|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$1,367.20 |
| Max. Negotiated Rate |
$2,284.46 |
| Rate for Payer: Aetna Commercial |
$2,125.82
|
| Rate for Payer: Aetna Medicare |
$1,649.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,284.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,125.82
|
| Rate for Payer: BCBS Complete |
$1,367.20
|
| Rate for Payer: BCBS MAPPO |
$1,586.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.43
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$2,284.46
|
| Rate for Payer: Cofinity Commercial |
$2,125.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,665.75
|
| Rate for Payer: Nomi Health Commercial |
$1,903.72
|
| Rate for Payer: PACE SWMI |
$1,586.43
|
| Rate for Payer: PHP Commercial |
$2,221.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health Medicare |
$1,586.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,586.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,586.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,572.28
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,045.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$1,682.29 |
| Max. Negotiated Rate |
$4,579.25 |
| Rate for Payer: Aetna Commercial |
$2,254.27
|
| Rate for Payer: Aetna Medicare |
$1,749.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,422.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,254.27
|
| Rate for Payer: BCBS Complete |
$2,818.00
|
| Rate for Payer: BCBS MAPPO |
$1,682.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,682.29
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cofinity Commercial |
$2,422.50
|
| Rate for Payer: Cofinity Commercial |
$2,254.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,682.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,766.40
|
| Rate for Payer: Nomi Health Commercial |
$2,018.75
|
| Rate for Payer: PACE SWMI |
$1,682.29
|
| Rate for Payer: PHP Commercial |
$2,355.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,682.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,579.25
|
| Rate for Payer: Priority Health Medicare |
$1,682.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,682.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,682.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,240.70
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$2,354.00 |
| Max. Negotiated Rate |
$4,734.72 |
| Rate for Payer: Aetna Commercial |
$4,405.92
|
| Rate for Payer: Aetna Medicare |
$3,419.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,734.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,405.92
|
| Rate for Payer: BCBS Complete |
$2,354.00
|
| Rate for Payer: BCBS MAPPO |
$3,288.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,288.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$4,734.72
|
| Rate for Payer: Cofinity Commercial |
$4,405.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,288.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,452.40
|
| Rate for Payer: Nomi Health Commercial |
$3,945.60
|
| Rate for Payer: PACE SWMI |
$3,288.00
|
| Rate for Payer: PHP Commercial |
$4,603.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,288.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.25
|
| Rate for Payer: Priority Health Medicare |
$3,288.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,288.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,288.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,707.10
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.37
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Commercial |
$953.22
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.70
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.37
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Commercial |
$953.22
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.70
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$941.65 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna American Axle |
$1,654.25
|
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$1,781.50
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.75
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$1,603.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$10,874.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: UMR Bronson Commercial |
$941.65
|
| Rate for Payer: VA VA |
$5,690.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,119.80 |
| Max. Negotiated Rate |
$2,290.50 |
| Rate for Payer: Aetna American Axle |
$1,654.25
|
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.25
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$1,781.50
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health SBD |
$1,603.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$574.80 |
| Max. Negotiated Rate |
$1,302.48 |
| Rate for Payer: Aetna Commercial |
$1,212.03
|
| Rate for Payer: Aetna Medicare |
$940.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.03
|
| Rate for Payer: BCBS Complete |
$574.80
|
| Rate for Payer: BCBS MAPPO |
$904.50
|
| Rate for Payer: BCN Medicare Advantage |
$904.50
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.48
|
| Rate for Payer: Cofinity Commercial |
$1,212.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.73
|
| Rate for Payer: Nomi Health Commercial |
$1,085.40
|
| Rate for Payer: PACE SWMI |
$904.50
|
| Rate for Payer: PHP Commercial |
$1,266.30
|
| Rate for Payer: PHP Medicare Advantage |
$904.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health Medicare |
$904.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.50
|
| Rate for Payer: UHC Medicare Advantage |
$904.50
|
| Rate for Payer: UMR Bronson Commercial |
$661.02
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$2,229.60 |
| Max. Negotiated Rate |
$4,117.75 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,973.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,117.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,831.80
|
| Rate for Payer: BCBS Complete |
$2,229.60
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Commercial |
$4,003.37
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health Medicare |
$2,859.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,564.04
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$3,186.00 |
| Max. Negotiated Rate |
$5,269.26 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,805.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,269.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,903.34
|
| Rate for Payer: BCBS Complete |
$3,186.00
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Commercial |
$5,122.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health Medicare |
$3,659.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
| Rate for Payer: UMR Bronson Commercial |
$3,663.90
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$190.04 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.65
|
| Rate for Payer: BCBS Complete |
$492.80
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Commercial |
$266.06
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health Medicare |
$190.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
| Rate for Payer: UMR Bronson Commercial |
$566.72
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$115.05 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.47
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Commercial |
$65.27
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health Medicare |
$46.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
| Rate for Payer: UMR Bronson Commercial |
$81.42
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$513.23 |
| Rate for Payer: Aetna Commercial |
$477.59
|
| Rate for Payer: Aetna Medicare |
$370.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.59
|
| Rate for Payer: BCBS Complete |
$232.40
|
| Rate for Payer: BCBS MAPPO |
$356.41
|
| Rate for Payer: BCN Medicare Advantage |
$356.41
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$513.23
|
| Rate for Payer: Cofinity Commercial |
$477.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.23
|
| Rate for Payer: Nomi Health Commercial |
$427.69
|
| Rate for Payer: PACE SWMI |
$356.41
|
| Rate for Payer: PHP Commercial |
$498.97
|
| Rate for Payer: PHP Medicare Advantage |
$356.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health Medicare |
$356.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.41
|
| Rate for Payer: UHC Medicare Advantage |
$356.41
|
| Rate for Payer: UMR Bronson Commercial |
$267.26
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$317.88 |
| Max. Negotiated Rate |
$618.80 |
| Rate for Payer: Aetna Commercial |
$425.96
|
| Rate for Payer: Aetna Medicare |
$330.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.96
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$317.88
|
| Rate for Payer: BCN Medicare Advantage |
$317.88
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$457.75
|
| Rate for Payer: Cofinity Commercial |
$425.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.77
|
| Rate for Payer: Nomi Health Commercial |
$381.46
|
| Rate for Payer: PACE SWMI |
$317.88
|
| Rate for Payer: PHP Commercial |
$445.03
|
| Rate for Payer: PHP Medicare Advantage |
$317.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$317.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.88
|
| Rate for Payer: UHC Medicare Advantage |
$317.88
|
| Rate for Payer: UMR Bronson Commercial |
$437.92
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$147.35
|
| Rate for Payer: Aetna Medicare |
$114.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.35
|
| Rate for Payer: BCBS Complete |
$184.80
|
| Rate for Payer: BCBS MAPPO |
$109.96
|
| Rate for Payer: BCN Medicare Advantage |
$109.96
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$147.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.46
|
| Rate for Payer: Nomi Health Commercial |
$131.95
|
| Rate for Payer: PACE SWMI |
$109.96
|
| Rate for Payer: PHP Commercial |
$153.94
|
| Rate for Payer: PHP Medicare Advantage |
$109.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health Medicare |
$109.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.96
|
| Rate for Payer: UHC Medicare Advantage |
$109.96
|
| Rate for Payer: UMR Bronson Commercial |
$212.52
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$1,257.95 |
| Max. Negotiated Rate |
$2,863.25 |
| Rate for Payer: Aetna Commercial |
$1,685.65
|
| Rate for Payer: Aetna Medicare |
$1,308.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,811.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,685.65
|
| Rate for Payer: BCBS Complete |
$1,762.00
|
| Rate for Payer: BCBS MAPPO |
$1,257.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.95
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cofinity Commercial |
$1,811.45
|
| Rate for Payer: Cofinity Commercial |
$1,685.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.85
|
| Rate for Payer: Nomi Health Commercial |
$1,509.54
|
| Rate for Payer: PACE SWMI |
$1,257.95
|
| Rate for Payer: PHP Commercial |
$1,761.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health Medicare |
$1,257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,026.30
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$542.00 |
| Max. Negotiated Rate |
$959.83 |
| Rate for Payer: Aetna Commercial |
$893.18
|
| Rate for Payer: Aetna Medicare |
$693.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.18
|
| Rate for Payer: BCBS Complete |
$542.00
|
| Rate for Payer: BCBS MAPPO |
$666.55
|
| Rate for Payer: BCN Medicare Advantage |
$666.55
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$959.83
|
| Rate for Payer: Cofinity Commercial |
$893.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.88
|
| Rate for Payer: Nomi Health Commercial |
$799.86
|
| Rate for Payer: PACE SWMI |
$666.55
|
| Rate for Payer: PHP Commercial |
$933.17
|
| Rate for Payer: PHP Medicare Advantage |
$666.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health Medicare |
$666.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$666.55
|
| Rate for Payer: UHC Medicare Advantage |
$666.55
|
| Rate for Payer: UMR Bronson Commercial |
$623.30
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$592.80 |
| Rate for Payer: Aetna Commercial |
$528.39
|
| Rate for Payer: Aetna Medicare |
$410.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.39
|
| Rate for Payer: BCBS Complete |
$364.80
|
| Rate for Payer: BCBS MAPPO |
$394.32
|
| Rate for Payer: BCN Medicare Advantage |
$394.32
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$567.82
|
| Rate for Payer: Cofinity Commercial |
$528.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.04
|
| Rate for Payer: Nomi Health Commercial |
$473.18
|
| Rate for Payer: PACE SWMI |
$394.32
|
| Rate for Payer: PHP Commercial |
$552.05
|
| Rate for Payer: PHP Medicare Advantage |
$394.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health Medicare |
$394.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.32
|
| Rate for Payer: UHC Medicare Advantage |
$394.32
|
| Rate for Payer: UMR Bronson Commercial |
$419.52
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.04
|
| Rate for Payer: BCBS Complete |
$323.60
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Commercial |
$448.25
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UMR Bronson Commercial |
$372.14
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$772.85 |
| Rate for Payer: Aetna Commercial |
$410.59
|
| Rate for Payer: Aetna Medicare |
$318.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.59
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| Rate for Payer: BCN Medicare Advantage |
$306.41
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$441.23
|
| Rate for Payer: Cofinity Commercial |
$410.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| Rate for Payer: Nomi Health Commercial |
$367.69
|
| Rate for Payer: PACE SWMI |
$306.41
|
| Rate for Payer: PHP Commercial |
$428.97
|
| Rate for Payer: PHP Medicare Advantage |
$306.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health Medicare |
$306.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.41
|
| Rate for Payer: UHC Medicare Advantage |
$306.41
|
| Rate for Payer: UMR Bronson Commercial |
$546.94
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$619.60 |
| Max. Negotiated Rate |
$1,289.68 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$931.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,289.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.12
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$895.61
|
| Rate for Payer: BCN Medicare Advantage |
$895.61
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,289.68
|
| Rate for Payer: Cofinity Commercial |
$1,200.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.39
|
| Rate for Payer: Nomi Health Commercial |
$1,074.73
|
| Rate for Payer: PACE SWMI |
$895.61
|
| Rate for Payer: PHP Commercial |
$1,253.85
|
| Rate for Payer: PHP Medicare Advantage |
$895.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$895.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.61
|
| Rate for Payer: UHC Medicare Advantage |
$895.61
|
| Rate for Payer: UMR Bronson Commercial |
$712.54
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$292.39 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$391.80
|
| Rate for Payer: Aetna Medicare |
$304.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.80
|
| Rate for Payer: BCBS Complete |
$420.00
|
| Rate for Payer: BCBS MAPPO |
$292.39
|
| Rate for Payer: BCN Medicare Advantage |
$292.39
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$421.04
|
| Rate for Payer: Cofinity Commercial |
$391.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.01
|
| Rate for Payer: Nomi Health Commercial |
$350.87
|
| Rate for Payer: PACE SWMI |
$292.39
|
| Rate for Payer: PHP Commercial |
$409.35
|
| Rate for Payer: PHP Medicare Advantage |
$292.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health Medicare |
$292.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.39
|
| Rate for Payer: UHC Medicare Advantage |
$292.39
|
| Rate for Payer: UMR Bronson Commercial |
$483.00
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$674.70 |
| Rate for Payer: Aetna Commercial |
$574.74
|
| Rate for Payer: Aetna Medicare |
$446.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.74
|
| Rate for Payer: BCBS Complete |
$415.20
|
| Rate for Payer: BCBS MAPPO |
$428.91
|
| Rate for Payer: BCN Medicare Advantage |
$428.91
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$617.63
|
| Rate for Payer: Cofinity Commercial |
$574.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.36
|
| Rate for Payer: Nomi Health Commercial |
$514.69
|
| Rate for Payer: PACE SWMI |
$428.91
|
| Rate for Payer: PHP Commercial |
$600.47
|
| Rate for Payer: PHP Medicare Advantage |
$428.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health Medicare |
$428.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.91
|
| Rate for Payer: UHC Medicare Advantage |
$428.91
|
| Rate for Payer: UMR Bronson Commercial |
$477.48
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Commercial |
$44.09
|
| Rate for Payer: Aetna Medicare |
$34.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.09
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Cofinity Commercial |
$44.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.55
|
| Rate for Payer: Nomi Health Commercial |
$39.48
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$46.06
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$32.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UMR Bronson Commercial |
$33.58
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$554.00 |
| Max. Negotiated Rate |
$900.76 |
| Rate for Payer: Aetna Commercial |
$838.21
|
| Rate for Payer: Aetna Medicare |
$650.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.21
|
| Rate for Payer: BCBS Complete |
$554.00
|
| Rate for Payer: BCBS MAPPO |
$625.53
|
| Rate for Payer: BCN Medicare Advantage |
$625.53
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$900.76
|
| Rate for Payer: Cofinity Commercial |
$838.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.81
|
| Rate for Payer: Nomi Health Commercial |
$750.64
|
| Rate for Payer: PACE SWMI |
$625.53
|
| Rate for Payer: PHP Commercial |
$875.74
|
| Rate for Payer: PHP Medicare Advantage |
$625.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health Medicare |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.53
|
| Rate for Payer: UHC Medicare Advantage |
$625.53
|
| Rate for Payer: UMR Bronson Commercial |
$637.10
|
|
