|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 22515
|
| Min. Negotiated Rate |
$209.25 |
| Max. Negotiated Rate |
$523.90 |
| Rate for Payer: Aetna Commercial |
$280.39
|
| Rate for Payer: Aetna Medicare |
$217.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.39
|
| Rate for Payer: BCBS Complete |
$322.40
|
| Rate for Payer: BCBS MAPPO |
$209.25
|
| Rate for Payer: BCN Medicare Advantage |
$209.25
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Cofinity Commercial |
$280.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.25
|
| Rate for Payer: Healthscope Commercial |
$387.11
|
| Rate for Payer: Healthscope Commercial |
$334.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.90
|
| Rate for Payer: Nomi Health Commercial |
$251.10
|
| Rate for Payer: PACE SWMI |
$209.25
|
| Rate for Payer: PHP Medicare Advantage |
$209.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health Medicare |
$209.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.25
|
| Rate for Payer: UHC Medicare Advantage |
$209.25
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR
|
Professional
|
Both
|
$1,444.00
|
|
|
Service Code
|
HCPCS 22514
|
| Min. Negotiated Rate |
$455.37 |
| Max. Negotiated Rate |
$938.60 |
| Rate for Payer: Aetna Commercial |
$610.20
|
| Rate for Payer: Aetna Medicare |
$473.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.20
|
| Rate for Payer: BCBS Complete |
$577.60
|
| Rate for Payer: BCBS MAPPO |
$455.37
|
| Rate for Payer: BCN Medicare Advantage |
$455.37
|
| Rate for Payer: Cash Price |
$1,155.20
|
| Rate for Payer: Cash Price |
$1,155.20
|
| Rate for Payer: Cofinity Commercial |
$655.73
|
| Rate for Payer: Cofinity Commercial |
$610.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.37
|
| Rate for Payer: Healthscope Commercial |
$728.59
|
| Rate for Payer: Healthscope Commercial |
$842.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$938.60
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE SWMI |
$455.37
|
| Rate for Payer: PHP Medicare Advantage |
$455.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.60
|
| Rate for Payer: Priority Health Medicare |
$455.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.37
|
| Rate for Payer: UHC Medicare Advantage |
$455.37
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL
|
Professional
|
Both
|
$1,057.00
|
|
|
Service Code
|
HCPCS 22511
|
| Min. Negotiated Rate |
$388.54 |
| Max. Negotiated Rate |
$718.80 |
| Rate for Payer: Aetna Commercial |
$520.64
|
| Rate for Payer: Aetna Medicare |
$404.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.64
|
| Rate for Payer: BCBS Complete |
$422.80
|
| Rate for Payer: BCBS MAPPO |
$388.54
|
| Rate for Payer: BCN Medicare Advantage |
$388.54
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Cofinity Commercial |
$559.50
|
| Rate for Payer: Cofinity Commercial |
$520.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.54
|
| Rate for Payer: Healthscope Commercial |
$718.80
|
| Rate for Payer: Healthscope Commercial |
$621.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.05
|
| Rate for Payer: Nomi Health Commercial |
$466.25
|
| Rate for Payer: PACE SWMI |
$388.54
|
| Rate for Payer: PHP Medicare Advantage |
$388.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$687.05
|
| Rate for Payer: Priority Health Medicare |
$388.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.54
|
| Rate for Payer: UHC Medicare Advantage |
$388.54
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC
|
Professional
|
Both
|
$3,421.00
|
|
|
Service Code
|
HCPCS 22510
|
| Min. Negotiated Rate |
$413.04 |
| Max. Negotiated Rate |
$2,223.65 |
| Rate for Payer: Aetna Commercial |
$553.47
|
| Rate for Payer: Aetna Medicare |
$429.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.47
|
| Rate for Payer: BCBS Complete |
$1,368.40
|
| Rate for Payer: BCBS MAPPO |
$413.04
|
| Rate for Payer: BCN Medicare Advantage |
$413.04
|
| Rate for Payer: Cash Price |
$2,736.80
|
| Rate for Payer: Cash Price |
$2,736.80
|
| Rate for Payer: Cofinity Commercial |
$594.78
|
| Rate for Payer: Cofinity Commercial |
$553.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.04
|
| Rate for Payer: Healthscope Commercial |
$660.86
|
| Rate for Payer: Healthscope Commercial |
$764.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.65
|
| Rate for Payer: Nomi Health Commercial |
$495.65
|
| Rate for Payer: PACE SWMI |
$413.04
|
| Rate for Payer: PHP Medicare Advantage |
$413.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,223.65
|
| Rate for Payer: Priority Health Medicare |
$413.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.04
|
| Rate for Payer: UHC Medicare Advantage |
$413.04
|
|
|
PR PESSARY REUSABLE NONRUBBER
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4562
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$131.63 |
| Rate for Payer: Aetna Commercial |
$95.34
|
| Rate for Payer: Aetna Medicare |
$74.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.46
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$71.15
|
| Rate for Payer: BCN Medicare Advantage |
$71.15
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$95.34
|
| Rate for Payer: Cofinity Commercial |
$102.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.15
|
| Rate for Payer: Healthscope Commercial |
$131.63
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.05
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: PACE SWMI |
$71.15
|
| Rate for Payer: PHP Medicare Advantage |
$71.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$71.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.15
|
| Rate for Payer: UHC Medicare Advantage |
$71.15
|
|
|
PR PESSARY REUSABLE RUB ANYTYPE
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS A4561
|
| Min. Negotiated Rate |
$28.64 |
| Max. Negotiated Rate |
$52.98 |
| Rate for Payer: Aetna Commercial |
$38.38
|
| Rate for Payer: Aetna Medicare |
$29.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.38
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$28.64
|
| Rate for Payer: BCN Medicare Advantage |
$28.64
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$41.24
|
| Rate for Payer: Cofinity Commercial |
$38.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.64
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Commercial |
$52.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.05
|
| Rate for Payer: Nomi Health Commercial |
$34.37
|
| Rate for Payer: PACE SWMI |
$28.64
|
| Rate for Payer: PHP Medicare Advantage |
$28.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$28.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.64
|
| Rate for Payer: UHC Medicare Advantage |
$28.64
|
|
|
PR PHALANGECTOMY TOE EACH TOE
|
Professional
|
Both
|
$849.00
|
|
|
Service Code
|
HCPCS 28150
|
| Min. Negotiated Rate |
$267.77 |
| Max. Negotiated Rate |
$551.85 |
| Rate for Payer: Aetna Commercial |
$358.81
|
| Rate for Payer: Aetna Medicare |
$278.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.81
|
| Rate for Payer: BCBS Complete |
$339.60
|
| Rate for Payer: BCBS MAPPO |
$267.77
|
| Rate for Payer: BCN Medicare Advantage |
$267.77
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cofinity Commercial |
$385.59
|
| Rate for Payer: Cofinity Commercial |
$358.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.77
|
| Rate for Payer: Healthscope Commercial |
$428.43
|
| Rate for Payer: Healthscope Commercial |
$495.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$551.85
|
| Rate for Payer: Nomi Health Commercial |
$321.32
|
| Rate for Payer: PACE SWMI |
$267.77
|
| Rate for Payer: PHP Medicare Advantage |
$267.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.85
|
| Rate for Payer: Priority Health Medicare |
$267.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.77
|
| Rate for Payer: UHC Medicare Advantage |
$267.77
|
|
|
PR PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 90863
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$55.25 |
| Rate for Payer: Aetna Medicare |
$42.50
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
|
|
PR PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX
|
Professional
|
Both
|
$1,441.00
|
|
|
Service Code
|
HCPCS 42950
|
| Min. Negotiated Rate |
$576.40 |
| Max. Negotiated Rate |
$1,367.34 |
| Rate for Payer: Aetna Commercial |
$990.39
|
| Rate for Payer: Aetna Medicare |
$768.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,064.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.39
|
| Rate for Payer: BCBS Complete |
$576.40
|
| Rate for Payer: BCBS MAPPO |
$739.10
|
| Rate for Payer: BCN Medicare Advantage |
$739.10
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cofinity Commercial |
$1,064.30
|
| Rate for Payer: Cofinity Commercial |
$990.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.10
|
| Rate for Payer: Healthscope Commercial |
$1,182.56
|
| Rate for Payer: Healthscope Commercial |
$1,367.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$936.65
|
| Rate for Payer: Nomi Health Commercial |
$886.92
|
| Rate for Payer: PACE SWMI |
$739.10
|
| Rate for Payer: PHP Medicare Advantage |
$739.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$936.65
|
| Rate for Payer: Priority Health Medicare |
$739.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$739.10
|
| Rate for Payer: UHC Medicare Advantage |
$739.10
|
|
|
PR PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 99195
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$147.28 |
| Rate for Payer: Aetna Commercial |
$106.68
|
| Rate for Payer: Aetna Medicare |
$82.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.68
|
| Rate for Payer: BCBS Complete |
$78.40
|
| Rate for Payer: BCBS MAPPO |
$79.61
|
| Rate for Payer: BCN Medicare Advantage |
$79.61
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$114.64
|
| Rate for Payer: Cofinity Commercial |
$106.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.61
|
| Rate for Payer: Healthscope Commercial |
$127.38
|
| Rate for Payer: Healthscope Commercial |
$147.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.40
|
| Rate for Payer: Nomi Health Commercial |
$95.53
|
| Rate for Payer: PACE SWMI |
$79.61
|
| Rate for Payer: PHP Medicare Advantage |
$79.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
| Rate for Payer: Priority Health Medicare |
$79.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.61
|
| Rate for Payer: UHC Medicare Advantage |
$79.61
|
|
|
PR PHTFAC ARMS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00079
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
PR PHTFAC CHEST/SHLD
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 00077
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR PHTFAC FACE & NECK/ FL ARMS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00076
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
PR PHTFAC FL LEGS
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 00080
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
|
|
PR PHTFAC HANDS
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 00078
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR PHTFAC HEMANGIOMAS/WARTS
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 00083
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR PHTFAC NASAL VEIN
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 00082
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
|
|
PR PHTFAC SNGL PIGMENT
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 00081
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97750
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$58.70 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.69
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$31.73
|
| Rate for Payer: BCN Medicare Advantage |
$31.73
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$42.52
|
| Rate for Payer: Cofinity Commercial |
$45.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.73
|
| Rate for Payer: Healthscope Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$58.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$38.08
|
| Rate for Payer: PACE SWMI |
$31.73
|
| Rate for Payer: PHP Medicare Advantage |
$31.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.73
|
| Rate for Payer: UHC Medicare Advantage |
$31.73
|
|
|
PR PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU
|
Professional
|
Both
|
$183.00
|
|
|
Service Code
|
HCPCS 93464
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$362.47 |
| Rate for Payer: Aetna Commercial |
$262.55
|
| Rate for Payer: Aetna Medicare |
$203.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.55
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: BCBS MAPPO |
$195.93
|
| Rate for Payer: BCN Medicare Advantage |
$195.93
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cofinity Commercial |
$282.14
|
| Rate for Payer: Cofinity Commercial |
$262.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.93
|
| Rate for Payer: Healthscope Commercial |
$313.49
|
| Rate for Payer: Healthscope Commercial |
$362.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.95
|
| Rate for Payer: Nomi Health Commercial |
$235.12
|
| Rate for Payer: PACE SWMI |
$195.93
|
| Rate for Payer: PHP Medicare Advantage |
$195.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
| Rate for Payer: Priority Health Medicare |
$195.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.93
|
| Rate for Payer: UHC Medicare Advantage |
$195.93
|
|
|
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 |
$4.55 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
|
|
PR PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 99183
|
| Min. Negotiated Rate |
$101.48 |
| Max. Negotiated Rate |
$242.45 |
| Rate for Payer: Aetna Commercial |
$135.98
|
| Rate for Payer: Aetna Medicare |
$105.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.13
|
| Rate for Payer: BCBS Complete |
$149.20
|
| Rate for Payer: BCBS MAPPO |
$101.48
|
| Rate for Payer: BCN Medicare Advantage |
$101.48
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Cofinity Commercial |
$146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.48
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Healthscope Commercial |
$187.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.45
|
| Rate for Payer: Nomi Health Commercial |
$121.78
|
| Rate for Payer: PACE SWMI |
$101.48
|
| Rate for Payer: PHP Medicare Advantage |
$101.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.45
|
| Rate for Payer: Priority Health Medicare |
$101.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.48
|
| Rate for Payer: UHC Medicare Advantage |
$101.48
|
|
|
PR PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 99288
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$162.50 |
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.50
|
|
|
PR PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 99078
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
|
|
PR PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99444
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
|
