|
PR PHYS/QHP O/P CARDIAC RHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$10.68
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$7.97
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$10.68
|
| Rate for Payer: Cofinity Commercial |
$11.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.97
|
| Rate for Payer: Healthscope Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$12.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$9.56
|
| Rate for Payer: PACE SWMI |
$7.97
|
| Rate for Payer: PHP Medicare Advantage |
$7.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$7.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.97
|
| Rate for Payer: UHC Medicare Advantage |
$7.97
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 99442
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$96.85 |
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 21-30 MIN
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 99443
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Medicare |
$108.00
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 99441
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
|
|
PR PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 99360
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
|
|
PR PINCH GRAFT 1/MLT SM ULCER TIP/OTH AR UP TO 2 CM
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 15050
|
| Min. Negotiated Rate |
$366.80 |
| Max. Negotiated Rate |
$805.51 |
| Rate for Payer: Aetna Commercial |
$583.45
|
| Rate for Payer: Aetna Medicare |
$452.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.99
|
| Rate for Payer: BCBS Complete |
$366.80
|
| Rate for Payer: BCBS MAPPO |
$435.41
|
| Rate for Payer: BCN Medicare Advantage |
$435.41
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cofinity Commercial |
$626.99
|
| Rate for Payer: Cofinity Commercial |
$583.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.41
|
| Rate for Payer: Healthscope Commercial |
$696.66
|
| Rate for Payer: Healthscope Commercial |
$805.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.05
|
| Rate for Payer: Nomi Health Commercial |
$522.49
|
| Rate for Payer: PACE SWMI |
$435.41
|
| Rate for Payer: PHP Medicare Advantage |
$435.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health Medicare |
$435.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.41
|
| Rate for Payer: UHC Medicare Advantage |
$435.41
|
|
|
PR PLACE CATH BRACHIAL ART
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 36120
|
| Min. Negotiated Rate |
$304.40 |
| Max. Negotiated Rate |
$494.65 |
| Rate for Payer: Aetna Medicare |
$380.50
|
| Rate for Payer: BCBS Complete |
$304.40
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
|
|
PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 48000
|
| Min. Negotiated Rate |
$1,313.20 |
| Max. Negotiated Rate |
$3,384.43 |
| Rate for Payer: Aetna Commercial |
$2,451.42
|
| Rate for Payer: Aetna Medicare |
$1,902.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,634.36
|
| Rate for Payer: BCBS Complete |
$1,313.20
|
| Rate for Payer: BCBS MAPPO |
$1,829.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,829.42
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$2,634.36
|
| Rate for Payer: Cofinity Commercial |
$2,451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,829.42
|
| Rate for Payer: Healthscope Commercial |
$3,384.43
|
| Rate for Payer: Healthscope Commercial |
$2,927.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,920.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,133.95
|
| Rate for Payer: Nomi Health Commercial |
$2,195.30
|
| Rate for Payer: PACE SWMI |
$1,829.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,829.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health Medicare |
$1,829.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,829.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,829.42
|
|
|
PR PLACEMENT CHOLEDOCHAL STENT
|
Professional
|
Both
|
$2,547.00
|
|
|
Service Code
|
HCPCS 47801
|
| Min. Negotiated Rate |
$1,018.80 |
| Max. Negotiated Rate |
$1,983.05 |
| Rate for Payer: Aetna Commercial |
$1,436.37
|
| Rate for Payer: Aetna Medicare |
$1,114.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.56
|
| Rate for Payer: BCBS Complete |
$1,018.80
|
| Rate for Payer: BCBS MAPPO |
$1,071.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.92
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,436.37
|
| Rate for Payer: Cofinity Commercial |
$1,543.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.92
|
| Rate for Payer: Healthscope Commercial |
$1,715.07
|
| Rate for Payer: Healthscope Commercial |
$1,983.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,655.55
|
| Rate for Payer: Nomi Health Commercial |
$1,286.30
|
| Rate for Payer: PACE SWMI |
$1,071.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.55
|
| Rate for Payer: Priority Health Medicare |
$1,071.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.92
|
|
|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$788.40 |
| Max. Negotiated Rate |
$1,511.69 |
| Rate for Payer: Aetna Commercial |
$1,094.95
|
| Rate for Payer: Aetna Medicare |
$849.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.95
|
| Rate for Payer: BCBS Complete |
$788.40
|
| Rate for Payer: BCBS MAPPO |
$817.13
|
| Rate for Payer: BCN Medicare Advantage |
$817.13
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,176.67
|
| Rate for Payer: Cofinity Commercial |
$1,094.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$817.13
|
| Rate for Payer: Healthscope Commercial |
$1,511.69
|
| Rate for Payer: Healthscope Commercial |
$1,307.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,281.15
|
| Rate for Payer: Nomi Health Commercial |
$980.56
|
| Rate for Payer: PACE SWMI |
$817.13
|
| Rate for Payer: PHP Medicare Advantage |
$817.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health Medicare |
$817.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$817.13
|
| Rate for Payer: UHC Medicare Advantage |
$817.13
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$57.69 |
| Max. Negotiated Rate |
$367.25 |
| Rate for Payer: Aetna Commercial |
$77.30
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.30
|
| Rate for Payer: BCBS Complete |
$226.00
|
| Rate for Payer: BCBS MAPPO |
$57.69
|
| Rate for Payer: BCN Medicare Advantage |
$57.69
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$83.07
|
| Rate for Payer: Cofinity Commercial |
$77.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.69
|
| Rate for Payer: Healthscope Commercial |
$106.73
|
| Rate for Payer: Healthscope Commercial |
$92.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.25
|
| Rate for Payer: Nomi Health Commercial |
$69.23
|
| Rate for Payer: PACE SWMI |
$57.69
|
| Rate for Payer: PHP Medicare Advantage |
$57.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$57.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.69
|
| Rate for Payer: UHC Medicare Advantage |
$57.69
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$112.34 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$150.54
|
| Rate for Payer: Aetna Medicare |
$116.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.54
|
| Rate for Payer: BCBS Complete |
$156.00
|
| Rate for Payer: BCBS MAPPO |
$112.34
|
| Rate for Payer: BCN Medicare Advantage |
$112.34
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$161.77
|
| Rate for Payer: Cofinity Commercial |
$150.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.34
|
| Rate for Payer: Healthscope Commercial |
$207.83
|
| Rate for Payer: Healthscope Commercial |
$179.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.50
|
| Rate for Payer: Nomi Health Commercial |
$134.81
|
| Rate for Payer: PACE SWMI |
$112.34
|
| Rate for Payer: PHP Medicare Advantage |
$112.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.50
|
| Rate for Payer: Priority Health Medicare |
$112.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.34
|
| Rate for Payer: UHC Medicare Advantage |
$112.34
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$681.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$272.40 |
| Max. Negotiated Rate |
$571.52 |
| Rate for Payer: Aetna Commercial |
$413.97
|
| Rate for Payer: Aetna Medicare |
$321.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.97
|
| Rate for Payer: BCBS Complete |
$272.40
|
| Rate for Payer: BCBS MAPPO |
$308.93
|
| Rate for Payer: BCN Medicare Advantage |
$308.93
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cofinity Commercial |
$444.86
|
| Rate for Payer: Cofinity Commercial |
$413.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.93
|
| Rate for Payer: Healthscope Commercial |
$494.29
|
| Rate for Payer: Healthscope Commercial |
$571.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.65
|
| Rate for Payer: Nomi Health Commercial |
$370.72
|
| Rate for Payer: PACE SWMI |
$308.93
|
| Rate for Payer: PHP Medicare Advantage |
$308.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.65
|
| Rate for Payer: Priority Health Medicare |
$308.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.93
|
| Rate for Payer: UHC Medicare Advantage |
$308.93
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$981.50 |
| Rate for Payer: Aetna Medicare |
$755.00
|
| Rate for Payer: BCBS Complete |
$604.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$981.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$981.50
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$269.20 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Medicare |
$336.50
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$437.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$793.20 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: BCBS Complete |
$793.20
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$242.46 |
| Max. Negotiated Rate |
$584.35 |
| Rate for Payer: Aetna Commercial |
$324.90
|
| Rate for Payer: Aetna Medicare |
$252.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.14
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$242.46
|
| Rate for Payer: BCN Medicare Advantage |
$242.46
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cofinity Commercial |
$324.90
|
| Rate for Payer: Cofinity Commercial |
$349.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.46
|
| Rate for Payer: Healthscope Commercial |
$448.55
|
| Rate for Payer: Healthscope Commercial |
$387.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.35
|
| Rate for Payer: Nomi Health Commercial |
$290.95
|
| Rate for Payer: PACE SWMI |
$242.46
|
| Rate for Payer: PHP Medicare Advantage |
$242.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.35
|
| Rate for Payer: Priority Health Medicare |
$242.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.46
|
| Rate for Payer: UHC Medicare Advantage |
$242.46
|
|
|
PR PLASTIC REPAIR URETHROCELE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 57230
|
| Min. Negotiated Rate |
$323.60 |
| Max. Negotiated Rate |
$737.30 |
| Rate for Payer: Aetna Commercial |
$534.04
|
| Rate for Payer: Aetna Medicare |
$414.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.04
|
| Rate for Payer: BCBS Complete |
$323.60
|
| Rate for Payer: BCBS MAPPO |
$398.54
|
| Rate for Payer: BCN Medicare Advantage |
$398.54
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$573.90
|
| Rate for Payer: Cofinity Commercial |
$534.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.54
|
| Rate for Payer: Healthscope Commercial |
$737.30
|
| Rate for Payer: Healthscope Commercial |
$637.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.85
|
| Rate for Payer: Nomi Health Commercial |
$478.25
|
| Rate for Payer: PACE SWMI |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$398.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health Medicare |
$398.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.54
|
| Rate for Payer: UHC Medicare Advantage |
$398.54
|
|
|
PR PLASTIC RPR PENIS CORRECT ANGULATION
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 54360
|
| Min. Negotiated Rate |
$689.38 |
| Max. Negotiated Rate |
$2,470.65 |
| Rate for Payer: Aetna Commercial |
$923.77
|
| Rate for Payer: Aetna Medicare |
$716.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.77
|
| Rate for Payer: BCBS Complete |
$1,520.40
|
| Rate for Payer: BCBS MAPPO |
$689.38
|
| Rate for Payer: BCN Medicare Advantage |
$689.38
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cofinity Commercial |
$992.71
|
| Rate for Payer: Cofinity Commercial |
$923.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.38
|
| Rate for Payer: Healthscope Commercial |
$1,103.01
|
| Rate for Payer: Healthscope Commercial |
$1,275.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,470.65
|
| Rate for Payer: Nomi Health Commercial |
$827.26
|
| Rate for Payer: PACE SWMI |
$689.38
|
| Rate for Payer: PHP Medicare Advantage |
$689.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.65
|
| Rate for Payer: Priority Health Medicare |
$689.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.38
|
| Rate for Payer: UHC Medicare Advantage |
$689.38
|
|
|
PR PLASTICS COSMETIC CONSULT OFFICE VISIT
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 00690
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Medicare |
$36.00
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
|
|
PR PLASTICS COSMETIC FAT GRAFTING
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 00691
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$1,625.00 |
| Rate for Payer: Aetna Medicare |
$1,250.00
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
|
|
PR PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH
|
Professional
|
Both
|
$1,097.00
|
|
|
Service Code
|
HCPCS 57220
|
| Min. Negotiated Rate |
$329.56 |
| Max. Negotiated Rate |
$713.05 |
| Rate for Payer: Aetna Commercial |
$441.61
|
| Rate for Payer: Aetna Medicare |
$342.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.61
|
| Rate for Payer: BCBS Complete |
$438.80
|
| Rate for Payer: BCBS MAPPO |
$329.56
|
| Rate for Payer: BCN Medicare Advantage |
$329.56
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cofinity Commercial |
$441.61
|
| Rate for Payer: Cofinity Commercial |
$474.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.56
|
| Rate for Payer: Healthscope Commercial |
$609.69
|
| Rate for Payer: Healthscope Commercial |
$527.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.05
|
| Rate for Payer: Nomi Health Commercial |
$395.47
|
| Rate for Payer: PACE SWMI |
$329.56
|
| Rate for Payer: PHP Medicare Advantage |
$329.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.05
|
| Rate for Payer: Priority Health Medicare |
$329.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.56
|
| Rate for Payer: UHC Medicare Advantage |
$329.56
|
|
|
PR PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 94726
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$68.47
|
| Rate for Payer: Aetna Commercial |
$68.47
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.58
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$68.47
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$68.47
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Commercial |
$81.76
|
| Rate for Payer: Healthscope Commercial |
$81.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Nomi Health Commercial |
$61.32
|
| Rate for Payer: Nomi Health Commercial |
$61.32
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$51.10
|
| Rate for Payer: Priority Health Medicare |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
|
|
PR PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX
|
Professional
|
Both
|
$2,177.00
|
|
|
Service Code
|
HCPCS 32215
|
| Min. Negotiated Rate |
$772.04 |
| Max. Negotiated Rate |
$1,428.27 |
| Rate for Payer: Aetna Commercial |
$1,034.53
|
| Rate for Payer: Aetna Medicare |
$802.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.53
|
| Rate for Payer: BCBS Complete |
$870.80
|
| Rate for Payer: BCBS MAPPO |
$772.04
|
| Rate for Payer: BCN Medicare Advantage |
$772.04
|
| Rate for Payer: Cash Price |
$1,741.60
|
| Rate for Payer: Cash Price |
$1,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,111.74
|
| Rate for Payer: Cofinity Commercial |
$1,034.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.04
|
| Rate for Payer: Healthscope Commercial |
$1,428.27
|
| Rate for Payer: Healthscope Commercial |
$1,235.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.05
|
| Rate for Payer: Nomi Health Commercial |
$926.45
|
| Rate for Payer: PACE SWMI |
$772.04
|
| Rate for Payer: PHP Medicare Advantage |
$772.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,415.05
|
| Rate for Payer: Priority Health Medicare |
$772.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.04
|
| Rate for Payer: UHC Medicare Advantage |
$772.04
|
|
|
PR PLEURECTOMY PARIETAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,949.00
|
|
|
Service Code
|
HCPCS 32310
|
| Min. Negotiated Rate |
$883.98 |
| Max. Negotiated Rate |
$1,916.85 |
| Rate for Payer: Aetna Commercial |
$1,184.53
|
| Rate for Payer: Aetna Medicare |
$919.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.53
|
| Rate for Payer: BCBS Complete |
$1,179.60
|
| Rate for Payer: BCBS MAPPO |
$883.98
|
| Rate for Payer: BCN Medicare Advantage |
$883.98
|
| Rate for Payer: Cash Price |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,272.93
|
| Rate for Payer: Cofinity Commercial |
$1,184.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.98
|
| Rate for Payer: Healthscope Commercial |
$1,414.37
|
| Rate for Payer: Healthscope Commercial |
$1,635.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,916.85
|
| Rate for Payer: Nomi Health Commercial |
$1,060.78
|
| Rate for Payer: PACE SWMI |
$883.98
|
| Rate for Payer: PHP Medicare Advantage |
$883.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.85
|
| Rate for Payer: Priority Health Medicare |
$883.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.98
|
| Rate for Payer: UHC Medicare Advantage |
$883.98
|
|
