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.06
|
| Rate for Payer: BCBS Complete |
$107.35
|
| Rate for Payer: BCBS MAPPO |
$161.15
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: BCN Medicare Advantage |
$161.15
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$232.06
|
| Rate for Payer: Cofinity Commercial |
$215.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.21
|
| Rate for Payer: Meridian Medicaid |
$107.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.26
|
| Rate for Payer: Nomi Health Commercial |
$193.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$161.15
|
| Rate for Payer: PHP Commercial |
$225.61
|
| Rate for Payer: PHP Medicare Advantage |
$161.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$288.10
|
| Rate for Payer: Priority Health Medicare |
$161.15
|
| Rate for Payer: Priority Health SBD |
$288.10
|
| Rate for Payer: Priority Health Tiered Network |
$288.10
|
| Rate for Payer: Railroad Medicare Medicare |
$161.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.85
|
| Rate for Payer: UHC Core |
$325.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.15
|
| Rate for Payer: UHC Exchange |
$325.85
|
| Rate for Payer: UHC Medicaid |
$102.24
|
| Rate for Payer: UHCCP Medicaid |
$102.24
|
| Rate for Payer: UMR Bronson Commercial |
$165.14
|
|
|
PR VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL
|
Professional
|
Both
|
$4,498.00
|
|
|
Service Code
|
HCPCS 37180
|
| Min. Negotiated Rate |
$1,250.74 |
| Max. Negotiated Rate |
$3,803.55 |
| Rate for Payer: Aetna Commercial |
$2,630.31
|
| Rate for Payer: Aetna Medicare |
$2,041.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,630.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,826.60
|
| Rate for Payer: BCBS Complete |
$1,313.28
|
| Rate for Payer: BCBS MAPPO |
$1,962.92
|
| Rate for Payer: BCN Commercial |
$3,176.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,962.92
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cofinity Commercial |
$2,630.31
|
| Rate for Payer: Cofinity Commercial |
$2,826.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,962.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,061.07
|
| Rate for Payer: Meridian Medicaid |
$1,313.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,159.21
|
| Rate for Payer: Nomi Health Commercial |
$2,355.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,373.50
|
| Rate for Payer: PACE SWMI |
$1,962.92
|
| Rate for Payer: PHP Commercial |
$2,748.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,962.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,250.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,415.52
|
| Rate for Payer: Priority Health Medicare |
$1,962.92
|
| Rate for Payer: Priority Health SBD |
$3,415.52
|
| Rate for Payer: Priority Health Tiered Network |
$3,415.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,962.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,803.55
|
| Rate for Payer: UHC Core |
$3,803.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,962.92
|
| Rate for Payer: UHC Exchange |
$3,803.55
|
| Rate for Payer: UHC Medicaid |
$1,250.74
|
| Rate for Payer: UHCCP Medicaid |
$1,250.74
|
| Rate for Payer: UMR Bronson Commercial |
$2,069.08
|
|
|
PR VENTILATING TUBE RMVL REQUIRING GENERAL ANES
|
Professional
|
Both
|
$631.00
|
|
|
Service Code
|
HCPCS 69424
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$473.25 |
| Rate for Payer: Aetna Commercial |
$71.93
|
| Rate for Payer: Aetna Medicare |
$55.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.30
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$53.68
|
| Rate for Payer: BCN Commercial |
$92.13
|
| Rate for Payer: BCN Medicare Advantage |
$53.68
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Cofinity Commercial |
$77.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.36
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.05
|
| Rate for Payer: Nomi Health Commercial |
$64.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$473.25
|
| Rate for Payer: PACE SWMI |
$53.68
|
| Rate for Payer: PHP Commercial |
$75.15
|
| Rate for Payer: PHP Medicare Advantage |
$53.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$91.03
|
| Rate for Payer: Priority Health Medicare |
$53.68
|
| Rate for Payer: Priority Health SBD |
$91.03
|
| Rate for Payer: Priority Health Tiered Network |
$91.03
|
| Rate for Payer: Railroad Medicare Medicare |
$53.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.52
|
| Rate for Payer: UHC Core |
$104.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.68
|
| Rate for Payer: UHC Exchange |
$104.52
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
| Rate for Payer: UMR Bronson Commercial |
$290.26
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT 1ST DAY
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 94002
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$150.39 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: Aetna Medicare |
$88.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.05
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$85.45
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$85.45
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$114.50
|
| Rate for Payer: Cofinity Commercial |
$123.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.72
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.00
|
| Rate for Payer: Nomi Health Commercial |
$102.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
| Rate for Payer: PACE SWMI |
$85.45
|
| Rate for Payer: PHP Commercial |
$119.63
|
| Rate for Payer: PHP Medicare Advantage |
$85.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$124.91
|
| Rate for Payer: Priority Health Medicare |
$85.45
|
| Rate for Payer: Priority Health SBD |
$124.91
|
| Rate for Payer: Priority Health Tiered Network |
$124.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.39
|
| Rate for Payer: UHC Core |
$150.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.45
|
| Rate for Payer: UHC Exchange |
$150.39
|
| Rate for Payer: UHC Medicaid |
$54.74
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
| Rate for Payer: UMR Bronson Commercial |
$81.42
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 94003
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$108.32 |
| Rate for Payer: Aetna Commercial |
$78.82
|
| Rate for Payer: Aetna Medicare |
$61.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.70
|
| Rate for Payer: BCBS Complete |
$39.59
|
| Rate for Payer: BCBS MAPPO |
$58.82
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$58.82
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$78.82
|
| Rate for Payer: Cofinity Commercial |
$84.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.76
|
| Rate for Payer: Meridian Medicaid |
$39.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.70
|
| Rate for Payer: Nomi Health Commercial |
$70.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$58.82
|
| Rate for Payer: PHP Commercial |
$82.35
|
| Rate for Payer: PHP Medicare Advantage |
$58.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.71
|
| Rate for Payer: Priority Health Medicare |
$58.82
|
| Rate for Payer: Priority Health SBD |
$87.71
|
| Rate for Payer: Priority Health Tiered Network |
$87.71
|
| Rate for Payer: Railroad Medicare Medicare |
$58.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.32
|
| Rate for Payer: UHC Core |
$108.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.82
|
| Rate for Payer: UHC Exchange |
$108.32
|
| Rate for Payer: UHC Medicaid |
$37.70
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
| Rate for Payer: UMR Bronson Commercial |
$59.80
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 61026
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$108.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.77
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS MAPPO |
$104.01
|
| Rate for Payer: BCN Commercial |
$170.31
|
| Rate for Payer: BCN Medicare Advantage |
$104.01
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$139.37
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.21
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.41
|
| Rate for Payer: Nomi Health Commercial |
$124.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$104.01
|
| Rate for Payer: PHP Commercial |
$145.61
|
| Rate for Payer: PHP Medicare Advantage |
$104.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.82
|
| Rate for Payer: Priority Health Medicare |
$104.01
|
| Rate for Payer: Priority Health SBD |
$197.82
|
| Rate for Payer: Priority Health Tiered Network |
$197.82
|
| Rate for Payer: Railroad Medicare Medicare |
$104.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.83
|
| Rate for Payer: UHC Core |
$187.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.01
|
| Rate for Payer: UHC Exchange |
$187.83
|
| Rate for Payer: UHC Medicaid |
$66.88
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
| Rate for Payer: UMR Bronson Commercial |
$266.80
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 61020
|
| Min. Negotiated Rate |
$62.84 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Aetna Commercial |
$131.20
|
| Rate for Payer: Aetna Medicare |
$101.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.99
|
| Rate for Payer: BCBS Complete |
$65.98
|
| Rate for Payer: BCBS MAPPO |
$97.91
|
| Rate for Payer: BCN Commercial |
$160.35
|
| Rate for Payer: BCN Medicare Advantage |
$97.91
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$140.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.81
|
| Rate for Payer: Meridian Medicaid |
$65.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.70
|
| Rate for Payer: Nomi Health Commercial |
$117.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.00
|
| Rate for Payer: PACE SWMI |
$97.91
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: PHP Medicare Advantage |
$97.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.25
|
| Rate for Payer: Priority Health Medicare |
$97.91
|
| Rate for Payer: Priority Health SBD |
$186.25
|
| Rate for Payer: Priority Health Tiered Network |
$186.25
|
| Rate for Payer: Railroad Medicare Medicare |
$97.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.74
|
| Rate for Payer: UHC Core |
$184.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.91
|
| Rate for Payer: UHC Exchange |
$184.74
|
| Rate for Payer: UHC Medicaid |
$62.84
|
| Rate for Payer: UHCCP Medicaid |
$62.84
|
| Rate for Payer: UMR Bronson Commercial |
$217.12
|
|
|
PR VENTRICULOCISTERNOSTOMY
|
Professional
|
Both
|
$4,896.00
|
|
|
Service Code
|
HCPCS 62180
|
| Min. Negotiated Rate |
$1,003.02 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$2,099.71
|
| Rate for Payer: Aetna Medicare |
$1,629.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,256.41
|
| Rate for Payer: BCBS Complete |
$1,053.17
|
| Rate for Payer: BCBS MAPPO |
$1,566.95
|
| Rate for Payer: BCN Commercial |
$3,375.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,566.95
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cofinity Commercial |
$2,099.71
|
| Rate for Payer: Cofinity Commercial |
$2,256.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,566.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.30
|
| Rate for Payer: Meridian Medicaid |
$1,053.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,723.64
|
| Rate for Payer: Nomi Health Commercial |
$1,880.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.00
|
| Rate for Payer: PACE SWMI |
$1,566.95
|
| Rate for Payer: PHP Commercial |
$2,193.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,566.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,837.61
|
| Rate for Payer: Priority Health Medicare |
$1,566.95
|
| Rate for Payer: Priority Health SBD |
$2,837.61
|
| Rate for Payer: Priority Health Tiered Network |
$2,837.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,566.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,816.73
|
| Rate for Payer: UHC Core |
$2,816.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,566.95
|
| Rate for Payer: UHC Exchange |
$2,816.73
|
| Rate for Payer: UHC Medicaid |
$1,003.02
|
| Rate for Payer: UHCCP Medicaid |
$1,003.02
|
| Rate for Payer: UMR Bronson Commercial |
$2,252.16
|
|
