|
PR OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH
|
Professional
|
Both
|
$4,022.00
|
|
|
Service Code
|
HCPCS 22327
|
| Min. Negotiated Rate |
$958.71 |
| Max. Negotiated Rate |
$3,016.50 |
| Rate for Payer: PHP Medicare Advantage |
$1,483.44
|
| Rate for Payer: Aetna Commercial |
$1,987.81
|
| Rate for Payer: Aetna Medicare |
$1,542.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,987.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,136.15
|
| Rate for Payer: BCBS Complete |
$1,006.65
|
| Rate for Payer: BCBS MAPPO |
$1,483.44
|
| Rate for Payer: BCN Commercial |
$2,346.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,483.44
|
| Rate for Payer: Cash Price |
$3,217.60
|
| Rate for Payer: Cash Price |
$3,217.60
|
| Rate for Payer: Cofinity Commercial |
$2,136.15
|
| Rate for Payer: Cofinity Commercial |
$1,987.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,483.44
|
| Rate for Payer: Healthscope Commercial |
$2,744.36
|
| Rate for Payer: Healthscope Commercial |
$2,373.50
|
| Rate for Payer: Mclaren Medicaid |
$958.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,557.61
|
| Rate for Payer: Meridian Medicaid |
$1,006.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,631.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,758.28
|
| Rate for Payer: Nomi Health Commercial |
$1,780.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,016.50
|
| Rate for Payer: PACE SWMI |
$1,483.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$958.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,508.33
|
| Rate for Payer: Priority Health Medicare |
$1,483.44
|
| Rate for Payer: Priority Health SBD |
$2,508.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,508.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,483.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,656.74
|
| Rate for Payer: UHC Core |
$2,656.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,483.44
|
| Rate for Payer: UHC Exchange |
$2,656.74
|
| Rate for Payer: UHC Medicaid |
$958.71
|
| Rate for Payer: UHCCP Medicaid |
$958.71
|
|
|
PR OPTX RDL SHAFT FX&CLTX DSTL RAD/ULN JT DISLC
|
Professional
|
Both
|
$2,656.00
|
|
|
Service Code
|
HCPCS 25525
|
| Min. Negotiated Rate |
$469.88 |
| Max. Negotiated Rate |
$1,992.00 |
| Rate for Payer: Aetna Commercial |
$961.42
|
| Rate for Payer: Aetna Medicare |
$746.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.42
|
| Rate for Payer: BCBS Complete |
$493.37
|
| Rate for Payer: BCBS MAPPO |
$717.48
|
| Rate for Payer: BCN Commercial |
$1,210.10
|
| Rate for Payer: BCN Medicare Advantage |
$717.48
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cofinity Commercial |
$961.42
|
| Rate for Payer: Cofinity Commercial |
$1,033.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.48
|
| Rate for Payer: Healthscope Commercial |
$1,327.34
|
| Rate for Payer: Healthscope Commercial |
$1,147.97
|
| Rate for Payer: Mclaren Medicaid |
$469.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.35
|
| Rate for Payer: Meridian Medicaid |
$493.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$789.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,404.22
|
| Rate for Payer: Nomi Health Commercial |
$860.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,992.00
|
| Rate for Payer: PACE SWMI |
$717.48
|
| Rate for Payer: PHP Medicare Advantage |
$717.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,293.56
|
| Rate for Payer: Priority Health Medicare |
$717.48
|
| Rate for Payer: Priority Health SBD |
$1,293.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,293.56
|
| Rate for Payer: Railroad Medicare Medicare |
$717.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.57
|
| Rate for Payer: UHC Core |
$1,373.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$717.48
|
| Rate for Payer: UHC Exchange |
$1,373.57
|
| Rate for Payer: UHC Medicaid |
$469.88
|
| Rate for Payer: UHCCP Medicaid |
$469.88
|
|
|
PR OPTX RDL SHAFT FX&OPTX DSTL RAD/ULN JT DISLC
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 25526
|
| Min. Negotiated Rate |
$570.84 |
| Max. Negotiated Rate |
$2,298.00 |
| Rate for Payer: Aetna Commercial |
$1,171.45
|
| Rate for Payer: Aetna Medicare |
$909.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.88
|
| Rate for Payer: BCBS Complete |
$599.38
|
| Rate for Payer: BCBS MAPPO |
$874.22
|
| Rate for Payer: BCN Commercial |
$1,458.59
|
| Rate for Payer: BCN Medicare Advantage |
$874.22
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,258.88
|
| Rate for Payer: Cofinity Commercial |
$1,171.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.22
|
| Rate for Payer: Healthscope Commercial |
$1,617.31
|
| Rate for Payer: Healthscope Commercial |
$1,398.75
|
| Rate for Payer: Mclaren Medicaid |
$570.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$917.93
|
| Rate for Payer: Meridian Medicaid |
$599.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$961.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.87
|
| Rate for Payer: Nomi Health Commercial |
$1,049.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,298.00
|
| Rate for Payer: PACE SWMI |
$874.22
|
| Rate for Payer: PHP Medicare Advantage |
$874.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,559.19
|
| Rate for Payer: Priority Health Medicare |
$874.22
|
| Rate for Payer: Priority Health SBD |
$1,559.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,559.19
|
| Rate for Payer: Railroad Medicare Medicare |
$874.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,667.46
|
| Rate for Payer: UHC Core |
$1,667.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$874.22
|
| Rate for Payer: UHC Exchange |
$1,667.46
|
| Rate for Payer: UHC Medicaid |
$570.84
|
| Rate for Payer: UHCCP Medicaid |
$570.84
|
|
|
PR OPTX SHO DISLC W/FX GR HUMERAL TUBRST INT FIXJ
|
Professional
|
Both
|
$3,027.00
|
|
|
Service Code
|
HCPCS 23670
|
| Min. Negotiated Rate |
$521.42 |
| Max. Negotiated Rate |
$2,270.25 |
| Rate for Payer: Aetna Commercial |
$1,071.30
|
| Rate for Payer: Aetna Medicare |
$831.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,071.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.25
|
| Rate for Payer: BCBS Complete |
$547.49
|
| Rate for Payer: BCBS MAPPO |
$799.48
|
| Rate for Payer: BCN Commercial |
$1,330.61
|
| Rate for Payer: BCN Medicare Advantage |
$799.48
|
| Rate for Payer: Cash Price |
$2,421.60
|
| Rate for Payer: Cash Price |
$2,421.60
|
| Rate for Payer: Cofinity Commercial |
$1,151.25
|
| Rate for Payer: Cofinity Commercial |
$1,071.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.48
|
| Rate for Payer: Healthscope Commercial |
$1,479.04
|
| Rate for Payer: Healthscope Commercial |
$1,279.17
|
| Rate for Payer: Mclaren Medicaid |
$521.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.45
|
| Rate for Payer: Meridian Medicaid |
$547.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$879.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,545.95
|
| Rate for Payer: Nomi Health Commercial |
$959.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,270.25
|
| Rate for Payer: PACE SWMI |
$799.48
|
| Rate for Payer: PHP Medicare Advantage |
$799.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,422.38
|
| Rate for Payer: Priority Health Medicare |
$799.48
|
| Rate for Payer: Priority Health SBD |
$1,422.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,422.38
|
| Rate for Payer: Railroad Medicare Medicare |
$799.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,527.04
|
| Rate for Payer: UHC Core |
$1,527.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$799.48
|
| Rate for Payer: UHC Exchange |
$1,527.04
|
| Rate for Payer: UHC Medicaid |
$521.42
|
| Rate for Payer: UHCCP Medicaid |
$521.42
|
|
|
PR OPTX SHO DISLC W/SURG/ANTMCL NECK FX INT FIXJ
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 23680
|
| Min. Negotiated Rate |
$551.67 |
| Max. Negotiated Rate |
$1,651.00 |
| Rate for Payer: Aetna Commercial |
$1,134.67
|
| Rate for Payer: Aetna Medicare |
$880.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.35
|
| Rate for Payer: BCBS Complete |
$579.25
|
| Rate for Payer: BCBS MAPPO |
$846.77
|
| Rate for Payer: BCN Commercial |
$1,416.76
|
| Rate for Payer: BCN Medicare Advantage |
$846.77
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,219.35
|
| Rate for Payer: Cofinity Commercial |
$1,134.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$846.77
|
| Rate for Payer: Healthscope Commercial |
$1,566.52
|
| Rate for Payer: Healthscope Commercial |
$1,354.83
|
| Rate for Payer: Mclaren Medicaid |
$551.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$889.11
|
| Rate for Payer: Meridian Medicaid |
$579.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$931.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.00
|
| Rate for Payer: Nomi Health Commercial |
$1,016.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$846.77
|
| Rate for Payer: PHP Medicare Advantage |
$846.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,514.48
|
| Rate for Payer: Priority Health Medicare |
$846.77
|
| Rate for Payer: Priority Health SBD |
$1,514.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,514.48
|
| Rate for Payer: Railroad Medicare Medicare |
$846.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,626.45
|
| Rate for Payer: UHC Core |
$1,626.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$846.77
|
| Rate for Payer: UHC Exchange |
$1,626.45
|
| Rate for Payer: UHC Medicaid |
$551.67
|
| Rate for Payer: UHCCP Medicaid |
$551.67
|
|
|
PR OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN
|
Professional
|
Both
|
$1,696.00
|
|
|
Service Code
|
HCPCS 27178
|
| Min. Negotiated Rate |
$546.35 |
| Max. Negotiated Rate |
$1,637.32 |
| Rate for Payer: Aetna Commercial |
$1,123.12
|
| Rate for Payer: Aetna Medicare |
$871.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.94
|
| Rate for Payer: BCBS Complete |
$573.67
|
| Rate for Payer: BCBS MAPPO |
$838.15
|
| Rate for Payer: BCN Commercial |
$1,403.31
|
| Rate for Payer: BCN Medicare Advantage |
$838.15
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cash Price |
$1,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,206.94
|
| Rate for Payer: Cofinity Commercial |
$1,123.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.15
|
| Rate for Payer: Healthscope Commercial |
$1,550.58
|
| Rate for Payer: Healthscope Commercial |
$1,341.04
|
| Rate for Payer: Mclaren Medicaid |
$546.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.06
|
| Rate for Payer: Meridian Medicaid |
$573.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$921.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.32
|
| Rate for Payer: Nomi Health Commercial |
$1,005.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,272.00
|
| Rate for Payer: PACE SWMI |
$838.15
|
| Rate for Payer: PHP Medicare Advantage |
$838.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,500.09
|
| Rate for Payer: Priority Health Medicare |
$838.15
|
| Rate for Payer: Priority Health SBD |
$1,500.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,500.09
|
| Rate for Payer: Railroad Medicare Medicare |
$838.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.13
|
| Rate for Payer: UHC Core |
$1,609.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$838.15
|
| Rate for Payer: UHC Exchange |
$1,609.13
|
| Rate for Payer: UHC Medicaid |
$546.35
|
| Rate for Payer: UHCCP Medicaid |
$546.35
|
|
|
PR OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ
|
Professional
|
Both
|
$2,422.00
|
|
|
Service Code
|
HCPCS 27181
|
| Min. Negotiated Rate |
$658.38 |
| Max. Negotiated Rate |
$1,985.98 |
| Rate for Payer: Aetna Commercial |
$1,356.91
|
| Rate for Payer: Aetna Medicare |
$1,053.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.17
|
| Rate for Payer: BCBS Complete |
$691.30
|
| Rate for Payer: BCBS MAPPO |
$1,012.62
|
| Rate for Payer: BCN Commercial |
$1,699.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.62
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cash Price |
$1,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,458.17
|
| Rate for Payer: Cofinity Commercial |
$1,356.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.62
|
| Rate for Payer: Healthscope Commercial |
$1,873.35
|
| Rate for Payer: Healthscope Commercial |
$1,620.19
|
| Rate for Payer: Mclaren Medicaid |
$658.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,063.25
|
| Rate for Payer: Meridian Medicaid |
$691.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,113.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,985.98
|
| Rate for Payer: Nomi Health Commercial |
$1,215.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,816.50
|
| Rate for Payer: PACE SWMI |
$1,012.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,816.30
|
| Rate for Payer: Priority Health Medicare |
$1,012.62
|
| Rate for Payer: Priority Health SBD |
$1,816.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,816.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,012.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,963.17
|
| Rate for Payer: UHC Core |
$1,963.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,012.62
|
| Rate for Payer: UHC Exchange |
$1,963.17
|
| Rate for Payer: UHC Medicaid |
$658.38
|
| Rate for Payer: UHCCP Medicaid |
$658.38
|
|
|
PR OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 27177
|
| Min. Negotiated Rate |
$654.55 |
| Max. Negotiated Rate |
$1,979.26 |
| Rate for Payer: PHP Medicare Advantage |
$1,006.80
|
| Rate for Payer: Aetna Commercial |
$1,349.11
|
| Rate for Payer: Aetna Medicare |
$1,047.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.79
|
| Rate for Payer: BCBS Complete |
$687.28
|
| Rate for Payer: BCBS MAPPO |
$1,006.80
|
| Rate for Payer: BCN Commercial |
$1,692.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,449.79
|
| Rate for Payer: Cofinity Commercial |
$1,349.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.80
|
| Rate for Payer: Healthscope Commercial |
$1,862.58
|
| Rate for Payer: Healthscope Commercial |
$1,610.88
|
| Rate for Payer: Mclaren Medicaid |
$654.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.14
|
| Rate for Payer: Meridian Medicaid |
$687.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,107.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.26
|
| Rate for Payer: Nomi Health Commercial |
$1,208.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,538.25
|
| Rate for Payer: PACE SWMI |
$1,006.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,808.84
|
| Rate for Payer: Priority Health Medicare |
$1,006.80
|
| Rate for Payer: Priority Health SBD |
$1,808.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,808.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.25
|
| Rate for Payer: UHC Core |
$1,952.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,006.80
|
| Rate for Payer: UHC Exchange |
$1,952.25
|
| Rate for Payer: UHC Medicaid |
$654.55
|
| Rate for Payer: UHCCP Medicaid |
$654.55
|
|
|
PR OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 27258
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$1,972.08 |
| Rate for Payer: Aetna Commercial |
$1,340.58
|
| Rate for Payer: Aetna Medicare |
$1,040.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.62
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$1,000.43
|
| Rate for Payer: BCN Commercial |
$1,684.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.43
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cofinity Commercial |
$1,440.62
|
| Rate for Payer: Cofinity Commercial |
$1,340.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.43
|
| Rate for Payer: Healthscope Commercial |
$1,850.80
|
| Rate for Payer: Healthscope Commercial |
$1,600.69
|
| Rate for Payer: Mclaren Medicaid |
$649.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.45
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,100.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,972.08
|
| Rate for Payer: Nomi Health Commercial |
$1,200.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,534.50
|
| Rate for Payer: PACE SWMI |
$1,000.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,800.33
|
| Rate for Payer: Priority Health Medicare |
$1,000.43
|
| Rate for Payer: Priority Health SBD |
$1,800.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,800.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,000.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,947.65
|
| Rate for Payer: UHC Core |
$1,947.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,000.43
|
| Rate for Payer: UHC Exchange |
$1,947.65
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
|
|
PR OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
|
Professional
|
Both
|
$2,202.00
|
|
|
Service Code
|
HCPCS 23532
|
| Min. Negotiated Rate |
$380.84 |
| Max. Negotiated Rate |
$1,651.50 |
| Rate for Payer: Aetna Commercial |
$778.22
|
| Rate for Payer: Aetna Medicare |
$603.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.29
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS MAPPO |
$580.76
|
| Rate for Payer: BCN Commercial |
$962.60
|
| Rate for Payer: BCN Medicare Advantage |
$580.76
|
| Rate for Payer: Cash Price |
$1,761.60
|
| Rate for Payer: Cash Price |
$1,761.60
|
| Rate for Payer: Cofinity Commercial |
$836.29
|
| Rate for Payer: Cofinity Commercial |
$778.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.76
|
| Rate for Payer: Healthscope Commercial |
$929.22
|
| Rate for Payer: Healthscope Commercial |
$1,074.41
|
| Rate for Payer: Mclaren Medicaid |
$380.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.80
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$638.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.79
|
| Rate for Payer: Nomi Health Commercial |
$696.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,651.50
|
| Rate for Payer: PACE SWMI |
$580.76
|
| Rate for Payer: PHP Medicare Advantage |
$580.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,028.99
|
| Rate for Payer: Priority Health Medicare |
$580.76
|
| Rate for Payer: Priority Health SBD |
$1,028.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,028.99
|
| Rate for Payer: Railroad Medicare Medicare |
$580.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.34
|
| Rate for Payer: UHC Core |
$1,088.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$580.76
|
| Rate for Payer: UHC Exchange |
$1,088.34
|
| Rate for Payer: UHC Medicaid |
$380.84
|
| Rate for Payer: UHCCP Medicaid |
$380.84
|
|
|
PR OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 27536
|
| Min. Negotiated Rate |
$695.66 |
| Max. Negotiated Rate |
$2,392.50 |
| Rate for Payer: Aetna Commercial |
$1,435.43
|
| Rate for Payer: Aetna Medicare |
$1,114.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,542.56
|
| Rate for Payer: BCBS Complete |
$730.44
|
| Rate for Payer: BCBS MAPPO |
$1,071.22
|
| Rate for Payer: BCN Commercial |
$1,799.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.22
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,542.56
|
| Rate for Payer: Cofinity Commercial |
$1,435.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.22
|
| Rate for Payer: Healthscope Commercial |
$1,981.76
|
| Rate for Payer: Healthscope Commercial |
$1,713.95
|
| Rate for Payer: Mclaren Medicaid |
$695.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.78
|
| Rate for Payer: Meridian Medicaid |
$730.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,178.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,104.88
|
| Rate for Payer: Nomi Health Commercial |
$1,285.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,392.50
|
| Rate for Payer: PACE SWMI |
$1,071.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,923.30
|
| Rate for Payer: Priority Health Medicare |
$1,071.22
|
| Rate for Payer: Priority Health SBD |
$1,923.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,923.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,071.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,084.03
|
| Rate for Payer: UHC Core |
$2,084.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,071.22
|
| Rate for Payer: UHC Exchange |
$2,084.03
|
| Rate for Payer: UHC Medicaid |
$695.66
|
| Rate for Payer: UHCCP Medicaid |
$695.66
|
|
|
PR OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,694.00
|
|
|
Service Code
|
HCPCS 27758
|
| Min. Negotiated Rate |
$531.44 |
| Max. Negotiated Rate |
$2,770.50 |
| Rate for Payer: Aetna Commercial |
$1,092.01
|
| Rate for Payer: Aetna Medicare |
$847.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.50
|
| Rate for Payer: BCBS Complete |
$558.01
|
| Rate for Payer: BCBS MAPPO |
$814.93
|
| Rate for Payer: BCN Commercial |
$1,363.47
|
| Rate for Payer: BCN Medicare Advantage |
$814.93
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cofinity Commercial |
$1,173.50
|
| Rate for Payer: Cofinity Commercial |
$1,092.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$814.93
|
| Rate for Payer: Healthscope Commercial |
$1,507.62
|
| Rate for Payer: Healthscope Commercial |
$1,303.89
|
| Rate for Payer: Mclaren Medicaid |
$531.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$855.68
|
| Rate for Payer: Meridian Medicaid |
$558.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$896.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,590.05
|
| Rate for Payer: Nomi Health Commercial |
$977.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,770.50
|
| Rate for Payer: PACE SWMI |
$814.93
|
| Rate for Payer: PHP Medicare Advantage |
$814.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,457.52
|
| Rate for Payer: Priority Health Medicare |
$814.93
|
| Rate for Payer: Priority Health SBD |
$1,457.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,457.52
|
| Rate for Payer: Railroad Medicare Medicare |
$814.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.05
|
| Rate for Payer: UHC Core |
$1,564.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$814.93
|
| Rate for Payer: UHC Exchange |
$1,564.05
|
| Rate for Payer: UHC Medicaid |
$531.44
|
| Rate for Payer: UHCCP Medicaid |
$531.44
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$373.35
|
|
|
Service Code
|
NDC 00480924201
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.73 |
| Max. Negotiated Rate |
$336.01 |
| Rate for Payer: Aetna Commercial |
$317.35
|
| Rate for Payer: Aetna Medicare |
$186.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.68
|
| Rate for Payer: BCBS Complete |
$149.34
|
| Rate for Payer: Cash Price |
$298.68
|
| Rate for Payer: Cofinity Advantage |
$261.35
|
| Rate for Payer: Cofinity Commercial |
$321.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.68
|
| Rate for Payer: Healthscope Commercial |
$336.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.01
|
| Rate for Payer: PHP Commercial |
$317.35
|
| Rate for Payer: Priority Health SBD |
$235.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.68
|
| Rate for Payer: UHC Core |
$194.52
|
| Rate for Payer: UHC Exchange |
$146.73
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$252.48
|
|
|
Service Code
|
NDC 00228234810
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$159.06 |
| Max. Negotiated Rate |
$227.23 |
| Rate for Payer: Aetna Commercial |
$214.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.11
|
| Rate for Payer: Cash Price |
$201.98
|
| Rate for Payer: Cofinity Advantage |
$176.74
|
| Rate for Payer: Cofinity Commercial |
$217.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.98
|
| Rate for Payer: Healthscope Commercial |
$227.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.36
|
| Rate for Payer: PHP Commercial |
$214.61
|
| Rate for Payer: Priority Health SBD |
$159.06
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$252.48
|
|
|
Service Code
|
NDC 00228234810
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.22 |
| Max. Negotiated Rate |
$227.23 |
| Rate for Payer: Aetna Commercial |
$214.61
|
| Rate for Payer: Aetna Medicare |
$126.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.11
|
| Rate for Payer: BCBS Complete |
$100.99
|
| Rate for Payer: Cash Price |
$201.98
|
| Rate for Payer: Cofinity Advantage |
$176.74
|
| Rate for Payer: Cofinity Commercial |
$217.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.98
|
| Rate for Payer: Healthscope Commercial |
$227.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.36
|
| Rate for Payer: PHP Commercial |
$214.61
|
| Rate for Payer: Priority Health SBD |
$159.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.11
|
| Rate for Payer: UHC Core |
$131.54
|
| Rate for Payer: UHC Exchange |
$99.22
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$289.05
|
|
|
Service Code
|
NDC 68084096425
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna Medicare |
$144.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.88
|
| Rate for Payer: BCBS Complete |
$115.62
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Advantage |
$202.34
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health SBD |
$182.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.88
|
| Rate for Payer: UHC Core |
$150.60
|
| Rate for Payer: UHC Exchange |
$113.60
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$9.64
|
|
|
Service Code
|
NDC 68084096495
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.79 |
| Max. Negotiated Rate |
$8.68 |
| Rate for Payer: Aetna Commercial |
$8.19
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.27
|
| Rate for Payer: BCBS Complete |
$3.86
|
| Rate for Payer: Cash Price |
$7.71
|
| Rate for Payer: Cofinity Advantage |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$8.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.23
|
| Rate for Payer: PHP Commercial |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.27
|
| Rate for Payer: UHC Core |
$5.02
|
| Rate for Payer: UHC Exchange |
$3.79
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$373.35
|
|
|
Service Code
|
NDC 00480924201
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$235.21 |
| Max. Negotiated Rate |
$336.01 |
| Rate for Payer: Aetna Commercial |
$317.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.68
|
| Rate for Payer: Cash Price |
$298.68
|
| Rate for Payer: Cofinity Advantage |
$261.35
|
| Rate for Payer: Cofinity Commercial |
$321.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.68
|
| Rate for Payer: Healthscope Commercial |
$336.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.01
|
| Rate for Payer: PHP Commercial |
$317.35
|
| Rate for Payer: Priority Health SBD |
$235.21
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$9.64
|
|
|
Service Code
|
NDC 68084096495
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$8.68 |
| Rate for Payer: Aetna Commercial |
$8.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.27
|
| Rate for Payer: Cash Price |
$7.71
|
| Rate for Payer: Cofinity Advantage |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$8.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.23
|
| Rate for Payer: PHP Commercial |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.07
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$289.05
|
|
|
Service Code
|
NDC 68084096425
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.10 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.88
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Advantage |
$202.34
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health SBD |
$182.10
|
|
|
PR ORAL DEXAMETHASONE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J8540
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Aetna Commercial |
$0.04
|
| Rate for Payer: Aetna Medicare |
$0.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.04
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.03
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.03
|
| Rate for Payer: Healthscope Commercial |
$0.06
|
| Rate for Payer: Healthscope Commercial |
$0.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.08
|
| Rate for Payer: Nomi Health Commercial |
$0.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
| Rate for Payer: PACE SWMI |
$0.03
|
| Rate for Payer: PHP Medicare Advantage |
$0.03
|
| Rate for Payer: Priority Health Medicare |
$0.03
|
| Rate for Payer: Railroad Medicare Medicare |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.01
|
|
|
PR ORAL POLIOVIRUS IMMUNIZATN,LIVE,OPC
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 90712
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
|
|
PR ORAL PRESCRIP DRUG NON CHEMO
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J8499
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 95933
|
| Min. Negotiated Rate |
$80.04 |
| Max. Negotiated Rate |
$148.07 |
| Rate for Payer: Aetna Commercial |
$107.25
|
| Rate for Payer: Aetna Medicare |
$83.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.26
|
| Rate for Payer: BCBS MAPPO |
$80.04
|
| Rate for Payer: BCN Commercial |
$119.51
|
| Rate for Payer: BCN Medicare Advantage |
$80.04
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$107.25
|
| Rate for Payer: Cofinity Commercial |
$115.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.04
|
| Rate for Payer: Healthscope Commercial |
$148.07
|
| Rate for Payer: Healthscope Commercial |
$128.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.00
|
| Rate for Payer: Nomi Health Commercial |
$96.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$80.04
|
| Rate for Payer: PHP Medicare Advantage |
$80.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.22
|
| Rate for Payer: Priority Health Medicare |
$80.04
|
| Rate for Payer: Priority Health SBD |
$110.22
|
| Rate for Payer: Priority Health Tiered Network |
$110.22
|
| Rate for Payer: Railroad Medicare Medicare |
$80.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.98
|
| Rate for Payer: UHC Core |
$126.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.04
|
| Rate for Payer: UHC Exchange |
$126.98
|
|
|
PR ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ
|
Professional
|
Both
|
$8,195.00
|
|
|
Service Code
|
HCPCS 61584
|
| Min. Negotiated Rate |
$1,805.60 |
| Max. Negotiated Rate |
$6,146.25 |
| Rate for Payer: Aetna Commercial |
$3,745.76
|
| Rate for Payer: Aetna Medicare |
$2,907.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,745.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,025.29
|
| Rate for Payer: BCBS Complete |
$1,895.88
|
| Rate for Payer: BCBS MAPPO |
$2,795.34
|
| Rate for Payer: BCN Commercial |
$6,003.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,795.34
|
| Rate for Payer: Cash Price |
$6,556.00
|
| Rate for Payer: Cash Price |
$6,556.00
|
| Rate for Payer: Cofinity Commercial |
$4,025.29
|
| Rate for Payer: Cofinity Commercial |
$3,745.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,795.34
|
| Rate for Payer: Healthscope Commercial |
$5,171.38
|
| Rate for Payer: Healthscope Commercial |
$4,472.54
|
| Rate for Payer: Mclaren Medicaid |
$1,805.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,935.11
|
| Rate for Payer: Meridian Medicaid |
$1,895.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,074.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,214.69
|
| Rate for Payer: Nomi Health Commercial |
$3,354.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,146.25
|
| Rate for Payer: PACE SWMI |
$2,795.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,795.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,805.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,047.66
|
| Rate for Payer: Priority Health Medicare |
$2,795.34
|
| Rate for Payer: Priority Health SBD |
$5,047.66
|
| Rate for Payer: Priority Health Tiered Network |
$5,047.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,795.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,033.00
|
| Rate for Payer: UHC Core |
$5,033.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,795.34
|
| Rate for Payer: UHC Exchange |
$5,033.00
|
| Rate for Payer: UHC Medicaid |
$1,805.60
|
| Rate for Payer: UHCCP Medicaid |
$1,805.60
|
|
