|
PR TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,814.00
|
|
|
Service Code
|
HCPCS 37218
|
| Min. Negotiated Rate |
$520.36 |
| Max. Negotiated Rate |
$1,292.34 |
| Rate for Payer: Aetna Commercial |
$1,061.76
|
| Rate for Payer: Aetna Medicare |
$824.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,061.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.00
|
| Rate for Payer: BCBS Complete |
$546.38
|
| Rate for Payer: BCBS MAPPO |
$792.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.92
|
| Rate for Payer: BCN Commercial |
$1,179.18
|
| Rate for Payer: BCN Medicare Advantage |
$792.36
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cash Price |
$1,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.76
|
| Rate for Payer: Cofinity Commercial |
$1,141.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.98
|
| Rate for Payer: Meridian Medicaid |
$546.38
|
| Rate for Payer: Nomi Health Commercial |
$950.83
|
| Rate for Payer: PACE SWMI |
$792.36
|
| Rate for Payer: PHP Commercial |
$1,109.30
|
| Rate for Payer: PHP Medicare Advantage |
$792.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.34
|
| Rate for Payer: Priority Health Medicare |
$792.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.34
|
| Rate for Payer: Priority Health SBD |
$1,292.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$792.36
|
| Rate for Payer: UHC Medicare Advantage |
$792.36
|
| Rate for Payer: UHCCP Medicaid |
$520.36
|
| Rate for Payer: UMR Bronson Commercial |
$834.44
|
|
|
PR TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,755.00
|
|
|
Service Code
|
HCPCS 37217
|
| Min. Negotiated Rate |
$677.34 |
| Max. Negotiated Rate |
$1,679.50 |
| Rate for Payer: Aetna Commercial |
$1,390.40
|
| Rate for Payer: Aetna Medicare |
$1,079.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.16
|
| Rate for Payer: BCBS Complete |
$711.21
|
| Rate for Payer: BCBS MAPPO |
$1,037.61
|
| Rate for Payer: BCBS Trust/PPO |
$721.66
|
| Rate for Payer: BCN Commercial |
$1,545.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.61
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$1,494.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.49
|
| Rate for Payer: Meridian Medicaid |
$711.21
|
| Rate for Payer: Nomi Health Commercial |
$1,245.13
|
| Rate for Payer: PACE SWMI |
$1,037.61
|
| Rate for Payer: PHP Commercial |
$1,452.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,679.50
|
| Rate for Payer: Priority Health Medicare |
$1,037.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,679.50
|
| Rate for Payer: Priority Health SBD |
$1,679.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.61
|
| Rate for Payer: UHCCP Medicaid |
$677.34
|
| Rate for Payer: UMR Bronson Commercial |
$807.30
|
|
|
PR TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 33289
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$1,657.81 |
| Rate for Payer: Aetna Commercial |
$426.75
|
| Rate for Payer: Aetna Medicare |
$331.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.60
|
| Rate for Payer: BCBS Complete |
$219.85
|
| Rate for Payer: BCBS MAPPO |
$318.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,657.81
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$318.47
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cofinity Commercial |
$426.75
|
| Rate for Payer: Cofinity Commercial |
$458.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.39
|
| Rate for Payer: Meridian Medicaid |
$219.85
|
| Rate for Payer: Nomi Health Commercial |
$382.16
|
| Rate for Payer: PACE SWMI |
$318.47
|
| Rate for Payer: PHP Commercial |
$445.86
|
| Rate for Payer: PHP Medicare Advantage |
$318.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.65
|
| Rate for Payer: Priority Health Medicare |
$318.47
|
| Rate for Payer: Priority Health Narrow Network |
$520.65
|
| Rate for Payer: Priority Health SBD |
$520.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.47
|
| Rate for Payer: UHC Medicare Advantage |
$318.47
|
| Rate for Payer: UHCCP Medicaid |
$209.38
|
| Rate for Payer: UMR Bronson Commercial |
$316.02
|
|
|
PR TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG
|
Professional
|
Both
|
$1,020.00
|
|
|
Service Code
|
HCPCS 33274
|
| Min. Negotiated Rate |
$300.54 |
| Max. Negotiated Rate |
$1,157.51 |
| Rate for Payer: Aetna Commercial |
$607.11
|
| Rate for Payer: Aetna Medicare |
$471.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.42
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$453.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$692.95
|
| Rate for Payer: BCN Medicare Advantage |
$453.07
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$607.11
|
| Rate for Payer: Cofinity Commercial |
$652.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.72
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Nomi Health Commercial |
$543.68
|
| Rate for Payer: PACE SWMI |
$453.07
|
| Rate for Payer: PHP Commercial |
$634.30
|
| Rate for Payer: PHP Medicare Advantage |
$453.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.81
|
| Rate for Payer: Priority Health Medicare |
$453.07
|
| Rate for Payer: Priority Health Narrow Network |
$748.81
|
| Rate for Payer: Priority Health SBD |
$748.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$453.07
|
| Rate for Payer: UHC Medicare Advantage |
$453.07
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
| Rate for Payer: UMR Bronson Commercial |
$469.20
|
|
|
PR TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 37215
|
| Min. Negotiated Rate |
$617.91 |
| Max. Negotiated Rate |
$1,544.42 |
| Rate for Payer: Aetna Commercial |
$1,265.54
|
| Rate for Payer: Aetna Medicare |
$982.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.98
|
| Rate for Payer: BCBS Complete |
$648.81
|
| Rate for Payer: BCBS MAPPO |
$944.43
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$1,417.66
|
| Rate for Payer: BCN Medicare Advantage |
$944.43
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$1,265.54
|
| Rate for Payer: Cofinity Commercial |
$1,359.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.65
|
| Rate for Payer: Meridian Medicaid |
$648.81
|
| Rate for Payer: Nomi Health Commercial |
$1,133.32
|
| Rate for Payer: PACE SWMI |
$944.43
|
| Rate for Payer: PHP Commercial |
$1,322.20
|
| Rate for Payer: PHP Medicare Advantage |
$944.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.42
|
| Rate for Payer: Priority Health Medicare |
$944.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.42
|
| Rate for Payer: Priority Health SBD |
$1,544.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$944.43
|
| Rate for Payer: UHC Medicare Advantage |
$944.43
|
| Rate for Payer: UHCCP Medicaid |
$617.91
|
| Rate for Payer: UMR Bronson Commercial |
$970.60
|
|
|
PR TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ
|
Professional
|
Both
|
$4,184.00
|
|
|
Service Code
|
HCPCS 37216
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$2,719.60 |
| Rate for Payer: Aetna Commercial |
$1,302.62
|
| Rate for Payer: Aetna Medicare |
$2,092.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.62
|
| Rate for Payer: BCBS Complete |
$1,673.60
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCN Commercial |
$1,417.16
|
| Rate for Payer: Cash Price |
$3,347.20
|
| Rate for Payer: Cash Price |
$3,347.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,719.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,551.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,551.87
|
| Rate for Payer: Priority Health SBD |
$1,551.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,924.64
|
|
|
PR TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS
|
Professional
|
Both
|
$3,759.00
|
|
|
Service Code
|
HCPCS 33418
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$2,810.16 |
| Rate for Payer: Aetna Commercial |
$2,297.56
|
| Rate for Payer: Aetna Medicare |
$1,783.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,297.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,469.02
|
| Rate for Payer: BCBS Complete |
$1,183.78
|
| Rate for Payer: BCBS MAPPO |
$1,714.60
|
| Rate for Payer: BCBS Trust/PPO |
$308.00
|
| Rate for Payer: BCN Commercial |
$2,567.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,714.60
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Cofinity Commercial |
$2,469.02
|
| Rate for Payer: Cofinity Commercial |
$2,297.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,714.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,800.33
|
| Rate for Payer: Meridian Medicaid |
$1,183.78
|
| Rate for Payer: Nomi Health Commercial |
$2,057.52
|
| Rate for Payer: PACE SWMI |
$1,714.60
|
| Rate for Payer: PHP Commercial |
$2,400.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,714.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,127.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,810.16
|
| Rate for Payer: Priority Health Medicare |
$1,714.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,810.16
|
| Rate for Payer: Priority Health SBD |
$2,810.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,714.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,714.60
|
| Rate for Payer: UHCCP Medicaid |
$1,127.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,729.14
|
|
|
PR TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS
|
Professional
|
Both
|
$4,624.00
|
|
|
Service Code
|
HCPCS 61624
|
| Min. Negotiated Rate |
$113.06 |
| Max. Negotiated Rate |
$3,005.60 |
| Rate for Payer: Aetna Commercial |
$1,530.57
|
| Rate for Payer: Aetna Medicare |
$1,187.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.80
|
| Rate for Payer: BCBS Complete |
$782.55
|
| Rate for Payer: BCBS MAPPO |
$1,142.22
|
| Rate for Payer: BCBS Trust/PPO |
$113.06
|
| Rate for Payer: BCN Commercial |
$2,342.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,142.22
|
| Rate for Payer: Cash Price |
$3,699.20
|
| Rate for Payer: Cash Price |
$3,699.20
|
| Rate for Payer: Cofinity Commercial |
$1,530.57
|
| Rate for Payer: Cofinity Commercial |
$1,644.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,142.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,199.33
|
| Rate for Payer: Meridian Medicaid |
$782.55
|
| Rate for Payer: Nomi Health Commercial |
$1,370.66
|
| Rate for Payer: PACE SWMI |
$1,142.22
|
| Rate for Payer: PHP Commercial |
$1,599.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,142.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,005.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,977.43
|
| Rate for Payer: Priority Health Medicare |
$1,142.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,977.43
|
| Rate for Payer: Priority Health SBD |
$1,977.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,142.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,142.22
|
| Rate for Payer: UHCCP Medicaid |
$745.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,127.04
|
|
|
PR TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS
|
Professional
|
Both
|
$1,849.00
|
|
|
Service Code
|
HCPCS 61626
|
| Min. Negotiated Rate |
$73.96 |
| Max. Negotiated Rate |
$1,532.69 |
| Rate for Payer: UHCCP Medicaid |
$578.08
|
| Rate for Payer: Aetna Commercial |
$1,182.15
|
| Rate for Payer: Aetna Medicare |
$917.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.37
|
| Rate for Payer: BCBS Complete |
$606.98
|
| Rate for Payer: BCBS MAPPO |
$882.20
|
| Rate for Payer: BCBS Trust/PPO |
$73.96
|
| Rate for Payer: BCN Commercial |
$1,301.35
|
| Rate for Payer: BCN Medicare Advantage |
$882.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cash Price |
$1,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.15
|
| Rate for Payer: Cofinity Commercial |
$1,270.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$926.31
|
| Rate for Payer: Meridian Medicaid |
$606.98
|
| Rate for Payer: Nomi Health Commercial |
$1,058.64
|
| Rate for Payer: PACE SWMI |
$882.20
|
| Rate for Payer: PHP Commercial |
$1,235.08
|
| Rate for Payer: PHP Medicare Advantage |
$882.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.69
|
| Rate for Payer: Priority Health Medicare |
$882.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.69
|
| Rate for Payer: Priority Health SBD |
$1,532.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$882.20
|
| Rate for Payer: UHC Medicare Advantage |
$882.20
|
| Rate for Payer: UMR Bronson Commercial |
$850.54
|
|
|
PR TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD
|
Professional
|
Both
|
$6,793.00
|
|
|
Service Code
|
HCPCS 61635
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$4,415.45 |
| Rate for Payer: Aetna Commercial |
$1,954.08
|
| Rate for Payer: Aetna Medicare |
$1,516.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,954.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,099.91
|
| Rate for Payer: BCBS Complete |
$2,717.20
|
| Rate for Payer: BCBS MAPPO |
$1,458.27
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$2,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,458.27
|
| Rate for Payer: Cash Price |
$5,434.40
|
| Rate for Payer: Cash Price |
$5,434.40
|
| Rate for Payer: Cofinity Commercial |
$2,099.91
|
| Rate for Payer: Cofinity Commercial |
$1,954.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,458.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,531.18
|
| Rate for Payer: Nomi Health Commercial |
$1,749.92
|
| Rate for Payer: PACE SWMI |
$1,458.27
|
| Rate for Payer: PHP Commercial |
$2,041.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,458.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,415.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,527.94
|
| Rate for Payer: Priority Health Medicare |
$1,458.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,527.94
|
| Rate for Payer: Priority Health SBD |
$2,527.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,458.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,458.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,124.78
|
|
|
PR TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL
|
Professional
|
Both
|
$9,873.00
|
|
|
Service Code
|
HCPCS 0075T
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$6,440.29 |
| Rate for Payer: Aetna Commercial |
$1,381.29
|
| Rate for Payer: Aetna Medicare |
$4,936.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.29
|
| Rate for Payer: BCBS Complete |
$3,949.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$6,440.29
|
| Rate for Payer: Cash Price |
$7,898.40
|
| Rate for Payer: Cash Price |
$7,898.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,417.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,900.00
|
| Rate for Payer: Priority Health Narrow Network |
$5,900.00
|
| Rate for Payer: Priority Health SBD |
$1,200.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,541.58
|
|
|
PR TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 33275
|
| Min. Negotiated Rate |
$317.80 |
| Max. Negotiated Rate |
$1,123.85 |
| Rate for Payer: Aetna Commercial |
$644.65
|
| Rate for Payer: Aetna Medicare |
$500.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.76
|
| Rate for Payer: BCBS Complete |
$333.69
|
| Rate for Payer: BCBS MAPPO |
$481.08
|
| Rate for Payer: BCN Commercial |
$722.76
|
| Rate for Payer: BCN Medicare Advantage |
$481.08
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$644.65
|
| Rate for Payer: Cofinity Commercial |
$692.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.13
|
| Rate for Payer: Meridian Medicaid |
$333.69
|
| Rate for Payer: Nomi Health Commercial |
$577.30
|
| Rate for Payer: PACE SWMI |
$481.08
|
| Rate for Payer: PHP Commercial |
$673.51
|
| Rate for Payer: PHP Medicare Advantage |
$481.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.36
|
| Rate for Payer: Priority Health Medicare |
$481.08
|
| Rate for Payer: Priority Health Narrow Network |
$791.36
|
| Rate for Payer: Priority Health SBD |
$791.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.08
|
| Rate for Payer: UHC Medicare Advantage |
$481.08
|
| Rate for Payer: UHCCP Medicaid |
$317.80
|
| Rate for Payer: UMR Bronson Commercial |
$795.34
|
|
|
PR TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 93893
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$578.11 |
| Rate for Payer: Aetna Commercial |
$400.83
|
| Rate for Payer: Aetna Medicare |
$311.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.75
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCBS MAPPO |
$299.13
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$299.13
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$400.83
|
| Rate for Payer: Cofinity Commercial |
$430.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.09
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Nomi Health Commercial |
$358.96
|
| Rate for Payer: PACE SWMI |
$299.13
|
| Rate for Payer: PHP Commercial |
$418.78
|
| Rate for Payer: PHP Medicare Advantage |
$299.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.85
|
| Rate for Payer: Priority Health Medicare |
$299.13
|
| Rate for Payer: Priority Health Narrow Network |
$546.85
|
| Rate for Payer: Priority Health SBD |
$79.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.13
|
| Rate for Payer: UHC Medicare Advantage |
$299.13
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
| Rate for Payer: UMR Bronson Commercial |
$310.50
|
|
|
PR TDAP VACCINE 7 YRS/> IM
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 90715
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$57.18 |
| Rate for Payer: Aetna Commercial |
$53.21
|
| Rate for Payer: Aetna Medicare |
$41.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.18
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$39.71
|
| Rate for Payer: BCBS Trust/PPO |
$40.48
|
| Rate for Payer: BCN Commercial |
$42.12
|
| Rate for Payer: BCN Medicare Advantage |
$39.71
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$53.21
|
| Rate for Payer: Cofinity Commercial |
$57.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.69
|
| Rate for Payer: Nomi Health Commercial |
$47.65
|
| Rate for Payer: PACE SWMI |
$39.71
|
| Rate for Payer: PHP Commercial |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$39.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$39.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.71
|
| Rate for Payer: UHC Medicare Advantage |
$39.71
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN
|
Professional
|
Both
|
$2,633.00
|
|
|
Service Code
|
HCPCS 25310
|
| Min. Negotiated Rate |
$467.54 |
| Max. Negotiated Rate |
$1,711.45 |
| Rate for Payer: Aetna Commercial |
$920.65
|
| Rate for Payer: Aetna Medicare |
$714.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.65
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$687.05
|
| Rate for Payer: BCBS Trust/PPO |
$791.39
|
| Rate for Payer: BCN Commercial |
$919.20
|
| Rate for Payer: BCN Medicare Advantage |
$687.05
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cofinity Commercial |
$920.65
|
| Rate for Payer: Cofinity Commercial |
$989.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.40
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: Nomi Health Commercial |
$824.46
|
| Rate for Payer: PACE SWMI |
$687.05
|
| Rate for Payer: PHP Commercial |
$961.87
|
| Rate for Payer: PHP Medicare Advantage |
$687.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,711.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.33
|
| Rate for Payer: Priority Health Medicare |
$687.05
|
| Rate for Payer: Priority Health Narrow Network |
$966.33
|
| Rate for Payer: Priority Health SBD |
$966.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.05
|
| Rate for Payer: UHC Medicare Advantage |
$687.05
|
| Rate for Payer: UHCCP Medicaid |
$467.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,211.18
|
|
|
PR TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR
|
Professional
|
Both
|
$1,583.00
|
|
|
Service Code
|
HCPCS 25312
|
| Min. Negotiated Rate |
$226.11 |
| Max. Negotiated Rate |
$1,111.35 |
| Rate for Payer: Aetna Commercial |
$931.21
|
| Rate for Payer: Aetna Medicare |
$722.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.21
|
| Rate for Payer: BCBS Complete |
$493.82
|
| Rate for Payer: BCBS MAPPO |
$694.93
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$1,058.97
|
| Rate for Payer: BCN Medicare Advantage |
$694.93
|
| Rate for Payer: Cash Price |
$1,266.40
|
| Rate for Payer: Cash Price |
$1,266.40
|
| Rate for Payer: Cofinity Commercial |
$931.21
|
| Rate for Payer: Cofinity Commercial |
$1,000.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.68
|
| Rate for Payer: Meridian Medicaid |
$493.82
|
| Rate for Payer: Nomi Health Commercial |
$833.92
|
| Rate for Payer: PACE SWMI |
$694.93
|
| Rate for Payer: PHP Commercial |
$972.90
|
| Rate for Payer: PHP Medicare Advantage |
$694.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.35
|
| Rate for Payer: Priority Health Medicare |
$694.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.35
|
| Rate for Payer: Priority Health SBD |
$1,111.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.93
|
| Rate for Payer: UHC Medicare Advantage |
$694.93
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
| Rate for Payer: UMR Bronson Commercial |
$728.18
|
|
|
PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 90714
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$52.37 |
| Rate for Payer: Aetna Commercial |
$48.73
|
| Rate for Payer: Aetna Medicare |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.37
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$36.36
|
| Rate for Payer: BCBS Trust/PPO |
$35.19
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$36.36
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$48.73
|
| Rate for Payer: Cofinity Commercial |
$52.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.18
|
| Rate for Payer: Nomi Health Commercial |
$43.64
|
| Rate for Payer: PACE SWMI |
$36.36
|
| Rate for Payer: PHP Commercial |
$50.91
|
| Rate for Payer: PHP Medicare Advantage |
$36.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$36.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.36
|
| Rate for Payer: UHC Medicare Advantage |
$36.36
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
PR TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 35306
|
| Min. Negotiated Rate |
$277.11 |
| Max. Negotiated Rate |
$991.62 |
| Rate for Payer: Aetna Commercial |
$575.30
|
| Rate for Payer: Aetna Medicare |
$446.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.24
|
| Rate for Payer: BCBS Complete |
$290.97
|
| Rate for Payer: BCBS MAPPO |
$429.33
|
| Rate for Payer: BCBS Trust/PPO |
$991.62
|
| Rate for Payer: BCN Commercial |
$633.82
|
| Rate for Payer: BCN Medicare Advantage |
$429.33
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$575.30
|
| Rate for Payer: Cofinity Commercial |
$618.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$429.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.80
|
| Rate for Payer: Meridian Medicaid |
$290.97
|
| Rate for Payer: Nomi Health Commercial |
$515.20
|
| Rate for Payer: PACE SWMI |
$429.33
|
| Rate for Payer: PHP Commercial |
$601.06
|
| Rate for Payer: PHP Medicare Advantage |
$429.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.78
|
| Rate for Payer: Priority Health Medicare |
$429.33
|
| Rate for Payer: Priority Health Narrow Network |
$689.78
|
| Rate for Payer: Priority Health SBD |
$689.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$429.33
|
| Rate for Payer: UHC Medicare Advantage |
$429.33
|
| Rate for Payer: UHCCP Medicaid |
$277.11
|
| Rate for Payer: UMR Bronson Commercial |
$433.32
|
|
|
PR TEAEC W/GRAFT POPLITEAL ARTERY
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 35303
|
| Min. Negotiated Rate |
$765.52 |
| Max. Negotiated Rate |
$1,908.19 |
| Rate for Payer: Aetna Commercial |
$1,575.83
|
| Rate for Payer: Aetna Medicare |
$1,223.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,575.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,693.43
|
| Rate for Payer: BCBS Complete |
$803.80
|
| Rate for Payer: BCBS MAPPO |
$1,175.99
|
| Rate for Payer: BCBS Trust/PPO |
$903.39
|
| Rate for Payer: BCN Commercial |
$1,765.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,175.99
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cofinity Commercial |
$1,575.83
|
| Rate for Payer: Cofinity Commercial |
$1,693.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,175.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,234.79
|
| Rate for Payer: Meridian Medicaid |
$803.80
|
| Rate for Payer: Nomi Health Commercial |
$1,411.19
|
| Rate for Payer: PACE SWMI |
$1,175.99
|
| Rate for Payer: PHP Commercial |
$1,646.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,175.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,551.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,908.19
|
| Rate for Payer: Priority Health Medicare |
$1,175.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,908.19
|
| Rate for Payer: Priority Health SBD |
$1,908.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,175.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,175.99
|
| Rate for Payer: UHCCP Medicaid |
$765.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.02
|
|
|
PR TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY
|
Professional
|
Both
|
$2,192.00
|
|
|
Service Code
|
HCPCS 35302
|
| Min. Negotiated Rate |
$655.62 |
| Max. Negotiated Rate |
$1,740.66 |
| Rate for Payer: Aetna Commercial |
$1,433.36
|
| Rate for Payer: Aetna Medicare |
$1,112.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.32
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,069.67
|
| Rate for Payer: BCBS Trust/PPO |
$655.62
|
| Rate for Payer: BCN Commercial |
$1,596.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.67
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cofinity Commercial |
$1,433.36
|
| Rate for Payer: Cofinity Commercial |
$1,540.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.15
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Nomi Health Commercial |
$1,283.60
|
| Rate for Payer: PACE SWMI |
$1,069.67
|
| Rate for Payer: PHP Commercial |
$1,497.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,424.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,740.66
|
| Rate for Payer: Priority Health Medicare |
$1,069.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,740.66
|
| Rate for Payer: Priority Health SBD |
$1,740.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.67
|
| Rate for Payer: UHCCP Medicaid |
$696.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,008.32
|
|
|
PR TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL
|
Professional
|
Both
|
$2,411.00
|
|
|
Service Code
|
HCPCS 35305
|
| Min. Negotiated Rate |
$501.36 |
| Max. Negotiated Rate |
$1,910.85 |
| Rate for Payer: Aetna Commercial |
$1,572.22
|
| Rate for Payer: Aetna Medicare |
$1,220.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,572.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,689.55
|
| Rate for Payer: BCBS Complete |
$801.56
|
| Rate for Payer: BCBS MAPPO |
$1,173.30
|
| Rate for Payer: BCBS Trust/PPO |
$501.36
|
| Rate for Payer: BCN Commercial |
$1,744.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,173.30
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cofinity Commercial |
$1,572.22
|
| Rate for Payer: Cofinity Commercial |
$1,689.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,173.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.96
|
| Rate for Payer: Meridian Medicaid |
$801.56
|
| Rate for Payer: Nomi Health Commercial |
$1,407.96
|
| Rate for Payer: PACE SWMI |
$1,173.30
|
| Rate for Payer: PHP Commercial |
$1,642.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,173.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,567.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,910.85
|
| Rate for Payer: Priority Health Medicare |
$1,173.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,910.85
|
| Rate for Payer: Priority Health SBD |
$1,910.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,173.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,173.30
|
| Rate for Payer: UHCCP Medicaid |
$763.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.06
|
|
|
PR TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 35304
|
| Min. Negotiated Rate |
$795.56 |
| Max. Negotiated Rate |
$1,986.37 |
| Rate for Payer: Aetna Commercial |
$1,638.54
|
| Rate for Payer: Aetna Medicare |
$1,271.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,638.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,760.82
|
| Rate for Payer: BCBS Complete |
$835.34
|
| Rate for Payer: BCBS MAPPO |
$1,222.79
|
| Rate for Payer: BCBS Trust/PPO |
$836.83
|
| Rate for Payer: BCN Commercial |
$1,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.79
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,638.54
|
| Rate for Payer: Cofinity Commercial |
$1,760.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.93
|
| Rate for Payer: Meridian Medicaid |
$835.34
|
| Rate for Payer: Nomi Health Commercial |
$1,467.35
|
| Rate for Payer: PACE SWMI |
$1,222.79
|
| Rate for Payer: PHP Commercial |
$1,711.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,986.37
|
| Rate for Payer: Priority Health Medicare |
$1,222.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,986.37
|
| Rate for Payer: Priority Health SBD |
$1,986.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.79
|
| Rate for Payer: UHCCP Medicaid |
$795.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.14
|
|
|
PR TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC
|
Professional
|
Both
|
$3,698.00
|
|
|
Service Code
|
HCPCS 35301
|
| Min. Negotiated Rate |
$276.83 |
| Max. Negotiated Rate |
$2,403.70 |
| Rate for Payer: Aetna Commercial |
$1,449.61
|
| Rate for Payer: Aetna Medicare |
$1,125.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.79
|
| Rate for Payer: BCBS Complete |
$740.73
|
| Rate for Payer: BCBS MAPPO |
$1,081.80
|
| Rate for Payer: BCBS Trust/PPO |
$276.83
|
| Rate for Payer: BCN Commercial |
$1,613.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,081.80
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,449.61
|
| Rate for Payer: Cofinity Commercial |
$1,557.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,081.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,135.89
|
| Rate for Payer: Meridian Medicaid |
$740.73
|
| Rate for Payer: Nomi Health Commercial |
$1,298.16
|
| Rate for Payer: PACE SWMI |
$1,081.80
|
| Rate for Payer: PHP Commercial |
$1,514.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,081.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,403.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.35
|
| Rate for Payer: Priority Health Medicare |
$1,081.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.35
|
| Rate for Payer: Priority Health SBD |
$1,760.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,081.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.80
|
| Rate for Payer: UHCCP Medicaid |
$705.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,701.08
|
|
|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,734.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$3,077.10 |
| Rate for Payer: Aetna Commercial |
$1,859.91
|
| Rate for Payer: Aetna Medicare |
$1,443.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.71
|
| Rate for Payer: BCBS Complete |
$949.40
|
| Rate for Payer: BCBS MAPPO |
$1,387.99
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,084.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.99
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cofinity Commercial |
$1,859.91
|
| Rate for Payer: Cofinity Commercial |
$1,998.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,457.39
|
| Rate for Payer: Meridian Medicaid |
$949.40
|
| Rate for Payer: Nomi Health Commercial |
$1,665.59
|
| Rate for Payer: PACE SWMI |
$1,387.99
|
| Rate for Payer: PHP Commercial |
$1,943.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$904.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,077.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,265.58
|
| Rate for Payer: Priority Health Medicare |
$1,387.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,265.58
|
| Rate for Payer: Priority Health SBD |
$2,265.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,387.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,387.99
|
| Rate for Payer: UHCCP Medicaid |
$904.19
|
| Rate for Payer: UMR Bronson Commercial |
$2,177.64
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,341.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$1,015.37 |
| Max. Negotiated Rate |
$2,528.30 |
| Rate for Payer: Aetna Commercial |
$2,097.86
|
| Rate for Payer: Aetna Medicare |
$1,628.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,097.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,254.42
|
| Rate for Payer: BCBS Complete |
$1,066.14
|
| Rate for Payer: BCBS MAPPO |
$1,565.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.79
|
| Rate for Payer: BCN Commercial |
$2,312.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.57
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cofinity Commercial |
$2,097.86
|
| Rate for Payer: Cofinity Commercial |
$2,254.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,643.85
|
| Rate for Payer: Meridian Medicaid |
$1,066.14
|
| Rate for Payer: Nomi Health Commercial |
$1,878.68
|
| Rate for Payer: PACE SWMI |
$1,565.57
|
| Rate for Payer: PHP Commercial |
$2,191.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,015.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,528.30
|
| Rate for Payer: Priority Health Medicare |
$1,565.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,528.30
|
| Rate for Payer: Priority Health SBD |
$2,528.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.57
|
| Rate for Payer: UHCCP Medicaid |
$1,015.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,536.86
|
|
