|
PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND
|
Professional
|
Both
|
$5,615.00
|
|
|
Service Code
|
HCPCS 26551
|
| Min. Negotiated Rate |
$201.28 |
| Max. Negotiated Rate |
$5,029.06 |
| Rate for Payer: Aetna Commercial |
$4,214.38
|
| Rate for Payer: Aetna Medicare |
$3,270.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,214.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,528.89
|
| Rate for Payer: BCBS Complete |
$2,217.26
|
| Rate for Payer: BCBS MAPPO |
$3,145.06
|
| Rate for Payer: BCBS Trust/PPO |
$201.28
|
| Rate for Payer: BCN Commercial |
$4,818.85
|
| 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 |
$4,214.38
|
| Rate for Payer: Cofinity Commercial |
$4,528.89
|
| 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: Meridian Medicaid |
$2,217.26
|
| 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 Choice Medicaid |
$2,111.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,649.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,029.06
|
| Rate for Payer: Priority Health Medicare |
$3,145.06
|
| Rate for Payer: Priority Health Narrow Network |
$5,029.06
|
| Rate for Payer: Priority Health SBD |
$5,029.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,145.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,145.06
|
| Rate for Payer: UHCCP Medicaid |
$2,111.68
|
| 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 |
$484.15 |
| Max. Negotiated Rate |
$2,829.97 |
| Rate for Payer: Aetna Commercial |
$957.64
|
| Rate for Payer: Aetna Medicare |
$743.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.64
|
| Rate for Payer: BCBS Complete |
$508.36
|
| Rate for Payer: BCBS MAPPO |
$714.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,829.97
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| 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 |
$1,029.11
|
| Rate for Payer: Cofinity Commercial |
$957.64
|
| 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: Meridian Medicaid |
$508.36
|
| 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 Choice Medicaid |
$484.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,832.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,145.95
|
| Rate for Payer: Priority Health Medicare |
$714.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,145.95
|
| Rate for Payer: Priority Health SBD |
$1,145.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.66
|
| Rate for Payer: UHC Medicare Advantage |
$714.66
|
| Rate for Payer: UHCCP Medicaid |
$484.15
|
| 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 |
$65.39 |
| Max. Negotiated Rate |
$3,094.06 |
| Rate for Payer: Aetna Commercial |
$132.19
|
| Rate for Payer: Aetna Medicare |
$102.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$98.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,094.06
|
| Rate for Payer: BCN Commercial |
$145.14
|
| 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 |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$142.06
|
| 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: Meridian Medicaid |
$68.66
|
| 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 Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.18
|
| Rate for Payer: Priority Health Medicare |
$98.65
|
| Rate for Payer: Priority Health Narrow Network |
$154.18
|
| Rate for Payer: Priority Health SBD |
$154.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.65
|
| Rate for Payer: UHC Medicare Advantage |
$98.65
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
| 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 |
$416.63 |
| 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) |
$822.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.00
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCBS MAPPO |
$613.89
|
| Rate for Payer: BCBS Trust/PPO |
$627.07
|
| Rate for Payer: BCN Commercial |
$935.81
|
| 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 |
$822.61
|
| Rate for Payer: Cofinity Commercial |
$884.00
|
| 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: Meridian Medicaid |
$437.46
|
| 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 Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$984.14
|
| Rate for Payer: Priority Health Medicare |
$613.89
|
| Rate for Payer: Priority Health Narrow Network |
$984.14
|
| Rate for Payer: Priority Health SBD |
$984.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.89
|
| Rate for Payer: UHC Medicare Advantage |
$613.89
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
| 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 |
$467.96 |
| 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) |
$921.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.20
|
| Rate for Payer: BCBS Complete |
$491.36
|
| Rate for Payer: BCBS MAPPO |
$687.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.37
|
| Rate for Payer: BCN Commercial |
$1,168.91
|
| 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 |
$921.44
|
| Rate for Payer: Cofinity Commercial |
$990.20
|
| 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: Meridian Medicaid |
$491.36
|
| 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 Choice Medicaid |
$467.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,214.65
|
| Rate for Payer: Priority Health Medicare |
$687.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,214.65
|
| Rate for Payer: Priority Health SBD |
$1,214.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.64
|
| Rate for Payer: UHC Medicare Advantage |
$687.64
|
| Rate for Payer: UHCCP Medicaid |
$467.96
|
| Rate for Payer: UMR Bronson Commercial |
$948.52
|
|
|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$283.70 |
| Max. Negotiated Rate |
$707.82 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Aetna Medicare |
$440.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.67
|
| Rate for Payer: BCBS Complete |
$299.24
|
| Rate for Payer: BCBS MAPPO |
$423.38
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$640.16
|
| 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 |
$567.33
|
| Rate for Payer: Cofinity Commercial |
$609.67
|
| 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: Meridian Medicaid |
$299.24
|
| 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 Choice Medicaid |
$284.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.82
|
| Rate for Payer: Priority Health Medicare |
$423.38
|
| Rate for Payer: Priority Health Narrow Network |
$707.82
|
| Rate for Payer: Priority Health SBD |
$707.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.38
|
| Rate for Payer: UHC Medicare Advantage |
$423.38
|
| Rate for Payer: UHCCP Medicaid |
$284.99
|
| 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 |
$246.23 |
| Max. Negotiated Rate |
$2,456.58 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.77
|
| Rate for Payer: BCBS Complete |
$258.54
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.86
|
| Rate for Payer: BCN Commercial |
$2,456.58
|
| 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 |
$487.40
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| 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: Meridian Medicaid |
$258.54
|
| 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 Choice Medicaid |
$246.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,307.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.42
|
| Rate for Payer: Priority Health Medicare |
$363.73
|
| Rate for Payer: Priority Health Narrow Network |
$611.42
|
| Rate for Payer: Priority Health SBD |
$611.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
| Rate for Payer: UHCCP Medicaid |
$246.23
|
| 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 |
$246.23 |
| Max. Negotiated Rate |
$2,032.41 |
| Rate for Payer: Aetna Commercial |
$487.40
|
| Rate for Payer: Aetna Medicare |
$378.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.77
|
| Rate for Payer: BCBS Complete |
$258.54
|
| Rate for Payer: BCBS MAPPO |
$363.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.92
|
| Rate for Payer: BCN Commercial |
$2,032.41
|
| 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 |
$487.40
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| 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: Meridian Medicaid |
$258.54
|
| 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 Choice Medicaid |
$246.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,907.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.42
|
| Rate for Payer: Priority Health Medicare |
$363.73
|
| Rate for Payer: Priority Health Narrow Network |
$611.42
|
| Rate for Payer: Priority Health SBD |
$611.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.73
|
| Rate for Payer: UHC Medicare Advantage |
$363.73
|
| Rate for Payer: UHCCP Medicaid |
$246.23
|
| 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 |
$465.62 |
| Max. Negotiated Rate |
$1,157.34 |
| Rate for Payer: Aetna Commercial |
$932.00
|
| Rate for Payer: Aetna Medicare |
$723.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.00
|
| Rate for Payer: BCBS Complete |
$488.90
|
| Rate for Payer: BCBS MAPPO |
$695.52
|
| Rate for Payer: BCBS Trust/PPO |
$659.32
|
| Rate for Payer: BCN Commercial |
$1,048.70
|
| 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 |
$1,001.55
|
| Rate for Payer: Cofinity Commercial |
$932.00
|
| 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: Meridian Medicaid |
$488.90
|
| 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 Choice Medicaid |
$465.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.34
|
| Rate for Payer: Priority Health Medicare |
$695.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.34
|
| Rate for Payer: Priority Health SBD |
$1,157.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.52
|
| Rate for Payer: UHC Medicare Advantage |
$695.52
|
| Rate for Payer: UHCCP Medicaid |
$465.62
|
| 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 |
$209.59 |
| Max. Negotiated Rate |
$733.28 |
| Rate for Payer: Aetna Commercial |
$413.72
|
| Rate for Payer: Aetna Medicare |
$321.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.60
|
| Rate for Payer: BCBS Complete |
$220.07
|
| Rate for Payer: BCBS MAPPO |
$308.75
|
| Rate for Payer: BCBS Trust/PPO |
$733.28
|
| Rate for Payer: BCN Commercial |
$467.17
|
| 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 |
$413.72
|
| Rate for Payer: Cofinity Commercial |
$444.60
|
| 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: Meridian Medicaid |
$220.07
|
| 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 Choice Medicaid |
$209.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.75
|
| Rate for Payer: Priority Health Medicare |
$308.75
|
| Rate for Payer: Priority Health Narrow Network |
$518.75
|
| Rate for Payer: Priority Health SBD |
$518.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.75
|
| Rate for Payer: UHC Medicare Advantage |
$308.75
|
| Rate for Payer: UHCCP Medicaid |
$209.59
|
| Rate for Payer: UMR Bronson Commercial |
$333.04
|
|
|
PR TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 52630
|
| Min. Negotiated Rate |
$262.20 |
| Max. Negotiated Rate |
$727.47 |
| Rate for Payer: Aetna Commercial |
$520.43
|
| Rate for Payer: Aetna Medicare |
$403.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.27
|
| Rate for Payer: BCBS Complete |
$275.31
|
| Rate for Payer: BCBS MAPPO |
$388.38
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$586.90
|
| Rate for Payer: BCN Medicare Advantage |
$388.38
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$520.43
|
| Rate for Payer: Cofinity Commercial |
$559.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.80
|
| Rate for Payer: Meridian Medicaid |
$275.31
|
| Rate for Payer: Nomi Health Commercial |
$466.06
|
| Rate for Payer: PACE SWMI |
$388.38
|
| Rate for Payer: PHP Commercial |
$543.73
|
| Rate for Payer: PHP Medicare Advantage |
$388.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.78
|
| Rate for Payer: Priority Health Medicare |
$388.38
|
| Rate for Payer: Priority Health Narrow Network |
$649.78
|
| Rate for Payer: Priority Health SBD |
$649.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.38
|
| Rate for Payer: UHC Medicare Advantage |
$388.38
|
| Rate for Payer: UHCCP Medicaid |
$262.20
|
| Rate for Payer: UMR Bronson Commercial |
$362.94
|
|
|
PR TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 95921
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$1,174.41 |
| Rate for Payer: Aetna Commercial |
$106.20
|
| Rate for Payer: Aetna Medicare |
$82.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.12
|
| Rate for Payer: BCBS Complete |
$29.07
|
| Rate for Payer: BCBS MAPPO |
$79.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.41
|
| Rate for Payer: BCN Commercial |
$127.55
|
| Rate for Payer: BCN Medicare Advantage |
$79.25
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$106.20
|
| Rate for Payer: Cofinity Commercial |
$114.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.21
|
| Rate for Payer: Meridian Medicaid |
$29.07
|
| Rate for Payer: Nomi Health Commercial |
$95.10
|
| Rate for Payer: PACE SWMI |
$79.25
|
| Rate for Payer: PHP Commercial |
$110.95
|
| Rate for Payer: PHP Medicare Advantage |
$79.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.96
|
| Rate for Payer: Priority Health Medicare |
$79.25
|
| Rate for Payer: Priority Health Narrow Network |
$118.96
|
| Rate for Payer: Priority Health SBD |
$58.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.25
|
| Rate for Payer: UHC Medicare Advantage |
$79.25
|
| Rate for Payer: UHCCP Medicaid |
$27.69
|
| Rate for Payer: UMR Bronson Commercial |
$70.84
|
|
|
PR TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 95924
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$987.92 |
| Rate for Payer: Aetna Commercial |
$181.95
|
| Rate for Payer: Aetna Medicare |
$141.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.52
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$135.78
|
| Rate for Payer: BCBS Trust/PPO |
$987.92
|
| Rate for Payer: BCN Commercial |
$221.37
|
| Rate for Payer: BCN Medicare Advantage |
$135.78
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$181.95
|
| Rate for Payer: Cofinity Commercial |
$195.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.57
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$162.94
|
| Rate for Payer: PACE SWMI |
$135.78
|
| Rate for Payer: PHP Commercial |
$190.09
|
| Rate for Payer: PHP Medicare Advantage |
$135.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.89
|
| Rate for Payer: Priority Health Medicare |
$135.78
|
| Rate for Payer: Priority Health Narrow Network |
$204.89
|
| Rate for Payer: Priority Health SBD |
$115.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.78
|
| Rate for Payer: UHC Medicare Advantage |
$135.78
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
PR TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 95922
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$759.70 |
| Rate for Payer: Aetna Commercial |
$109.42
|
| Rate for Payer: Aetna Medicare |
$84.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.59
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$81.66
|
| Rate for Payer: BCBS Trust/PPO |
$759.70
|
| Rate for Payer: BCN Commercial |
$141.23
|
| Rate for Payer: BCN Medicare Advantage |
$81.66
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$117.59
|
| Rate for Payer: Cofinity Commercial |
$109.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.74
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Nomi Health Commercial |
$97.99
|
| Rate for Payer: PACE SWMI |
$81.66
|
| Rate for Payer: PHP Commercial |
$114.32
|
| Rate for Payer: PHP Medicare Advantage |
$81.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.46
|
| Rate for Payer: Priority Health Medicare |
$81.66
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Priority Health SBD |
$61.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.66
|
| Rate for Payer: UHC Medicare Advantage |
$81.66
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
| Rate for Payer: UMR Bronson Commercial |
$85.10
|
|
|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$1,574.52 |
| Rate for Payer: Aetna Commercial |
$193.52
|
| Rate for Payer: Aetna Medicare |
$150.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.96
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: BCBS MAPPO |
$144.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.54
|
| Rate for Payer: BCN Commercial |
$1,574.52
|
| Rate for Payer: BCN Medicare Advantage |
$144.42
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$193.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.64
|
| Rate for Payer: Nomi Health Commercial |
$173.30
|
| Rate for Payer: PACE SWMI |
$144.42
|
| Rate for Payer: PHP Commercial |
$202.19
|
| Rate for Payer: PHP Medicare Advantage |
$144.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.46
|
| Rate for Payer: Priority Health Medicare |
$144.42
|
| Rate for Payer: Priority Health Narrow Network |
$203.46
|
| Rate for Payer: Priority Health SBD |
$203.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.42
|
| Rate for Payer: UHC Medicare Advantage |
$144.42
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$2,262.71 |
| Rate for Payer: Aetna Commercial |
$183.11
|
| Rate for Payer: Aetna Medicare |
$142.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.78
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$136.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.71
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$136.65
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$183.11
|
| Rate for Payer: Cofinity Commercial |
$196.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.48
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$163.98
|
| Rate for Payer: PACE SWMI |
$136.65
|
| Rate for Payer: PHP Commercial |
$191.31
|
| Rate for Payer: PHP Medicare Advantage |
$136.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Medicare |
$136.65
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: Priority Health SBD |
$249.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.65
|
| Rate for Payer: UHC Medicare Advantage |
$136.65
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$571.78
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$753.36 |
| Rate for Payer: Aetna Commercial |
$199.78
|
| Rate for Payer: Aetna Medicare |
$155.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.69
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$149.09
|
| Rate for Payer: BCBS Trust/PPO |
$753.36
|
| Rate for Payer: BCN Commercial |
$223.81
|
| Rate for Payer: BCN Medicare Advantage |
$149.09
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$199.78
|
| Rate for Payer: Cofinity Commercial |
$214.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.54
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Nomi Health Commercial |
$178.91
|
| Rate for Payer: PACE SWMI |
$149.09
|
| Rate for Payer: PHP Commercial |
$208.73
|
| Rate for Payer: PHP Medicare Advantage |
$149.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.73
|
| Rate for Payer: Priority Health Medicare |
$149.09
|
| Rate for Payer: Priority Health Narrow Network |
$212.73
|
| Rate for Payer: Priority Health SBD |
$212.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.09
|
| Rate for Payer: UHC Medicare Advantage |
$149.09
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
| Rate for Payer: UMR Bronson Commercial |
$276.92
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,653.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,360.16 |
| Rate for Payer: Aetna Commercial |
$1,170.95
|
| Rate for Payer: Aetna Medicare |
$908.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.33
|
| Rate for Payer: BCBS Complete |
$661.20
|
| Rate for Payer: BCBS MAPPO |
$873.84
|
| Rate for Payer: BCBS Trust/PPO |
$428.98
|
| Rate for Payer: BCN Commercial |
$1,334.09
|
| Rate for Payer: BCN Medicare Advantage |
$873.84
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cash Price |
$1,322.40
|
| Rate for Payer: Cofinity Commercial |
$1,258.33
|
| Rate for Payer: Cofinity Commercial |
$1,170.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$917.53
|
| Rate for Payer: Nomi Health Commercial |
$1,048.61
|
| Rate for Payer: PACE SWMI |
$873.84
|
| Rate for Payer: PHP Commercial |
$1,223.38
|
| Rate for Payer: PHP Medicare Advantage |
$873.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,074.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,360.16
|
| Rate for Payer: Priority Health Medicare |
$873.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,360.16
|
| Rate for Payer: Priority Health SBD |
$1,360.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.84
|
| Rate for Payer: UHC Medicare Advantage |
$873.84
|
| Rate for Payer: UMR Bronson Commercial |
$760.38
|
|
|
PR TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA
|
Professional
|
Both
|
$3,910.00
|
|
|
Service Code
|
HCPCS 61108
|
| Min. Negotiated Rate |
$594.70 |
| Max. Negotiated Rate |
$2,541.50 |
| Rate for Payer: Aetna Commercial |
$1,199.38
|
| Rate for Payer: Aetna Medicare |
$930.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.38
|
| Rate for Payer: BCBS Complete |
$624.44
|
| Rate for Payer: BCBS MAPPO |
$895.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.07
|
| Rate for Payer: BCN Commercial |
$1,862.28
|
| Rate for Payer: BCN Medicare Advantage |
$895.06
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.89
|
| Rate for Payer: Cofinity Commercial |
$1,199.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$939.81
|
| Rate for Payer: Meridian Medicaid |
$624.44
|
| Rate for Payer: Nomi Health Commercial |
$1,074.07
|
| Rate for Payer: PACE SWMI |
$895.06
|
| Rate for Payer: PHP Commercial |
$1,253.08
|
| Rate for Payer: PHP Medicare Advantage |
$895.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,541.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,577.62
|
| Rate for Payer: Priority Health Medicare |
$895.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,577.62
|
| Rate for Payer: Priority Health SBD |
$1,577.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.06
|
| Rate for Payer: UHC Medicare Advantage |
$895.06
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,798.60
|
|
|
PR TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Professional
|
Both
|
$2,479.00
|
|
|
Service Code
|
HCPCS 61107
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$1,611.35 |
| Rate for Payer: Aetna Commercial |
$414.94
|
| Rate for Payer: Aetna Medicare |
$322.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.91
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$309.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.60
|
| Rate for Payer: BCN Commercial |
$633.87
|
| Rate for Payer: BCN Medicare Advantage |
$309.66
|
| Rate for Payer: Cash Price |
$1,983.20
|
| Rate for Payer: Cash Price |
$1,983.20
|
| Rate for Payer: Cofinity Commercial |
$414.94
|
| Rate for Payer: Cofinity Commercial |
$445.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.14
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Nomi Health Commercial |
$371.59
|
| Rate for Payer: PACE SWMI |
$309.66
|
| Rate for Payer: PHP Commercial |
$433.52
|
| Rate for Payer: PHP Medicare Advantage |
$309.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,611.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.17
|
| Rate for Payer: Priority Health Medicare |
$309.66
|
| Rate for Payer: Priority Health Narrow Network |
$535.17
|
| Rate for Payer: Priority Health SBD |
$535.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.66
|
| Rate for Payer: UHC Medicare Advantage |
$309.66
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,140.34
|
|
|
PR TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$2,149.00
|
|
|
Service Code
|
HCPCS 61105
|
| Min. Negotiated Rate |
$188.07 |
| Max. Negotiated Rate |
$1,396.85 |
| Rate for Payer: Aetna Commercial |
$615.86
|
| Rate for Payer: Aetna Medicare |
$477.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.82
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$459.60
|
| Rate for Payer: BCBS Trust/PPO |
$188.07
|
| Rate for Payer: BCN Commercial |
$957.24
|
| Rate for Payer: BCN Medicare Advantage |
$459.60
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cofinity Commercial |
$615.86
|
| Rate for Payer: Cofinity Commercial |
$661.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.58
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Nomi Health Commercial |
$551.52
|
| Rate for Payer: PACE SWMI |
$459.60
|
| Rate for Payer: PHP Commercial |
$643.44
|
| Rate for Payer: PHP Medicare Advantage |
$459.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$812.70
|
| Rate for Payer: Priority Health Medicare |
$459.60
|
| Rate for Payer: Priority Health Narrow Network |
$812.70
|
| Rate for Payer: Priority Health SBD |
$812.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.60
|
| Rate for Payer: UHC Medicare Advantage |
$459.60
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
| Rate for Payer: UMR Bronson Commercial |
$988.54
|
|
|
PR TWO AREA LIPOSUCTION - 2 AREA 2.0 HR
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 00528
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,101.60 |
| Max. Negotiated Rate |
$1,790.10 |
| Rate for Payer: Aetna Medicare |
$1,377.00
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,266.84
|
|
|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$312.47 |
| Max. Negotiated Rate |
$5,471.60 |
| Rate for Payer: Aetna Commercial |
$616.75
|
| Rate for Payer: Aetna Medicare |
$478.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.77
|
| Rate for Payer: BCBS Complete |
$328.09
|
| Rate for Payer: BCBS MAPPO |
$460.26
|
| Rate for Payer: BCBS Trust/PPO |
$5,471.60
|
| Rate for Payer: BCN Commercial |
$706.14
|
| Rate for Payer: BCN Medicare Advantage |
$460.26
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$662.77
|
| Rate for Payer: Cofinity Commercial |
$616.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.27
|
| Rate for Payer: Meridian Medicaid |
$328.09
|
| Rate for Payer: Nomi Health Commercial |
$552.31
|
| Rate for Payer: PACE SWMI |
$460.26
|
| Rate for Payer: PHP Commercial |
$644.36
|
| Rate for Payer: PHP Medicare Advantage |
$460.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.86
|
| Rate for Payer: Priority Health Medicare |
$460.26
|
| Rate for Payer: Priority Health Narrow Network |
$866.86
|
| Rate for Payer: Priority Health SBD |
$866.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.26
|
| Rate for Payer: UHC Medicare Advantage |
$460.26
|
| Rate for Payer: UHCCP Medicaid |
$312.47
|
| Rate for Payer: UMR Bronson Commercial |
$673.90
|
|
|
PR TX ECTOPIC PREGNANCY ABDL PREGNANCY
|
Professional
|
Both
|
$1,505.00
|
|
|
Service Code
|
HCPCS 59130
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$1,397.13 |
| Rate for Payer: Aetna Commercial |
$1,240.85
|
| Rate for Payer: Aetna Medicare |
$963.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.45
|
| Rate for Payer: BCBS Complete |
$640.53
|
| Rate for Payer: BCBS MAPPO |
$926.01
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$1,397.13
|
| Rate for Payer: BCN Medicare Advantage |
$926.01
|
| Rate for Payer: Cash Price |
$1,204.00
|
| Rate for Payer: Cash Price |
$1,204.00
|
| Rate for Payer: Cofinity Commercial |
$1,240.85
|
| Rate for Payer: Cofinity Commercial |
$1,333.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.31
|
| Rate for Payer: Meridian Medicaid |
$640.53
|
| Rate for Payer: Nomi Health Commercial |
$1,111.21
|
| Rate for Payer: PACE SWMI |
$926.01
|
| Rate for Payer: PHP Commercial |
$1,296.41
|
| Rate for Payer: PHP Medicare Advantage |
$926.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$978.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.13
|
| Rate for Payer: Priority Health Medicare |
$926.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,338.13
|
| Rate for Payer: Priority Health SBD |
$1,338.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$926.01
|
| Rate for Payer: UHC Medicare Advantage |
$926.01
|
| Rate for Payer: UHCCP Medicaid |
$610.03
|
| Rate for Payer: UMR Bronson Commercial |
$692.30
|
|
|
PR TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 59120
|
| Min. Negotiated Rate |
$51.77 |
| Max. Negotiated Rate |
$1,203.12 |
| Rate for Payer: Aetna Commercial |
$1,067.02
|
| Rate for Payer: Aetna Medicare |
$828.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.64
|
| Rate for Payer: BCBS Complete |
$551.96
|
| Rate for Payer: BCBS MAPPO |
$796.28
|
| Rate for Payer: BCBS Trust/PPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$796.28
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,067.02
|
| Rate for Payer: Cofinity Commercial |
$1,146.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.09
|
| Rate for Payer: Meridian Medicaid |
$551.96
|
| Rate for Payer: Nomi Health Commercial |
$955.54
|
| Rate for Payer: PACE SWMI |
$796.28
|
| Rate for Payer: PHP Commercial |
$1,114.79
|
| Rate for Payer: PHP Medicare Advantage |
$796.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,153.23
|
| Rate for Payer: Priority Health Medicare |
$796.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.23
|
| Rate for Payer: Priority Health SBD |
$1,153.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.28
|
| Rate for Payer: UHC Medicare Advantage |
$796.28
|
| Rate for Payer: UHCCP Medicaid |
$525.68
|
| Rate for Payer: UMR Bronson Commercial |
$795.34
|
|
