|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$356.60 |
| Max. Negotiated Rate |
$952.25 |
| Rate for Payer: Aetna Commercial |
$608.90
|
| Rate for Payer: Aetna Medicare |
$472.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.34
|
| Rate for Payer: BCBS Complete |
$586.00
|
| Rate for Payer: BCBS MAPPO |
$454.40
|
| Rate for Payer: BCBS Trust/PPO |
$356.60
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$454.40
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$654.34
|
| Rate for Payer: Cofinity Commercial |
$608.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.12
|
| Rate for Payer: Nomi Health Commercial |
$545.28
|
| Rate for Payer: PACE SWMI |
$454.40
|
| Rate for Payer: PHP Commercial |
$636.16
|
| Rate for Payer: PHP Medicare Advantage |
$454.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.56
|
| Rate for Payer: Priority Health Medicare |
$454.40
|
| Rate for Payer: Priority Health Narrow Network |
$760.56
|
| Rate for Payer: Priority Health SBD |
$760.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.40
|
| Rate for Payer: UHC Medicare Advantage |
$454.40
|
| Rate for Payer: UMR Bronson Commercial |
$673.90
|
|
|
PR TRANSURETHRAL RESECTION BLADDER NECK
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 52500
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$1,096.55 |
| Rate for Payer: Aetna Commercial |
$632.19
|
| Rate for Payer: Aetna Medicare |
$490.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.19
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS MAPPO |
$471.78
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: BCN Medicare Advantage |
$471.78
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$679.36
|
| Rate for Payer: Cofinity Commercial |
$632.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.37
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Nomi Health Commercial |
$566.14
|
| Rate for Payer: PACE SWMI |
$471.78
|
| Rate for Payer: PHP Commercial |
$660.49
|
| Rate for Payer: PHP Medicare Advantage |
$471.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$789.31
|
| Rate for Payer: Priority Health Medicare |
$471.78
|
| Rate for Payer: Priority Health Narrow Network |
$789.31
|
| Rate for Payer: Priority Health SBD |
$789.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.78
|
| Rate for Payer: UHC Medicare Advantage |
$471.78
|
| Rate for Payer: UHCCP Medicaid |
$318.01
|
| Rate for Payer: UMR Bronson Commercial |
$776.02
|
|
|
PR TRANSV AORTIC ARCH GRAFT W BYPASS
|
Professional
|
Both
|
$10,285.00
|
|
|
Service Code
|
HCPCS 33870
|
| Min. Negotiated Rate |
$4,114.00 |
| Max. Negotiated Rate |
$6,685.25 |
| Rate for Payer: Aetna Medicare |
$5,142.50
|
| Rate for Payer: BCBS Complete |
$4,114.00
|
| Rate for Payer: Cash Price |
$8,228.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,685.25
|
| Rate for Payer: UMR Bronson Commercial |
$4,731.10
|
|
|
PR TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA
|
Professional
|
Both
|
$5,629.00
|
|
|
Service Code
|
HCPCS 33871
|
| Min. Negotiated Rate |
$972.07 |
| Max. Negotiated Rate |
$5,074.67 |
| Rate for Payer: Aetna Commercial |
$4,175.45
|
| Rate for Payer: Aetna Medicare |
$3,240.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,175.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,487.05
|
| Rate for Payer: BCBS Complete |
$2,138.99
|
| Rate for Payer: BCBS MAPPO |
$3,116.01
|
| Rate for Payer: BCBS Trust/PPO |
$972.07
|
| Rate for Payer: BCN Commercial |
$4,652.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,116.01
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cofinity Commercial |
$4,487.05
|
| Rate for Payer: Cofinity Commercial |
$4,175.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,116.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.81
|
| Rate for Payer: Meridian Medicaid |
$2,138.99
|
| Rate for Payer: Nomi Health Commercial |
$3,739.21
|
| Rate for Payer: PACE SWMI |
$3,116.01
|
| Rate for Payer: PHP Commercial |
$4,362.41
|
| Rate for Payer: PHP Medicare Advantage |
$3,116.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,037.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,658.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,074.67
|
| Rate for Payer: Priority Health Medicare |
$3,116.01
|
| Rate for Payer: Priority Health Narrow Network |
$5,074.67
|
| Rate for Payer: Priority Health SBD |
$5,074.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,116.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,116.01
|
| Rate for Payer: UHCCP Medicaid |
$2,037.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,589.34
|
|
|
PR TRAY FEE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 00521
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$852.80 |
| Rate for Payer: Aetna Commercial |
$619.62
|
| Rate for Payer: Aetna Medicare |
$480.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.86
|
| Rate for Payer: BCBS Complete |
$331.22
|
| Rate for Payer: BCBS MAPPO |
$462.40
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$711.51
|
| Rate for Payer: BCN Medicare Advantage |
$462.40
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$665.86
|
| Rate for Payer: Cofinity Commercial |
$619.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.52
|
| Rate for Payer: Meridian Medicaid |
$331.22
|
| Rate for Payer: Nomi Health Commercial |
$554.88
|
| Rate for Payer: PACE SWMI |
$462.40
|
| Rate for Payer: PHP Commercial |
$647.36
|
| Rate for Payer: PHP Medicare Advantage |
$462.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.06
|
| Rate for Payer: Priority Health Medicare |
$462.40
|
| Rate for Payer: Priority Health Narrow Network |
$750.06
|
| Rate for Payer: Priority Health SBD |
$750.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.40
|
| Rate for Payer: UHC Medicare Advantage |
$462.40
|
| Rate for Payer: UHCCP Medicaid |
$315.45
|
| Rate for Payer: UMR Bronson Commercial |
$603.52
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$229.61 |
| Max. Negotiated Rate |
$567.84 |
| Rate for Payer: Aetna Commercial |
$452.63
|
| Rate for Payer: Aetna Medicare |
$351.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.40
|
| Rate for Payer: BCBS Complete |
$241.09
|
| Rate for Payer: BCBS MAPPO |
$337.78
|
| Rate for Payer: BCBS Trust/PPO |
$525.13
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: BCN Medicare Advantage |
$337.78
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$486.40
|
| Rate for Payer: Cofinity Commercial |
$452.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.67
|
| Rate for Payer: Meridian Medicaid |
$241.09
|
| Rate for Payer: Nomi Health Commercial |
$405.34
|
| Rate for Payer: PACE SWMI |
$337.78
|
| Rate for Payer: PHP Commercial |
$472.89
|
| Rate for Payer: PHP Medicare Advantage |
$337.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Medicare |
$337.78
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: Priority Health SBD |
$542.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.78
|
| Rate for Payer: UHC Medicare Advantage |
$337.78
|
| Rate for Payer: UHCCP Medicaid |
$229.61
|
| Rate for Payer: UMR Bronson Commercial |
$345.00
|
|
|
PR TRIAMCINOLONE ACET INJ NOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: Aetna Medicare |
$0.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.24
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.55
|
| Rate for Payer: BCN Commercial |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.86
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$1.16
|
| Rate for Payer: Cofinity Commercial |
$1.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.91
|
| Rate for Payer: Nomi Health Commercial |
$1.03
|
| Rate for Payer: PACE SWMI |
$0.86
|
| Rate for Payer: PHP Commercial |
$1.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$0.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.86
|
| Rate for Payer: UHC Medicare Advantage |
$0.86
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$76.90 |
| Rate for Payer: Aetna Commercial |
$71.56
|
| Rate for Payer: Aetna Medicare |
$55.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.90
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$48.74
|
| Rate for Payer: BCN Commercial |
$45.78
|
| Rate for Payer: BCN Medicare Advantage |
$53.40
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$71.56
|
| Rate for Payer: Cofinity Commercial |
$76.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.07
|
| Rate for Payer: Nomi Health Commercial |
$64.08
|
| Rate for Payer: PACE SWMI |
$53.40
|
| Rate for Payer: PHP Commercial |
$74.76
|
| Rate for Payer: PHP Medicare Advantage |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.40
|
| Rate for Payer: UHC Medicare Advantage |
$53.40
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$21.45 |
| 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 |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$12.00
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| 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 |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: Priority Health SBD |
$9.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$1,929.35 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.35
|
| Rate for Payer: BCN Commercial |
$34.21
|
| 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 HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: Priority Health SBD |
$9.93
|
| 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 |
$217.26 |
| Max. Negotiated Rate |
$2,674.54 |
| 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 |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$332.08
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$2,674.54
|
| 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: Meridian Medicaid |
$228.12
|
| 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 Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.28
|
| Rate for Payer: Priority Health Medicare |
$332.08
|
| Rate for Payer: Priority Health Narrow Network |
$539.28
|
| Rate for Payer: Priority Health SBD |
$539.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.08
|
| Rate for Payer: UHC Medicare Advantage |
$332.08
|
| Rate for Payer: UHCCP Medicaid |
$217.26
|
| 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 |
$108.42 |
| Max. Negotiated Rate |
$1,142.18 |
| Rate for Payer: Aetna Commercial |
$221.65
|
| Rate for Payer: Aetna Medicare |
$172.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.19
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS MAPPO |
$165.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,142.18
|
| Rate for Payer: BCN Commercial |
$828.80
|
| 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 |
$221.65
|
| Rate for Payer: Cofinity Commercial |
$238.19
|
| 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: Meridian Medicaid |
$113.84
|
| 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 Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.57
|
| Rate for Payer: Priority Health Medicare |
$165.41
|
| Rate for Payer: Priority Health Narrow Network |
$268.57
|
| Rate for Payer: Priority Health SBD |
$268.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.41
|
| Rate for Payer: UHC Medicare Advantage |
$165.41
|
| Rate for Payer: UHCCP Medicaid |
$108.42
|
| 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 |
$184.88 |
| Max. Negotiated Rate |
$1,997.22 |
| Rate for Payer: Aetna Commercial |
$376.11
|
| Rate for Payer: Aetna Medicare |
$291.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.18
|
| Rate for Payer: BCBS Complete |
$194.12
|
| Rate for Payer: BCBS MAPPO |
$280.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.73
|
| Rate for Payer: BCN Commercial |
$1,997.22
|
| 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 |
$376.11
|
| Rate for Payer: Cofinity Commercial |
$404.18
|
| 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: Meridian Medicaid |
$194.12
|
| 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 Choice Medicaid |
$184.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.03
|
| Rate for Payer: Priority Health Medicare |
$280.68
|
| Rate for Payer: Priority Health Narrow Network |
$460.03
|
| Rate for Payer: Priority Health SBD |
$460.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.68
|
| Rate for Payer: UHC Medicare Advantage |
$280.68
|
| Rate for Payer: UHCCP Medicaid |
$184.88
|
| 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 |
$91.38 |
| Max. Negotiated Rate |
$647.99 |
| Rate for Payer: Aetna Commercial |
$186.98
|
| Rate for Payer: Aetna Medicare |
$145.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$139.54
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$647.99
|
| 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 |
$186.98
|
| Rate for Payer: Cofinity Commercial |
$200.94
|
| 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: Meridian Medicaid |
$95.95
|
| 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 Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.50
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: Priority Health Narrow Network |
$225.50
|
| Rate for Payer: Priority Health SBD |
$225.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.54
|
| Rate for Payer: UHC Medicare Advantage |
$139.54
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
| 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 |
$91.59 |
| Max. Negotiated Rate |
$1,983.24 |
| Rate for Payer: Aetna Commercial |
$186.82
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.76
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$139.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.24
|
| Rate for Payer: BCN Commercial |
$867.89
|
| 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 |
$186.82
|
| Rate for Payer: Cofinity Commercial |
$200.76
|
| 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: Meridian Medicaid |
$96.17
|
| 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 Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.02
|
| Rate for Payer: Priority Health Medicare |
$139.42
|
| Rate for Payer: Priority Health Narrow Network |
$226.02
|
| Rate for Payer: Priority Health SBD |
$226.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.42
|
| Rate for Payer: UHC Medicare Advantage |
$139.42
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
| 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 |
$100.60 |
| Max. Negotiated Rate |
$9,819.16 |
| Rate for Payer: Aetna Commercial |
$4,395.81
|
| Rate for Payer: Aetna Medicare |
$4,910.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,395.81
|
| Rate for Payer: BCBS Complete |
$260.96
|
| Rate for Payer: BCBS Trust/PPO |
$100.60
|
| Rate for Payer: BCN Commercial |
$9,819.16
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Meridian Medicaid |
$260.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,383.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,548.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.58
|
| Rate for Payer: Priority Health SBD |
$1,548.58
|
| Rate for Payer: UHCCP Medicaid |
$248.53
|
| 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 |
$1,813.13 |
| Max. Negotiated Rate |
$6,047.84 |
| 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 |
$1,981.99
|
| Rate for Payer: BCBS MAPPO |
$2,857.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.13
|
| Rate for Payer: BCN Commercial |
$6,047.84
|
| 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 |
$4,115.29
|
| Rate for Payer: Cofinity Commercial |
$3,829.51
|
| 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: Meridian Medicaid |
$1,981.99
|
| 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 Choice Medicaid |
$1,887.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,691.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,112.76
|
| Rate for Payer: Priority Health Medicare |
$2,857.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,112.76
|
| Rate for Payer: Priority Health SBD |
$5,112.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,857.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,857.84
|
| Rate for Payer: UHCCP Medicaid |
$1,887.61
|
| 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 |
$28.12 |
| Max. Negotiated Rate |
$1,622.41 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.89
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.41
|
| Rate for Payer: BCN Commercial |
$64.99
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.54
|
| Rate for Payer: Priority Health Narrow Network |
$88.54
|
| Rate for Payer: Priority Health SBD |
$88.54
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
| 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 |
$567.22 |
| 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 |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$840.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.41
|
| Rate for Payer: BCN Commercial |
$1,280.34
|
| 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 |
$1,209.69
|
| Rate for Payer: Cofinity Commercial |
$1,125.68
|
| 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: Meridian Medicaid |
$595.58
|
| 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 Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,106.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,344.42
|
| Rate for Payer: Priority Health Medicare |
$840.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,344.42
|
| Rate for Payer: Priority Health SBD |
$1,344.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$840.06
|
| Rate for Payer: UHC Medicare Advantage |
$840.06
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
| 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 |
$642.62 |
| Max. Negotiated Rate |
$1,599.73 |
| Rate for Payer: Aetna Commercial |
$1,324.79
|
| Rate for Payer: Aetna Medicare |
$1,028.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,324.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.66
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$988.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.09
|
| Rate for Payer: BCN Commercial |
$1,463.59
|
| 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 |
$1,324.79
|
| Rate for Payer: Cofinity Commercial |
$1,423.66
|
| 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: Meridian Medicaid |
$674.75
|
| 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 Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,349.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,599.73
|
| Rate for Payer: Priority Health Medicare |
$988.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,599.73
|
| Rate for Payer: Priority Health SBD |
$1,599.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$988.65
|
| Rate for Payer: UHC Medicare Advantage |
$988.65
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
| 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 |
$619.40 |
| Max. Negotiated Rate |
$1,541.75 |
| Rate for Payer: Aetna Commercial |
$1,276.59
|
| Rate for Payer: Aetna Medicare |
$990.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,276.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.86
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS MAPPO |
$952.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$1,409.84
|
| 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 |
$1,276.59
|
| Rate for Payer: Cofinity Commercial |
$1,371.86
|
| 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: Meridian Medicaid |
$650.37
|
| 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 Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.75
|
| Rate for Payer: Priority Health Medicare |
$952.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,541.75
|
| Rate for Payer: Priority Health SBD |
$1,541.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$952.68
|
| Rate for Payer: UHC Medicare Advantage |
$952.68
|
| Rate for Payer: UHCCP Medicaid |
$619.40
|
| 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 |
$592.78 |
| 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) |
$1,221.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,312.40
|
| Rate for Payer: BCBS Complete |
$622.42
|
| Rate for Payer: BCBS MAPPO |
$911.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.26
|
| Rate for Payer: BCN Commercial |
$1,350.70
|
| 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 |
$1,221.26
|
| Rate for Payer: Cofinity Commercial |
$1,312.40
|
| 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: Meridian Medicaid |
$622.42
|
| 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 Choice Medicaid |
$592.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,967.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,476.34
|
| Rate for Payer: Priority Health Medicare |
$911.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,476.34
|
| Rate for Payer: Priority Health SBD |
$1,476.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$911.39
|
| Rate for Payer: UHC Medicare Advantage |
$911.39
|
| Rate for Payer: UHCCP Medicaid |
$592.78
|
| 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 |
$526.11 |
| Max. Negotiated Rate |
$2,046.11 |
| Rate for Payer: Aetna Commercial |
$1,079.84
|
| Rate for Payer: Aetna Medicare |
$838.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.42
|
| Rate for Payer: BCBS Complete |
$552.42
|
| Rate for Payer: BCBS MAPPO |
$805.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.11
|
| Rate for Payer: BCN Commercial |
$1,193.84
|
| 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 |
$1,079.84
|
| Rate for Payer: Cofinity Commercial |
$1,160.42
|
| 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: Meridian Medicaid |
$552.42
|
| 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 Choice Medicaid |
$526.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,309.35
|
| Rate for Payer: Priority Health Medicare |
$805.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,309.35
|
| Rate for Payer: Priority Health SBD |
$1,309.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.85
|
| Rate for Payer: UHC Medicare Advantage |
$805.85
|
| Rate for Payer: UHCCP Medicaid |
$526.11
|
| 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 |
$584.26 |
| Max. Negotiated Rate |
$2,458.71 |
| Rate for Payer: Aetna Commercial |
$1,143.37
|
| Rate for Payer: Aetna Medicare |
$887.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,228.69
|
| Rate for Payer: BCBS Complete |
$613.47
|
| Rate for Payer: BCBS MAPPO |
$853.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.71
|
| Rate for Payer: BCN Commercial |
$1,344.84
|
| 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 |
$1,143.37
|
| Rate for Payer: Cofinity Commercial |
$1,228.69
|
| 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: Meridian Medicaid |
$613.47
|
| 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 Choice Medicaid |
$584.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,399.37
|
| Rate for Payer: Priority Health Medicare |
$853.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,399.37
|
| Rate for Payer: Priority Health SBD |
$1,399.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.26
|
| Rate for Payer: UHC Medicare Advantage |
$853.26
|
| Rate for Payer: UHCCP Medicaid |
$584.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.50
|
|
