|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$3,399.00
|
|
|
Service Code
|
HCPCS 29827
|
| Hospital Charge Code |
29827
|
| Min. Negotiated Rate |
$691.61 |
| Max. Negotiated Rate |
$2,209.35 |
| Rate for Payer: Aetna Commercial |
$1,376.68
|
| Rate for Payer: Aetna Medicare |
$1,068.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.41
|
| Rate for Payer: BCBS Complete |
$726.19
|
| Rate for Payer: BCBS MAPPO |
$1,027.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.58
|
| Rate for Payer: BCN Commercial |
$1,566.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.37
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cash Price |
$2,719.20
|
| Rate for Payer: Cofinity Commercial |
$1,479.41
|
| Rate for Payer: Cofinity Commercial |
$1,376.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.74
|
| Rate for Payer: Meridian Medicaid |
$726.19
|
| Rate for Payer: Nomi Health Commercial |
$1,232.84
|
| Rate for Payer: PACE SWMI |
$1,027.37
|
| Rate for Payer: PHP Commercial |
$1,438.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,641.58
|
| Rate for Payer: Priority Health Medicare |
$1,027.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,641.58
|
| Rate for Payer: Priority Health SBD |
$1,641.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.37
|
| Rate for Payer: UHCCP Medicaid |
$691.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,563.54
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$765.86
|
| Rate for Payer: Aetna Medicare |
$594.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.02
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$571.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.32
|
| Rate for Payer: BCN Commercial |
$962.07
|
| Rate for Payer: BCN Medicare Advantage |
$571.54
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$823.02
|
| Rate for Payer: Cofinity Commercial |
$765.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.12
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Nomi Health Commercial |
$685.85
|
| Rate for Payer: PACE SWMI |
$571.54
|
| Rate for Payer: PHP Commercial |
$800.16
|
| Rate for Payer: PHP Medicare Advantage |
$571.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$917.99
|
| Rate for Payer: Priority Health Medicare |
$571.54
|
| Rate for Payer: Priority Health Narrow Network |
$917.99
|
| Rate for Payer: Priority Health SBD |
$917.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.54
|
| Rate for Payer: UHC Medicare Advantage |
$571.54
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29823
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Commercial |
$765.86
|
| Rate for Payer: Aetna Medicare |
$594.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.02
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$571.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.32
|
| Rate for Payer: BCN Commercial |
$962.07
|
| Rate for Payer: BCN Medicare Advantage |
$571.54
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$765.86
|
| Rate for Payer: Cofinity Commercial |
$823.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.12
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Nomi Health Commercial |
$685.85
|
| Rate for Payer: PACE SWMI |
$571.54
|
| Rate for Payer: PHP Commercial |
$800.16
|
| Rate for Payer: PHP Medicare Advantage |
$571.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$917.99
|
| Rate for Payer: Priority Health Medicare |
$571.54
|
| Rate for Payer: Priority Health Narrow Network |
$917.99
|
| Rate for Payer: Priority Health SBD |
$917.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.54
|
| Rate for Payer: UHC Medicare Advantage |
$571.54
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$1,111.00 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29823
|
| Hospital Charge Code |
29823
|
| Min. Negotiated Rate |
$574.86 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.35
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$574.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$934.25
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,706.63
|
| Rate for Payer: BCN Commercial |
$3,706.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
IP
|
$2,525.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$1,111.00 |
| Max. Negotiated Rate |
$2,272.50 |
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
OP
|
$2,525.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$165.85 |
| Max. Negotiated Rate |
$3,194.19 |
| Rate for Payer: Aetna American Axle |
$1,641.25
|
| Rate for Payer: Aetna Commercial |
$2,146.25
|
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.25
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,194.19
|
| Rate for Payer: BCN Commercial |
$3,194.19
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$2,171.50
|
| Rate for Payer: Cofinity Commercial |
$1,767.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,767.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,020.00
|
| Rate for Payer: Healthscope Commercial |
$2,272.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,767.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,893.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,146.25
|
| Rate for Payer: PHP Commercial |
$2,146.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health SBD |
$1,590.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.44
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$165.85
|
| Rate for Payer: UMR Bronson Commercial |
$934.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,893.75
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$221.64
|
| Rate for Payer: Aetna Medicare |
$172.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.18
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$165.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.40
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Cofinity Commercial |
$221.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.67
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$198.48
|
| Rate for Payer: PACE SWMI |
$165.40
|
| Rate for Payer: PHP Commercial |
$231.56
|
| Rate for Payer: PHP Medicare Advantage |
$165.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.52
|
| Rate for Payer: Priority Health Medicare |
$165.40
|
| Rate for Payer: Priority Health Narrow Network |
$259.52
|
| Rate for Payer: Priority Health SBD |
$259.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.40
|
| Rate for Payer: UHC Medicare Advantage |
$165.40
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$221.64
|
| Rate for Payer: Aetna Medicare |
$172.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.18
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$165.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.40
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Cofinity Commercial |
$221.64
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.67
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$198.48
|
| Rate for Payer: PACE SWMI |
$165.40
|
| Rate for Payer: PHP Commercial |
$231.56
|
| Rate for Payer: PHP Medicare Advantage |
$165.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.52
|
| Rate for Payer: Priority Health Medicare |
$165.40
|
| Rate for Payer: Priority Health Narrow Network |
$259.52
|
| Rate for Payer: Priority Health SBD |
$259.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.40
|
| Rate for Payer: UHC Medicare Advantage |
$165.40
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.50
|
|
|
PR SURGICAL TRAYS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS A4550
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Commercial |
$15.00
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,673.00
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$4,200.67 |
| Rate for Payer: Aetna Commercial |
$311.48
|
| Rate for Payer: Aetna Medicare |
$241.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.73
|
| Rate for Payer: BCBS Complete |
$163.04
|
| Rate for Payer: BCBS MAPPO |
$232.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,280.67
|
| Rate for Payer: BCN Commercial |
$4,200.67
|
| Rate for Payer: BCN Medicare Advantage |
$232.45
|
| Rate for Payer: Cash Price |
$4,538.40
|
| Rate for Payer: Cash Price |
$4,538.40
|
| Rate for Payer: Cofinity Commercial |
$311.48
|
| Rate for Payer: Cofinity Commercial |
$334.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.07
|
| Rate for Payer: Meridian Medicaid |
$163.04
|
| Rate for Payer: Nomi Health Commercial |
$278.94
|
| Rate for Payer: PACE SWMI |
$232.45
|
| Rate for Payer: PHP Commercial |
$325.43
|
| Rate for Payer: PHP Medicare Advantage |
$232.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,687.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.61
|
| Rate for Payer: Priority Health Medicare |
$232.45
|
| Rate for Payer: Priority Health Narrow Network |
$352.61
|
| Rate for Payer: Priority Health SBD |
$352.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.45
|
| Rate for Payer: UHC Medicare Advantage |
$232.45
|
| Rate for Payer: UHCCP Medicaid |
$155.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,609.58
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,488.00
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$111.19 |
| Max. Negotiated Rate |
$4,063.84 |
| Rate for Payer: Aetna Commercial |
$222.69
|
| Rate for Payer: Aetna Medicare |
$172.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.31
|
| Rate for Payer: BCBS Complete |
$116.75
|
| Rate for Payer: BCBS MAPPO |
$166.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,634.18
|
| Rate for Payer: BCN Commercial |
$4,063.84
|
| Rate for Payer: BCN Medicare Advantage |
$166.19
|
| Rate for Payer: Cash Price |
$4,390.40
|
| Rate for Payer: Cash Price |
$4,390.40
|
| Rate for Payer: Cofinity Commercial |
$222.69
|
| Rate for Payer: Cofinity Commercial |
$239.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.50
|
| Rate for Payer: Meridian Medicaid |
$116.75
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: PACE SWMI |
$166.19
|
| Rate for Payer: PHP Commercial |
$232.67
|
| Rate for Payer: PHP Medicare Advantage |
$166.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,567.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.43
|
| Rate for Payer: Priority Health Medicare |
$166.19
|
| Rate for Payer: Priority Health Narrow Network |
$252.43
|
| Rate for Payer: Priority Health SBD |
$252.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.19
|
| Rate for Payer: UHC Medicare Advantage |
$166.19
|
| Rate for Payer: UHCCP Medicaid |
$111.19
|
| Rate for Payer: UMR Bronson Commercial |
$2,524.48
|
|
|
PR SURG OPENING,ESOPHAGUS,ABD APPRCH
|
Professional
|
Both
|
$2,787.00
|
|
|
Service Code
|
HCPCS 43350
|
| Min. Negotiated Rate |
$1,114.80 |
| Max. Negotiated Rate |
$1,811.55 |
| Rate for Payer: Aetna Medicare |
$1,393.50
|
| Rate for Payer: BCBS Complete |
$1,114.80
|
| Rate for Payer: Cash Price |
$2,229.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,282.02
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$276.69 |
| Max. Negotiated Rate |
$2,300.22 |
| Rate for Payer: Aetna Commercial |
$545.09
|
| Rate for Payer: Aetna Medicare |
$423.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.76
|
| Rate for Payer: BCBS Complete |
$290.52
|
| Rate for Payer: BCBS MAPPO |
$406.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,300.22
|
| Rate for Payer: BCN Commercial |
$826.84
|
| Rate for Payer: BCN Medicare Advantage |
$406.78
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$585.76
|
| Rate for Payer: Cofinity Commercial |
$545.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.12
|
| Rate for Payer: Meridian Medicaid |
$290.52
|
| Rate for Payer: Nomi Health Commercial |
$488.14
|
| Rate for Payer: PACE SWMI |
$406.78
|
| Rate for Payer: PHP Commercial |
$569.49
|
| Rate for Payer: PHP Medicare Advantage |
$406.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.43
|
| Rate for Payer: Priority Health Medicare |
$406.78
|
| Rate for Payer: Priority Health Narrow Network |
$765.43
|
| Rate for Payer: Priority Health SBD |
$765.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.78
|
| Rate for Payer: UHC Medicare Advantage |
$406.78
|
| Rate for Payer: UHCCP Medicaid |
$276.69
|
| Rate for Payer: UMR Bronson Commercial |
$446.20
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,315.00
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$274.98 |
| Max. Negotiated Rate |
$4,730.40 |
| Rate for Payer: Aetna Commercial |
$541.36
|
| Rate for Payer: Aetna Medicare |
$420.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.76
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS MAPPO |
$404.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,730.40
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$404.00
|
| Rate for Payer: Cash Price |
$1,052.00
|
| Rate for Payer: Cash Price |
$1,052.00
|
| Rate for Payer: Cofinity Commercial |
$541.36
|
| Rate for Payer: Cofinity Commercial |
$581.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.20
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Nomi Health Commercial |
$484.80
|
| Rate for Payer: PACE SWMI |
$404.00
|
| Rate for Payer: PHP Commercial |
$565.60
|
| Rate for Payer: PHP Medicare Advantage |
$404.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.05
|
| Rate for Payer: Priority Health Medicare |
$404.00
|
| Rate for Payer: Priority Health Narrow Network |
$763.05
|
| Rate for Payer: Priority Health SBD |
$763.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.00
|
| Rate for Payer: UHC Medicare Advantage |
$404.00
|
| Rate for Payer: UHCCP Medicaid |
$274.98
|
| Rate for Payer: UMR Bronson Commercial |
$604.90
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$261.99 |
| Max. Negotiated Rate |
$2,437.58 |
| Rate for Payer: Aetna Commercial |
$515.69
|
| Rate for Payer: Aetna Medicare |
$400.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.17
|
| Rate for Payer: BCBS Complete |
$275.09
|
| Rate for Payer: BCBS MAPPO |
$384.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,437.58
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$384.84
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$515.69
|
| Rate for Payer: Cofinity Commercial |
$554.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.08
|
| Rate for Payer: Meridian Medicaid |
$275.09
|
| Rate for Payer: Nomi Health Commercial |
$461.81
|
| Rate for Payer: PACE SWMI |
$384.84
|
| Rate for Payer: PHP Commercial |
$538.78
|
| Rate for Payer: PHP Medicare Advantage |
$384.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.86
|
| Rate for Payer: Priority Health Medicare |
$384.84
|
| Rate for Payer: Priority Health Narrow Network |
$724.86
|
| Rate for Payer: Priority Health SBD |
$724.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.84
|
| Rate for Payer: UHC Medicare Advantage |
$384.84
|
| Rate for Payer: UHCCP Medicaid |
$261.99
|
| Rate for Payer: UMR Bronson Commercial |
$396.52
|
|
|
PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD
|
Professional
|
Both
|
$11,334.00
|
|
|
Service Code
|
HCPCS 33548
|
| Min. Negotiated Rate |
$624.98 |
| Max. Negotiated Rate |
$7,367.10 |
| Rate for Payer: Aetna Commercial |
$3,774.12
|
| Rate for Payer: Aetna Medicare |
$2,929.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,774.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,055.77
|
| Rate for Payer: BCBS Complete |
$1,939.72
|
| Rate for Payer: BCBS MAPPO |
$2,816.51
|
| Rate for Payer: BCBS Trust/PPO |
$624.98
|
| Rate for Payer: BCN Commercial |
$4,215.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,816.51
|
| Rate for Payer: Cash Price |
$9,067.20
|
| Rate for Payer: Cash Price |
$9,067.20
|
| Rate for Payer: Cofinity Commercial |
$3,774.12
|
| Rate for Payer: Cofinity Commercial |
$4,055.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,816.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,957.34
|
| Rate for Payer: Meridian Medicaid |
$1,939.72
|
| Rate for Payer: Nomi Health Commercial |
$3,379.81
|
| Rate for Payer: PACE SWMI |
$2,816.51
|
| Rate for Payer: PHP Commercial |
$3,943.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,816.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,847.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,367.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,592.84
|
| Rate for Payer: Priority Health Medicare |
$2,816.51
|
| Rate for Payer: Priority Health Narrow Network |
$4,592.84
|
| Rate for Payer: Priority Health SBD |
$4,592.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,816.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,816.51
|
| Rate for Payer: UHCCP Medicaid |
$1,847.35
|
| Rate for Payer: UMR Bronson Commercial |
$5,213.64
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$1,323.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$210.87 |
| Max. Negotiated Rate |
$859.95 |
| Rate for Payer: Aetna Commercial |
$424.53
|
| Rate for Payer: Aetna Medicare |
$329.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.21
|
| Rate for Payer: BCBS Complete |
$221.41
|
| Rate for Payer: BCBS MAPPO |
$316.81
|
| Rate for Payer: BCBS Trust/PPO |
$294.79
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$316.81
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cofinity Commercial |
$424.53
|
| Rate for Payer: Cofinity Commercial |
$456.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.65
|
| Rate for Payer: Meridian Medicaid |
$221.41
|
| Rate for Payer: Nomi Health Commercial |
$380.17
|
| Rate for Payer: PACE SWMI |
$316.81
|
| Rate for Payer: PHP Commercial |
$443.53
|
| Rate for Payer: PHP Medicare Advantage |
$316.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.33
|
| Rate for Payer: Priority Health Medicare |
$316.81
|
| Rate for Payer: Priority Health Narrow Network |
$561.33
|
| Rate for Payer: Priority Health SBD |
$561.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.81
|
| Rate for Payer: UHC Medicare Advantage |
$316.81
|
| Rate for Payer: UHCCP Medicaid |
$210.87
|
| Rate for Payer: UMR Bronson Commercial |
$608.58
|
|
|
PR SUTR ESOPHGL WND/INJ CRV APPR
|
Professional
|
Both
|
$2,855.00
|
|
|
Service Code
|
HCPCS 43410
|
| Min. Negotiated Rate |
$666.69 |
| Max. Negotiated Rate |
$1,858.40 |
| Rate for Payer: Aetna Commercial |
$1,326.14
|
| Rate for Payer: Aetna Medicare |
$1,029.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.11
|
| Rate for Payer: BCBS Complete |
$700.02
|
| Rate for Payer: BCBS MAPPO |
$989.66
|
| Rate for Payer: BCBS Trust/PPO |
$949.92
|
| Rate for Payer: BCN Commercial |
$1,513.44
|
| Rate for Payer: BCN Medicare Advantage |
$989.66
|
| Rate for Payer: Cash Price |
$2,284.00
|
| Rate for Payer: Cash Price |
$2,284.00
|
| Rate for Payer: Cofinity Commercial |
$1,326.14
|
| Rate for Payer: Cofinity Commercial |
$1,425.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$989.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.14
|
| Rate for Payer: Meridian Medicaid |
$700.02
|
| Rate for Payer: Nomi Health Commercial |
$1,187.59
|
| Rate for Payer: PACE SWMI |
$989.66
|
| Rate for Payer: PHP Commercial |
$1,385.52
|
| Rate for Payer: PHP Medicare Advantage |
$989.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,858.40
|
| Rate for Payer: Priority Health Medicare |
$989.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,858.40
|
| Rate for Payer: Priority Health SBD |
$1,858.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$989.66
|
| Rate for Payer: UHC Medicare Advantage |
$989.66
|
| Rate for Payer: UHCCP Medicaid |
$666.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,313.30
|
|
|
PR SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,076.00
|
|
|
Service Code
|
HCPCS 43415
|
| Min. Negotiated Rate |
$1,207.03 |
| Max. Negotiated Rate |
$4,566.34 |
| Rate for Payer: Aetna Commercial |
$3,314.30
|
| Rate for Payer: Aetna Medicare |
$2,572.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,314.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,561.64
|
| Rate for Payer: BCBS Complete |
$1,710.25
|
| Rate for Payer: BCBS MAPPO |
$2,473.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,207.03
|
| Rate for Payer: BCN Commercial |
$3,715.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,473.36
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Cofinity Commercial |
$3,314.30
|
| Rate for Payer: Cofinity Commercial |
$3,561.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,473.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,597.03
|
| Rate for Payer: Meridian Medicaid |
$1,710.25
|
| Rate for Payer: Nomi Health Commercial |
$2,968.03
|
| Rate for Payer: PACE SWMI |
$2,473.36
|
| Rate for Payer: PHP Commercial |
$3,462.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,473.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,628.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,649.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,566.34
|
| Rate for Payer: Priority Health Medicare |
$2,473.36
|
| Rate for Payer: Priority Health Narrow Network |
$4,566.34
|
| Rate for Payer: Priority Health SBD |
$4,566.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,473.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,473.36
|
| Rate for Payer: UHCCP Medicaid |
$1,628.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,874.96
|
|
|
PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 27381
|
| Min. Negotiated Rate |
$533.78 |
| Max. Negotiated Rate |
$3,176.14 |
| Rate for Payer: Aetna Commercial |
$1,055.24
|
| Rate for Payer: Aetna Medicare |
$818.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.99
|
| Rate for Payer: BCBS Complete |
$560.47
|
| Rate for Payer: BCBS MAPPO |
$787.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,176.14
|
| Rate for Payer: BCN Commercial |
$1,209.96
|
| Rate for Payer: BCN Medicare Advantage |
$787.49
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$1,055.24
|
| Rate for Payer: Cofinity Commercial |
$1,133.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.86
|
| Rate for Payer: Meridian Medicaid |
$560.47
|
| Rate for Payer: Nomi Health Commercial |
$944.99
|
| Rate for Payer: PACE SWMI |
$787.49
|
| Rate for Payer: PHP Commercial |
$1,102.49
|
| Rate for Payer: PHP Medicare Advantage |
$787.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,267.57
|
| Rate for Payer: Priority Health Medicare |
$787.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,267.57
|
| Rate for Payer: Priority Health SBD |
$1,267.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.49
|
| Rate for Payer: UHC Medicare Advantage |
$787.49
|
| Rate for Payer: UHCCP Medicaid |
$533.78
|
| Rate for Payer: UMR Bronson Commercial |
$729.56
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY
|
Professional
|
Both
|
$2,938.00
|
|
|
Service Code
|
HCPCS 44605
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$2,295.10 |
| Rate for Payer: Aetna Commercial |
$1,671.96
|
| Rate for Payer: Aetna Medicare |
$1,297.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,796.73
|
| Rate for Payer: BCBS Complete |
$865.75
|
| Rate for Payer: BCBS MAPPO |
$1,247.73
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$1,885.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,247.73
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,671.96
|
| Rate for Payer: Cofinity Commercial |
$1,796.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,247.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,310.12
|
| Rate for Payer: Meridian Medicaid |
$865.75
|
| Rate for Payer: Nomi Health Commercial |
$1,497.28
|
| Rate for Payer: PACE SWMI |
$1,247.73
|
| Rate for Payer: PHP Commercial |
$1,746.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,247.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,909.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,295.10
|
| Rate for Payer: Priority Health Medicare |
$1,247.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,295.10
|
| Rate for Payer: Priority Health SBD |
$2,295.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,247.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,247.73
|
| Rate for Payer: UHCCP Medicaid |
$824.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,351.48
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$2,002.65 |
| Rate for Payer: Aetna Commercial |
$1,367.85
|
| Rate for Payer: Aetna Medicare |
$1,061.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.92
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,020.78
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$1,534.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.78
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,367.85
|
| Rate for Payer: Cofinity Commercial |
$1,469.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.82
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Nomi Health Commercial |
$1,224.94
|
| Rate for Payer: PACE SWMI |
$1,020.78
|
| Rate for Payer: PHP Commercial |
$1,429.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.05
|
| Rate for Payer: Priority Health Medicare |
$1,020.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,881.05
|
| Rate for Payer: Priority Health SBD |
$1,881.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,020.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,020.78
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.26
|
|
|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$5,927.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$516.53 |
| Max. Negotiated Rate |
$3,852.55 |
| Rate for Payer: Aetna Commercial |
$1,045.51
|
| Rate for Payer: Aetna Medicare |
$811.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.53
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$780.23
|
| Rate for Payer: BCBS Trust/PPO |
$540.98
|
| Rate for Payer: BCN Commercial |
$1,163.05
|
| Rate for Payer: BCN Medicare Advantage |
$780.23
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,045.51
|
| Rate for Payer: Cofinity Commercial |
$1,123.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.24
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Nomi Health Commercial |
$936.28
|
| Rate for Payer: PACE SWMI |
$780.23
|
| Rate for Payer: PHP Commercial |
$1,092.32
|
| Rate for Payer: PHP Medicare Advantage |
$780.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,596.46
|
| Rate for Payer: Priority Health Medicare |
$780.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,596.46
|
| Rate for Payer: Priority Health SBD |
$1,596.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.23
|
| Rate for Payer: UHC Medicare Advantage |
$780.23
|
| Rate for Payer: UHCCP Medicaid |
$516.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,726.42
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$740.81 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$1,462.68
|
| Rate for Payer: Aetna Medicare |
$1,135.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.83
|
| Rate for Payer: BCBS Complete |
$777.85
|
| Rate for Payer: BCBS MAPPO |
$1,091.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$1,709.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.55
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,462.68
|
| Rate for Payer: Cofinity Commercial |
$1,571.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,146.13
|
| Rate for Payer: Meridian Medicaid |
$777.85
|
| Rate for Payer: Nomi Health Commercial |
$1,309.86
|
| Rate for Payer: PACE SWMI |
$1,091.55
|
| Rate for Payer: PHP Commercial |
$1,528.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,699.40
|
| Rate for Payer: Priority Health Medicare |
$1,091.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,699.40
|
| Rate for Payer: Priority Health SBD |
$1,699.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,091.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,091.55
|
| Rate for Payer: UHCCP Medicaid |
$740.81
|
| Rate for Payer: UMR Bronson Commercial |
$945.30
|
|
