|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$1,085.66 |
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.15
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$9.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.66
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: BCN Medicare Advantage |
$9.13
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Cofinity Commercial |
$12.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.59
|
| Rate for Payer: Nomi Health Commercial |
$10.96
|
| Rate for Payer: PACE SWMI |
$9.13
|
| Rate for Payer: PHP Commercial |
$12.78
|
| Rate for Payer: PHP Medicare Advantage |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.47
|
| Rate for Payer: Priority Health Medicare |
$9.13
|
| Rate for Payer: Priority Health Narrow Network |
$14.47
|
| Rate for Payer: Priority Health SBD |
$2.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.13
|
| Rate for Payer: UHC Medicare Advantage |
$9.13
|
| Rate for Payer: UMR Bronson Commercial |
$10.12
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$794.10 |
| Rate for Payer: Aetna Commercial |
$687.23
|
| Rate for Payer: Aetna Medicare |
$533.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.23
|
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: BCBS MAPPO |
$512.86
|
| Rate for Payer: BCBS Trust/PPO |
$547.32
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$512.86
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cofinity Commercial |
$738.52
|
| Rate for Payer: Cofinity Commercial |
$687.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.50
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Nomi Health Commercial |
$615.43
|
| Rate for Payer: PACE SWMI |
$512.86
|
| Rate for Payer: PHP Commercial |
$718.00
|
| Rate for Payer: PHP Medicare Advantage |
$512.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.12
|
| Rate for Payer: Priority Health Medicare |
$512.86
|
| Rate for Payer: Priority Health Narrow Network |
$760.12
|
| Rate for Payer: Priority Health SBD |
$760.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.86
|
| Rate for Payer: UHC Medicare Advantage |
$512.86
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
| Rate for Payer: UMR Bronson Commercial |
$361.10
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$296.50 |
| Max. Negotiated Rate |
$695.95 |
| Rate for Payer: Aetna Commercial |
$589.12
|
| Rate for Payer: Aetna Medicare |
$457.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.08
|
| Rate for Payer: BCBS Complete |
$311.32
|
| Rate for Payer: BCBS MAPPO |
$439.64
|
| Rate for Payer: BCBS Trust/PPO |
$568.45
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: BCN Medicare Advantage |
$439.64
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$633.08
|
| Rate for Payer: Cofinity Commercial |
$589.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.62
|
| Rate for Payer: Meridian Medicaid |
$311.32
|
| Rate for Payer: Nomi Health Commercial |
$527.57
|
| Rate for Payer: PACE SWMI |
$439.64
|
| Rate for Payer: PHP Commercial |
$615.50
|
| Rate for Payer: PHP Medicare Advantage |
$439.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.95
|
| Rate for Payer: Priority Health Medicare |
$439.64
|
| Rate for Payer: Priority Health Narrow Network |
$695.95
|
| Rate for Payer: Priority Health SBD |
$695.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.64
|
| Rate for Payer: UHC Medicare Advantage |
$439.64
|
| Rate for Payer: UHCCP Medicaid |
$296.50
|
| Rate for Payer: UMR Bronson Commercial |
$397.44
|
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$3,097.42 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,068.89
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.42
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,257.64
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$596.98 |
| Rate for Payer: Aetna Commercial |
$205.93
|
| Rate for Payer: Aetna Medicare |
$159.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.30
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$153.68
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$153.68
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.36
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Nomi Health Commercial |
$184.42
|
| Rate for Payer: PACE SWMI |
$153.68
|
| Rate for Payer: PHP Commercial |
$215.15
|
| Rate for Payer: PHP Medicare Advantage |
$153.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.31
|
| Rate for Payer: Priority Health Medicare |
$153.68
|
| Rate for Payer: Priority Health Narrow Network |
$295.31
|
| Rate for Payer: Priority Health SBD |
$295.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.68
|
| Rate for Payer: UHC Medicare Advantage |
$153.68
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
| Rate for Payer: UMR Bronson Commercial |
$263.58
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,124.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$190.19 |
| Max. Negotiated Rate |
$2,030.60 |
| Rate for Payer: Aetna Commercial |
$1,601.43
|
| Rate for Payer: Aetna Medicare |
$1,242.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,720.94
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,195.10
|
| Rate for Payer: BCBS Trust/PPO |
$190.19
|
| Rate for Payer: BCN Commercial |
$1,823.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,195.10
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cofinity Commercial |
$1,601.43
|
| Rate for Payer: Cofinity Commercial |
$1,720.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,195.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,254.86
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Nomi Health Commercial |
$1,434.12
|
| Rate for Payer: PACE SWMI |
$1,195.10
|
| Rate for Payer: PHP Commercial |
$1,673.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,195.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,030.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.72
|
| Rate for Payer: Priority Health Medicare |
$1,195.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,855.72
|
| Rate for Payer: Priority Health SBD |
$1,855.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,195.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,195.10
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,437.04
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,457.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$2,247.05 |
| Rate for Payer: Aetna Commercial |
$1,687.26
|
| Rate for Payer: Aetna Medicare |
$1,309.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,813.18
|
| Rate for Payer: BCBS Complete |
$879.62
|
| Rate for Payer: BCBS MAPPO |
$1,259.15
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$1,921.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,259.15
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Cofinity Commercial |
$1,687.26
|
| Rate for Payer: Cofinity Commercial |
$1,813.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,259.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,322.11
|
| Rate for Payer: Meridian Medicaid |
$879.62
|
| Rate for Payer: Nomi Health Commercial |
$1,510.98
|
| Rate for Payer: PACE SWMI |
$1,259.15
|
| Rate for Payer: PHP Commercial |
$1,762.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,259.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,955.41
|
| Rate for Payer: Priority Health Medicare |
$1,259.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,955.41
|
| Rate for Payer: Priority Health SBD |
$1,955.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,259.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,259.15
|
| Rate for Payer: UHCCP Medicaid |
$837.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,590.22
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$2,973.00
|
|
|
Service Code
|
HCPCS 58262
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$1,932.45 |
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: Aetna Medicare |
$926.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,282.80
|
| Rate for Payer: BCBS Complete |
$624.44
|
| Rate for Payer: BCBS MAPPO |
$890.83
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$1,359.01
|
| Rate for Payer: BCN Medicare Advantage |
$890.83
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Cofinity Commercial |
$1,193.71
|
| Rate for Payer: Cofinity Commercial |
$1,282.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$935.37
|
| Rate for Payer: Meridian Medicaid |
$624.44
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE SWMI |
$890.83
|
| Rate for Payer: PHP Commercial |
$1,247.16
|
| Rate for Payer: PHP Medicare Advantage |
$890.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,386.95
|
| Rate for Payer: Priority Health Medicare |
$890.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.95
|
| Rate for Payer: Priority Health SBD |
$1,386.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.83
|
| Rate for Payer: UHC Medicare Advantage |
$890.83
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,367.58
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,245.00
|
|
|
Service Code
|
HCPCS 58263
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$2,109.25 |
| Rate for Payer: Aetna Commercial |
$1,281.68
|
| Rate for Payer: Aetna Medicare |
$994.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.33
|
| Rate for Payer: BCBS Complete |
$669.84
|
| Rate for Payer: BCBS MAPPO |
$956.48
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$1,457.73
|
| Rate for Payer: BCN Medicare Advantage |
$956.48
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,281.68
|
| Rate for Payer: Cofinity Commercial |
$1,377.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.30
|
| Rate for Payer: Meridian Medicaid |
$669.84
|
| Rate for Payer: Nomi Health Commercial |
$1,147.78
|
| Rate for Payer: PACE SWMI |
$956.48
|
| Rate for Payer: PHP Commercial |
$1,339.07
|
| Rate for Payer: PHP Medicare Advantage |
$956.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.15
|
| Rate for Payer: Priority Health Medicare |
$956.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,486.15
|
| Rate for Payer: Priority Health SBD |
$1,486.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.48
|
| Rate for Payer: UHC Medicare Advantage |
$956.48
|
| Rate for Payer: UHCCP Medicaid |
$637.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,492.70
|
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 58280
|
| Min. Negotiated Rate |
$237.74 |
| Max. Negotiated Rate |
$2,425.80 |
| Rate for Payer: Aetna Commercial |
$1,362.99
|
| Rate for Payer: Aetna Medicare |
$1,057.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,464.71
|
| Rate for Payer: BCBS Complete |
$712.33
|
| Rate for Payer: BCBS MAPPO |
$1,017.16
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: BCN Commercial |
$1,554.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.16
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,362.99
|
| Rate for Payer: Cofinity Commercial |
$1,464.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.02
|
| Rate for Payer: Meridian Medicaid |
$712.33
|
| Rate for Payer: Nomi Health Commercial |
$1,220.59
|
| Rate for Payer: PACE SWMI |
$1,017.16
|
| Rate for Payer: PHP Commercial |
$1,424.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,584.37
|
| Rate for Payer: Priority Health Medicare |
$1,017.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,584.37
|
| Rate for Payer: Priority Health SBD |
$1,584.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,017.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,017.16
|
| Rate for Payer: UHCCP Medicaid |
$678.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,716.72
|
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 59612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$1,191.25
|
| Rate for Payer: Aetna Medicare |
$924.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,280.15
|
| Rate for Payer: BCBS Complete |
$886.77
|
| Rate for Payer: BCBS MAPPO |
$888.99
|
| Rate for Payer: BCBS Trust/PPO |
$187.55
|
| Rate for Payer: BCN Commercial |
$1,636.60
|
| Rate for Payer: BCN Medicare Advantage |
$888.99
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.25
|
| Rate for Payer: Cofinity Commercial |
$1,280.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.44
|
| Rate for Payer: Meridian Medicaid |
$886.77
|
| Rate for Payer: Nomi Health Commercial |
$1,066.79
|
| Rate for Payer: PACE SWMI |
$888.99
|
| Rate for Payer: PHP Commercial |
$1,244.59
|
| Rate for Payer: PHP Medicare Advantage |
$888.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,267.33
|
| Rate for Payer: Priority Health Medicare |
$888.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,267.33
|
| Rate for Payer: Priority Health SBD |
$1,267.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$888.99
|
| Rate for Payer: UHC Medicare Advantage |
$888.99
|
| Rate for Payer: UHCCP Medicaid |
$844.54
|
| Rate for Payer: UMR Bronson Commercial |
$986.70
|
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
HCPCS 59409
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$1,558.66 |
| Rate for Payer: Aetna Commercial |
$1,046.55
|
| Rate for Payer: Aetna Medicare |
$812.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,124.65
|
| Rate for Payer: BCBS Complete |
$779.06
|
| Rate for Payer: BCBS MAPPO |
$781.01
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: BCN Commercial |
$1,558.66
|
| Rate for Payer: BCN Medicare Advantage |
$781.01
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cofinity Commercial |
$1,046.55
|
| Rate for Payer: Cofinity Commercial |
$1,124.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.06
|
| Rate for Payer: Meridian Medicaid |
$779.06
|
| Rate for Payer: Nomi Health Commercial |
$937.21
|
| Rate for Payer: PACE SWMI |
$781.01
|
| Rate for Payer: PHP Commercial |
$1,093.41
|
| Rate for Payer: PHP Medicare Advantage |
$781.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.29
|
| Rate for Payer: Priority Health Medicare |
$781.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.29
|
| Rate for Payer: Priority Health SBD |
$1,118.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.01
|
| Rate for Payer: UHC Medicare Advantage |
$781.01
|
| Rate for Payer: UHCCP Medicaid |
$741.96
|
| Rate for Payer: UMR Bronson Commercial |
$906.20
|
|
|
PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 59410
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$1,809.19 |
| Rate for Payer: Aetna Commercial |
$1,413.43
|
| Rate for Payer: Aetna Medicare |
$1,096.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,518.91
|
| Rate for Payer: BCBS Complete |
$1,052.16
|
| Rate for Payer: BCBS MAPPO |
$1,054.80
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: BCN Commercial |
$1,809.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,054.80
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$1,413.43
|
| Rate for Payer: Cofinity Commercial |
$1,518.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.54
|
| Rate for Payer: Meridian Medicaid |
$1,052.16
|
| Rate for Payer: Nomi Health Commercial |
$1,265.76
|
| Rate for Payer: PACE SWMI |
$1,054.80
|
| Rate for Payer: PHP Commercial |
$1,476.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,054.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,002.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.19
|
| Rate for Payer: Priority Health Medicare |
$1,054.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,514.19
|
| Rate for Payer: Priority Health SBD |
$1,514.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,054.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,054.80
|
| Rate for Payer: UHCCP Medicaid |
$1,002.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,031.32
|
|
|
PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 59614
|
| Min. Negotiated Rate |
$325.96 |
| Max. Negotiated Rate |
$1,899.65 |
| Rate for Payer: Aetna Commercial |
$1,537.32
|
| Rate for Payer: Aetna Medicare |
$1,193.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,652.04
|
| Rate for Payer: BCBS Complete |
$1,144.38
|
| Rate for Payer: BCBS MAPPO |
$1,147.25
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCN Commercial |
$1,899.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.25
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cofinity Commercial |
$1,537.32
|
| Rate for Payer: Cofinity Commercial |
$1,652.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,204.61
|
| Rate for Payer: Meridian Medicaid |
$1,144.38
|
| Rate for Payer: Nomi Health Commercial |
$1,376.70
|
| Rate for Payer: PACE SWMI |
$1,147.25
|
| Rate for Payer: PHP Commercial |
$1,606.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,637.16
|
| Rate for Payer: Priority Health Medicare |
$1,147.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,637.16
|
| Rate for Payer: Priority Health SBD |
$1,637.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,147.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,147.25
|
| Rate for Payer: UHCCP Medicaid |
$1,089.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.82
|
|
|
PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 58294
|
| Min. Negotiated Rate |
$327.55 |
| Max. Negotiated Rate |
$1,816.03 |
| Rate for Payer: Aetna Commercial |
$1,567.37
|
| Rate for Payer: Aetna Medicare |
$1,216.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,567.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,684.34
|
| Rate for Payer: BCBS Complete |
$817.45
|
| Rate for Payer: BCBS MAPPO |
$1,169.68
|
| Rate for Payer: BCBS Trust/PPO |
$327.55
|
| Rate for Payer: BCN Commercial |
$1,784.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.68
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cofinity Commercial |
$1,567.37
|
| Rate for Payer: Cofinity Commercial |
$1,684.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,228.16
|
| Rate for Payer: Meridian Medicaid |
$817.45
|
| Rate for Payer: Nomi Health Commercial |
$1,403.62
|
| Rate for Payer: PACE SWMI |
$1,169.68
|
| Rate for Payer: PHP Commercial |
$1,637.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,816.03
|
| Rate for Payer: Priority Health Medicare |
$1,169.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,816.03
|
| Rate for Payer: Priority Health SBD |
$1,816.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,169.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,169.68
|
| Rate for Payer: UHCCP Medicaid |
$778.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.48
|
|
|
PR VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE
|
Professional
|
Both
|
$2,757.00
|
|
|
Service Code
|
HCPCS 58270
|
| Min. Negotiated Rate |
$233.51 |
| Max. Negotiated Rate |
$1,792.05 |
| Rate for Payer: Aetna Commercial |
$1,150.51
|
| Rate for Payer: Aetna Medicare |
$892.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.37
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$858.59
|
| Rate for Payer: BCBS Trust/PPO |
$233.51
|
| Rate for Payer: BCN Commercial |
$1,313.56
|
| Rate for Payer: BCN Medicare Advantage |
$858.59
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cofinity Commercial |
$1,150.51
|
| Rate for Payer: Cofinity Commercial |
$1,236.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.52
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Nomi Health Commercial |
$1,030.31
|
| Rate for Payer: PACE SWMI |
$858.59
|
| Rate for Payer: PHP Commercial |
$1,202.03
|
| Rate for Payer: PHP Medicare Advantage |
$858.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.85
|
| Rate for Payer: Priority Health Medicare |
$858.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.85
|
| Rate for Payer: Priority Health SBD |
$1,336.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.59
|
| Rate for Payer: UHC Medicare Advantage |
$858.59
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,268.22
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS > 250 GM
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 58290
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,896.05 |
| Rate for Payer: Aetna Commercial |
$1,482.36
|
| Rate for Payer: Aetna Medicare |
$1,150.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,592.99
|
| Rate for Payer: BCBS Complete |
$773.38
|
| Rate for Payer: BCBS MAPPO |
$1,106.24
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$1,687.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.24
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,482.36
|
| Rate for Payer: Cofinity Commercial |
$1,592.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.55
|
| Rate for Payer: Meridian Medicaid |
$773.38
|
| Rate for Payer: Nomi Health Commercial |
$1,327.49
|
| Rate for Payer: PACE SWMI |
$1,106.24
|
| Rate for Payer: PHP Commercial |
$1,548.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.31
|
| Rate for Payer: Priority Health Medicare |
$1,106.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.31
|
| Rate for Payer: Priority Health SBD |
$1,718.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.24
|
| Rate for Payer: UHCCP Medicaid |
$736.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,341.82
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,684.00
|
|
|
Service Code
|
HCPCS 58260
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,744.60 |
| Rate for Payer: Aetna Commercial |
$1,078.59
|
| Rate for Payer: Aetna Medicare |
$837.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,159.08
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS MAPPO |
$804.92
|
| Rate for Payer: BCBS Trust/PPO |
$240.90
|
| Rate for Payer: BCN Commercial |
$1,231.47
|
| Rate for Payer: BCN Medicare Advantage |
$804.92
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,078.59
|
| Rate for Payer: Cofinity Commercial |
$1,159.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.17
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Nomi Health Commercial |
$965.90
|
| Rate for Payer: PACE SWMI |
$804.92
|
| Rate for Payer: PHP Commercial |
$1,126.89
|
| Rate for Payer: PHP Medicare Advantage |
$804.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.50
|
| Rate for Payer: Priority Health Medicare |
$804.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,255.50
|
| Rate for Payer: Priority Health SBD |
$1,255.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.92
|
| Rate for Payer: UHC Medicare Advantage |
$804.92
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,234.64
|
|
|
PR VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 58275
|
| Min. Negotiated Rate |
$263.09 |
| Max. Negotiated Rate |
$1,570.40 |
| Rate for Payer: Aetna Commercial |
$1,277.02
|
| Rate for Payer: Aetna Medicare |
$991.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.32
|
| Rate for Payer: BCBS Complete |
$667.82
|
| Rate for Payer: BCBS MAPPO |
$953.00
|
| Rate for Payer: BCBS Trust/PPO |
$263.09
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$953.00
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,277.02
|
| Rate for Payer: Cofinity Commercial |
$1,372.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.65
|
| Rate for Payer: Meridian Medicaid |
$667.82
|
| Rate for Payer: Nomi Health Commercial |
$1,143.60
|
| Rate for Payer: PACE SWMI |
$953.00
|
| Rate for Payer: PHP Commercial |
$1,334.20
|
| Rate for Payer: PHP Medicare Advantage |
$953.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,481.19
|
| Rate for Payer: Priority Health Medicare |
$953.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,481.19
|
| Rate for Payer: Priority Health SBD |
$1,481.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.00
|
| Rate for Payer: UHC Medicare Advantage |
$953.00
|
| Rate for Payer: UHCCP Medicaid |
$636.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.36
|
|
|
PR VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57110
|
| Min. Negotiated Rate |
$578.51 |
| Max. Negotiated Rate |
$2,148.07 |
| Rate for Payer: Aetna Commercial |
$1,160.33
|
| Rate for Payer: Aetna Medicare |
$900.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,246.92
|
| Rate for Payer: BCBS Complete |
$607.44
|
| Rate for Payer: BCBS MAPPO |
$865.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.07
|
| Rate for Payer: BCN Commercial |
$1,325.29
|
| Rate for Payer: BCN Medicare Advantage |
$865.92
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,160.33
|
| Rate for Payer: Cofinity Commercial |
$1,246.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$865.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.22
|
| Rate for Payer: Meridian Medicaid |
$607.44
|
| Rate for Payer: Nomi Health Commercial |
$1,039.10
|
| Rate for Payer: PACE SWMI |
$865.92
|
| Rate for Payer: PHP Commercial |
$1,212.29
|
| Rate for Payer: PHP Medicare Advantage |
$865.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.25
|
| Rate for Payer: Priority Health Medicare |
$865.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.25
|
| Rate for Payer: Priority Health SBD |
$1,350.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$865.92
|
| Rate for Payer: UHC Medicare Advantage |
$865.92
|
| Rate for Payer: UHCCP Medicaid |
$578.51
|
| Rate for Payer: UMR Bronson Commercial |
$931.50
|
|
|
PR VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$1,993.00
|
|
|
Service Code
|
HCPCS 57106
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$3,372.14 |
| Rate for Payer: Aetna Commercial |
$683.78
|
| Rate for Payer: Aetna Medicare |
$530.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.80
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS MAPPO |
$510.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,372.14
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$510.28
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cofinity Commercial |
$683.78
|
| Rate for Payer: Cofinity Commercial |
$734.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.79
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Nomi Health Commercial |
$612.34
|
| Rate for Payer: PACE SWMI |
$510.28
|
| Rate for Payer: PHP Commercial |
$714.39
|
| Rate for Payer: PHP Medicare Advantage |
$510.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.56
|
| Rate for Payer: Priority Health Medicare |
$510.28
|
| Rate for Payer: Priority Health Narrow Network |
$807.56
|
| Rate for Payer: Priority Health SBD |
$807.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.28
|
| Rate for Payer: UHC Medicare Advantage |
$510.28
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
| Rate for Payer: UMR Bronson Commercial |
$916.78
|
|
|
PR VAGINOPLASTY INTERSEX STATE
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 57335
|
| Min. Negotiated Rate |
$753.17 |
| Max. Negotiated Rate |
$1,759.48 |
| Rate for Payer: Aetna Commercial |
$1,511.52
|
| Rate for Payer: Aetna Medicare |
$1,173.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,624.32
|
| Rate for Payer: BCBS Complete |
$790.83
|
| Rate for Payer: BCBS MAPPO |
$1,128.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.54
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.00
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,511.52
|
| Rate for Payer: Cofinity Commercial |
$1,624.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.40
|
| Rate for Payer: Meridian Medicaid |
$790.83
|
| Rate for Payer: Nomi Health Commercial |
$1,353.60
|
| Rate for Payer: PACE SWMI |
$1,128.00
|
| Rate for Payer: PHP Commercial |
$1,579.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$753.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,759.48
|
| Rate for Payer: Priority Health Medicare |
$1,128.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,759.48
|
| Rate for Payer: Priority Health SBD |
$1,759.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.00
|
| Rate for Payer: UHCCP Medicaid |
$753.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,165.18
|
|
|
PR VAGNC PRTL RMVL VAG WALL W/RMVL PARAVAGINAL TISS
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 57107
|
| Min. Negotiated Rate |
$935.28 |
| Max. Negotiated Rate |
$3,758.85 |
| Rate for Payer: Aetna Commercial |
$1,874.71
|
| Rate for Payer: Aetna Medicare |
$1,455.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,874.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,014.62
|
| Rate for Payer: BCBS Complete |
$982.04
|
| Rate for Payer: BCBS MAPPO |
$1,399.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,758.85
|
| Rate for Payer: BCN Commercial |
$2,129.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.04
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cofinity Commercial |
$1,874.71
|
| Rate for Payer: Cofinity Commercial |
$2,014.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,468.99
|
| Rate for Payer: Meridian Medicaid |
$982.04
|
| Rate for Payer: Nomi Health Commercial |
$1,678.85
|
| Rate for Payer: PACE SWMI |
$1,399.04
|
| Rate for Payer: PHP Commercial |
$1,958.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,180.62
|
| Rate for Payer: Priority Health Medicare |
$1,399.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,180.62
|
| Rate for Payer: Priority Health SBD |
$2,180.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,399.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,399.04
|
| Rate for Payer: UHCCP Medicaid |
$935.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,182.66
|
|
|
PR VAGOTOMY PFRMD W/PRTL DSTL GSTRCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 43635
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$806.71 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$113.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.46
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$109.35
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$163.22
|
| Rate for Payer: BCN Medicare Advantage |
$109.35
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$146.53
|
| Rate for Payer: Cofinity Commercial |
$157.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.82
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Nomi Health Commercial |
$131.22
|
| Rate for Payer: PACE SWMI |
$109.35
|
| Rate for Payer: PHP Commercial |
$153.09
|
| Rate for Payer: PHP Medicare Advantage |
$109.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.26
|
| Rate for Payer: Priority Health Medicare |
$109.35
|
| Rate for Payer: Priority Health Narrow Network |
$199.26
|
| Rate for Payer: Priority Health SBD |
$199.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.35
|
| Rate for Payer: UHC Medicare Advantage |
$109.35
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 33460
|
| Min. Negotiated Rate |
$1,500.37 |
| Max. Negotiated Rate |
$3,731.81 |
| Rate for Payer: Aetna Commercial |
$3,069.82
|
| Rate for Payer: Aetna Medicare |
$2,382.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,069.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,298.91
|
| Rate for Payer: BCBS Complete |
$1,575.39
|
| Rate for Payer: BCBS MAPPO |
$2,290.91
|
| Rate for Payer: BCN Commercial |
$3,425.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,290.91
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cofinity Commercial |
$3,069.82
|
| Rate for Payer: Cofinity Commercial |
$3,298.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,290.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,405.46
|
| Rate for Payer: Meridian Medicaid |
$1,575.39
|
| Rate for Payer: Nomi Health Commercial |
$2,749.09
|
| Rate for Payer: PACE SWMI |
$2,290.91
|
| Rate for Payer: PHP Commercial |
$3,207.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,290.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,500.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,158.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,731.81
|
| Rate for Payer: Priority Health Medicare |
$2,290.91
|
| Rate for Payer: Priority Health Narrow Network |
$3,731.81
|
| Rate for Payer: Priority Health SBD |
$3,731.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,290.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,290.91
|
| Rate for Payer: UHCCP Medicaid |
$1,500.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,235.14
|
|
