|
PR VENTRICULOCISTERNOSTOMY 3RD VENTRICLE
|
Professional
|
Both
|
$6,744.00
|
|
|
Service Code
|
HCPCS 62200
|
| Min. Negotiated Rate |
$866.91 |
| Max. Negotiated Rate |
$5,058.00 |
| Rate for Payer: Aetna Commercial |
$1,813.05
|
| Rate for Payer: Aetna Medicare |
$1,407.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,813.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,948.35
|
| Rate for Payer: BCBS Complete |
$910.26
|
| Rate for Payer: BCBS MAPPO |
$1,353.02
|
| Rate for Payer: BCN Commercial |
$2,907.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.02
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,813.05
|
| Rate for Payer: Cofinity Commercial |
$1,948.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.67
|
| Rate for Payer: Meridian Medicaid |
$910.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,488.32
|
| Rate for Payer: Nomi Health Commercial |
$1,623.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,058.00
|
| Rate for Payer: PACE SWMI |
$1,353.02
|
| Rate for Payer: PHP Commercial |
$1,894.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,444.29
|
| Rate for Payer: Priority Health Medicare |
$1,353.02
|
| Rate for Payer: Priority Health SBD |
$2,444.29
|
| Rate for Payer: Priority Health Tiered Network |
$2,444.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,353.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,422.76
|
| Rate for Payer: UHC Core |
$2,422.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,353.02
|
| Rate for Payer: UHC Exchange |
$2,422.76
|
| Rate for Payer: UHC Medicaid |
$866.91
|
| Rate for Payer: UHCCP Medicaid |
$866.91
|
| Rate for Payer: UMR Bronson Commercial |
$3,102.24
|
|
|
PR VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC
|
Professional
|
Both
|
$6,129.00
|
|
|
Service Code
|
HCPCS 62201
|
| Min. Negotiated Rate |
$782.14 |
| Max. Negotiated Rate |
$4,596.75 |
| Rate for Payer: Aetna Commercial |
$1,624.72
|
| Rate for Payer: Aetna Medicare |
$1,260.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,624.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,745.97
|
| Rate for Payer: BCBS Complete |
$821.25
|
| Rate for Payer: BCBS MAPPO |
$1,212.48
|
| Rate for Payer: BCN Commercial |
$2,572.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.48
|
| Rate for Payer: Cash Price |
$4,903.20
|
| Rate for Payer: Cash Price |
$4,903.20
|
| Rate for Payer: Cofinity Commercial |
$1,624.72
|
| Rate for Payer: Cofinity Commercial |
$1,745.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.10
|
| Rate for Payer: Meridian Medicaid |
$821.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,333.73
|
| Rate for Payer: Nomi Health Commercial |
$1,454.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,596.75
|
| Rate for Payer: PACE SWMI |
$1,212.48
|
| Rate for Payer: PHP Commercial |
$1,697.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$782.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,162.63
|
| Rate for Payer: Priority Health Medicare |
$1,212.48
|
| Rate for Payer: Priority Health SBD |
$2,162.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,162.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,212.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,116.12
|
| Rate for Payer: UHC Core |
$2,116.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,212.48
|
| Rate for Payer: UHC Exchange |
$2,116.12
|
| Rate for Payer: UHC Medicaid |
$782.14
|
| Rate for Payer: UHCCP Medicaid |
$782.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,819.34
|
|
|
PR VENTRICULOMYOTOMY-MYECTOMY
|
Professional
|
Both
|
$9,371.00
|
|
|
Service Code
|
HCPCS 33416
|
| Min. Negotiated Rate |
$1,213.04 |
| Max. Negotiated Rate |
$7,028.25 |
| Rate for Payer: Aetna Commercial |
$2,550.77
|
| Rate for Payer: Aetna Medicare |
$1,979.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,550.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,741.13
|
| Rate for Payer: BCBS Complete |
$1,273.69
|
| Rate for Payer: BCBS MAPPO |
$1,903.56
|
| Rate for Payer: BCN Commercial |
$2,975.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,903.56
|
| Rate for Payer: Cash Price |
$7,496.80
|
| Rate for Payer: Cash Price |
$7,496.80
|
| Rate for Payer: Cofinity Commercial |
$2,550.77
|
| Rate for Payer: Cofinity Commercial |
$2,741.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,903.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,998.74
|
| Rate for Payer: Meridian Medicaid |
$1,273.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,093.92
|
| Rate for Payer: Nomi Health Commercial |
$2,284.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,028.25
|
| Rate for Payer: PACE SWMI |
$1,903.56
|
| Rate for Payer: PHP Commercial |
$2,664.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,903.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,213.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,200.25
|
| Rate for Payer: Priority Health Medicare |
$1,903.56
|
| Rate for Payer: Priority Health SBD |
$3,200.25
|
| Rate for Payer: Priority Health Tiered Network |
$3,200.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,903.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,602.22
|
| Rate for Payer: UHC Core |
$3,602.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,903.56
|
| Rate for Payer: UHC Exchange |
$3,602.22
|
| Rate for Payer: UHC Medicaid |
$1,213.04
|
| Rate for Payer: UHCCP Medicaid |
$1,213.04
|
| Rate for Payer: UMR Bronson Commercial |
$4,310.66
|
|
|
PR VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 40500
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$683.82 |
| Rate for Payer: Aetna Commercial |
$429.90
|
| Rate for Payer: Aetna Medicare |
$333.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.98
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$320.82
|
| Rate for Payer: BCN Commercial |
$561.22
|
| Rate for Payer: BCN Medicare Advantage |
$320.82
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$429.90
|
| Rate for Payer: Cofinity Commercial |
$461.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.86
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.90
|
| Rate for Payer: Nomi Health Commercial |
$384.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.25
|
| Rate for Payer: PACE SWMI |
$320.82
|
| Rate for Payer: PHP Commercial |
$449.15
|
| Rate for Payer: PHP Medicare Advantage |
$320.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$683.82
|
| Rate for Payer: Priority Health Medicare |
$320.82
|
| Rate for Payer: Priority Health SBD |
$683.82
|
| Rate for Payer: Priority Health Tiered Network |
$683.82
|
| Rate for Payer: Railroad Medicare Medicare |
$320.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.43
|
| Rate for Payer: UHC Core |
$624.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.82
|
| Rate for Payer: UHC Exchange |
$624.43
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
| Rate for Payer: UMR Bronson Commercial |
$354.66
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG
|
Professional
|
Both
|
$8,831.00
|
|
|
Service Code
|
HCPCS 63102
|
| Min. Negotiated Rate |
$1,386.42 |
| Max. Negotiated Rate |
$6,623.25 |
| Rate for Payer: Aetna Commercial |
$2,901.02
|
| Rate for Payer: Aetna Medicare |
$2,251.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,901.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,117.51
|
| Rate for Payer: BCBS Complete |
$1,455.74
|
| Rate for Payer: BCBS MAPPO |
$2,164.94
|
| Rate for Payer: BCN Commercial |
$3,479.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,164.94
|
| Rate for Payer: Cash Price |
$7,064.80
|
| Rate for Payer: Cash Price |
$7,064.80
|
| Rate for Payer: Cofinity Commercial |
$2,901.02
|
| Rate for Payer: Cofinity Commercial |
$3,117.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,164.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,273.19
|
| Rate for Payer: Meridian Medicaid |
$1,455.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,381.43
|
| Rate for Payer: Nomi Health Commercial |
$2,597.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,623.25
|
| Rate for Payer: PACE SWMI |
$2,164.94
|
| Rate for Payer: PHP Commercial |
$3,030.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,164.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,386.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,041.82
|
| Rate for Payer: Priority Health Medicare |
$2,164.94
|
| Rate for Payer: Priority Health SBD |
$4,041.82
|
| Rate for Payer: Priority Health Tiered Network |
$4,041.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,164.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,997.95
|
| Rate for Payer: UHC Core |
$3,997.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,164.94
|
| Rate for Payer: UHC Exchange |
$3,997.95
|
| Rate for Payer: UHC Medicaid |
$1,386.42
|
| Rate for Payer: UHCCP Medicaid |
$1,386.42
|
| Rate for Payer: UMR Bronson Commercial |
$4,062.26
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG
|
Professional
|
Both
|
$5,017.00
|
|
|
Service Code
|
HCPCS 63101
|
| Min. Negotiated Rate |
$1,414.11 |
| Max. Negotiated Rate |
$4,105.15 |
| Rate for Payer: Aetna Commercial |
$2,960.53
|
| Rate for Payer: Aetna Medicare |
$2,297.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,960.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,181.46
|
| Rate for Payer: BCBS Complete |
$1,484.82
|
| Rate for Payer: BCBS MAPPO |
$2,209.35
|
| Rate for Payer: BCN Commercial |
$3,517.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,209.35
|
| Rate for Payer: Cash Price |
$4,013.60
|
| Rate for Payer: Cash Price |
$4,013.60
|
| Rate for Payer: Cofinity Commercial |
$2,960.53
|
| Rate for Payer: Cofinity Commercial |
$3,181.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,209.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,319.82
|
| Rate for Payer: Meridian Medicaid |
$1,484.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,430.28
|
| Rate for Payer: Nomi Health Commercial |
$2,651.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,762.75
|
| Rate for Payer: PACE SWMI |
$2,209.35
|
| Rate for Payer: PHP Commercial |
$3,093.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,209.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,414.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,085.20
|
| Rate for Payer: Priority Health Medicare |
$2,209.35
|
| Rate for Payer: Priority Health SBD |
$4,085.20
|
| Rate for Payer: Priority Health Tiered Network |
$4,085.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,209.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,105.15
|
| Rate for Payer: UHC Core |
$4,105.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,209.35
|
| Rate for Payer: UHC Exchange |
$4,105.15
|
| Rate for Payer: UHC Medicaid |
$1,414.11
|
| Rate for Payer: UHCCP Medicaid |
$1,414.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,307.82
|
|
|
PR VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG
|
Professional
|
Both
|
$6,630.00
|
|
|
Service Code
|
HCPCS 63081
|
| Min. Negotiated Rate |
$1,058.61 |
| Max. Negotiated Rate |
$4,972.50 |
| Rate for Payer: Aetna Commercial |
$2,213.53
|
| Rate for Payer: Aetna Medicare |
$1,717.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,213.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,378.72
|
| Rate for Payer: BCBS Complete |
$1,111.54
|
| Rate for Payer: BCBS MAPPO |
$1,651.89
|
| Rate for Payer: BCN Commercial |
$2,936.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,651.89
|
| Rate for Payer: Cash Price |
$5,304.00
|
| Rate for Payer: Cash Price |
$5,304.00
|
| Rate for Payer: Cofinity Commercial |
$2,213.53
|
| Rate for Payer: Cofinity Commercial |
$2,378.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,651.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,734.48
|
| Rate for Payer: Meridian Medicaid |
$1,111.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,817.08
|
| Rate for Payer: Nomi Health Commercial |
$1,982.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,972.50
|
| Rate for Payer: PACE SWMI |
$1,651.89
|
| Rate for Payer: PHP Commercial |
$2,312.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,651.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,058.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,104.25
|
| Rate for Payer: Priority Health Medicare |
$1,651.89
|
| Rate for Payer: Priority Health SBD |
$3,104.25
|
| Rate for Payer: Priority Health Tiered Network |
$3,104.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,651.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,107.90
|
| Rate for Payer: UHC Core |
$3,107.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,651.89
|
| Rate for Payer: UHC Exchange |
$3,107.90
|
| Rate for Payer: UHC Medicaid |
$1,058.61
|
| Rate for Payer: UHCCP Medicaid |
$1,058.61
|
| Rate for Payer: UMR Bronson Commercial |
$3,049.80
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG
|
Professional
|
Both
|
$2,210.00
|
|
|
Service Code
|
HCPCS 63082
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$320.92
|
| Rate for Payer: Aetna Medicare |
$249.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.87
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS MAPPO |
$239.49
|
| Rate for Payer: BCN Commercial |
$437.10
|
| Rate for Payer: BCN Medicare Advantage |
$239.49
|
| Rate for Payer: Cash Price |
$1,768.00
|
| Rate for Payer: Cash Price |
$1,768.00
|
| Rate for Payer: Cofinity Commercial |
$320.92
|
| Rate for Payer: Cofinity Commercial |
$344.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.46
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.44
|
| Rate for Payer: Nomi Health Commercial |
$287.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,657.50
|
| Rate for Payer: PACE SWMI |
$239.49
|
| Rate for Payer: PHP Commercial |
$335.29
|
| Rate for Payer: PHP Medicare Advantage |
$239.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$462.14
|
| Rate for Payer: Priority Health Medicare |
$239.49
|
| Rate for Payer: Priority Health SBD |
$462.14
|
| Rate for Payer: Priority Health Tiered Network |
$462.14
|
| Rate for Payer: Railroad Medicare Medicare |
$239.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.59
|
| Rate for Payer: UHC Core |
$473.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.49
|
| Rate for Payer: UHC Exchange |
$473.59
|
| Rate for Payer: UHC Medicaid |
$151.44
|
| Rate for Payer: UHCCP Medicaid |
$151.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,016.60
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG
|
Professional
|
Both
|
$7,305.00
|
|
|
Service Code
|
HCPCS 63085
|
| Min. Negotiated Rate |
$1,160.64 |
| Max. Negotiated Rate |
$5,478.75 |
| Rate for Payer: Aetna Commercial |
$2,431.62
|
| Rate for Payer: Aetna Medicare |
$1,887.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,431.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,613.08
|
| Rate for Payer: BCBS Complete |
$1,218.67
|
| Rate for Payer: BCBS MAPPO |
$1,814.64
|
| Rate for Payer: BCN Commercial |
$3,206.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,814.64
|
| Rate for Payer: Cash Price |
$5,844.00
|
| Rate for Payer: Cash Price |
$5,844.00
|
| Rate for Payer: Cofinity Commercial |
$2,431.62
|
| Rate for Payer: Cofinity Commercial |
$2,613.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,814.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,905.37
|
| Rate for Payer: Meridian Medicaid |
$1,218.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,996.10
|
| Rate for Payer: Nomi Health Commercial |
$2,177.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,478.75
|
| Rate for Payer: PACE SWMI |
$1,814.64
|
| Rate for Payer: PHP Commercial |
$2,540.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,814.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,160.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,389.98
|
| Rate for Payer: Priority Health Medicare |
$1,814.64
|
| Rate for Payer: Priority Health SBD |
$3,389.98
|
| Rate for Payer: Priority Health Tiered Network |
$3,389.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,814.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,404.07
|
| Rate for Payer: UHC Core |
$3,404.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,814.64
|
| Rate for Payer: UHC Exchange |
$3,404.07
|
| Rate for Payer: UHC Medicaid |
$1,160.64
|
| Rate for Payer: UHCCP Medicaid |
$1,160.64
|
| Rate for Payer: UMR Bronson Commercial |
$3,360.30
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG
|
Professional
|
Both
|
$2,435.00
|
|
|
Service Code
|
HCPCS 63086
|
| Min. Negotiated Rate |
$109.06 |
| Max. Negotiated Rate |
$1,826.25 |
| Rate for Payer: Aetna Commercial |
$231.28
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.54
|
| Rate for Payer: BCBS Complete |
$114.51
|
| Rate for Payer: BCBS MAPPO |
$172.60
|
| Rate for Payer: BCN Commercial |
$313.47
|
| Rate for Payer: BCN Medicare Advantage |
$172.60
|
| Rate for Payer: Cash Price |
$1,948.00
|
| Rate for Payer: Cash Price |
$1,948.00
|
| Rate for Payer: Cofinity Commercial |
$231.28
|
| Rate for Payer: Cofinity Commercial |
$248.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.23
|
| Rate for Payer: Meridian Medicaid |
$114.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.86
|
| Rate for Payer: Nomi Health Commercial |
$207.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,826.25
|
| Rate for Payer: PACE SWMI |
$172.60
|
| Rate for Payer: PHP Commercial |
$241.64
|
| Rate for Payer: PHP Medicare Advantage |
$172.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$331.43
|
| Rate for Payer: Priority Health Medicare |
$172.60
|
| Rate for Payer: Priority Health SBD |
$331.43
|
| Rate for Payer: Priority Health Tiered Network |
$331.43
|
| Rate for Payer: Railroad Medicare Medicare |
$172.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.42
|
| Rate for Payer: UHC Core |
$339.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.60
|
| Rate for Payer: UHC Exchange |
$339.42
|
| Rate for Payer: UHC Medicaid |
$109.06
|
| Rate for Payer: UHCCP Medicaid |
$109.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,120.10
|
|
|
PR VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 63308
|
| Min. Negotiated Rate |
$184.25 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna Commercial |
$391.05
|
| Rate for Payer: Aetna Medicare |
$303.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.24
|
| Rate for Payer: BCBS Complete |
$193.46
|
| Rate for Payer: BCBS MAPPO |
$291.83
|
| Rate for Payer: BCN Commercial |
$525.19
|
| Rate for Payer: BCN Medicare Advantage |
$291.83
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$391.05
|
| Rate for Payer: Cofinity Commercial |
$420.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.42
|
| Rate for Payer: Meridian Medicaid |
$193.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.01
|
| Rate for Payer: Nomi Health Commercial |
$350.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,208.25
|
| Rate for Payer: PACE SWMI |
$291.83
|
| Rate for Payer: PHP Commercial |
$408.56
|
| Rate for Payer: PHP Medicare Advantage |
$291.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$555.27
|
| Rate for Payer: Priority Health Medicare |
$291.83
|
| Rate for Payer: Priority Health SBD |
$555.27
|
| Rate for Payer: Priority Health Tiered Network |
$555.27
|
| Rate for Payer: Railroad Medicare Medicare |
$291.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.26
|
| Rate for Payer: UHC Core |
$575.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$291.83
|
| Rate for Payer: UHC Exchange |
$575.26
|
| Rate for Payer: UHC Medicaid |
$184.25
|
| Rate for Payer: UHCCP Medicaid |
$184.25
|
| Rate for Payer: UMR Bronson Commercial |
$741.06
|
|
|
PR VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL
|
Professional
|
Both
|
$1,810.00
|
|
|
Service Code
|
HCPCS 22512
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$1,357.50 |
| Rate for Payer: Aetna Commercial |
$244.04
|
| Rate for Payer: Aetna Medicare |
$189.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.25
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$182.12
|
| Rate for Payer: BCN Commercial |
$306.75
|
| Rate for Payer: BCN Medicare Advantage |
$182.12
|
| Rate for Payer: Cash Price |
$1,448.00
|
| Rate for Payer: Cash Price |
$1,448.00
|
| Rate for Payer: Cofinity Commercial |
$244.04
|
| Rate for Payer: Cofinity Commercial |
$262.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.23
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.33
|
| Rate for Payer: Nomi Health Commercial |
$218.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,357.50
|
| Rate for Payer: PACE SWMI |
$182.12
|
| Rate for Payer: PHP Commercial |
$254.97
|
| Rate for Payer: PHP Medicare Advantage |
$182.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.91
|
| Rate for Payer: Priority Health Medicare |
$182.12
|
| Rate for Payer: Priority Health SBD |
$327.91
|
| Rate for Payer: Priority Health Tiered Network |
$327.91
|
| Rate for Payer: Railroad Medicare Medicare |
$182.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.65
|
| Rate for Payer: UHC Core |
$366.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$182.12
|
| Rate for Payer: UHC Exchange |
$366.65
|
| Rate for Payer: UHC Medicaid |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
| Rate for Payer: UMR Bronson Commercial |
$832.60
|
|
|
PR VESICULOTOMY COMPLICATED
|
Professional
|
Both
|
$855.00
|
|
|
Service Code
|
HCPCS 55605
|
| Min. Negotiated Rate |
$307.36 |
| Max. Negotiated Rate |
$917.94 |
| Rate for Payer: Aetna Commercial |
$633.55
|
| Rate for Payer: Aetna Medicare |
$491.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.83
|
| Rate for Payer: BCBS Complete |
$322.73
|
| Rate for Payer: BCBS MAPPO |
$472.80
|
| Rate for Payer: BCN Commercial |
$788.80
|
| Rate for Payer: BCN Medicare Advantage |
$472.80
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$633.55
|
| Rate for Payer: Cofinity Commercial |
$680.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.44
|
| Rate for Payer: Meridian Medicaid |
$322.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.08
|
| Rate for Payer: Nomi Health Commercial |
$567.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$641.25
|
| Rate for Payer: PACE SWMI |
$472.80
|
| Rate for Payer: PHP Commercial |
$661.92
|
| Rate for Payer: PHP Medicare Advantage |
$472.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$859.26
|
| Rate for Payer: Priority Health Medicare |
$472.80
|
| Rate for Payer: Priority Health SBD |
$859.26
|
| Rate for Payer: Priority Health Tiered Network |
$859.26
|
| Rate for Payer: Railroad Medicare Medicare |
$472.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.94
|
| Rate for Payer: UHC Core |
$917.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$472.80
|
| Rate for Payer: UHC Exchange |
$917.94
|
| Rate for Payer: UHC Medicaid |
$307.36
|
| Rate for Payer: UHCCP Medicaid |
$307.36
|
| Rate for Payer: UMR Bronson Commercial |
$393.30
|
|
|
PR VESSEL MAPPING HEMO ACCESS
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS G0365
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$282.75 |
| Rate for Payer: Aetna Medicare |
$188.50
|
| Rate for Payer: BCBS Complete |
$150.80
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.75
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV
|
Professional
|
Both
|
$3,738.00
|
|
|
Service Code
|
HCPCS 43640
|
| Min. Negotiated Rate |
$715.25 |
| Max. Negotiated Rate |
$2,803.50 |
| Rate for Payer: Aetna Commercial |
$1,495.65
|
| Rate for Payer: Aetna Medicare |
$1,160.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,495.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,607.27
|
| Rate for Payer: BCBS Complete |
$751.01
|
| Rate for Payer: BCBS MAPPO |
$1,116.16
|
| Rate for Payer: BCN Commercial |
$1,794.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,116.16
|
| Rate for Payer: Cash Price |
$2,990.40
|
| Rate for Payer: Cash Price |
$2,990.40
|
| Rate for Payer: Cofinity Commercial |
$1,607.27
|
| Rate for Payer: Cofinity Commercial |
$1,495.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.97
|
| Rate for Payer: Meridian Medicaid |
$751.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,227.78
|
| Rate for Payer: Nomi Health Commercial |
$1,339.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,803.50
|
| Rate for Payer: PACE SWMI |
$1,116.16
|
| Rate for Payer: PHP Commercial |
$1,562.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,116.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,186.14
|
| Rate for Payer: Priority Health Medicare |
$1,116.16
|
| Rate for Payer: Priority Health SBD |
$2,186.14
|
| Rate for Payer: Priority Health Tiered Network |
$2,186.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,116.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,102.25
|
| Rate for Payer: UHC Core |
$2,102.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,116.16
|
| Rate for Payer: UHC Exchange |
$2,102.25
|
| Rate for Payer: UHC Medicaid |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,719.48
|
|
|
PR VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 34845
|
| Min. Negotiated Rate |
$412.62 |
| Max. Negotiated Rate |
$2,923.92 |
| Rate for Payer: Aetna Commercial |
$2,344.71
|
| Rate for Payer: Aetna Medicare |
$448.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.71
|
| Rate for Payer: BCBS Complete |
$1,424.60
|
| Rate for Payer: BCN Commercial |
$1,831.76
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Meridian Medicaid |
$1,424.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$672.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,356.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,923.92
|
| Rate for Payer: Priority Health SBD |
$2,923.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,923.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,696.18
|
| Rate for Payer: UHC Core |
$2,696.18
|
| Rate for Payer: UHC Exchange |
$2,696.18
|
| Rate for Payer: UHC Medicaid |
$1,356.76
|
| Rate for Payer: UHCCP Medicaid |
$1,356.76
|
| Rate for Payer: UMR Bronson Commercial |
$412.62
|
|
|
PR VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 34846
|
| Min. Negotiated Rate |
$1,449.92 |
| Max. Negotiated Rate |
$3,161.14 |
| Rate for Payer: Aetna Commercial |
$2,496.07
|
| Rate for Payer: Aetna Medicare |
$1,576.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,496.07
|
| Rate for Payer: BCBS Complete |
$1,567.05
|
| Rate for Payer: BCN Commercial |
$2,035.28
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Meridian Medicaid |
$1,567.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,492.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,161.14
|
| Rate for Payer: Priority Health SBD |
$3,161.14
|
| Rate for Payer: Priority Health Tiered Network |
$3,161.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,811.60
|
| Rate for Payer: UHC Core |
$2,811.60
|
| Rate for Payer: UHC Exchange |
$2,811.60
|
| Rate for Payer: UHC Medicaid |
$1,492.43
|
| Rate for Payer: UHCCP Medicaid |
$1,492.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,449.92
|
|
|
PR VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS
|
Professional
|
Both
|
$5,253.00
|
|
|
Service Code
|
HCPCS 34847
|
| Min. Negotiated Rate |
$1,628.11 |
| Max. Negotiated Rate |
$3,939.75 |
| Rate for Payer: Aetna Commercial |
$2,642.90
|
| Rate for Payer: Aetna Medicare |
$2,626.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,642.90
|
| Rate for Payer: BCBS Complete |
$1,709.52
|
| Rate for Payer: BCN Commercial |
$2,442.34
|
| Rate for Payer: Cash Price |
$4,202.40
|
| Rate for Payer: Cash Price |
$4,202.40
|
| Rate for Payer: Meridian Medicaid |
$1,709.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,939.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,628.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,343.77
|
| Rate for Payer: Priority Health SBD |
$3,343.77
|
| Rate for Payer: Priority Health Tiered Network |
$3,343.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,825.88
|
| Rate for Payer: UHC Core |
$2,825.88
|
| Rate for Payer: UHC Exchange |
$2,825.88
|
| Rate for Payer: UHC Medicaid |
$1,628.11
|
| Rate for Payer: UHCCP Medicaid |
$1,628.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,416.38
|
|
|
PR VISCO GEL SPACER - LARGE
|
Professional
|
Both
|
$7.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
PR VISCO GEL SPACER - MEDIUM
|
Professional
|
Both
|
$7.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
PR VISCO GEL SPACER - SMALL
|
Professional
|
Both
|
$7.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
PR VISION EXAM
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000008
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$12.67
|
| Rate for Payer: BCN Commercial |
$12.67
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Advantage |
$37.10
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.45
|
| Rate for Payer: UHC Core |
$27.61
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UMR Bronson Commercial |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
PR VISION EXAM
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000008
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Advantage |
$37.10
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: UMR Bronson Commercial |
$23.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
PR VISIT TO DETERM LDCT ELIG
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS G0296
|
| Min. Negotiated Rate |
$22.16 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$29.69
|
| Rate for Payer: Aetna Medicare |
$23.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.91
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$22.16
|
| Rate for Payer: BCN Commercial |
$37.35
|
| Rate for Payer: BCN Medicare Advantage |
$22.16
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$31.91
|
| Rate for Payer: Cofinity Commercial |
$29.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.38
|
| Rate for Payer: Nomi Health Commercial |
$26.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$22.16
|
| Rate for Payer: PHP Commercial |
$31.02
|
| Rate for Payer: PHP Medicare Advantage |
$22.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34.44
|
| Rate for Payer: Priority Health Medicare |
$22.16
|
| Rate for Payer: Priority Health SBD |
$34.44
|
| Rate for Payer: Priority Health Tiered Network |
$34.44
|
| Rate for Payer: Railroad Medicare Medicare |
$22.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.58
|
| Rate for Payer: UHC Core |
$38.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.16
|
| Rate for Payer: UHC Exchange |
$38.58
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 95930
|
| Min. Negotiated Rate |
$63.04 |
| Max. Negotiated Rate |
$210.75 |
| Rate for Payer: Aetna Commercial |
$84.47
|
| Rate for Payer: Aetna Medicare |
$65.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.78
|
| Rate for Payer: BCBS MAPPO |
$63.04
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$63.04
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$84.47
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.34
|
| Rate for Payer: Nomi Health Commercial |
$75.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.75
|
| Rate for Payer: PACE SWMI |
$63.04
|
| Rate for Payer: PHP Commercial |
$88.26
|
| Rate for Payer: PHP Medicare Advantage |
$63.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$63.04
|
| Rate for Payer: Priority Health SBD |
$90.94
|
| Rate for Payer: Priority Health Tiered Network |
$90.94
|
| Rate for Payer: Railroad Medicare Medicare |
$63.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.78
|
| Rate for Payer: UHC Core |
$101.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.04
|
| Rate for Payer: UHC Exchange |
$101.78
|
| Rate for Payer: UMR Bronson Commercial |
$129.26
|
|
