|
PR PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS
|
Professional
|
Both
|
$4,993.00
|
|
|
Service Code
|
HCPCS 45120
|
| Min. Negotiated Rate |
$1,555.36 |
| Max. Negotiated Rate |
$3,245.45 |
| Rate for Payer: Aetna Commercial |
$2,084.18
|
| Rate for Payer: Aetna Medicare |
$1,617.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,084.18
|
| Rate for Payer: BCBS Complete |
$1,997.20
|
| Rate for Payer: BCBS MAPPO |
$1,555.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,555.36
|
| Rate for Payer: Cash Price |
$3,994.40
|
| Rate for Payer: Cash Price |
$3,994.40
|
| Rate for Payer: Cofinity Commercial |
$2,239.72
|
| Rate for Payer: Cofinity Commercial |
$2,084.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,555.36
|
| Rate for Payer: Healthscope Commercial |
$2,877.42
|
| Rate for Payer: Healthscope Commercial |
$2,488.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,633.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,245.45
|
| Rate for Payer: Nomi Health Commercial |
$1,866.43
|
| Rate for Payer: PACE SWMI |
$1,555.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,555.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,245.45
|
| Rate for Payer: Priority Health Medicare |
$1,555.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,555.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.36
|
|
|
PR PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 45121
|
| Min. Negotiated Rate |
$1,696.93 |
| Max. Negotiated Rate |
$3,185.00 |
| Rate for Payer: Aetna Commercial |
$2,273.89
|
| Rate for Payer: Aetna Medicare |
$1,764.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,443.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,273.89
|
| Rate for Payer: BCBS Complete |
$1,960.00
|
| Rate for Payer: BCBS MAPPO |
$1,696.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,696.93
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cash Price |
$3,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,443.58
|
| Rate for Payer: Cofinity Commercial |
$2,273.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,696.93
|
| Rate for Payer: Healthscope Commercial |
$2,715.09
|
| Rate for Payer: Healthscope Commercial |
$3,139.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,781.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.00
|
| Rate for Payer: Nomi Health Commercial |
$2,036.32
|
| Rate for Payer: PACE SWMI |
$1,696.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,696.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,185.00
|
| Rate for Payer: Priority Health Medicare |
$1,696.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,696.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,696.93
|
|
|
PR PRCTECT PRTL RESCJ RECTUM TABDL APPR
|
Professional
|
Both
|
$1,973.00
|
|
|
Service Code
|
HCPCS 45111
|
| Min. Negotiated Rate |
$789.20 |
| Max. Negotiated Rate |
$1,927.90 |
| Rate for Payer: Aetna Commercial |
$1,396.43
|
| Rate for Payer: Aetna Medicare |
$1,083.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,500.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,396.43
|
| Rate for Payer: BCBS Complete |
$789.20
|
| Rate for Payer: BCBS MAPPO |
$1,042.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,042.11
|
| Rate for Payer: Cash Price |
$1,578.40
|
| Rate for Payer: Cash Price |
$1,578.40
|
| Rate for Payer: Cofinity Commercial |
$1,500.64
|
| Rate for Payer: Cofinity Commercial |
$1,396.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,042.11
|
| Rate for Payer: Healthscope Commercial |
$1,927.90
|
| Rate for Payer: Healthscope Commercial |
$1,667.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.45
|
| Rate for Payer: Nomi Health Commercial |
$1,250.53
|
| Rate for Payer: PACE SWMI |
$1,042.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,042.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,282.45
|
| Rate for Payer: Priority Health Medicare |
$1,042.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,042.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,042.11
|
|
|
PR PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 45114
|
| Min. Negotiated Rate |
$1,303.60 |
| Max. Negotiated Rate |
$3,268.49 |
| Rate for Payer: Aetna Commercial |
$2,367.45
|
| Rate for Payer: Aetna Medicare |
$1,837.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,544.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.45
|
| Rate for Payer: BCBS Complete |
$1,303.60
|
| Rate for Payer: BCBS MAPPO |
$1,766.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,766.75
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cash Price |
$2,607.20
|
| Rate for Payer: Cofinity Commercial |
$2,544.12
|
| Rate for Payer: Cofinity Commercial |
$2,367.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,766.75
|
| Rate for Payer: Healthscope Commercial |
$2,826.80
|
| Rate for Payer: Healthscope Commercial |
$3,268.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,855.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,118.35
|
| Rate for Payer: Nomi Health Commercial |
$2,120.10
|
| Rate for Payer: PACE SWMI |
$1,766.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,766.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health Medicare |
$1,766.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,766.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,766.75
|
|
|
PR PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY
|
Professional
|
Both
|
$3,811.00
|
|
|
Service Code
|
HCPCS 45116
|
| Min. Negotiated Rate |
$1,469.87 |
| Max. Negotiated Rate |
$2,719.26 |
| Rate for Payer: Aetna Commercial |
$1,969.63
|
| Rate for Payer: Aetna Medicare |
$1,528.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,116.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.63
|
| Rate for Payer: BCBS Complete |
$1,524.40
|
| Rate for Payer: BCBS MAPPO |
$1,469.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,469.87
|
| Rate for Payer: Cash Price |
$3,048.80
|
| Rate for Payer: Cash Price |
$3,048.80
|
| Rate for Payer: Cofinity Commercial |
$2,116.61
|
| Rate for Payer: Cofinity Commercial |
$1,969.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,469.87
|
| Rate for Payer: Healthscope Commercial |
$2,719.26
|
| Rate for Payer: Healthscope Commercial |
$2,351.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,543.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.15
|
| Rate for Payer: Nomi Health Commercial |
$1,763.84
|
| Rate for Payer: PACE SWMI |
$1,469.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,469.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,477.15
|
| Rate for Payer: Priority Health Medicare |
$1,469.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,469.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,469.87
|
|
|
PR PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR
|
Professional
|
Both
|
$5,455.00
|
|
|
Service Code
|
HCPCS 45113
|
| Min. Negotiated Rate |
$1,769.06 |
| Max. Negotiated Rate |
$3,545.75 |
| Rate for Payer: Aetna Commercial |
$2,370.54
|
| Rate for Payer: Aetna Medicare |
$1,839.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,547.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,370.54
|
| Rate for Payer: BCBS Complete |
$2,182.00
|
| Rate for Payer: BCBS MAPPO |
$1,769.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,769.06
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cofinity Commercial |
$2,547.45
|
| Rate for Payer: Cofinity Commercial |
$2,370.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,769.06
|
| Rate for Payer: Healthscope Commercial |
$2,830.50
|
| Rate for Payer: Healthscope Commercial |
$3,272.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,857.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,545.75
|
| Rate for Payer: Nomi Health Commercial |
$2,122.87
|
| Rate for Payer: PACE SWMI |
$1,769.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,769.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,545.75
|
| Rate for Payer: Priority Health Medicare |
$1,769.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,769.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,769.06
|
|
|
PR PRCTECT PRTL W/O ANAST PRNL APPR
|
Professional
|
Both
|
$3,047.00
|
|
|
Service Code
|
HCPCS 45123
|
| Min. Negotiated Rate |
$1,064.41 |
| Max. Negotiated Rate |
$1,980.55 |
| Rate for Payer: Aetna Commercial |
$1,426.31
|
| Rate for Payer: Aetna Medicare |
$1,106.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,532.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,426.31
|
| Rate for Payer: BCBS Complete |
$1,218.80
|
| Rate for Payer: BCBS MAPPO |
$1,064.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.41
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Cofinity Commercial |
$1,532.75
|
| Rate for Payer: Cofinity Commercial |
$1,426.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.41
|
| Rate for Payer: Healthscope Commercial |
$1,969.16
|
| Rate for Payer: Healthscope Commercial |
$1,703.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,980.55
|
| Rate for Payer: Nomi Health Commercial |
$1,277.29
|
| Rate for Payer: PACE SWMI |
$1,064.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,980.55
|
| Rate for Payer: Priority Health Medicare |
$1,064.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,064.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,064.41
|
|
|
PR PREDNISONE IR OR DR ORAL 1MG
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7512
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.01
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.02
|
| Rate for Payer: Healthscope Commercial |
$0.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.65
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: PACE SWMI |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
| Rate for Payer: Priority Health Medicare |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.01
|
| Rate for Payer: UHC Medicare Advantage |
$0.01
|
|
|
PR PREDNISONE ORAL
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7506
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
|
|
PR PREPARE FECAL MICROBIOTA FOR INSTILLATION
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 44705
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
|
|
PR PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 49013
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$820.36 |
| Rate for Payer: Aetna Commercial |
$594.21
|
| Rate for Payer: Aetna Medicare |
$461.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$638.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.21
|
| Rate for Payer: BCBS Complete |
$376.80
|
| Rate for Payer: BCBS MAPPO |
$443.44
|
| Rate for Payer: BCN Medicare Advantage |
$443.44
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$594.21
|
| Rate for Payer: Cofinity Commercial |
$638.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.44
|
| Rate for Payer: Healthscope Commercial |
$820.36
|
| Rate for Payer: Healthscope Commercial |
$709.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.30
|
| Rate for Payer: Nomi Health Commercial |
$532.13
|
| Rate for Payer: PACE SWMI |
$443.44
|
| Rate for Payer: PHP Medicare Advantage |
$443.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health Medicare |
$443.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.44
|
| Rate for Payer: UHC Medicare Advantage |
$443.44
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 15004
|
| Min. Negotiated Rate |
$248.67 |
| Max. Negotiated Rate |
$460.04 |
| Rate for Payer: Aetna Commercial |
$333.22
|
| Rate for Payer: Aetna Medicare |
$258.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.22
|
| Rate for Payer: BCBS Complete |
$268.00
|
| Rate for Payer: BCBS MAPPO |
$248.67
|
| Rate for Payer: BCN Medicare Advantage |
$248.67
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$358.08
|
| Rate for Payer: Cofinity Commercial |
$333.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.67
|
| Rate for Payer: Healthscope Commercial |
$460.04
|
| Rate for Payer: Healthscope Commercial |
$397.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.50
|
| Rate for Payer: Nomi Health Commercial |
$298.40
|
| Rate for Payer: PACE SWMI |
$248.67
|
| Rate for Payer: PHP Medicare Advantage |
$248.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health Medicare |
$248.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.67
|
| Rate for Payer: UHC Medicare Advantage |
$248.67
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 15005
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$159.95 |
| Rate for Payer: Aetna Commercial |
$115.86
|
| Rate for Payer: Aetna Medicare |
$89.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.86
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$86.46
|
| Rate for Payer: BCN Medicare Advantage |
$86.46
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$124.50
|
| Rate for Payer: Cofinity Commercial |
$115.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.46
|
| Rate for Payer: Healthscope Commercial |
$138.34
|
| Rate for Payer: Healthscope Commercial |
$159.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$103.75
|
| Rate for Payer: PACE SWMI |
$86.46
|
| Rate for Payer: PHP Medicare Advantage |
$86.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$86.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.46
|
| Rate for Payer: UHC Medicare Advantage |
$86.46
|
|
|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$210.50 |
| Max. Negotiated Rate |
$389.43 |
| Rate for Payer: Aetna Commercial |
$282.07
|
| Rate for Payer: Aetna Medicare |
$218.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.07
|
| Rate for Payer: BCBS Complete |
$224.80
|
| Rate for Payer: BCBS MAPPO |
$210.50
|
| Rate for Payer: BCN Medicare Advantage |
$210.50
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$303.12
|
| Rate for Payer: Cofinity Commercial |
$282.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.50
|
| Rate for Payer: Healthscope Commercial |
$389.43
|
| Rate for Payer: Healthscope Commercial |
$336.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.30
|
| Rate for Payer: Nomi Health Commercial |
$252.60
|
| Rate for Payer: PACE SWMI |
$210.50
|
| Rate for Payer: PHP Medicare Advantage |
$210.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health Medicare |
$210.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.50
|
| Rate for Payer: UHC Medicare Advantage |
$210.50
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$42.94 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.54
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Healthscope Commercial |
$68.70
|
| Rate for Payer: Healthscope Commercial |
$79.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.31
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$7.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.16
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.59
|
| Rate for Payer: Cofinity Commercial |
$10.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Healthscope Commercial |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.70
|
| Rate for Payer: Nomi Health Commercial |
$8.59
|
| Rate for Payer: PACE SWMI |
$7.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Medicare |
$7.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.16
|
| Rate for Payer: UHC Medicare Advantage |
$7.16
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$60.77 |
| Max. Negotiated Rate |
$112.42 |
| Rate for Payer: Aetna Commercial |
$81.43
|
| Rate for Payer: Aetna Medicare |
$63.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.51
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$60.77
|
| Rate for Payer: BCN Medicare Advantage |
$60.77
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$81.43
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.77
|
| Rate for Payer: Healthscope Commercial |
$97.23
|
| Rate for Payer: Healthscope Commercial |
$112.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.20
|
| Rate for Payer: Nomi Health Commercial |
$72.92
|
| Rate for Payer: PACE SWMI |
$60.77
|
| Rate for Payer: PHP Medicare Advantage |
$60.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health Medicare |
$60.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.77
|
| Rate for Payer: UHC Medicare Advantage |
$60.77
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$99.18 |
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Medicare |
$55.75
|
| Rate for Payer: Aetna Medicare |
$55.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.20
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Healthscope Commercial |
$99.18
|
| Rate for Payer: Healthscope Commercial |
$99.18
|
| Rate for Payer: Healthscope Commercial |
$85.78
|
| Rate for Payer: Healthscope Commercial |
$85.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$53.61
|
| Rate for Payer: Priority Health Medicare |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$177.53 |
| Rate for Payer: Aetna Commercial |
$128.59
|
| Rate for Payer: Aetna Medicare |
$99.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.59
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$95.96
|
| Rate for Payer: BCN Medicare Advantage |
$95.96
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Cofinity Commercial |
$128.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.96
|
| Rate for Payer: Healthscope Commercial |
$177.53
|
| Rate for Payer: Healthscope Commercial |
$153.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$115.15
|
| Rate for Payer: PACE SWMI |
$95.96
|
| Rate for Payer: PHP Medicare Advantage |
$95.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$95.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.96
|
| Rate for Payer: UHC Medicare Advantage |
$95.96
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$164.47 |
| Rate for Payer: Aetna Commercial |
$119.13
|
| Rate for Payer: Aetna Medicare |
$92.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.13
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$88.90
|
| Rate for Payer: BCN Medicare Advantage |
$88.90
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$128.02
|
| Rate for Payer: Cofinity Commercial |
$119.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.90
|
| Rate for Payer: Healthscope Commercial |
$142.24
|
| Rate for Payer: Healthscope Commercial |
$164.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.70
|
| Rate for Payer: Nomi Health Commercial |
$106.68
|
| Rate for Payer: PACE SWMI |
$88.90
|
| Rate for Payer: PHP Medicare Advantage |
$88.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health Medicare |
$88.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.90
|
| Rate for Payer: UHC Medicare Advantage |
$88.90
|
|
