|
PR PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 34813
|
| Min. Negotiated Rate |
$135.04 |
| Max. Negotiated Rate |
$942.00 |
| Rate for Payer: Aetna Commercial |
$288.96
|
| Rate for Payer: Aetna Medicare |
$224.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.52
|
| Rate for Payer: BCBS Complete |
$141.79
|
| Rate for Payer: BCBS MAPPO |
$215.64
|
| Rate for Payer: BCN Commercial |
$341.12
|
| Rate for Payer: BCN Medicare Advantage |
$215.64
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$310.52
|
| Rate for Payer: Cofinity Commercial |
$288.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.64
|
| Rate for Payer: Healthscope Commercial |
$398.93
|
| Rate for Payer: Healthscope Commercial |
$345.02
|
| Rate for Payer: Mclaren Medicaid |
$135.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.42
|
| Rate for Payer: Meridian Medicaid |
$141.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.68
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$942.00
|
| Rate for Payer: PACE SWMI |
$215.64
|
| Rate for Payer: PHP Medicare Advantage |
$215.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$366.82
|
| Rate for Payer: Priority Health Medicare |
$215.64
|
| Rate for Payer: Priority Health SBD |
$366.82
|
| Rate for Payer: Priority Health Tiered Network |
$366.82
|
| Rate for Payer: Railroad Medicare Medicare |
$215.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.04
|
| Rate for Payer: UHC Core |
$428.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.64
|
| Rate for Payer: UHC Exchange |
$428.04
|
| Rate for Payer: UHC Medicaid |
$135.04
|
| Rate for Payer: UHCCP Medicaid |
$135.04
|
|
|
PR PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 55876
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$213.75 |
| Rate for Payer: Aetna Commercial |
$119.57
|
| Rate for Payer: Aetna Medicare |
$92.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.49
|
| Rate for Payer: BCBS Complete |
$60.84
|
| Rate for Payer: BCBS MAPPO |
$89.23
|
| Rate for Payer: BCN Commercial |
$152.88
|
| Rate for Payer: BCN Medicare Advantage |
$89.23
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$128.49
|
| Rate for Payer: Cofinity Commercial |
$119.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.23
|
| Rate for Payer: Healthscope Commercial |
$165.08
|
| Rate for Payer: Healthscope Commercial |
$142.77
|
| Rate for Payer: Mclaren Medicaid |
$57.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.69
|
| Rate for Payer: Meridian Medicaid |
$60.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.00
|
| Rate for Payer: Nomi Health Commercial |
$107.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE SWMI |
$89.23
|
| Rate for Payer: PHP Medicare Advantage |
$89.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.53
|
| Rate for Payer: Priority Health Medicare |
$89.23
|
| Rate for Payer: Priority Health SBD |
$166.53
|
| Rate for Payer: Priority Health Tiered Network |
$166.53
|
| Rate for Payer: Railroad Medicare Medicare |
$89.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.39
|
| Rate for Payer: UHC Core |
$177.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.23
|
| Rate for Payer: UHC Exchange |
$177.39
|
| Rate for Payer: UHC Medicaid |
$57.94
|
| Rate for Payer: UHCCP Medicaid |
$57.94
|
|
|
PR PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 50432
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$1,248.00 |
| Rate for Payer: Aetna Commercial |
$236.74
|
| Rate for Payer: Aetna Medicare |
$183.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.40
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$176.67
|
| Rate for Payer: BCN Commercial |
$299.28
|
| Rate for Payer: BCN Medicare Advantage |
$176.67
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$236.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.67
|
| Rate for Payer: Healthscope Commercial |
$326.84
|
| Rate for Payer: Healthscope Commercial |
$282.67
|
| Rate for Payer: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.50
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.04
|
| Rate for Payer: Nomi Health Commercial |
$212.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,248.00
|
| Rate for Payer: PACE SWMI |
$176.67
|
| Rate for Payer: PHP Medicare Advantage |
$176.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$326.02
|
| Rate for Payer: Priority Health Medicare |
$176.67
|
| Rate for Payer: Priority Health SBD |
$326.02
|
| Rate for Payer: Priority Health Tiered Network |
$326.02
|
| Rate for Payer: Railroad Medicare Medicare |
$176.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.64
|
| Rate for Payer: UHC Core |
$365.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.67
|
| Rate for Payer: UHC Exchange |
$365.64
|
| Rate for Payer: UHC Medicaid |
$113.32
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 33884
|
| Min. Negotiated Rate |
$361.20 |
| Max. Negotiated Rate |
$702.47 |
| Rate for Payer: Aetna Commercial |
$532.47
|
| Rate for Payer: Aetna Medicare |
$451.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.47
|
| Rate for Payer: BCBS Complete |
$361.20
|
| Rate for Payer: BCN Commercial |
$574.67
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$677.25
|
|
|
PR PLMT SFT TISS LOCLZJ DEV PERQ 1ST LESION
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 10035
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Aetna Commercial |
$95.14
|
| Rate for Payer: Aetna Medicare |
$73.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.24
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$71.00
|
| Rate for Payer: BCN Commercial |
$123.49
|
| Rate for Payer: BCN Medicare Advantage |
$71.00
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$95.14
|
| Rate for Payer: Cofinity Commercial |
$102.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.00
|
| Rate for Payer: Healthscope Commercial |
$131.35
|
| Rate for Payer: Healthscope Commercial |
$113.60
|
| Rate for Payer: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.96
|
| Rate for Payer: Nomi Health Commercial |
$85.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.00
|
| Rate for Payer: PACE SWMI |
$71.00
|
| Rate for Payer: PHP Medicare Advantage |
$71.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$113.03
|
| Rate for Payer: Priority Health Medicare |
$71.00
|
| Rate for Payer: Priority Health SBD |
$113.03
|
| Rate for Payer: Priority Health Tiered Network |
$113.03
|
| Rate for Payer: Railroad Medicare Medicare |
$71.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.10
|
| Rate for Payer: UHC Core |
$151.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.00
|
| Rate for Payer: UHC Exchange |
$151.10
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 50693
|
| Min. Negotiated Rate |
$112.46 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$234.85
|
| Rate for Payer: Aetna Medicare |
$182.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.37
|
| Rate for Payer: BCBS Complete |
$118.08
|
| Rate for Payer: BCBS MAPPO |
$175.26
|
| Rate for Payer: BCN Commercial |
$297.79
|
| Rate for Payer: BCN Medicare Advantage |
$175.26
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$252.37
|
| Rate for Payer: Cofinity Commercial |
$234.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.26
|
| Rate for Payer: Healthscope Commercial |
$324.23
|
| Rate for Payer: Healthscope Commercial |
$280.42
|
| Rate for Payer: Mclaren Medicaid |
$112.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.02
|
| Rate for Payer: Meridian Medicaid |
$118.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.83
|
| Rate for Payer: Nomi Health Commercial |
$210.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$175.26
|
| Rate for Payer: PHP Medicare Advantage |
$175.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$324.39
|
| Rate for Payer: Priority Health Medicare |
$175.26
|
| Rate for Payer: Priority Health SBD |
$324.39
|
| Rate for Payer: Priority Health Tiered Network |
$324.39
|
| Rate for Payer: Railroad Medicare Medicare |
$175.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.09
|
| Rate for Payer: UHC Core |
$363.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.26
|
| Rate for Payer: UHC Exchange |
$363.09
|
| Rate for Payer: UHC Medicaid |
$112.46
|
| Rate for Payer: UHCCP Medicaid |
$112.46
|
|
|
PR PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 35685
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$358.74 |
| Rate for Payer: Aetna Commercial |
$243.83
|
| Rate for Payer: Aetna Medicare |
$189.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.02
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCBS MAPPO |
$181.96
|
| Rate for Payer: BCN Commercial |
$288.34
|
| Rate for Payer: BCN Medicare Advantage |
$181.96
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$262.02
|
| Rate for Payer: Cofinity Commercial |
$243.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.96
|
| Rate for Payer: Healthscope Commercial |
$336.63
|
| Rate for Payer: Healthscope Commercial |
$291.14
|
| Rate for Payer: Mclaren Medicaid |
$113.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.06
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.86
|
| Rate for Payer: Nomi Health Commercial |
$218.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: PACE SWMI |
$181.96
|
| Rate for Payer: PHP Medicare Advantage |
$181.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$310.07
|
| Rate for Payer: Priority Health Medicare |
$181.96
|
| Rate for Payer: Priority Health SBD |
$310.07
|
| Rate for Payer: Priority Health Tiered Network |
$310.07
|
| Rate for Payer: Railroad Medicare Medicare |
$181.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.74
|
| Rate for Payer: UHC Core |
$358.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.96
|
| Rate for Payer: UHC Exchange |
$358.74
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
|
PR PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 34839
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.00
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCN Commercial |
$146.64
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.92
|
| Rate for Payer: UHC Core |
$440.92
|
| Rate for Payer: UHC Exchange |
$440.92
|
|
|
PR PL REJUV/PERFECT
|
Professional
|
Both
|
$126.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
|
|
PR PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL
|
Professional
|
Both
|
$1,939.00
|
|
|
Service Code
|
HCPCS 40720
|
| Min. Negotiated Rate |
$588.31 |
| Max. Negotiated Rate |
$1,887.02 |
| Rate for Payer: Aetna Commercial |
$1,210.33
|
| Rate for Payer: Aetna Medicare |
$939.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,210.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.65
|
| Rate for Payer: BCBS Complete |
$617.73
|
| Rate for Payer: BCBS MAPPO |
$903.23
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: BCN Medicare Advantage |
$903.23
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Cofinity Commercial |
$1,210.33
|
| Rate for Payer: Cofinity Commercial |
$1,300.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.23
|
| Rate for Payer: Healthscope Commercial |
$1,670.98
|
| Rate for Payer: Healthscope Commercial |
$1,445.17
|
| Rate for Payer: Mclaren Medicaid |
$588.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.39
|
| Rate for Payer: Meridian Medicaid |
$617.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$993.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.73
|
| Rate for Payer: Nomi Health Commercial |
$1,083.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,454.25
|
| Rate for Payer: PACE SWMI |
$903.23
|
| Rate for Payer: PHP Medicare Advantage |
$903.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,887.02
|
| Rate for Payer: Priority Health Medicare |
$903.23
|
| Rate for Payer: Priority Health SBD |
$1,887.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,887.02
|
| Rate for Payer: Railroad Medicare Medicare |
$903.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,806.21
|
| Rate for Payer: UHC Core |
$1,806.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.23
|
| Rate for Payer: UHC Exchange |
$1,806.21
|
| Rate for Payer: UHC Medicaid |
$588.31
|
| Rate for Payer: UHCCP Medicaid |
$588.31
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 42500
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Commercial |
$406.07
|
| Rate for Payer: Aetna Medicare |
$315.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.38
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$303.04
|
| Rate for Payer: BCN Commercial |
$523.38
|
| Rate for Payer: BCN Medicare Advantage |
$303.04
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$436.38
|
| Rate for Payer: Cofinity Commercial |
$406.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.04
|
| Rate for Payer: Healthscope Commercial |
$560.62
|
| Rate for Payer: Healthscope Commercial |
$484.86
|
| Rate for Payer: Mclaren Medicaid |
$199.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.19
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.96
|
| Rate for Payer: Nomi Health Commercial |
$363.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
| Rate for Payer: PACE SWMI |
$303.04
|
| Rate for Payer: PHP Medicare Advantage |
$303.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$637.70
|
| Rate for Payer: Priority Health Medicare |
$303.04
|
| Rate for Payer: Priority Health SBD |
$637.70
|
| Rate for Payer: Priority Health Tiered Network |
$637.70
|
| Rate for Payer: Railroad Medicare Medicare |
$303.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$584.52
|
| Rate for Payer: UHC Core |
$584.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.04
|
| Rate for Payer: UHC Exchange |
$584.52
|
| Rate for Payer: UHC Medicaid |
$199.79
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 42505
|
| Min. Negotiated Rate |
$261.56 |
| Max. Negotiated Rate |
$858.75 |
| Rate for Payer: Aetna Commercial |
$534.49
|
| Rate for Payer: Aetna Medicare |
$414.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.37
|
| Rate for Payer: BCBS Complete |
$274.64
|
| Rate for Payer: BCBS MAPPO |
$398.87
|
| Rate for Payer: BCN Commercial |
$692.19
|
| Rate for Payer: BCN Medicare Advantage |
$398.87
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$574.37
|
| Rate for Payer: Cofinity Commercial |
$534.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.87
|
| Rate for Payer: Healthscope Commercial |
$737.91
|
| Rate for Payer: Healthscope Commercial |
$638.19
|
| Rate for Payer: Mclaren Medicaid |
$261.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.81
|
| Rate for Payer: Meridian Medicaid |
$274.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.22
|
| Rate for Payer: Nomi Health Commercial |
$478.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.75
|
| Rate for Payer: PACE SWMI |
$398.87
|
| Rate for Payer: PHP Medicare Advantage |
$398.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$843.40
|
| Rate for Payer: Priority Health Medicare |
$398.87
|
| Rate for Payer: Priority Health SBD |
$843.40
|
| Rate for Payer: Priority Health Tiered Network |
$843.40
|
| Rate for Payer: Railroad Medicare Medicare |
$398.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.58
|
| Rate for Payer: UHC Core |
$780.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.87
|
| Rate for Payer: UHC Exchange |
$780.58
|
| Rate for Payer: UHC Medicaid |
$261.56
|
| Rate for Payer: UHCCP Medicaid |
$261.56
|
|
|
PR PL VITALIZE
|
Professional
|
Both
|
$105.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
|
|
PR PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY
|
Professional
|
Both
|
$3,774.00
|
|
|
Service Code
|
HCPCS 48140
|
| Min. Negotiated Rate |
$928.89 |
| Max. Negotiated Rate |
$2,864.51 |
| Rate for Payer: Aetna Commercial |
$1,944.22
|
| Rate for Payer: Aetna Medicare |
$1,508.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,944.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,089.31
|
| Rate for Payer: BCBS Complete |
$975.33
|
| Rate for Payer: BCBS MAPPO |
$1,450.91
|
| Rate for Payer: BCN Commercial |
$2,350.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,450.91
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,089.31
|
| Rate for Payer: Cofinity Commercial |
$1,944.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,450.91
|
| Rate for Payer: Healthscope Commercial |
$2,321.46
|
| Rate for Payer: Healthscope Commercial |
$2,684.18
|
| Rate for Payer: Mclaren Medicaid |
$928.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.46
|
| Rate for Payer: Meridian Medicaid |
$975.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,596.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,805.01
|
| Rate for Payer: Nomi Health Commercial |
$1,741.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,830.50
|
| Rate for Payer: PACE SWMI |
$1,450.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,450.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,864.51
|
| Rate for Payer: Priority Health Medicare |
$1,450.91
|
| Rate for Payer: Priority Health SBD |
$2,864.51
|
| Rate for Payer: Priority Health Tiered Network |
$2,864.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,450.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,791.99
|
| Rate for Payer: UHC Core |
$2,791.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,450.91
|
| Rate for Payer: UHC Exchange |
$2,791.99
|
| Rate for Payer: UHC Medicaid |
$928.89
|
| Rate for Payer: UHCCP Medicaid |
$928.89
|
|
|
PR PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$5,729.00
|
|
|
Service Code
|
HCPCS 48150
|
| Min. Negotiated Rate |
$1,830.95 |
| Max. Negotiated Rate |
$5,677.43 |
| Rate for Payer: Aetna Commercial |
$3,838.14
|
| Rate for Payer: Aetna Medicare |
$2,978.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,838.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,124.56
|
| Rate for Payer: BCBS Complete |
$1,922.50
|
| Rate for Payer: BCBS MAPPO |
$2,864.28
|
| Rate for Payer: BCN Commercial |
$4,659.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,864.28
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Cofinity Commercial |
$4,124.56
|
| Rate for Payer: Cofinity Commercial |
$3,838.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,864.28
|
| Rate for Payer: Healthscope Commercial |
$5,298.92
|
| Rate for Payer: Healthscope Commercial |
$4,582.85
|
| Rate for Payer: Mclaren Medicaid |
$1,830.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,007.49
|
| Rate for Payer: Meridian Medicaid |
$1,922.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,150.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,571.81
|
| Rate for Payer: Nomi Health Commercial |
$3,437.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.75
|
| Rate for Payer: PACE SWMI |
$2,864.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,864.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,830.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,677.43
|
| Rate for Payer: Priority Health Medicare |
$2,864.28
|
| Rate for Payer: Priority Health SBD |
$5,677.43
|
| Rate for Payer: Priority Health Tiered Network |
$5,677.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2,864.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,570.94
|
| Rate for Payer: UHC Core |
$5,570.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,864.28
|
| Rate for Payer: UHC Exchange |
$5,570.94
|
| Rate for Payer: UHC Medicaid |
$1,830.95
|
| Rate for Payer: UHCCP Medicaid |
$1,830.95
|
|
|
PR PNCRTECT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$8,552.00
|
|
|
Service Code
|
HCPCS 48153
|
| Min. Negotiated Rate |
$1,825.62 |
| Max. Negotiated Rate |
$6,414.00 |
| Rate for Payer: Aetna Commercial |
$3,831.78
|
| Rate for Payer: Aetna Medicare |
$2,973.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,831.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,117.74
|
| Rate for Payer: BCBS Complete |
$1,916.90
|
| Rate for Payer: BCBS MAPPO |
$2,859.54
|
| Rate for Payer: BCN Commercial |
$4,632.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.54
|
| Rate for Payer: Cash Price |
$6,841.60
|
| Rate for Payer: Cash Price |
$6,841.60
|
| Rate for Payer: Cofinity Commercial |
$4,117.74
|
| Rate for Payer: Cofinity Commercial |
$3,831.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.54
|
| Rate for Payer: Healthscope Commercial |
$5,290.15
|
| Rate for Payer: Healthscope Commercial |
$4,575.26
|
| Rate for Payer: Mclaren Medicaid |
$1,825.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.52
|
| Rate for Payer: Meridian Medicaid |
$1,916.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,145.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,556.67
|
| Rate for Payer: Nomi Health Commercial |
$3,431.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,414.00
|
| Rate for Payer: PACE SWMI |
$2,859.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,825.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,644.05
|
| Rate for Payer: Priority Health Medicare |
$2,859.54
|
| Rate for Payer: Priority Health SBD |
$5,644.05
|
| Rate for Payer: Priority Health Tiered Network |
$5,644.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,859.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,549.68
|
| Rate for Payer: UHC Core |
$5,549.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,859.54
|
| Rate for Payer: UHC Exchange |
$5,549.68
|
| Rate for Payer: UHC Medicaid |
$1,825.62
|
| Rate for Payer: UHCCP Medicaid |
$1,825.62
|
|
|
PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 90669
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
|
|
PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX
|
Professional
|
Both
|
$2,651.00
|
|
|
Service Code
|
HCPCS 32940
|
| Min. Negotiated Rate |
$749.33 |
| Max. Negotiated Rate |
$2,185.81 |
| Rate for Payer: Aetna Commercial |
$1,569.17
|
| Rate for Payer: Aetna Medicare |
$1,217.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,569.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,686.27
|
| Rate for Payer: BCBS Complete |
$786.80
|
| Rate for Payer: BCBS MAPPO |
$1,171.02
|
| Rate for Payer: BCN Commercial |
$1,825.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.02
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cofinity Commercial |
$1,686.27
|
| Rate for Payer: Cofinity Commercial |
$1,569.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.02
|
| Rate for Payer: Healthscope Commercial |
$1,873.63
|
| Rate for Payer: Healthscope Commercial |
$2,166.39
|
| Rate for Payer: Mclaren Medicaid |
$749.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,229.57
|
| Rate for Payer: Meridian Medicaid |
$786.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,185.81
|
| Rate for Payer: Nomi Health Commercial |
$1,405.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,988.25
|
| Rate for Payer: PACE SWMI |
$1,171.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,719.17
|
| Rate for Payer: Priority Health Medicare |
$1,171.02
|
| Rate for Payer: Priority Health SBD |
$1,719.17
|
| Rate for Payer: Priority Health Tiered Network |
$1,719.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,185.58
|
| Rate for Payer: UHC Core |
$2,185.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,171.02
|
| Rate for Payer: UHC Exchange |
$2,185.58
|
| Rate for Payer: UHC Medicaid |
$749.33
|
| Rate for Payer: UHCCP Medicaid |
$749.33
|
|
|
PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST
|
Professional
|
Both
|
$2,811.00
|
|
|
Service Code
|
HCPCS 32200
|
| Min. Negotiated Rate |
$707.16 |
| Max. Negotiated Rate |
$2,108.25 |
| Rate for Payer: Aetna Commercial |
$1,471.84
|
| Rate for Payer: Aetna Medicare |
$1,142.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,471.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,581.68
|
| Rate for Payer: BCBS Complete |
$742.52
|
| Rate for Payer: BCBS MAPPO |
$1,098.39
|
| Rate for Payer: BCN Commercial |
$1,696.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,098.39
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,581.68
|
| Rate for Payer: Cofinity Commercial |
$1,471.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,098.39
|
| Rate for Payer: Healthscope Commercial |
$2,032.02
|
| Rate for Payer: Healthscope Commercial |
$1,757.42
|
| Rate for Payer: Mclaren Medicaid |
$707.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,153.31
|
| Rate for Payer: Meridian Medicaid |
$742.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,208.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,016.58
|
| Rate for Payer: Nomi Health Commercial |
$1,318.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,108.25
|
| Rate for Payer: PACE SWMI |
$1,098.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,098.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$707.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,597.24
|
| Rate for Payer: Priority Health Medicare |
$1,098.39
|
| Rate for Payer: Priority Health SBD |
$1,597.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,597.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,098.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,006.19
|
| Rate for Payer: UHC Core |
$2,006.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,098.39
|
| Rate for Payer: UHC Exchange |
$2,006.19
|
| Rate for Payer: UHC Medicaid |
$707.16
|
| Rate for Payer: UHCCP Medicaid |
$707.16
|
|
|
PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 32960
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna Medicare |
$84.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.07
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$81.30
|
| Rate for Payer: BCN Commercial |
$133.96
|
| Rate for Payer: BCN Medicare Advantage |
$81.30
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$117.07
|
| Rate for Payer: Cofinity Commercial |
$108.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.30
|
| Rate for Payer: Healthscope Commercial |
$150.41
|
| Rate for Payer: Healthscope Commercial |
$130.08
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.36
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.61
|
| Rate for Payer: Nomi Health Commercial |
$97.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.50
|
| Rate for Payer: PACE SWMI |
$81.30
|
| Rate for Payer: PHP Medicare Advantage |
$81.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$126.14
|
| Rate for Payer: Priority Health Medicare |
$81.30
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: Priority Health Tiered Network |
$126.14
|
| Rate for Payer: Railroad Medicare Medicare |
$81.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.05
|
| Rate for Payer: UHC Core |
$161.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$81.30
|
| Rate for Payer: UHC Exchange |
$161.05
|
| Rate for Payer: UHC Medicaid |
$52.40
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 55000
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$101.55
|
| Rate for Payer: Aetna Medicare |
$78.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.12
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$75.78
|
| Rate for Payer: BCN Commercial |
$126.49
|
| Rate for Payer: BCN Medicare Advantage |
$75.78
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$109.12
|
| Rate for Payer: Cofinity Commercial |
$101.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.78
|
| Rate for Payer: Healthscope Commercial |
$140.19
|
| Rate for Payer: Healthscope Commercial |
$121.25
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.57
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.94
|
| Rate for Payer: Nomi Health Commercial |
$90.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$75.78
|
| Rate for Payer: PHP Medicare Advantage |
$75.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$137.79
|
| Rate for Payer: Priority Health Medicare |
$75.78
|
| Rate for Payer: Priority Health SBD |
$137.79
|
| Rate for Payer: Priority Health Tiered Network |
$137.79
|
| Rate for Payer: Railroad Medicare Medicare |
$75.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.79
|
| Rate for Payer: UHC Core |
$148.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.78
|
| Rate for Payer: UHC Exchange |
$148.79
|
| Rate for Payer: UHC Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 90713
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Aetna Commercial |
$43.27
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.27
|
| Rate for Payer: BCBS Trust/PPO |
$47.81
|
| Rate for Payer: BCN Commercial |
$43.89
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.27
|
| Rate for Payer: UHC Core |
$46.27
|
| Rate for Payer: UHC Exchange |
$46.27
|
|
|
PR POLLICIZATION DIGIT
|
Professional
|
Both
|
$2,851.00
|
|
|
Service Code
|
HCPCS 26550
|
| Min. Negotiated Rate |
$981.08 |
| Max. Negotiated Rate |
$2,929.32 |
| Rate for Payer: Aetna Commercial |
$2,007.99
|
| Rate for Payer: Aetna Medicare |
$1,558.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,007.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,157.84
|
| Rate for Payer: BCBS Complete |
$1,030.13
|
| Rate for Payer: BCBS MAPPO |
$1,498.50
|
| Rate for Payer: BCN Commercial |
$2,479.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,498.50
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cofinity Commercial |
$2,157.84
|
| Rate for Payer: Cofinity Commercial |
$2,007.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,498.50
|
| Rate for Payer: Healthscope Commercial |
$2,397.60
|
| Rate for Payer: Healthscope Commercial |
$2,772.22
|
| Rate for Payer: Mclaren Medicaid |
$981.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,573.42
|
| Rate for Payer: Meridian Medicaid |
$1,030.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,648.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,929.32
|
| Rate for Payer: Nomi Health Commercial |
$1,798.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,138.25
|
| Rate for Payer: PACE SWMI |
$1,498.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,498.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$981.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,651.00
|
| Rate for Payer: Priority Health Medicare |
$1,498.50
|
| Rate for Payer: Priority Health SBD |
$2,651.00
|
| Rate for Payer: Priority Health Tiered Network |
$2,651.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,498.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,863.59
|
| Rate for Payer: UHC Core |
$2,863.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,498.50
|
| Rate for Payer: UHC Exchange |
$2,863.59
|
| Rate for Payer: UHC Medicaid |
$981.08
|
| Rate for Payer: UHCCP Medicaid |
$981.08
|
|
|
PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$488.00
|
|
|
Service Code
|
HCPCS 95810
|
| Min. Negotiated Rate |
$366.00 |
| Max. Negotiated Rate |
$1,154.49 |
| Rate for Payer: Aetna Commercial |
$836.23
|
| Rate for Payer: Aetna Commercial |
$836.23
|
| Rate for Payer: Aetna Medicare |
$649.01
|
| Rate for Payer: Aetna Medicare |
$649.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.23
|
| Rate for Payer: BCBS MAPPO |
$624.05
|
| Rate for Payer: BCBS MAPPO |
$624.05
|
| Rate for Payer: BCN Commercial |
$738.67
|
| Rate for Payer: BCN Commercial |
$738.67
|
| Rate for Payer: BCN Medicare Advantage |
$624.05
|
| Rate for Payer: BCN Medicare Advantage |
$624.05
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cofinity Commercial |
$898.63
|
| Rate for Payer: Cofinity Commercial |
$836.23
|
| Rate for Payer: Cofinity Commercial |
$836.23
|
| Rate for Payer: Cofinity Commercial |
$898.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.05
|
| Rate for Payer: Healthscope Commercial |
$998.48
|
| Rate for Payer: Healthscope Commercial |
$998.48
|
| Rate for Payer: Healthscope Commercial |
$1,154.49
|
| Rate for Payer: Healthscope Commercial |
$1,154.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$686.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.79
|
| Rate for Payer: Nomi Health Commercial |
$748.86
|
| Rate for Payer: Nomi Health Commercial |
$748.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$770.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.00
|
| Rate for Payer: PACE SWMI |
$624.05
|
| Rate for Payer: PACE SWMI |
$624.05
|
| Rate for Payer: PHP Medicare Advantage |
$624.05
|
| Rate for Payer: PHP Medicare Advantage |
$624.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$863.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$863.84
|
| Rate for Payer: Priority Health Medicare |
$624.05
|
| Rate for Payer: Priority Health Medicare |
$624.05
|
| Rate for Payer: Priority Health SBD |
$863.84
|
| Rate for Payer: Priority Health SBD |
$863.84
|
| Rate for Payer: Priority Health Tiered Network |
$863.84
|
| Rate for Payer: Priority Health Tiered Network |
$863.84
|
| Rate for Payer: Railroad Medicare Medicare |
$624.05
|
| Rate for Payer: Railroad Medicare Medicare |
$624.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.29
|
| Rate for Payer: UHC Core |
$928.29
|
| Rate for Payer: UHC Core |
$928.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$624.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$624.05
|
| Rate for Payer: UHC Exchange |
$928.29
|
| Rate for Payer: UHC Exchange |
$928.29
|
|
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 95782
|
| Min. Negotiated Rate |
$199.50 |
| Max. Negotiated Rate |
$1,723.52 |
| Rate for Payer: Aetna Commercial |
$1,248.38
|
| Rate for Payer: Aetna Commercial |
$1,248.38
|
| Rate for Payer: Aetna Medicare |
$968.90
|
| Rate for Payer: Aetna Medicare |
$968.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.38
|
| Rate for Payer: BCBS MAPPO |
$931.63
|
| Rate for Payer: BCBS MAPPO |
$931.63
|
| Rate for Payer: BCN Commercial |
$1,451.62
|
| Rate for Payer: BCN Commercial |
$1,451.62
|
| Rate for Payer: BCN Medicare Advantage |
$931.63
|
| Rate for Payer: BCN Medicare Advantage |
$931.63
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$1,341.55
|
| Rate for Payer: Cofinity Commercial |
$1,248.38
|
| Rate for Payer: Cofinity Commercial |
$1,248.38
|
| Rate for Payer: Cofinity Commercial |
$1,341.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.63
|
| Rate for Payer: Healthscope Commercial |
$1,723.52
|
| Rate for Payer: Healthscope Commercial |
$1,723.52
|
| Rate for Payer: Healthscope Commercial |
$1,490.61
|
| Rate for Payer: Healthscope Commercial |
$1,490.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$978.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$978.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,024.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.65
|
| Rate for Payer: Nomi Health Commercial |
$1,117.96
|
| Rate for Payer: Nomi Health Commercial |
$1,117.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.50
|
| Rate for Payer: PACE SWMI |
$931.63
|
| Rate for Payer: PACE SWMI |
$931.63
|
| Rate for Payer: PHP Medicare Advantage |
$931.63
|
| Rate for Payer: PHP Medicare Advantage |
$931.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,338.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,338.70
|
| Rate for Payer: Priority Health Medicare |
$931.63
|
| Rate for Payer: Priority Health Medicare |
$931.63
|
| Rate for Payer: Priority Health SBD |
$1,338.70
|
| Rate for Payer: Priority Health SBD |
$1,338.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,338.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,338.70
|
| Rate for Payer: Railroad Medicare Medicare |
$931.63
|
| Rate for Payer: Railroad Medicare Medicare |
$931.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.40
|
| Rate for Payer: UHC Core |
$1,369.40
|
| Rate for Payer: UHC Core |
$1,369.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$931.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$931.63
|
| Rate for Payer: UHC Exchange |
$1,369.40
|
| Rate for Payer: UHC Exchange |
$1,369.40
|
|
