|
PR PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX
|
Professional
|
Both
|
$8,076.00
|
|
|
Service Code
|
HCPCS 22520
|
| Min. Negotiated Rate |
$3,230.40 |
| Max. Negotiated Rate |
$6,057.00 |
| Rate for Payer: Aetna Medicare |
$4,038.00
|
| Rate for Payer: BCBS Complete |
$3,230.40
|
| Rate for Payer: Cash Price |
$6,460.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,249.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,057.00
|
|
|
PR PERCUT DILATN RENAL TRACT
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 50395
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
|
|
PR PERCUT INSERT KIDNEY CATH/DRAIN
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 50392
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$282.00 |
| Rate for Payer: Aetna Medicare |
$188.00
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, EA ADD
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 22525
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Medicare |
$260.00
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.00
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, LUMBAR
|
Professional
|
Both
|
$1,107.00
|
|
|
Service Code
|
HCPCS 22524
|
| Min. Negotiated Rate |
$442.80 |
| Max. Negotiated Rate |
$830.25 |
| Rate for Payer: Aetna Medicare |
$553.50
|
| Rate for Payer: BCBS Complete |
$442.80
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$719.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.25
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, THOR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 22523
|
| Min. Negotiated Rate |
$470.00 |
| Max. Negotiated Rate |
$881.25 |
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$763.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$881.25
|
|
|
PR PEREYRA PX W/ANTERIOR COLPORRHAPHY
|
Professional
|
Both
|
$2,279.00
|
|
|
Service Code
|
HCPCS 57289
|
| Min. Negotiated Rate |
$446.24 |
| Max. Negotiated Rate |
$1,709.25 |
| Rate for Payer: Aetna Commercial |
$925.86
|
| Rate for Payer: Aetna Medicare |
$718.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.95
|
| Rate for Payer: BCBS Complete |
$468.55
|
| Rate for Payer: BCBS MAPPO |
$690.94
|
| Rate for Payer: BCN Commercial |
$1,188.18
|
| Rate for Payer: BCN Medicare Advantage |
$690.94
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cofinity Commercial |
$994.95
|
| Rate for Payer: Cofinity Commercial |
$925.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.94
|
| Rate for Payer: Healthscope Commercial |
$1,105.50
|
| Rate for Payer: Healthscope Commercial |
$1,278.24
|
| Rate for Payer: Mclaren Medicaid |
$446.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.49
|
| Rate for Payer: Meridian Medicaid |
$468.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$760.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.47
|
| Rate for Payer: Nomi Health Commercial |
$829.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,709.25
|
| Rate for Payer: PACE SWMI |
$690.94
|
| Rate for Payer: PHP Medicare Advantage |
$690.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,203.38
|
| Rate for Payer: Priority Health Medicare |
$690.94
|
| Rate for Payer: Priority Health SBD |
$1,203.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,203.38
|
| Rate for Payer: Railroad Medicare Medicare |
$690.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.31
|
| Rate for Payer: UHC Core |
$1,380.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$690.94
|
| Rate for Payer: UHC Exchange |
$1,380.31
|
| Rate for Payer: UHC Medicaid |
$446.24
|
| Rate for Payer: UHCCP Medicaid |
$446.24
|
|
|
PR PERICARDIOCENTESIS INITIAL
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 33010
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$348.75 |
| Rate for Payer: Aetna Medicare |
$232.50
|
| Rate for Payer: BCBS Complete |
$186.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$348.75
|
|
|
PR PERICARDIOCENTESIS SUBSEQUENT
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 33011
|
| Min. Negotiated Rate |
$185.60 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Medicare |
$232.00
|
| Rate for Payer: BCBS Complete |
$185.60
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$348.00
|
|
|
PR PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 33016
|
| Min. Negotiated Rate |
$130.14 |
| Max. Negotiated Rate |
$421.93 |
| Rate for Payer: Aetna Commercial |
$275.95
|
| Rate for Payer: Aetna Medicare |
$214.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.54
|
| Rate for Payer: BCBS Complete |
$136.65
|
| Rate for Payer: BCBS MAPPO |
$205.93
|
| Rate for Payer: BCN Commercial |
$343.11
|
| Rate for Payer: BCN Medicare Advantage |
$205.93
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$296.54
|
| Rate for Payer: Cofinity Commercial |
$275.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.93
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Healthscope Commercial |
$329.49
|
| Rate for Payer: Mclaren Medicaid |
$130.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.23
|
| Rate for Payer: Meridian Medicaid |
$136.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.54
|
| Rate for Payer: Nomi Health Commercial |
$247.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.50
|
| Rate for Payer: PACE SWMI |
$205.93
|
| Rate for Payer: PHP Medicare Advantage |
$205.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$368.97
|
| Rate for Payer: Priority Health Medicare |
$205.93
|
| Rate for Payer: Priority Health SBD |
$368.97
|
| Rate for Payer: Priority Health Tiered Network |
$368.97
|
| Rate for Payer: Railroad Medicare Medicare |
$205.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.93
|
| Rate for Payer: UHC Core |
$421.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$205.93
|
| Rate for Payer: UHC Exchange |
$421.93
|
| Rate for Payer: UHC Medicaid |
$130.14
|
| Rate for Payer: UHCCP Medicaid |
$130.14
|
|
|
PR PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 33020
|
| Min. Negotiated Rate |
$499.70 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Aetna Commercial |
$1,045.94
|
| Rate for Payer: Aetna Medicare |
$811.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.99
|
| Rate for Payer: BCBS Complete |
$524.68
|
| Rate for Payer: BCBS MAPPO |
$780.55
|
| Rate for Payer: BCN Commercial |
$1,226.52
|
| Rate for Payer: BCN Medicare Advantage |
$780.55
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$1,123.99
|
| Rate for Payer: Cofinity Commercial |
$1,045.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.55
|
| Rate for Payer: Healthscope Commercial |
$1,444.02
|
| Rate for Payer: Healthscope Commercial |
$1,248.88
|
| Rate for Payer: Mclaren Medicaid |
$499.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.58
|
| Rate for Payer: Meridian Medicaid |
$524.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$858.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,463.02
|
| Rate for Payer: Nomi Health Commercial |
$936.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.75
|
| Rate for Payer: PACE SWMI |
$780.55
|
| Rate for Payer: PHP Medicare Advantage |
$780.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,318.97
|
| Rate for Payer: Priority Health Medicare |
$780.55
|
| Rate for Payer: Priority Health SBD |
$1,318.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,318.97
|
| Rate for Payer: Railroad Medicare Medicare |
$780.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,466.26
|
| Rate for Payer: UHC Core |
$1,466.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$780.55
|
| Rate for Payer: UHC Exchange |
$1,466.26
|
| Rate for Payer: UHC Medicaid |
$499.70
|
| Rate for Payer: UHCCP Medicaid |
$499.70
|
|
|
PR PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE
|
Professional
|
Both
|
$2,217.00
|
|
|
Service Code
|
HCPCS 19371
|
| Min. Negotiated Rate |
$414.07 |
| Max. Negotiated Rate |
$1,662.75 |
| Rate for Payer: Aetna Commercial |
$850.06
|
| Rate for Payer: Aetna Medicare |
$659.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.49
|
| Rate for Payer: BCBS Complete |
$434.77
|
| Rate for Payer: BCBS MAPPO |
$634.37
|
| Rate for Payer: BCN Commercial |
$1,080.12
|
| Rate for Payer: BCN Medicare Advantage |
$634.37
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cofinity Commercial |
$913.49
|
| Rate for Payer: Cofinity Commercial |
$850.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.37
|
| Rate for Payer: Healthscope Commercial |
$1,173.58
|
| Rate for Payer: Healthscope Commercial |
$1,014.99
|
| Rate for Payer: Mclaren Medicaid |
$414.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$666.09
|
| Rate for Payer: Meridian Medicaid |
$434.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$697.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.64
|
| Rate for Payer: Nomi Health Commercial |
$761.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,662.75
|
| Rate for Payer: PACE SWMI |
$634.37
|
| Rate for Payer: PHP Medicare Advantage |
$634.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$988.60
|
| Rate for Payer: Priority Health Medicare |
$634.37
|
| Rate for Payer: Priority Health SBD |
$988.60
|
| Rate for Payer: Priority Health Tiered Network |
$988.60
|
| Rate for Payer: Railroad Medicare Medicare |
$634.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.41
|
| Rate for Payer: UHC Core |
$1,374.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$634.37
|
| Rate for Payer: UHC Exchange |
$1,374.41
|
| Rate for Payer: UHC Medicaid |
$414.07
|
| Rate for Payer: UHCCP Medicaid |
$414.07
|
|
|
PR PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX
|
Professional
|
Both
|
$943.00
|
|
|
Service Code
|
HCPCS 56810
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$707.25 |
| Rate for Payer: Aetna Commercial |
$318.17
|
| Rate for Payer: Aetna Medicare |
$246.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.91
|
| Rate for Payer: BCBS Complete |
$161.48
|
| Rate for Payer: BCBS MAPPO |
$237.44
|
| Rate for Payer: BCN Commercial |
$407.85
|
| Rate for Payer: BCN Medicare Advantage |
$237.44
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cash Price |
$754.40
|
| Rate for Payer: Cofinity Commercial |
$341.91
|
| Rate for Payer: Cofinity Commercial |
$318.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.44
|
| Rate for Payer: Healthscope Commercial |
$439.26
|
| Rate for Payer: Healthscope Commercial |
$379.90
|
| Rate for Payer: Mclaren Medicaid |
$153.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.31
|
| Rate for Payer: Meridian Medicaid |
$161.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$484.22
|
| Rate for Payer: Nomi Health Commercial |
$284.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.25
|
| Rate for Payer: PACE SWMI |
$237.44
|
| Rate for Payer: PHP Medicare Advantage |
$237.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$413.06
|
| Rate for Payer: Priority Health Medicare |
$237.44
|
| Rate for Payer: Priority Health SBD |
$413.06
|
| Rate for Payer: Priority Health Tiered Network |
$413.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.85
|
| Rate for Payer: UHC Core |
$469.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.44
|
| Rate for Payer: UHC Exchange |
$469.85
|
| Rate for Payer: UHC Medicaid |
$153.79
|
| Rate for Payer: UHCCP Medicaid |
$153.79
|
|
|
PR PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 99391
|
| Min. Negotiated Rate |
$61.21 |
| Max. Negotiated Rate |
$146.80 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: Aetna Medicare |
$79.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.14
|
| Rate for Payer: BCBS Complete |
$64.27
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Mclaren Medicaid |
$61.21
|
| Rate for Payer: Meridian Medicaid |
$64.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.80
|
| Rate for Payer: Priority Health SBD |
$146.80
|
| Rate for Payer: Priority Health Tiered Network |
$146.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.69
|
| Rate for Payer: UHC Core |
$100.69
|
| Rate for Payer: UHC Exchange |
$100.69
|
| Rate for Payer: UHC Medicaid |
$61.21
|
| Rate for Payer: UHCCP Medicaid |
$61.21
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 99394
|
| Min. Negotiated Rate |
$75.52 |
| Max. Negotiated Rate |
$128.25 |
| Rate for Payer: Aetna Commercial |
$88.48
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.48
|
| Rate for Payer: BCBS Complete |
$79.30
|
| Rate for Payer: BCN Commercial |
$124.23
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Mclaren Medicaid |
$75.52
|
| Rate for Payer: Meridian Medicaid |
$79.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$107.58
|
| Rate for Payer: Priority Health SBD |
$107.58
|
| Rate for Payer: Priority Health Tiered Network |
$107.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.25
|
| Rate for Payer: UHC Core |
$124.25
|
| Rate for Payer: UHC Exchange |
$124.25
|
| Rate for Payer: UHC Medicaid |
$75.52
|
| Rate for Payer: UHCCP Medicaid |
$75.52
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 99392
|
| Min. Negotiated Rate |
$66.69 |
| Max. Negotiated Rate |
$156.69 |
| Rate for Payer: Aetna Commercial |
$78.23
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: BCBS Complete |
$70.02
|
| Rate for Payer: BCN Commercial |
$155.86
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Mclaren Medicaid |
$66.69
|
| Rate for Payer: Meridian Medicaid |
$70.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$156.69
|
| Rate for Payer: Priority Health SBD |
$156.69
|
| Rate for Payer: Priority Health Tiered Network |
$156.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.70
|
| Rate for Payer: UHC Core |
$109.70
|
| Rate for Payer: UHC Exchange |
$109.70
|
| Rate for Payer: UHC Medicaid |
$66.69
|
| Rate for Payer: UHCCP Medicaid |
$66.69
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 99395
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$90.96
|
| Rate for Payer: Aetna Medicare |
$87.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.96
|
| Rate for Payer: BCBS Complete |
$81.54
|
| Rate for Payer: BCN Commercial |
$127.86
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Mclaren Medicaid |
$77.66
|
| Rate for Payer: Meridian Medicaid |
$81.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.50
|
| Rate for Payer: Priority Health SBD |
$111.50
|
| Rate for Payer: Priority Health Tiered Network |
$111.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.76
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: UHC Exchange |
$127.76
|
| Rate for Payer: UHC Medicaid |
$77.66
|
| Rate for Payer: UHCCP Medicaid |
$77.66
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 99396
|
| Min. Negotiated Rate |
$85.27 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$98.74
|
| Rate for Payer: Aetna Medicare |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.74
|
| Rate for Payer: BCBS Complete |
$89.53
|
| Rate for Payer: BCN Commercial |
$135.86
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Mclaren Medicaid |
$85.27
|
| Rate for Payer: Meridian Medicaid |
$89.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.08
|
| Rate for Payer: Priority Health SBD |
$121.08
|
| Rate for Payer: Priority Health Tiered Network |
$121.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.27
|
| Rate for Payer: UHC Core |
$139.27
|
| Rate for Payer: UHC Exchange |
$139.27
|
| Rate for Payer: UHC Medicaid |
$85.27
|
| Rate for Payer: UHCCP Medicaid |
$85.27
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 99393
|
| Min. Negotiated Rate |
$66.69 |
| Max. Negotiated Rate |
$117.75 |
| Rate for Payer: Aetna Commercial |
$78.23
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: BCBS Complete |
$70.02
|
| Rate for Payer: BCN Commercial |
$113.70
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Mclaren Medicaid |
$66.69
|
| Rate for Payer: Meridian Medicaid |
$70.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.51
|
| Rate for Payer: Priority Health SBD |
$94.51
|
| Rate for Payer: Priority Health Tiered Network |
$94.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.70
|
| Rate for Payer: UHC Core |
$109.70
|
| Rate for Payer: UHC Exchange |
$109.70
|
| Rate for Payer: UHC Medicaid |
$66.69
|
| Rate for Payer: UHCCP Medicaid |
$66.69
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 99397
|
| Min. Negotiated Rate |
$89.84 |
| Max. Negotiated Rate |
$151.50 |
| Rate for Payer: Aetna Commercial |
$103.72
|
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.72
|
| Rate for Payer: BCBS Complete |
$94.33
|
| Rate for Payer: BCN Commercial |
$146.39
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Mclaren Medicaid |
$89.84
|
| Rate for Payer: Meridian Medicaid |
$94.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.18
|
| Rate for Payer: Priority Health SBD |
$127.18
|
| Rate for Payer: Priority Health Tiered Network |
$127.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.79
|
| Rate for Payer: UHC Core |
$146.79
|
| Rate for Payer: UHC Exchange |
$146.79
|
| Rate for Payer: UHC Medicaid |
$89.84
|
| Rate for Payer: UHCCP Medicaid |
$89.84
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 93286
|
| Min. Negotiated Rate |
$41.55 |
| Max. Negotiated Rate |
$76.87 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.83
|
| Rate for Payer: BCBS MAPPO |
$41.55
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: BCN Medicare Advantage |
$41.55
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$59.83
|
| Rate for Payer: Cofinity Commercial |
$55.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.55
|
| Rate for Payer: Healthscope Commercial |
$76.87
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.43
|
| Rate for Payer: Nomi Health Commercial |
$49.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: PACE SWMI |
$41.55
|
| Rate for Payer: PHP Medicare Advantage |
$41.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.95
|
| Rate for Payer: Priority Health Medicare |
$41.55
|
| Rate for Payer: Priority Health SBD |
$62.95
|
| Rate for Payer: Priority Health Tiered Network |
$62.95
|
| Rate for Payer: Railroad Medicare Medicare |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.19
|
| Rate for Payer: UHC Core |
$62.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.55
|
| Rate for Payer: UHC Exchange |
$62.19
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 93287
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Aetna Commercial |
$65.34
|
| Rate for Payer: Aetna Medicare |
$50.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.34
|
| Rate for Payer: BCBS MAPPO |
$48.76
|
| Rate for Payer: BCN Commercial |
$76.69
|
| Rate for Payer: BCN Medicare Advantage |
$48.76
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$70.21
|
| Rate for Payer: Cofinity Commercial |
$65.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.76
|
| Rate for Payer: Healthscope Commercial |
$78.02
|
| Rate for Payer: Healthscope Commercial |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.29
|
| Rate for Payer: Nomi Health Commercial |
$58.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$48.76
|
| Rate for Payer: PHP Medicare Advantage |
$48.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.88
|
| Rate for Payer: Priority Health Medicare |
$48.76
|
| Rate for Payer: Priority Health SBD |
$72.88
|
| Rate for Payer: Priority Health Tiered Network |
$72.88
|
| Rate for Payer: Railroad Medicare Medicare |
$48.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.67
|
| Rate for Payer: UHC Core |
$74.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.76
|
| Rate for Payer: UHC Exchange |
$74.67
|
|
|
PR PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 45520
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$224.25 |
| Rate for Payer: Aetna Commercial |
$48.95
|
| Rate for Payer: Aetna Medicare |
$37.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.60
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$36.53
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.53
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$52.60
|
| Rate for Payer: Cofinity Commercial |
$48.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.53
|
| Rate for Payer: Healthscope Commercial |
$67.58
|
| Rate for Payer: Healthscope Commercial |
$58.45
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.36
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.38
|
| Rate for Payer: Nomi Health Commercial |
$43.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: PACE SWMI |
$36.53
|
| Rate for Payer: PHP Medicare Advantage |
$36.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74.02
|
| Rate for Payer: Priority Health Medicare |
$36.53
|
| Rate for Payer: Priority Health SBD |
$74.02
|
| Rate for Payer: Priority Health Tiered Network |
$74.02
|
| Rate for Payer: Railroad Medicare Medicare |
$36.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.43
|
| Rate for Payer: UHC Core |
$69.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.53
|
| Rate for Payer: UHC Exchange |
$69.43
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR PERITONEAL LAVAGE W/WO IMAGING GUIDANCE
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 49084
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$195.38 |
| Rate for Payer: Aetna Commercial |
$129.32
|
| Rate for Payer: Aetna Medicare |
$100.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.97
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$96.51
|
| Rate for Payer: BCN Commercial |
$160.35
|
| Rate for Payer: BCN Medicare Advantage |
$96.51
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$138.97
|
| Rate for Payer: Cofinity Commercial |
$129.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.51
|
| Rate for Payer: Healthscope Commercial |
$178.54
|
| Rate for Payer: Healthscope Commercial |
$154.42
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.34
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.99
|
| Rate for Payer: Nomi Health Commercial |
$115.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$96.51
|
| Rate for Payer: PHP Medicare Advantage |
$96.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$195.38
|
| Rate for Payer: Priority Health Medicare |
$96.51
|
| Rate for Payer: Priority Health SBD |
$195.38
|
| Rate for Payer: Priority Health Tiered Network |
$195.38
|
| Rate for Payer: Railroad Medicare Medicare |
$96.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.51
|
| Rate for Payer: UHC Core |
$194.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.51
|
| Rate for Payer: UHC Exchange |
$194.51
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 34713
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$224.88 |
| Rate for Payer: Aetna Commercial |
$150.15
|
| Rate for Payer: Aetna Medicare |
$116.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.35
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$112.05
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: BCN Medicare Advantage |
$112.05
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$161.35
|
| Rate for Payer: Cofinity Commercial |
$150.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.05
|
| Rate for Payer: Healthscope Commercial |
$207.29
|
| Rate for Payer: Healthscope Commercial |
$179.28
|
| Rate for Payer: Mclaren Medicaid |
$70.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.65
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.01
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
| Rate for Payer: PACE SWMI |
$112.05
|
| Rate for Payer: PHP Medicare Advantage |
$112.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.79
|
| Rate for Payer: Priority Health Medicare |
$112.05
|
| Rate for Payer: Priority Health SBD |
$192.79
|
| Rate for Payer: Priority Health Tiered Network |
$192.79
|
| Rate for Payer: Railroad Medicare Medicare |
$112.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.88
|
| Rate for Payer: UHC Core |
$224.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.05
|
| Rate for Payer: UHC Exchange |
$224.88
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
