|
PR PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 61645
|
| Min. Negotiated Rate |
$482.02 |
| Max. Negotiated Rate |
$1,511.44 |
| Rate for Payer: Aetna Commercial |
$1,023.37
|
| Rate for Payer: Aetna Medicare |
$794.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.74
|
| Rate for Payer: BCBS Complete |
$506.12
|
| Rate for Payer: BCBS MAPPO |
$763.71
|
| Rate for Payer: BCN Commercial |
$1,264.87
|
| Rate for Payer: BCN Medicare Advantage |
$763.71
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cofinity Commercial |
$1,099.74
|
| Rate for Payer: Cofinity Commercial |
$1,023.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.71
|
| Rate for Payer: Healthscope Commercial |
$1,412.86
|
| Rate for Payer: Healthscope Commercial |
$1,221.94
|
| Rate for Payer: Mclaren Medicaid |
$482.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.90
|
| Rate for Payer: Meridian Medicaid |
$506.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$840.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,511.44
|
| Rate for Payer: Nomi Health Commercial |
$916.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,247.25
|
| Rate for Payer: PACE SWMI |
$763.71
|
| Rate for Payer: PHP Medicare Advantage |
$763.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,469.12
|
| Rate for Payer: Priority Health Medicare |
$763.71
|
| Rate for Payer: Priority Health SBD |
$1,469.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,469.12
|
| Rate for Payer: Railroad Medicare Medicare |
$763.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.75
|
| Rate for Payer: UHC Core |
$1,487.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$763.71
|
| Rate for Payer: UHC Exchange |
$1,487.75
|
| Rate for Payer: UHC Medicaid |
$482.02
|
| Rate for Payer: UHCCP Medicaid |
$482.02
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 61642
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$617.84 |
| Rate for Payer: Aetna Commercial |
$445.23
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.23
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$605.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$535.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$569.14
|
| Rate for Payer: Priority Health SBD |
$569.14
|
| Rate for Payer: Priority Health Tiered Network |
$569.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.84
|
| Rate for Payer: UHC Core |
$617.84
|
| Rate for Payer: UHC Exchange |
$617.84
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL SM VASC TER
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 61641
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$308.92 |
| Rate for Payer: Aetna Commercial |
$222.61
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.61
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCN Commercial |
$245.01
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$284.56
|
| Rate for Payer: Priority Health SBD |
$284.56
|
| Rate for Payer: Priority Health Tiered Network |
$284.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.92
|
| Rate for Payer: UHC Core |
$308.92
|
| Rate for Payer: UHC Exchange |
$308.92
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 19285
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna Commercial |
$96.06
|
| Rate for Payer: Aetna Medicare |
$74.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.06
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.69
|
| Rate for Payer: BCN Commercial |
$123.49
|
| Rate for Payer: BCN Medicare Advantage |
$71.69
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.69
|
| Rate for Payer: Healthscope Commercial |
$132.63
|
| Rate for Payer: Healthscope Commercial |
$114.70
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.27
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.96
|
| Rate for Payer: Nomi Health Commercial |
$86.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: PACE SWMI |
$71.69
|
| Rate for Payer: PHP Medicare Advantage |
$71.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$113.03
|
| Rate for Payer: Priority Health Medicare |
$71.69
|
| Rate for Payer: Priority Health SBD |
$113.03
|
| Rate for Payer: Priority Health Tiered Network |
$113.03
|
| Rate for Payer: Railroad Medicare Medicare |
$71.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.98
|
| Rate for Payer: UHC Core |
$152.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.69
|
| Rate for Payer: UHC Exchange |
$152.98
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 19286
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$77.41 |
| Rate for Payer: Aetna Commercial |
$48.24
|
| Rate for Payer: Aetna Medicare |
$37.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.84
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$36.00
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$51.84
|
| Rate for Payer: Cofinity Commercial |
$48.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Healthscope Commercial |
$57.60
|
| Rate for Payer: Mclaren Medicaid |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.80
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.64
|
| Rate for Payer: Nomi Health Commercial |
$43.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: PACE SWMI |
$36.00
|
| Rate for Payer: PHP Medicare Advantage |
$36.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.52
|
| Rate for Payer: Priority Health Medicare |
$36.00
|
| Rate for Payer: Priority Health SBD |
$56.52
|
| Rate for Payer: Priority Health Tiered Network |
$56.52
|
| Rate for Payer: Railroad Medicare Medicare |
$36.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.41
|
| Rate for Payer: UHC Core |
$77.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.00
|
| Rate for Payer: UHC Exchange |
$77.41
|
| Rate for Payer: UHC Medicaid |
$23.00
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
PR PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT
|
Professional
|
Both
|
$1,713.00
|
|
|
Service Code
|
HCPCS 33340
|
| Min. Negotiated Rate |
$394.48 |
| Max. Negotiated Rate |
$1,408.50 |
| Rate for Payer: Aetna Commercial |
$818.40
|
| Rate for Payer: Aetna Medicare |
$635.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.48
|
| Rate for Payer: BCBS Complete |
$414.20
|
| Rate for Payer: BCBS MAPPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$1,138.89
|
| Rate for Payer: BCN Medicare Advantage |
$610.75
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cofinity Commercial |
$879.48
|
| Rate for Payer: Cofinity Commercial |
$818.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.75
|
| Rate for Payer: Healthscope Commercial |
$977.20
|
| Rate for Payer: Healthscope Commercial |
$1,129.89
|
| Rate for Payer: Mclaren Medicaid |
$394.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.29
|
| Rate for Payer: Meridian Medicaid |
$414.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$671.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,383.16
|
| Rate for Payer: Nomi Health Commercial |
$732.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,284.75
|
| Rate for Payer: PACE SWMI |
$610.75
|
| Rate for Payer: PHP Medicare Advantage |
$610.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,224.72
|
| Rate for Payer: Priority Health Medicare |
$610.75
|
| Rate for Payer: Priority Health SBD |
$1,224.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,224.72
|
| Rate for Payer: Railroad Medicare Medicare |
$610.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.50
|
| Rate for Payer: UHC Core |
$1,408.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$610.75
|
| Rate for Payer: UHC Exchange |
$1,408.50
|
| Rate for Payer: UHC Medicaid |
$394.48
|
| Rate for Payer: UHCCP Medicaid |
$394.48
|
|
|
PR PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 19281
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$282.75 |
| Rate for Payer: Aetna Commercial |
$111.18
|
| Rate for Payer: Aetna Medicare |
$86.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.48
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$82.97
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$82.97
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$119.48
|
| Rate for Payer: Cofinity Commercial |
$111.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.97
|
| Rate for Payer: Healthscope Commercial |
$153.49
|
| Rate for Payer: Healthscope Commercial |
$132.75
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.12
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.37
|
| Rate for Payer: Nomi Health Commercial |
$99.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.75
|
| Rate for Payer: PACE SWMI |
$82.97
|
| Rate for Payer: PHP Medicare Advantage |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.17
|
| Rate for Payer: Priority Health Medicare |
$82.97
|
| Rate for Payer: Priority Health SBD |
$132.17
|
| Rate for Payer: Priority Health Tiered Network |
$132.17
|
| Rate for Payer: Railroad Medicare Medicare |
$82.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.14
|
| Rate for Payer: UHC Core |
$178.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.97
|
| Rate for Payer: UHC Exchange |
$178.14
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 19282
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$55.26
|
| Rate for Payer: Aetna Medicare |
$42.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.39
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$41.24
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.24
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.24
|
| Rate for Payer: Healthscope Commercial |
$76.29
|
| Rate for Payer: Healthscope Commercial |
$65.98
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.30
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.13
|
| Rate for Payer: Nomi Health Commercial |
$49.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: PACE SWMI |
$41.24
|
| Rate for Payer: PHP Medicare Advantage |
$41.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$41.24
|
| Rate for Payer: Priority Health SBD |
$66.08
|
| Rate for Payer: Priority Health Tiered Network |
$66.08
|
| Rate for Payer: Railroad Medicare Medicare |
$41.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.70
|
| Rate for Payer: UHC Core |
$89.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.24
|
| Rate for Payer: UHC Exchange |
$89.70
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 50436
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$266.20 |
| Rate for Payer: Aetna Commercial |
$180.66
|
| Rate for Payer: Aetna Medicare |
$140.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.14
|
| Rate for Payer: BCBS Complete |
$91.25
|
| Rate for Payer: BCBS MAPPO |
$134.82
|
| Rate for Payer: BCN Commercial |
$223.60
|
| Rate for Payer: BCN Medicare Advantage |
$134.82
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Cofinity Commercial |
$180.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.82
|
| Rate for Payer: Healthscope Commercial |
$249.42
|
| Rate for Payer: Healthscope Commercial |
$215.71
|
| Rate for Payer: Mclaren Medicaid |
$86.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.56
|
| Rate for Payer: Meridian Medicaid |
$91.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.28
|
| Rate for Payer: Nomi Health Commercial |
$161.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$134.82
|
| Rate for Payer: PHP Medicare Advantage |
$134.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$243.57
|
| Rate for Payer: Priority Health Medicare |
$134.82
|
| Rate for Payer: Priority Health SBD |
$243.57
|
| Rate for Payer: Priority Health Tiered Network |
$243.57
|
| Rate for Payer: Railroad Medicare Medicare |
$134.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.20
|
| Rate for Payer: UHC Core |
$266.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.82
|
| Rate for Payer: UHC Exchange |
$266.20
|
| Rate for Payer: UHC Medicaid |
$86.90
|
| Rate for Payer: UHCCP Medicaid |
$86.90
|
|
|
PR PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 50437
|
| Min. Negotiated Rate |
$142.92 |
| Max. Negotiated Rate |
$657.75 |
| Rate for Payer: Aetna Commercial |
$298.12
|
| Rate for Payer: Aetna Medicare |
$231.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.37
|
| Rate for Payer: BCBS Complete |
$150.07
|
| Rate for Payer: BCBS MAPPO |
$222.48
|
| Rate for Payer: BCN Commercial |
$371.49
|
| Rate for Payer: BCN Medicare Advantage |
$222.48
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$320.37
|
| Rate for Payer: Cofinity Commercial |
$298.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.48
|
| Rate for Payer: Healthscope Commercial |
$411.59
|
| Rate for Payer: Healthscope Commercial |
$355.97
|
| Rate for Payer: Mclaren Medicaid |
$142.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.60
|
| Rate for Payer: Meridian Medicaid |
$150.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$244.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.04
|
| Rate for Payer: Nomi Health Commercial |
$266.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.75
|
| Rate for Payer: PACE SWMI |
$222.48
|
| Rate for Payer: PHP Medicare Advantage |
$222.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$404.67
|
| Rate for Payer: Priority Health Medicare |
$222.48
|
| Rate for Payer: Priority Health SBD |
$404.67
|
| Rate for Payer: Priority Health Tiered Network |
$404.67
|
| Rate for Payer: Railroad Medicare Medicare |
$222.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.23
|
| Rate for Payer: UHC Core |
$447.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$222.48
|
| Rate for Payer: UHC Exchange |
$447.23
|
| Rate for Payer: UHC Medicaid |
$142.92
|
| Rate for Payer: UHCCP Medicaid |
$142.92
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING
|
Professional
|
Both
|
$1,014.00
|
|
|
Service Code
|
HCPCS 32557
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$173.17
|
| Rate for Payer: Aetna Medicare |
$134.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.09
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$129.23
|
| Rate for Payer: BCN Commercial |
$218.12
|
| Rate for Payer: BCN Medicare Advantage |
$129.23
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cofinity Commercial |
$186.09
|
| Rate for Payer: Cofinity Commercial |
$173.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.23
|
| Rate for Payer: Healthscope Commercial |
$239.08
|
| Rate for Payer: Healthscope Commercial |
$206.77
|
| Rate for Payer: Mclaren Medicaid |
$82.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.69
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.34
|
| Rate for Payer: Nomi Health Commercial |
$155.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$760.50
|
| Rate for Payer: PACE SWMI |
$129.23
|
| Rate for Payer: PHP Medicare Advantage |
$129.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$129.23
|
| Rate for Payer: Priority Health SBD |
$205.40
|
| Rate for Payer: Priority Health Tiered Network |
$205.40
|
| Rate for Payer: Railroad Medicare Medicare |
$129.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.90
|
| Rate for Payer: UHC Core |
$270.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$129.23
|
| Rate for Payer: UHC Exchange |
$270.90
|
| Rate for Payer: UHC Medicaid |
$82.43
|
| Rate for Payer: UHCCP Medicaid |
$82.43
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
HCPCS 32556
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$683.25 |
| Rate for Payer: Aetna Commercial |
$149.97
|
| Rate for Payer: Aetna Medicare |
$116.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.16
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$111.92
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$111.92
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cofinity Commercial |
$161.16
|
| Rate for Payer: Cofinity Commercial |
$149.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.92
|
| Rate for Payer: Healthscope Commercial |
$207.05
|
| Rate for Payer: Healthscope Commercial |
$179.07
|
| Rate for Payer: Mclaren Medicaid |
$71.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.52
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.92
|
| Rate for Payer: Nomi Health Commercial |
$134.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$683.25
|
| Rate for Payer: PACE SWMI |
$111.92
|
| Rate for Payer: PHP Medicare Advantage |
$111.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$173.04
|
| Rate for Payer: Priority Health Medicare |
$111.92
|
| Rate for Payer: Priority Health SBD |
$173.04
|
| Rate for Payer: Priority Health Tiered Network |
$173.04
|
| Rate for Payer: Railroad Medicare Medicare |
$111.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.38
|
| Rate for Payer: UHC Core |
$219.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.92
|
| Rate for Payer: UHC Exchange |
$219.38
|
| Rate for Payer: UHC Medicaid |
$71.36
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
|
|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$638.79 |
| Max. Negotiated Rate |
$2,259.95 |
| Rate for Payer: Aetna Commercial |
$1,330.12
|
| Rate for Payer: Aetna Medicare |
$1,032.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.39
|
| Rate for Payer: BCBS Complete |
$670.73
|
| Rate for Payer: BCBS MAPPO |
$992.63
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$992.63
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cofinity Commercial |
$1,429.39
|
| Rate for Payer: Cofinity Commercial |
$1,330.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.63
|
| Rate for Payer: Healthscope Commercial |
$1,836.37
|
| Rate for Payer: Healthscope Commercial |
$1,588.21
|
| Rate for Payer: Mclaren Medicaid |
$638.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.26
|
| Rate for Payer: Meridian Medicaid |
$670.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,091.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,978.34
|
| Rate for Payer: Nomi Health Commercial |
$1,191.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: PACE SWMI |
$992.63
|
| Rate for Payer: PHP Medicare Advantage |
$992.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,823.76
|
| Rate for Payer: Priority Health Medicare |
$992.63
|
| Rate for Payer: Priority Health SBD |
$1,823.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,823.76
|
| Rate for Payer: Railroad Medicare Medicare |
$992.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,259.95
|
| Rate for Payer: UHC Core |
$2,259.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$992.63
|
| Rate for Payer: UHC Exchange |
$2,259.95
|
| Rate for Payer: UHC Medicaid |
$638.79
|
| Rate for Payer: UHCCP Medicaid |
$638.79
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$1,535.13 |
| Rate for Payer: Aetna Commercial |
$831.24
|
| Rate for Payer: Aetna Medicare |
$645.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.28
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$620.33
|
| Rate for Payer: BCN Commercial |
$1,042.27
|
| Rate for Payer: BCN Medicare Advantage |
$620.33
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cofinity Commercial |
$893.28
|
| Rate for Payer: Cofinity Commercial |
$831.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.33
|
| Rate for Payer: Healthscope Commercial |
$992.53
|
| Rate for Payer: Healthscope Commercial |
$1,147.61
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.35
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$682.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.29
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,285.50
|
| Rate for Payer: PACE SWMI |
$620.33
|
| Rate for Payer: PHP Medicare Advantage |
$620.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,135.37
|
| Rate for Payer: Priority Health Medicare |
$620.33
|
| Rate for Payer: Priority Health SBD |
$1,135.37
|
| Rate for Payer: Priority Health Tiered Network |
$1,135.37
|
| Rate for Payer: Railroad Medicare Medicare |
$620.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,535.13
|
| Rate for Payer: UHC Core |
$1,535.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$620.33
|
| Rate for Payer: UHC Exchange |
$1,535.13
|
| Rate for Payer: UHC Medicaid |
$400.87
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$437.37 |
| Rate for Payer: Aetna Commercial |
$289.51
|
| Rate for Payer: Aetna Medicare |
$224.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.11
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$216.05
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: BCN Medicare Advantage |
$216.05
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$311.11
|
| Rate for Payer: Cofinity Commercial |
$289.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.05
|
| Rate for Payer: Healthscope Commercial |
$399.69
|
| Rate for Payer: Healthscope Commercial |
$345.68
|
| Rate for Payer: Mclaren Medicaid |
$136.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.85
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.04
|
| Rate for Payer: Nomi Health Commercial |
$259.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$392.25
|
| Rate for Payer: PACE SWMI |
$216.05
|
| Rate for Payer: PHP Medicare Advantage |
$216.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$388.25
|
| Rate for Payer: Priority Health Medicare |
$216.05
|
| Rate for Payer: Priority Health SBD |
$388.25
|
| Rate for Payer: Priority Health Tiered Network |
$388.25
|
| Rate for Payer: Railroad Medicare Medicare |
$216.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.37
|
| Rate for Payer: UHC Core |
$437.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.05
|
| Rate for Payer: UHC Exchange |
$437.37
|
| Rate for Payer: UHC Medicaid |
$136.53
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
|
|
PR PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 43762
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare |
$35.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.84
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$34.61
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: BCN Medicare Advantage |
$34.61
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$49.84
|
| Rate for Payer: Cofinity Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.61
|
| Rate for Payer: Healthscope Commercial |
$64.03
|
| Rate for Payer: Healthscope Commercial |
$55.38
|
| Rate for Payer: Mclaren Medicaid |
$21.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.34
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.84
|
| Rate for Payer: Nomi Health Commercial |
$41.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.00
|
| Rate for Payer: PACE SWMI |
$34.61
|
| Rate for Payer: PHP Medicare Advantage |
$34.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.96
|
| Rate for Payer: Priority Health Medicare |
$34.61
|
| Rate for Payer: Priority Health SBD |
$67.96
|
| Rate for Payer: Priority Health Tiered Network |
$67.96
|
| Rate for Payer: Railroad Medicare Medicare |
$34.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.84
|
| Rate for Payer: UHC Core |
$67.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.61
|
| Rate for Payer: UHC Exchange |
$67.84
|
| Rate for Payer: UHC Medicaid |
$21.94
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 43763
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$496.50 |
| Rate for Payer: Aetna Commercial |
$109.79
|
| Rate for Payer: Aetna Medicare |
$85.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.98
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$81.93
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: BCN Medicare Advantage |
$81.93
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cofinity Commercial |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$109.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.93
|
| Rate for Payer: Healthscope Commercial |
$151.57
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.03
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.30
|
| Rate for Payer: Nomi Health Commercial |
$98.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$496.50
|
| Rate for Payer: PACE SWMI |
$81.93
|
| Rate for Payer: PHP Medicare Advantage |
$81.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.57
|
| Rate for Payer: Priority Health Medicare |
$81.93
|
| Rate for Payer: Priority Health SBD |
$159.57
|
| Rate for Payer: Priority Health Tiered Network |
$159.57
|
| Rate for Payer: Railroad Medicare Medicare |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.05
|
| Rate for Payer: UHC Core |
$149.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$81.93
|
| Rate for Payer: UHC Exchange |
$149.05
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 0201T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,396.07
|
| Rate for Payer: Aetna Medicare |
$1,258.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,396.07
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,546.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,887.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,651.42
|
| Rate for Payer: UHC Core |
$3,651.42
|
| Rate for Payer: UHC Exchange |
$3,651.42
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 0200T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,679.39 |
| Rate for Payer: Aetna Commercial |
$2,325.11
|
| Rate for Payer: Aetna Medicare |
$1,193.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,325.11
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCN Commercial |
$6,679.39
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,471.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,790.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,562.39
|
| Rate for Payer: UHC Core |
$2,562.39
|
| Rate for Payer: UHC Exchange |
$2,562.39
|
| Rate for Payer: UHC Medicaid |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SKELETAL FIXATION METATARSAL FX W/MNPJ EACH
|
Professional
|
Both
|
$1,109.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$831.75 |
| Rate for Payer: Aetna Commercial |
$493.40
|
| Rate for Payer: Aetna Medicare |
$382.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.22
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS MAPPO |
$368.21
|
| Rate for Payer: BCN Commercial |
$599.57
|
| Rate for Payer: BCN Medicare Advantage |
$368.21
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cofinity Commercial |
$530.22
|
| Rate for Payer: Cofinity Commercial |
$493.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.21
|
| Rate for Payer: Healthscope Commercial |
$681.19
|
| Rate for Payer: Healthscope Commercial |
$589.14
|
| Rate for Payer: Mclaren Medicaid |
$247.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.62
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.68
|
| Rate for Payer: Nomi Health Commercial |
$441.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.75
|
| Rate for Payer: PACE SWMI |
$368.21
|
| Rate for Payer: PHP Medicare Advantage |
$368.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.92
|
| Rate for Payer: Priority Health Medicare |
$368.21
|
| Rate for Payer: Priority Health SBD |
$640.92
|
| Rate for Payer: Priority Health Tiered Network |
$640.92
|
| Rate for Payer: Railroad Medicare Medicare |
$368.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.98
|
| Rate for Payer: UHC Core |
$628.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$368.21
|
| Rate for Payer: UHC Exchange |
$628.98
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
|
|
PR PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 27216
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$2,450.25 |
| Rate for Payer: Aetna Commercial |
$1,191.27
|
| Rate for Payer: Aetna Medicare |
$1,633.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.27
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Mclaren Medicaid |
$508.22
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,582.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,433.03
|
| Rate for Payer: Priority Health SBD |
$1,433.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,433.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,576.42
|
| Rate for Payer: UHC Core |
$1,576.42
|
| Rate for Payer: UHC Exchange |
$1,576.42
|
| Rate for Payer: UHC Medicaid |
$508.22
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
|
|
PR PERQ SKELETAL FIXATION TALUS FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 28436
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$882.00 |
| Rate for Payer: Aetna Commercial |
$636.62
|
| Rate for Payer: Aetna Medicare |
$494.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.62
|
| Rate for Payer: BCBS Complete |
$332.79
|
| Rate for Payer: BCBS MAPPO |
$475.09
|
| Rate for Payer: BCN Commercial |
$761.91
|
| Rate for Payer: BCN Medicare Advantage |
$475.09
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Cofinity Commercial |
$636.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.09
|
| Rate for Payer: Healthscope Commercial |
$878.92
|
| Rate for Payer: Healthscope Commercial |
$760.14
|
| Rate for Payer: Mclaren Medicaid |
$316.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.84
|
| Rate for Payer: Meridian Medicaid |
$332.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$874.44
|
| Rate for Payer: Nomi Health Commercial |
$570.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.00
|
| Rate for Payer: PACE SWMI |
$475.09
|
| Rate for Payer: PHP Medicare Advantage |
$475.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$814.46
|
| Rate for Payer: Priority Health Medicare |
$475.09
|
| Rate for Payer: Priority Health SBD |
$814.46
|
| Rate for Payer: Priority Health Tiered Network |
$814.46
|
| Rate for Payer: Railroad Medicare Medicare |
$475.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.04
|
| Rate for Payer: UHC Core |
$804.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$475.09
|
| Rate for Payer: UHC Exchange |
$804.04
|
| Rate for Payer: UHC Medicaid |
$316.94
|
| Rate for Payer: UHCCP Medicaid |
$316.94
|
|
|
PR PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 25651
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$870.17 |
| Rate for Payer: Aetna Commercial |
$612.45
|
| Rate for Payer: Aetna Medicare |
$475.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.15
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$457.05
|
| Rate for Payer: BCN Commercial |
$758.43
|
| Rate for Payer: BCN Medicare Advantage |
$457.05
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$658.15
|
| Rate for Payer: Cofinity Commercial |
$612.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.05
|
| Rate for Payer: Healthscope Commercial |
$845.54
|
| Rate for Payer: Healthscope Commercial |
$731.28
|
| Rate for Payer: Mclaren Medicaid |
$302.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.90
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.17
|
| Rate for Payer: Nomi Health Commercial |
$548.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.75
|
| Rate for Payer: PACE SWMI |
$457.05
|
| Rate for Payer: PHP Medicare Advantage |
$457.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$810.74
|
| Rate for Payer: Priority Health Medicare |
$457.05
|
| Rate for Payer: Priority Health SBD |
$810.74
|
| Rate for Payer: Priority Health Tiered Network |
$810.74
|
| Rate for Payer: Railroad Medicare Medicare |
$457.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$844.11
|
| Rate for Payer: UHC Core |
$844.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.05
|
| Rate for Payer: UHC Exchange |
$844.11
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
|
|
PR PERQ SKELETAL FIXJ CALCANEAL FRACTURE W/MNPJ
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 28406
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$708.82
|
| Rate for Payer: Aetna Medicare |
$550.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$761.72
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$528.97
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$528.97
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$761.72
|
| Rate for Payer: Cofinity Commercial |
$708.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.97
|
| Rate for Payer: Healthscope Commercial |
$978.59
|
| Rate for Payer: Healthscope Commercial |
$846.35
|
| Rate for Payer: Mclaren Medicaid |
$350.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.42
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$581.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$995.58
|
| Rate for Payer: Nomi Health Commercial |
$634.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: PACE SWMI |
$528.97
|
| Rate for Payer: PHP Medicare Advantage |
$528.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$528.97
|
| Rate for Payer: Priority Health SBD |
$967.25
|
| Rate for Payer: Priority Health Tiered Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$528.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.33
|
| Rate for Payer: UHC Core |
$936.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$528.97
|
| Rate for Payer: UHC Exchange |
$936.33
|
| Rate for Payer: UHC Medicaid |
$350.39
|
| Rate for Payer: UHCCP Medicaid |
$350.39
|
|
|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$333.35 |
| Max. Negotiated Rate |
$1,103.25 |
| Rate for Payer: Aetna Commercial |
$676.90
|
| Rate for Payer: Aetna Medicare |
$525.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.42
|
| Rate for Payer: BCBS Complete |
$350.02
|
| Rate for Payer: BCBS MAPPO |
$505.15
|
| Rate for Payer: BCN Commercial |
$827.64
|
| Rate for Payer: BCN Medicare Advantage |
$505.15
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cofinity Commercial |
$727.42
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.15
|
| Rate for Payer: Healthscope Commercial |
$934.53
|
| Rate for Payer: Healthscope Commercial |
$808.24
|
| Rate for Payer: Mclaren Medicaid |
$333.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.41
|
| Rate for Payer: Meridian Medicaid |
$350.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$555.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$943.97
|
| Rate for Payer: Nomi Health Commercial |
$606.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.25
|
| Rate for Payer: PACE SWMI |
$505.15
|
| Rate for Payer: PHP Medicare Advantage |
$505.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$884.73
|
| Rate for Payer: Priority Health Medicare |
$505.15
|
| Rate for Payer: Priority Health SBD |
$884.73
|
| Rate for Payer: Priority Health Tiered Network |
$884.73
|
| Rate for Payer: Railroad Medicare Medicare |
$505.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.13
|
| Rate for Payer: UHC Core |
$920.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$505.15
|
| Rate for Payer: UHC Exchange |
$920.13
|
| Rate for Payer: UHC Medicaid |
$333.35
|
| Rate for Payer: UHCCP Medicaid |
$333.35
|
|
