|
PR PESSARY REUSABLE RUB ANYTYPE
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS A4561
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.06
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCN Commercial |
$27.97
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Cofinity Commercial |
$39.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$46.74
|
| Rate for Payer: Healthscope Commercial |
$54.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.26
|
| Rate for Payer: Nomi Health Commercial |
$35.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.52
|
| Rate for Payer: UHC Core |
$9.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.21
|
| Rate for Payer: UHC Exchange |
$9.52
|
|
|
PR PHALANGECTOMY TOE EACH TOE
|
Professional
|
Both
|
$874.00
|
|
|
Service Code
|
HCPCS 28150
|
| Min. Negotiated Rate |
$169.34 |
| Max. Negotiated Rate |
$655.50 |
| Rate for Payer: Aetna Commercial |
$345.06
|
| Rate for Payer: Aetna Medicare |
$267.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.81
|
| Rate for Payer: BCBS Complete |
$177.81
|
| Rate for Payer: BCBS MAPPO |
$257.51
|
| Rate for Payer: BCN Commercial |
$425.77
|
| Rate for Payer: BCN Medicare Advantage |
$257.51
|
| Rate for Payer: Cash Price |
$699.20
|
| Rate for Payer: Cash Price |
$699.20
|
| Rate for Payer: Cofinity Commercial |
$370.81
|
| Rate for Payer: Cofinity Commercial |
$345.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.51
|
| Rate for Payer: Healthscope Commercial |
$476.39
|
| Rate for Payer: Healthscope Commercial |
$412.02
|
| Rate for Payer: Mclaren Medicaid |
$169.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.39
|
| Rate for Payer: Meridian Medicaid |
$177.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.21
|
| Rate for Payer: Nomi Health Commercial |
$309.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.50
|
| Rate for Payer: PACE SWMI |
$257.51
|
| Rate for Payer: PHP Medicare Advantage |
$257.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$455.14
|
| Rate for Payer: Priority Health Medicare |
$257.51
|
| Rate for Payer: Priority Health SBD |
$455.14
|
| Rate for Payer: Priority Health Tiered Network |
$455.14
|
| Rate for Payer: Railroad Medicare Medicare |
$257.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.09
|
| Rate for Payer: UHC Core |
$485.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.51
|
| Rate for Payer: UHC Exchange |
$485.09
|
| Rate for Payer: UHC Medicaid |
$169.34
|
| Rate for Payer: UHCCP Medicaid |
$169.34
|
|
|
PR PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 90863
|
| Min. Negotiated Rate |
$31.40 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$31.40
|
| Rate for Payer: Aetna Medicare |
$44.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.40
|
| Rate for Payer: BCBS Complete |
$35.20
|
| Rate for Payer: BCN Commercial |
$53.43
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.18
|
| Rate for Payer: Priority Health SBD |
$36.18
|
| Rate for Payer: Priority Health Tiered Network |
$36.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.36
|
| Rate for Payer: UHC Core |
$40.36
|
| Rate for Payer: UHC Exchange |
$40.36
|
|
|
PR PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX
|
Professional
|
Both
|
$1,484.00
|
|
|
Service Code
|
HCPCS 42950
|
| Min. Negotiated Rate |
$467.54 |
| Max. Negotiated Rate |
$1,451.37 |
| Rate for Payer: Aetna Commercial |
$939.93
|
| Rate for Payer: Aetna Medicare |
$729.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.93
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$701.44
|
| Rate for Payer: BCN Commercial |
$1,191.17
|
| Rate for Payer: BCN Medicare Advantage |
$701.44
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cofinity Commercial |
$939.93
|
| Rate for Payer: Cofinity Commercial |
$1,010.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.44
|
| Rate for Payer: Healthscope Commercial |
$1,297.66
|
| Rate for Payer: Healthscope Commercial |
$1,122.30
|
| Rate for Payer: Mclaren Medicaid |
$467.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$736.51
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$771.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.94
|
| Rate for Payer: Nomi Health Commercial |
$841.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.00
|
| Rate for Payer: PACE SWMI |
$701.44
|
| Rate for Payer: PHP Medicare Advantage |
$701.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,451.37
|
| Rate for Payer: Priority Health Medicare |
$701.44
|
| Rate for Payer: Priority Health SBD |
$1,451.37
|
| Rate for Payer: Priority Health Tiered Network |
$1,451.37
|
| Rate for Payer: Railroad Medicare Medicare |
$701.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,363.71
|
| Rate for Payer: UHC Core |
$1,363.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$701.44
|
| Rate for Payer: UHC Exchange |
$1,363.71
|
| Rate for Payer: UHC Medicaid |
$467.54
|
| Rate for Payer: UHCCP Medicaid |
$467.54
|
|
|
PR PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 99195
|
| Min. Negotiated Rate |
$90.02 |
| Max. Negotiated Rate |
$166.54 |
| Rate for Payer: Aetna Commercial |
$120.63
|
| Rate for Payer: Aetna Medicare |
$93.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.63
|
| Rate for Payer: BCBS MAPPO |
$90.02
|
| Rate for Payer: BCN Commercial |
$133.96
|
| Rate for Payer: BCN Medicare Advantage |
$90.02
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$129.63
|
| Rate for Payer: Cofinity Commercial |
$120.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.02
|
| Rate for Payer: Healthscope Commercial |
$166.54
|
| Rate for Payer: Healthscope Commercial |
$144.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.79
|
| Rate for Payer: Nomi Health Commercial |
$108.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: PACE SWMI |
$90.02
|
| Rate for Payer: PHP Medicare Advantage |
$90.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$123.53
|
| Rate for Payer: Priority Health Medicare |
$90.02
|
| Rate for Payer: Priority Health SBD |
$123.53
|
| Rate for Payer: Priority Health Tiered Network |
$123.53
|
| Rate for Payer: Railroad Medicare Medicare |
$90.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.81
|
| Rate for Payer: UHC Core |
$151.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.02
|
| Rate for Payer: UHC Exchange |
$151.81
|
|
|
PR PHTFAC ARMS
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR PHTFAC CHEST/SHLD
|
Professional
|
Both
|
$132.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
|
|
PR PHTFAC FACE & NECK/ FL ARMS
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR PHTFAC FL LEGS
|
Professional
|
Both
|
$368.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Medicare |
$184.00
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
|
|
PR PHTFAC HANDS
|
Professional
|
Both
|
$53.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR PHTFAC HEMANGIOMAS/WARTS
|
Professional
|
Both
|
$37.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR PHTFAC NASAL VEIN
|
Professional
|
Both
|
$47.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
|
|
PR PHTFAC SNGL PIGMENT
|
Professional
|
Both
|
$37.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97750
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$43.12
|
| Rate for Payer: Aetna Medicare |
$33.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.34
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$32.18
|
| Rate for Payer: BCN Commercial |
$34.38
|
| Rate for Payer: BCN Medicare Advantage |
$32.18
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$46.34
|
| Rate for Payer: Cofinity Commercial |
$43.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.18
|
| Rate for Payer: Healthscope Commercial |
$59.53
|
| Rate for Payer: Healthscope Commercial |
$51.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.89
|
| Rate for Payer: Nomi Health Commercial |
$38.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$32.18
|
| Rate for Payer: PHP Medicare Advantage |
$32.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$32.18
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$32.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.72
|
| Rate for Payer: UHC Core |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.18
|
| Rate for Payer: UHC Exchange |
$30.72
|
|
|
PR PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 93464
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$387.26 |
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna Medicare |
$217.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.44
|
| Rate for Payer: BCBS MAPPO |
$209.33
|
| Rate for Payer: BCN Commercial |
$320.20
|
| Rate for Payer: BCN Medicare Advantage |
$209.33
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$301.44
|
| Rate for Payer: Cofinity Commercial |
$280.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.33
|
| Rate for Payer: Healthscope Commercial |
$334.93
|
| Rate for Payer: Healthscope Commercial |
$387.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$230.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.00
|
| Rate for Payer: Nomi Health Commercial |
$251.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.00
|
| Rate for Payer: PACE SWMI |
$209.33
|
| Rate for Payer: PHP Medicare Advantage |
$209.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$304.34
|
| Rate for Payer: Priority Health Medicare |
$209.33
|
| Rate for Payer: Priority Health SBD |
$304.34
|
| Rate for Payer: Priority Health Tiered Network |
$304.34
|
| Rate for Payer: Railroad Medicare Medicare |
$209.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.69
|
| Rate for Payer: UHC Core |
$375.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$209.33
|
| Rate for Payer: UHC Exchange |
$375.69
|
|
|
PR PHYSIOL SUPPORT HARVEST ORGAN FROM BRAIN-DEAD PT
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 01990
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
|
|
PR PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 99183
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$144.57
|
| Rate for Payer: Aetna Medicare |
$112.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.36
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS MAPPO |
$107.89
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$107.89
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$155.36
|
| Rate for Payer: Cofinity Commercial |
$144.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.89
|
| Rate for Payer: Healthscope Commercial |
$172.62
|
| Rate for Payer: Healthscope Commercial |
$199.60
|
| Rate for Payer: Mclaren Medicaid |
$69.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.28
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.13
|
| Rate for Payer: Nomi Health Commercial |
$129.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.00
|
| Rate for Payer: PACE SWMI |
$107.89
|
| Rate for Payer: PHP Medicare Advantage |
$107.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$145.11
|
| Rate for Payer: Priority Health Medicare |
$107.89
|
| Rate for Payer: Priority Health SBD |
$145.11
|
| Rate for Payer: Priority Health Tiered Network |
$145.11
|
| Rate for Payer: Railroad Medicare Medicare |
$107.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.74
|
| Rate for Payer: UHC Core |
$179.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.89
|
| Rate for Payer: UHC Exchange |
$179.74
|
| Rate for Payer: UHC Medicaid |
$69.86
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
|
|
PR PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 99288
|
| Min. Negotiated Rate |
$48.26 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$48.75
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCN Commercial |
$48.26
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.00
|
| Rate for Payer: Priority Health SBD |
$72.00
|
| Rate for Payer: Priority Health Tiered Network |
$72.00
|
|
|
PR PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 99078
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$25.00
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCN Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.89
|
| Rate for Payer: Priority Health SBD |
$31.89
|
| Rate for Payer: Priority Health Tiered Network |
$31.89
|
|
|
PR PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 99444
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
|
|
PR PHYS/QHP O/P CARDIAC RHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$12.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Healthscope Commercial |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$12.18
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.95
|
| Rate for Payer: Nomi Health Commercial |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.84
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: Priority Health SBD |
$11.84
|
| Rate for Payer: Priority Health Tiered Network |
$11.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.23
|
| Rate for Payer: UHC Core |
$14.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.61
|
| Rate for Payer: UHC Exchange |
$14.23
|
| Rate for Payer: UHC Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 99442
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$67.27
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.27
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCN Commercial |
$37.41
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 21-30 MIN
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 99443
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$99.17
|
| Rate for Payer: Aetna Medicare |
$111.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.17
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 99441
|
| Min. Negotiated Rate |
$18.69 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Aetna Commercial |
$35.71
|
| Rate for Payer: Aetna Medicare |
$46.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: BCBS Complete |
$37.20
|
| Rate for Payer: BCN Commercial |
$18.69
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
|
|
PR PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 99360
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.51
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.49
|
| Rate for Payer: Priority Health SBD |
$77.49
|
| Rate for Payer: Priority Health Tiered Network |
$77.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.67
|
| Rate for Payer: UHC Core |
$87.67
|
| Rate for Payer: UHC Exchange |
$87.67
|
|
