|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$1,500.62 |
| Max. Negotiated Rate |
$3,682.25 |
| Rate for Payer: Aetna Commercial |
$2,010.83
|
| Rate for Payer: Aetna Medicare |
$1,560.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,160.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,010.83
|
| Rate for Payer: BCBS Complete |
$2,266.00
|
| Rate for Payer: BCBS MAPPO |
$1,500.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,500.62
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cofinity Commercial |
$2,160.89
|
| Rate for Payer: Cofinity Commercial |
$2,010.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,500.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,575.65
|
| Rate for Payer: Nomi Health Commercial |
$1,800.74
|
| Rate for Payer: PACE SWMI |
$1,500.62
|
| Rate for Payer: PHP Commercial |
$2,100.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,500.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health Medicare |
$1,500.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,500.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,500.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,605.90
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,630.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$652.00 |
| Max. Negotiated Rate |
$1,059.50 |
| Rate for Payer: Aetna Medicare |
$815.00
|
| Rate for Payer: BCBS Complete |
$652.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.50
|
| Rate for Payer: UMR Bronson Commercial |
$749.80
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$77.35 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: UMR Bronson Commercial |
$54.74
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$742.40 |
| Max. Negotiated Rate |
$1,206.40 |
| Rate for Payer: Aetna Medicare |
$928.00
|
| Rate for Payer: BCBS Complete |
$742.40
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.40
|
| Rate for Payer: UMR Bronson Commercial |
$853.76
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,065.35 |
| Rate for Payer: Aetna Medicare |
$819.50
|
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.35
|
| Rate for Payer: UMR Bronson Commercial |
$753.94
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$371.20 |
| Max. Negotiated Rate |
$603.20 |
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$371.20
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
| Rate for Payer: UMR Bronson Commercial |
$426.88
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,719.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Aetna Medicare |
$859.50
|
| Rate for Payer: BCBS Complete |
$687.60
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.35
|
| Rate for Payer: UMR Bronson Commercial |
$790.74
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,519.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,807.60 |
| Max. Negotiated Rate |
$3,328.83 |
| Rate for Payer: Aetna Commercial |
$3,097.66
|
| Rate for Payer: Aetna Medicare |
$2,404.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,097.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,328.83
|
| Rate for Payer: BCBS Complete |
$1,807.60
|
| Rate for Payer: BCBS MAPPO |
$2,311.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,311.69
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cofinity Commercial |
$3,097.66
|
| Rate for Payer: Cofinity Commercial |
$3,328.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,311.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,427.27
|
| Rate for Payer: Nomi Health Commercial |
$2,774.03
|
| Rate for Payer: PACE SWMI |
$2,311.69
|
| Rate for Payer: PHP Commercial |
$3,236.37
|
| Rate for Payer: PHP Medicare Advantage |
$2,311.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,937.35
|
| Rate for Payer: Priority Health Medicare |
$2,311.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,311.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,311.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,078.74
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna Commercial |
$351.75
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.75
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$262.50
|
| Rate for Payer: BCN Medicare Advantage |
$262.50
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$378.00
|
| Rate for Payer: Cofinity Commercial |
$351.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.62
|
| Rate for Payer: Nomi Health Commercial |
$315.00
|
| Rate for Payer: PACE SWMI |
$262.50
|
| Rate for Payer: PHP Commercial |
$367.50
|
| Rate for Payer: PHP Medicare Advantage |
$262.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health Medicare |
$262.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.50
|
| Rate for Payer: UHC Medicare Advantage |
$262.50
|
| Rate for Payer: UMR Bronson Commercial |
$56.58
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$229.50 |
| Max. Negotiated Rate |
$410.80 |
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Medicare |
$238.68
|
| Rate for Payer: Aetna Medicare |
$238.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.53
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS Complete |
$252.80
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PHP Commercial |
$321.30
|
| Rate for Payer: PHP Commercial |
$321.30
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health Medicare |
$229.50
|
| Rate for Payer: Priority Health Medicare |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
| Rate for Payer: UMR Bronson Commercial |
$290.72
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$144.94 |
| Max. Negotiated Rate |
$239.20 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$150.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.22
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: BCBS MAPPO |
$144.94
|
| Rate for Payer: BCN Medicare Advantage |
$144.94
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$208.71
|
| Rate for Payer: Cofinity Commercial |
$194.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.19
|
| Rate for Payer: Nomi Health Commercial |
$173.93
|
| Rate for Payer: PACE SWMI |
$144.94
|
| Rate for Payer: PHP Commercial |
$202.92
|
| Rate for Payer: PHP Medicare Advantage |
$144.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.20
|
| Rate for Payer: Priority Health Medicare |
$144.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.94
|
| Rate for Payer: UHC Medicare Advantage |
$144.94
|
| Rate for Payer: UMR Bronson Commercial |
$169.28
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$346.80 |
| Max. Negotiated Rate |
$717.21 |
| Rate for Payer: Aetna Commercial |
$667.40
|
| Rate for Payer: Aetna Medicare |
$517.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.40
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$498.06
|
| Rate for Payer: BCN Medicare Advantage |
$498.06
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$717.21
|
| Rate for Payer: Cofinity Commercial |
$667.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.96
|
| Rate for Payer: Nomi Health Commercial |
$597.67
|
| Rate for Payer: PACE SWMI |
$498.06
|
| Rate for Payer: PHP Commercial |
$697.28
|
| Rate for Payer: PHP Medicare Advantage |
$498.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health Medicare |
$498.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.06
|
| Rate for Payer: UHC Medicare Advantage |
$498.06
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$522.80 |
| Max. Negotiated Rate |
$849.55 |
| Rate for Payer: Aetna Commercial |
$718.49
|
| Rate for Payer: Aetna Medicare |
$557.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.49
|
| Rate for Payer: BCBS Complete |
$522.80
|
| Rate for Payer: BCBS MAPPO |
$536.19
|
| Rate for Payer: BCN Medicare Advantage |
$536.19
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cofinity Commercial |
$772.11
|
| Rate for Payer: Cofinity Commercial |
$718.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.00
|
| Rate for Payer: Nomi Health Commercial |
$643.43
|
| Rate for Payer: PACE SWMI |
$536.19
|
| Rate for Payer: PHP Commercial |
$750.67
|
| Rate for Payer: PHP Medicare Advantage |
$536.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$849.55
|
| Rate for Payer: Priority Health Medicare |
$536.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.19
|
| Rate for Payer: UHC Medicare Advantage |
$536.19
|
| Rate for Payer: UMR Bronson Commercial |
$601.22
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,061.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$424.40 |
| Max. Negotiated Rate |
$728.86 |
| Rate for Payer: Aetna Commercial |
$678.24
|
| Rate for Payer: Aetna Medicare |
$526.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.24
|
| Rate for Payer: BCBS Complete |
$424.40
|
| Rate for Payer: BCBS MAPPO |
$506.15
|
| Rate for Payer: BCN Medicare Advantage |
$506.15
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Cofinity Commercial |
$728.86
|
| Rate for Payer: Cofinity Commercial |
$678.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.46
|
| Rate for Payer: Nomi Health Commercial |
$607.38
|
| Rate for Payer: PACE SWMI |
$506.15
|
| Rate for Payer: PHP Commercial |
$708.61
|
| Rate for Payer: PHP Medicare Advantage |
$506.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.65
|
| Rate for Payer: Priority Health Medicare |
$506.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.15
|
| Rate for Payer: UHC Medicare Advantage |
$506.15
|
| Rate for Payer: UMR Bronson Commercial |
$488.06
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$673.33 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$902.26
|
| Rate for Payer: Aetna Medicare |
$700.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.26
|
| Rate for Payer: BCBS Complete |
$1,062.80
|
| Rate for Payer: BCBS MAPPO |
$673.33
|
| Rate for Payer: BCN Medicare Advantage |
$673.33
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$969.60
|
| Rate for Payer: Cofinity Commercial |
$902.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.00
|
| Rate for Payer: Nomi Health Commercial |
$808.00
|
| Rate for Payer: PACE SWMI |
$673.33
|
| Rate for Payer: PHP Commercial |
$942.66
|
| Rate for Payer: PHP Medicare Advantage |
$673.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health Medicare |
$673.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.33
|
| Rate for Payer: UHC Medicare Advantage |
$673.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,222.22
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$294.80 |
| Max. Negotiated Rate |
$553.18 |
| Rate for Payer: Aetna Commercial |
$514.76
|
| Rate for Payer: Aetna Medicare |
$399.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.76
|
| Rate for Payer: BCBS Complete |
$294.80
|
| Rate for Payer: BCBS MAPPO |
$384.15
|
| Rate for Payer: BCN Medicare Advantage |
$384.15
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$553.18
|
| Rate for Payer: Cofinity Commercial |
$514.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.36
|
| Rate for Payer: Nomi Health Commercial |
$460.98
|
| Rate for Payer: PACE SWMI |
$384.15
|
| Rate for Payer: PHP Commercial |
$537.81
|
| Rate for Payer: PHP Medicare Advantage |
$384.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.05
|
| Rate for Payer: Priority Health Medicare |
$384.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.15
|
| Rate for Payer: UHC Medicare Advantage |
$384.15
|
| Rate for Payer: UMR Bronson Commercial |
$339.02
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$6,949.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$936.20 |
| Max. Negotiated Rate |
$4,516.85 |
| Rate for Payer: Aetna Commercial |
$1,254.51
|
| Rate for Payer: Aetna Medicare |
$973.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.51
|
| Rate for Payer: BCBS Complete |
$2,779.60
|
| Rate for Payer: BCBS MAPPO |
$936.20
|
| Rate for Payer: BCN Medicare Advantage |
$936.20
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Cofinity Commercial |
$1,348.13
|
| Rate for Payer: Cofinity Commercial |
$1,254.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.01
|
| Rate for Payer: Nomi Health Commercial |
$1,123.44
|
| Rate for Payer: PACE SWMI |
$936.20
|
| Rate for Payer: PHP Commercial |
$1,310.68
|
| Rate for Payer: PHP Medicare Advantage |
$936.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,516.85
|
| Rate for Payer: Priority Health Medicare |
$936.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.20
|
| Rate for Payer: UHC Medicare Advantage |
$936.20
|
| Rate for Payer: UMR Bronson Commercial |
$3,196.54
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,666.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$780.70 |
| Max. Negotiated Rate |
$1,732.90 |
| Rate for Payer: Aetna Commercial |
$1,046.14
|
| Rate for Payer: Aetna Medicare |
$811.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.14
|
| Rate for Payer: BCBS Complete |
$1,066.40
|
| Rate for Payer: BCBS MAPPO |
$780.70
|
| Rate for Payer: BCN Medicare Advantage |
$780.70
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,124.21
|
| Rate for Payer: Cofinity Commercial |
$1,046.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.74
|
| Rate for Payer: Nomi Health Commercial |
$936.84
|
| Rate for Payer: PACE SWMI |
$780.70
|
| Rate for Payer: PHP Commercial |
$1,092.98
|
| Rate for Payer: PHP Medicare Advantage |
$780.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.90
|
| Rate for Payer: Priority Health Medicare |
$780.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.70
|
| Rate for Payer: UHC Medicare Advantage |
$780.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,226.36
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$55.11 |
| Rate for Payer: Aetna Commercial |
$51.28
|
| Rate for Payer: Aetna Medicare |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.28
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$38.27
|
| Rate for Payer: BCN Medicare Advantage |
$38.27
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Cofinity Commercial |
$51.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.18
|
| Rate for Payer: Nomi Health Commercial |
$45.92
|
| Rate for Payer: PACE SWMI |
$38.27
|
| Rate for Payer: PHP Commercial |
$53.58
|
| Rate for Payer: PHP Medicare Advantage |
$38.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$38.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.27
|
| Rate for Payer: UHC Medicare Advantage |
$38.27
|
| Rate for Payer: UMR Bronson Commercial |
$38.64
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$329.80 |
| Max. Negotiated Rate |
$920.40 |
| Rate for Payer: Aetna Commercial |
$441.93
|
| Rate for Payer: Aetna Medicare |
$342.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.93
|
| Rate for Payer: BCBS Complete |
$566.40
|
| Rate for Payer: BCBS MAPPO |
$329.80
|
| Rate for Payer: BCN Medicare Advantage |
$329.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cofinity Commercial |
$474.91
|
| Rate for Payer: Cofinity Commercial |
$441.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.29
|
| Rate for Payer: Nomi Health Commercial |
$395.76
|
| Rate for Payer: PACE SWMI |
$329.80
|
| Rate for Payer: PHP Commercial |
$461.72
|
| Rate for Payer: PHP Medicare Advantage |
$329.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$920.40
|
| Rate for Payer: Priority Health Medicare |
$329.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.80
|
| Rate for Payer: UHC Medicare Advantage |
$329.80
|
| Rate for Payer: UMR Bronson Commercial |
$651.36
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$240.05
|
| Rate for Payer: Aetna Medicare |
$186.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.05
|
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: BCBS MAPPO |
$179.14
|
| Rate for Payer: BCN Medicare Advantage |
$179.14
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$257.96
|
| Rate for Payer: Cofinity Commercial |
$240.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.10
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: PACE SWMI |
$179.14
|
| Rate for Payer: PHP Commercial |
$250.80
|
| Rate for Payer: PHP Medicare Advantage |
$179.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.10
|
| Rate for Payer: Priority Health Medicare |
$179.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.14
|
| Rate for Payer: UHC Medicare Advantage |
$179.14
|
| Rate for Payer: UMR Bronson Commercial |
$162.84
|
|
|
PR TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 99495
|
| Min. Negotiated Rate |
$100.40 |
| Max. Negotiated Rate |
$189.69 |
| Rate for Payer: Aetna Commercial |
$176.52
|
| Rate for Payer: Aetna Medicare |
$137.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.52
|
| Rate for Payer: BCBS Complete |
$100.40
|
| Rate for Payer: BCBS MAPPO |
$131.73
|
| Rate for Payer: BCN Medicare Advantage |
$131.73
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$189.69
|
| Rate for Payer: Cofinity Commercial |
$176.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.32
|
| Rate for Payer: Nomi Health Commercial |
$158.08
|
| Rate for Payer: PACE SWMI |
$131.73
|
| Rate for Payer: PHP Commercial |
$184.42
|
| Rate for Payer: PHP Medicare Advantage |
$131.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health Medicare |
$131.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.73
|
| Rate for Payer: UHC Medicare Advantage |
$131.73
|
| Rate for Payer: UMR Bronson Commercial |
$115.46
|
|
|
PR TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 75962
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: UMR Bronson Commercial |
$53.36
|
|
|
PR TRANSMASTOID ANTROTOMY
|
Professional
|
Both
|
$1,780.00
|
|
|
Service Code
|
HCPCS 69501
|
| Min. Negotiated Rate |
$667.00 |
| Max. Negotiated Rate |
$1,157.00 |
| Rate for Payer: Aetna Commercial |
$893.78
|
| Rate for Payer: Aetna Medicare |
$693.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.48
|
| Rate for Payer: BCBS Complete |
$712.00
|
| Rate for Payer: BCBS MAPPO |
$667.00
|
| Rate for Payer: BCN Medicare Advantage |
$667.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cofinity Commercial |
$893.78
|
| Rate for Payer: Cofinity Commercial |
$960.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.35
|
| Rate for Payer: Nomi Health Commercial |
$800.40
|
| Rate for Payer: PACE SWMI |
$667.00
|
| Rate for Payer: PHP Commercial |
$933.80
|
| Rate for Payer: PHP Medicare Advantage |
$667.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.00
|
| Rate for Payer: Priority Health Medicare |
$667.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.00
|
| Rate for Payer: UHC Medicare Advantage |
$667.00
|
| Rate for Payer: UMR Bronson Commercial |
$818.80
|
|
|
PR TRANSMETACARPAL AMPUTATION RE-AMPUTATION
|
Professional
|
Both
|
$2,264.00
|
|
|
Service Code
|
HCPCS 25931
|
| Min. Negotiated Rate |
$748.69 |
| Max. Negotiated Rate |
$1,471.60 |
| Rate for Payer: Aetna Commercial |
$1,003.24
|
| Rate for Payer: Aetna Medicare |
$778.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.24
|
| Rate for Payer: BCBS Complete |
$905.60
|
| Rate for Payer: BCBS MAPPO |
$748.69
|
| Rate for Payer: BCN Medicare Advantage |
$748.69
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Cofinity Commercial |
$1,078.11
|
| Rate for Payer: Cofinity Commercial |
$1,003.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.12
|
| Rate for Payer: Nomi Health Commercial |
$898.43
|
| Rate for Payer: PACE SWMI |
$748.69
|
| Rate for Payer: PHP Commercial |
$1,048.17
|
| Rate for Payer: PHP Medicare Advantage |
$748.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.60
|
| Rate for Payer: Priority Health Medicare |
$748.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.69
|
| Rate for Payer: UHC Medicare Advantage |
$748.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.44
|
|
