|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$24.05 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$10.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.41
|
| Rate for Payer: Nomi Health Commercial |
$8.47
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Commercial |
$9.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37246
|
| Min. Negotiated Rate |
$332.08 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$444.99
|
| Rate for Payer: Aetna Medicare |
$345.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.99
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$332.08
|
| Rate for Payer: BCN Medicare Advantage |
$332.08
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$478.20
|
| Rate for Payer: Cofinity Commercial |
$444.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.68
|
| Rate for Payer: Nomi Health Commercial |
$398.50
|
| Rate for Payer: PACE SWMI |
$332.08
|
| Rate for Payer: PHP Commercial |
$464.91
|
| Rate for Payer: PHP Medicare Advantage |
$332.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$332.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.08
|
| Rate for Payer: UHC Medicare Advantage |
$332.08
|
| Rate for Payer: UMR Bronson Commercial |
$505.08
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$165.41 |
| Max. Negotiated Rate |
$543.40 |
| Rate for Payer: Aetna Commercial |
$221.65
|
| Rate for Payer: Aetna Medicare |
$172.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.65
|
| Rate for Payer: BCBS Complete |
$334.40
|
| Rate for Payer: BCBS MAPPO |
$165.41
|
| Rate for Payer: BCN Medicare Advantage |
$165.41
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cofinity Commercial |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$221.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.68
|
| Rate for Payer: Nomi Health Commercial |
$198.49
|
| Rate for Payer: PACE SWMI |
$165.41
|
| Rate for Payer: PHP Commercial |
$231.57
|
| Rate for Payer: PHP Medicare Advantage |
$165.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health Medicare |
$165.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.41
|
| Rate for Payer: UHC Medicare Advantage |
$165.41
|
| Rate for Payer: UMR Bronson Commercial |
$384.56
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$280.68 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$376.11
|
| Rate for Payer: Aetna Medicare |
$291.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.11
|
| Rate for Payer: BCBS Complete |
$377.60
|
| Rate for Payer: BCBS MAPPO |
$280.68
|
| Rate for Payer: BCN Medicare Advantage |
$280.68
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$404.18
|
| Rate for Payer: Cofinity Commercial |
$376.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Nomi Health Commercial |
$336.82
|
| Rate for Payer: PACE SWMI |
$280.68
|
| Rate for Payer: PHP Commercial |
$392.95
|
| Rate for Payer: PHP Medicare Advantage |
$280.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health Medicare |
$280.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.68
|
| Rate for Payer: UHC Medicare Advantage |
$280.68
|
| Rate for Payer: UMR Bronson Commercial |
$434.24
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN
|
Professional
|
Both
|
$463.00
|
|
|
Service Code
|
HCPCS 37249
|
| Min. Negotiated Rate |
$139.54 |
| Max. Negotiated Rate |
$300.95 |
| Rate for Payer: Aetna Commercial |
$186.98
|
| Rate for Payer: Aetna Medicare |
$145.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.98
|
| Rate for Payer: BCBS Complete |
$185.20
|
| Rate for Payer: BCBS MAPPO |
$139.54
|
| Rate for Payer: BCN Medicare Advantage |
$139.54
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cofinity Commercial |
$200.94
|
| Rate for Payer: Cofinity Commercial |
$186.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.52
|
| Rate for Payer: Nomi Health Commercial |
$167.45
|
| Rate for Payer: PACE SWMI |
$139.54
|
| Rate for Payer: PHP Commercial |
$195.36
|
| Rate for Payer: PHP Medicare Advantage |
$139.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.95
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.54
|
| Rate for Payer: UHC Medicare Advantage |
$139.54
|
| Rate for Payer: UMR Bronson Commercial |
$212.98
|
|
|
PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 36907
|
| Min. Negotiated Rate |
$129.60 |
| Max. Negotiated Rate |
$210.60 |
| Rate for Payer: Aetna Commercial |
$186.82
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.82
|
| Rate for Payer: BCBS Complete |
$129.60
|
| Rate for Payer: BCBS MAPPO |
$139.42
|
| Rate for Payer: BCN Medicare Advantage |
$139.42
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$200.76
|
| Rate for Payer: Cofinity Commercial |
$186.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.39
|
| Rate for Payer: Nomi Health Commercial |
$167.30
|
| Rate for Payer: PACE SWMI |
$139.42
|
| Rate for Payer: PHP Commercial |
$195.19
|
| Rate for Payer: PHP Medicare Advantage |
$139.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health Medicare |
$139.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.42
|
| Rate for Payer: UHC Medicare Advantage |
$139.42
|
| Rate for Payer: UMR Bronson Commercial |
$149.04
|
|
|
PR TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL
|
Professional
|
Both
|
$9,821.00
|
|
|
Service Code
|
HCPCS 0237T
|
| Min. Negotiated Rate |
$3,928.40 |
| Max. Negotiated Rate |
$6,383.65 |
| Rate for Payer: Aetna Medicare |
$4,910.50
|
| Rate for Payer: BCBS Complete |
$3,928.40
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,383.65
|
| Rate for Payer: UMR Bronson Commercial |
$4,517.66
|
|
|
PR TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL
|
Professional
|
Both
|
$8,756.00
|
|
|
Service Code
|
HCPCS 61597
|
| Min. Negotiated Rate |
$2,857.84 |
| Max. Negotiated Rate |
$5,691.40 |
| Rate for Payer: Aetna Commercial |
$3,829.51
|
| Rate for Payer: Aetna Medicare |
$2,972.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,829.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,115.29
|
| Rate for Payer: BCBS Complete |
$3,502.40
|
| Rate for Payer: BCBS MAPPO |
$2,857.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,857.84
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cofinity Commercial |
$3,829.51
|
| Rate for Payer: Cofinity Commercial |
$4,115.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,857.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,000.73
|
| Rate for Payer: Nomi Health Commercial |
$3,429.41
|
| Rate for Payer: PACE SWMI |
$2,857.84
|
| Rate for Payer: PHP Commercial |
$4,000.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,857.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,691.40
|
| Rate for Payer: Priority Health Medicare |
$2,857.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,857.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,857.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,027.76
|
|
|
PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 38207
|
| Min. Negotiated Rate |
$183.60 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: BCBS Complete |
$183.60
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: UMR Bronson Commercial |
$211.14
|
|
|
PR TR PARASPI MUSC HIP FASC/TDN XTN GRF
|
Professional
|
Both
|
$6,317.00
|
|
|
Service Code
|
HCPCS 27105
|
| Min. Negotiated Rate |
$840.06 |
| Max. Negotiated Rate |
$4,106.05 |
| Rate for Payer: Aetna Commercial |
$1,125.68
|
| Rate for Payer: Aetna Medicare |
$873.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.69
|
| Rate for Payer: BCBS Complete |
$2,526.80
|
| Rate for Payer: BCBS MAPPO |
$840.06
|
| Rate for Payer: BCN Medicare Advantage |
$840.06
|
| Rate for Payer: Cash Price |
$5,053.60
|
| Rate for Payer: Cash Price |
$5,053.60
|
| Rate for Payer: Cofinity Commercial |
$1,125.68
|
| Rate for Payer: Cofinity Commercial |
$1,209.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$882.06
|
| Rate for Payer: Nomi Health Commercial |
$1,008.07
|
| Rate for Payer: PACE SWMI |
$840.06
|
| Rate for Payer: PHP Commercial |
$1,176.08
|
| Rate for Payer: PHP Medicare Advantage |
$840.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,106.05
|
| Rate for Payer: Priority Health Medicare |
$840.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$840.06
|
| Rate for Payer: UHC Medicare Advantage |
$840.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,905.82
|
|
|
PR TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 35695
|
| Min. Negotiated Rate |
$830.40 |
| Max. Negotiated Rate |
$1,423.66 |
| Rate for Payer: Aetna Commercial |
$1,324.79
|
| Rate for Payer: Aetna Medicare |
$1,028.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,324.79
|
| Rate for Payer: BCBS Complete |
$830.40
|
| Rate for Payer: BCBS MAPPO |
$988.65
|
| Rate for Payer: BCN Medicare Advantage |
$988.65
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cofinity Commercial |
$1,423.66
|
| Rate for Payer: Cofinity Commercial |
$1,324.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,038.08
|
| Rate for Payer: Nomi Health Commercial |
$1,186.38
|
| Rate for Payer: PACE SWMI |
$988.65
|
| Rate for Payer: PHP Commercial |
$1,384.11
|
| Rate for Payer: PHP Medicare Advantage |
$988.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,349.40
|
| Rate for Payer: Priority Health Medicare |
$988.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$988.65
|
| Rate for Payer: UHC Medicare Advantage |
$988.65
|
| Rate for Payer: UMR Bronson Commercial |
$954.96
|
|
|
PR TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 35694
|
| Min. Negotiated Rate |
$856.80 |
| Max. Negotiated Rate |
$1,392.30 |
| Rate for Payer: Aetna Commercial |
$1,276.59
|
| Rate for Payer: Aetna Medicare |
$990.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,276.59
|
| Rate for Payer: BCBS Complete |
$856.80
|
| Rate for Payer: BCBS MAPPO |
$952.68
|
| Rate for Payer: BCN Medicare Advantage |
$952.68
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$1,371.86
|
| Rate for Payer: Cofinity Commercial |
$1,276.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.31
|
| Rate for Payer: Nomi Health Commercial |
$1,143.22
|
| Rate for Payer: PACE SWMI |
$952.68
|
| Rate for Payer: PHP Commercial |
$1,333.75
|
| Rate for Payer: PHP Medicare Advantage |
$952.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health Medicare |
$952.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$952.68
|
| Rate for Payer: UHC Medicare Advantage |
$952.68
|
| Rate for Payer: UMR Bronson Commercial |
$985.32
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART
|
Professional
|
Both
|
$4,566.00
|
|
|
Service Code
|
HCPCS 35691
|
| Min. Negotiated Rate |
$911.39 |
| Max. Negotiated Rate |
$2,967.90 |
| Rate for Payer: Aetna Commercial |
$1,221.26
|
| Rate for Payer: Aetna Medicare |
$947.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,312.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.26
|
| Rate for Payer: BCBS Complete |
$1,826.40
|
| Rate for Payer: BCBS MAPPO |
$911.39
|
| Rate for Payer: BCN Medicare Advantage |
$911.39
|
| Rate for Payer: Cash Price |
$3,652.80
|
| Rate for Payer: Cash Price |
$3,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,312.40
|
| Rate for Payer: Cofinity Commercial |
$1,221.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$911.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$956.96
|
| Rate for Payer: Nomi Health Commercial |
$1,093.67
|
| Rate for Payer: PACE SWMI |
$911.39
|
| Rate for Payer: PHP Commercial |
$1,275.95
|
| Rate for Payer: PHP Medicare Advantage |
$911.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,967.90
|
| Rate for Payer: Priority Health Medicare |
$911.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$911.39
|
| Rate for Payer: UHC Medicare Advantage |
$911.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,100.36
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART
|
Professional
|
Both
|
$1,756.00
|
|
|
Service Code
|
HCPCS 35693
|
| Min. Negotiated Rate |
$702.40 |
| Max. Negotiated Rate |
$1,160.42 |
| Rate for Payer: Aetna Commercial |
$1,079.84
|
| Rate for Payer: Aetna Medicare |
$838.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.84
|
| Rate for Payer: BCBS Complete |
$702.40
|
| Rate for Payer: BCBS MAPPO |
$805.85
|
| Rate for Payer: BCN Medicare Advantage |
$805.85
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Cofinity Commercial |
$1,160.42
|
| Rate for Payer: Cofinity Commercial |
$1,079.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$846.14
|
| Rate for Payer: Nomi Health Commercial |
$967.02
|
| Rate for Payer: PACE SWMI |
$805.85
|
| Rate for Payer: PHP Commercial |
$1,128.19
|
| Rate for Payer: PHP Medicare Advantage |
$805.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.40
|
| Rate for Payer: Priority Health Medicare |
$805.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.85
|
| Rate for Payer: UHC Medicare Advantage |
$805.85
|
| Rate for Payer: UMR Bronson Commercial |
$807.76
|
|
|
PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 26497
|
| Min. Negotiated Rate |
$853.26 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$1,143.37
|
| Rate for Payer: Aetna Medicare |
$887.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,228.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.37
|
| Rate for Payer: BCBS Complete |
$1,110.00
|
| Rate for Payer: BCBS MAPPO |
$853.26
|
| Rate for Payer: BCN Medicare Advantage |
$853.26
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,228.69
|
| Rate for Payer: Cofinity Commercial |
$1,143.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.92
|
| Rate for Payer: Nomi Health Commercial |
$1,023.91
|
| Rate for Payer: PACE SWMI |
$853.26
|
| Rate for Payer: PHP Commercial |
$1,194.56
|
| Rate for Payer: PHP Medicare Advantage |
$853.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health Medicare |
$853.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.26
|
| Rate for Payer: UHC Medicare Advantage |
$853.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.50
|
|
|
PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND
|
Professional
|
Both
|
$5,615.00
|
|
|
Service Code
|
HCPCS 26551
|
| Min. Negotiated Rate |
$2,246.00 |
| Max. Negotiated Rate |
$4,528.89 |
| Rate for Payer: Aetna Commercial |
$4,214.38
|
| Rate for Payer: Aetna Medicare |
$3,270.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,528.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,214.38
|
| Rate for Payer: BCBS Complete |
$2,246.00
|
| Rate for Payer: BCBS MAPPO |
$3,145.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,145.06
|
| Rate for Payer: Cash Price |
$4,492.00
|
| Rate for Payer: Cash Price |
$4,492.00
|
| Rate for Payer: Cofinity Commercial |
$4,528.89
|
| Rate for Payer: Cofinity Commercial |
$4,214.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,145.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,302.31
|
| Rate for Payer: Nomi Health Commercial |
$3,774.07
|
| Rate for Payer: PACE SWMI |
$3,145.06
|
| Rate for Payer: PHP Commercial |
$4,403.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,145.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,649.75
|
| Rate for Payer: Priority Health Medicare |
$3,145.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,145.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,145.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,582.90
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP
|
Professional
|
Both
|
$2,819.00
|
|
|
Service Code
|
HCPCS 27691
|
| Min. Negotiated Rate |
$714.66 |
| Max. Negotiated Rate |
$1,832.35 |
| Rate for Payer: Aetna Commercial |
$957.64
|
| Rate for Payer: Aetna Medicare |
$743.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.11
|
| Rate for Payer: BCBS Complete |
$1,127.60
|
| Rate for Payer: BCBS MAPPO |
$714.66
|
| Rate for Payer: BCN Medicare Advantage |
$714.66
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cofinity Commercial |
$957.64
|
| Rate for Payer: Cofinity Commercial |
$1,029.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.39
|
| Rate for Payer: Nomi Health Commercial |
$857.59
|
| Rate for Payer: PACE SWMI |
$714.66
|
| Rate for Payer: PHP Commercial |
$1,000.52
|
| Rate for Payer: PHP Medicare Advantage |
$714.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,832.35
|
| Rate for Payer: Priority Health Medicare |
$714.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.66
|
| Rate for Payer: UHC Medicare Advantage |
$714.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,296.74
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 27692
|
| Min. Negotiated Rate |
$98.65 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Commercial |
$132.19
|
| Rate for Payer: Aetna Medicare |
$102.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.19
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: BCBS MAPPO |
$98.65
|
| Rate for Payer: BCN Medicare Advantage |
$98.65
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$142.06
|
| Rate for Payer: Cofinity Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.58
|
| Rate for Payer: Nomi Health Commercial |
$118.38
|
| Rate for Payer: PACE SWMI |
$98.65
|
| Rate for Payer: PHP Commercial |
$138.11
|
| Rate for Payer: PHP Medicare Advantage |
$98.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health Medicare |
$98.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.65
|
| Rate for Payer: UHC Medicare Advantage |
$98.65
|
| Rate for Payer: UMR Bronson Commercial |
$234.60
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 27690
|
| Min. Negotiated Rate |
$613.89 |
| Max. Negotiated Rate |
$1,296.75 |
| Rate for Payer: Aetna Commercial |
$822.61
|
| Rate for Payer: Aetna Medicare |
$638.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.61
|
| Rate for Payer: BCBS Complete |
$798.00
|
| Rate for Payer: BCBS MAPPO |
$613.89
|
| Rate for Payer: BCN Medicare Advantage |
$613.89
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$822.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.58
|
| Rate for Payer: Nomi Health Commercial |
$736.67
|
| Rate for Payer: PACE SWMI |
$613.89
|
| Rate for Payer: PHP Commercial |
$859.45
|
| Rate for Payer: PHP Medicare Advantage |
$613.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health Medicare |
$613.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.89
|
| Rate for Payer: UHC Medicare Advantage |
$613.89
|
| Rate for Payer: UMR Bronson Commercial |
$917.70
|
|
|
PR TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 26480
|
| Min. Negotiated Rate |
$687.64 |
| Max. Negotiated Rate |
$1,340.30 |
| Rate for Payer: Aetna Commercial |
$921.44
|
| Rate for Payer: Aetna Medicare |
$715.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.44
|
| Rate for Payer: BCBS Complete |
$824.80
|
| Rate for Payer: BCBS MAPPO |
$687.64
|
| Rate for Payer: BCN Medicare Advantage |
$687.64
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$990.20
|
| Rate for Payer: Cofinity Commercial |
$921.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$722.02
|
| Rate for Payer: Nomi Health Commercial |
$825.17
|
| Rate for Payer: PACE SWMI |
$687.64
|
| Rate for Payer: PHP Commercial |
$962.70
|
| Rate for Payer: PHP Medicare Advantage |
$687.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health Medicare |
$687.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.64
|
| Rate for Payer: UHC Medicare Advantage |
$687.64
|
| Rate for Payer: UMR Bronson Commercial |
$948.52
|
|
|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$330.80 |
| Max. Negotiated Rate |
$609.67 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Aetna Medicare |
$440.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.33
|
| Rate for Payer: BCBS Complete |
$330.80
|
| Rate for Payer: BCBS MAPPO |
$423.38
|
| Rate for Payer: BCN Medicare Advantage |
$423.38
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$609.67
|
| Rate for Payer: Cofinity Commercial |
$567.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.55
|
| Rate for Payer: Nomi Health Commercial |
$508.06
|
| Rate for Payer: PACE SWMI |
$423.38
|
| Rate for Payer: PHP Commercial |
$592.73
|
| Rate for Payer: PHP Medicare Advantage |
$423.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health Medicare |
$423.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.38
|
| Rate for Payer: UHC Medicare Advantage |
$423.38
|
| Rate for Payer: UMR Bronson Commercial |
$380.42
|
|
|
PR TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY
|
Professional
|
Both
|
$3,550.00
|
|
|
Service Code
|
HCPCS 53854
|
| Min. Negotiated Rate |
$363.73 |
| Max. Negotiated Rate |
$2,307.50 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.40
|
| Rate for Payer: BCBS Complete |
$1,420.00
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCN Medicare Advantage |
$363.73
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Cofinity Commercial |
$487.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.92
|
| Rate for Payer: Nomi Health Commercial |
$436.48
|
| Rate for Payer: PACE SWMI |
$363.73
|
| Rate for Payer: PHP Commercial |
$509.22
|
| Rate for Payer: PHP Medicare Advantage |
$363.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,307.50
|
| Rate for Payer: Priority Health Medicare |
$363.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,633.00
|
|
|
PR TRURL DSTRJ PRSTATE TISS RF THERMOTH
|
Professional
|
Both
|
$2,935.00
|
|
|
Service Code
|
HCPCS 53852
|
| Min. Negotiated Rate |
$363.73 |
| Max. Negotiated Rate |
$1,907.75 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.40
|
| Rate for Payer: BCBS Complete |
$1,174.00
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCN Medicare Advantage |
$363.73
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Cofinity Commercial |
$487.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.92
|
| Rate for Payer: Nomi Health Commercial |
$436.48
|
| Rate for Payer: PACE SWMI |
$363.73
|
| Rate for Payer: PHP Commercial |
$509.22
|
| Rate for Payer: PHP Medicare Advantage |
$363.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,907.75
|
| Rate for Payer: Priority Health Medicare |
$363.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,350.10
|
|
|
PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$1,590.00
|
|
|
Service Code
|
HCPCS 52601
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$1,033.50 |
| Rate for Payer: Aetna Commercial |
$932.00
|
| Rate for Payer: Aetna Medicare |
$723.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.55
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS MAPPO |
$695.52
|
| Rate for Payer: BCN Medicare Advantage |
$695.52
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$1,001.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.30
|
| Rate for Payer: Nomi Health Commercial |
$834.62
|
| Rate for Payer: PACE SWMI |
$695.52
|
| Rate for Payer: PHP Commercial |
$973.73
|
| Rate for Payer: PHP Medicare Advantage |
$695.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health Medicare |
$695.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.52
|
| Rate for Payer: UHC Medicare Advantage |
$695.52
|
| Rate for Payer: UMR Bronson Commercial |
$731.40
|
|
|
PR TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 52640
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$470.60 |
| Rate for Payer: Aetna Commercial |
$413.73
|
| Rate for Payer: Aetna Medicare |
$321.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.73
|
| Rate for Payer: BCBS Complete |
$289.60
|
| Rate for Payer: BCBS MAPPO |
$308.75
|
| Rate for Payer: BCN Medicare Advantage |
$308.75
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$444.60
|
| Rate for Payer: Cofinity Commercial |
$413.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.19
|
| Rate for Payer: Nomi Health Commercial |
$370.50
|
| Rate for Payer: PACE SWMI |
$308.75
|
| Rate for Payer: PHP Commercial |
$432.25
|
| Rate for Payer: PHP Medicare Advantage |
$308.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.60
|
| Rate for Payer: Priority Health Medicare |
$308.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.75
|
| Rate for Payer: UHC Medicare Advantage |
$308.75
|
| Rate for Payer: UMR Bronson Commercial |
$333.04
|
|
