|
PR PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST
|
Professional
|
Both
|
$10,186.00
|
|
|
Service Code
|
HCPCS 19296
|
| Min. Negotiated Rate |
$134.62 |
| Max. Negotiated Rate |
$37,586.00 |
| Rate for Payer: Aetna Commercial |
$273.67
|
| Rate for Payer: Aetna Medicare |
$212.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.09
|
| Rate for Payer: BCBS Complete |
$141.35
|
| Rate for Payer: BCBS MAPPO |
$204.23
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$5,484.92
|
| Rate for Payer: BCN Medicare Advantage |
$204.23
|
| Rate for Payer: Cash Price |
$8,148.80
|
| Rate for Payer: Cash Price |
$8,148.80
|
| Rate for Payer: Cofinity Commercial |
$294.09
|
| Rate for Payer: Cofinity Commercial |
$273.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.23
|
| Rate for Payer: Healthscope Commercial |
$377.83
|
| Rate for Payer: Healthscope Commercial |
$326.77
|
| Rate for Payer: Mclaren Medicaid |
$134.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.44
|
| Rate for Payer: Meridian Medicaid |
$141.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,586.00
|
| Rate for Payer: Nomi Health Commercial |
$245.08
|
| Rate for Payer: PACE SWMI |
$204.23
|
| Rate for Payer: PHP Medicare Advantage |
$204.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,620.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.56
|
| Rate for Payer: Priority Health Medicare |
$204.23
|
| Rate for Payer: Priority Health Narrow Network |
$283.56
|
| Rate for Payer: Priority Health SBD |
$283.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.23
|
| Rate for Payer: UHC Exchange |
$224.87
|
| Rate for Payer: UHC Medicare Advantage |
$204.23
|
| Rate for Payer: UHCCP Medicaid |
$134.62
|
|
|
PR PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 34813
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$41,868.00 |
| Rate for Payer: Aetna Commercial |
$302.13
|
| Rate for Payer: Aetna Medicare |
$234.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$225.47
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$225.47
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cofinity Commercial |
$324.68
|
| Rate for Payer: Cofinity Commercial |
$302.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.47
|
| Rate for Payer: Healthscope Commercial |
$417.12
|
| Rate for Payer: Healthscope Commercial |
$360.75
|
| Rate for Payer: Mclaren Medicaid |
$145.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.74
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,868.00
|
| Rate for Payer: Nomi Health Commercial |
$270.56
|
| Rate for Payer: PACE SWMI |
$225.47
|
| Rate for Payer: PHP Medicare Advantage |
$225.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.30
|
| Rate for Payer: Priority Health Medicare |
$225.47
|
| Rate for Payer: Priority Health Narrow Network |
$364.30
|
| Rate for Payer: Priority Health SBD |
$364.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.47
|
| Rate for Payer: UHC Exchange |
$328.70
|
| Rate for Payer: UHC Medicare Advantage |
$225.47
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
|
|
PR PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 55876
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$17,800.00 |
| Rate for Payer: Aetna Commercial |
$129.83
|
| Rate for Payer: Aetna Medicare |
$100.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.52
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$96.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.92
|
| Rate for Payer: BCN Commercial |
$220.88
|
| Rate for Payer: BCN Medicare Advantage |
$96.89
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$139.52
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.89
|
| Rate for Payer: Healthscope Commercial |
$179.25
|
| Rate for Payer: Healthscope Commercial |
$155.02
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.73
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,800.00
|
| Rate for Payer: Nomi Health Commercial |
$116.27
|
| Rate for Payer: PACE SWMI |
$96.89
|
| Rate for Payer: PHP Medicare Advantage |
$96.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.45
|
| Rate for Payer: Priority Health Medicare |
$96.89
|
| Rate for Payer: Priority Health Narrow Network |
$162.45
|
| Rate for Payer: Priority Health SBD |
$162.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.89
|
| Rate for Payer: UHC Exchange |
$182.81
|
| Rate for Payer: UHC Medicare Advantage |
$96.89
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I
|
Professional
|
Both
|
$1,616.00
|
|
|
Service Code
|
HCPCS 50432
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$35,804.00 |
| Rate for Payer: Aetna Commercial |
$257.29
|
| Rate for Payer: Aetna Medicare |
$199.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.49
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$192.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,416.97
|
| Rate for Payer: BCN Commercial |
$1,340.94
|
| Rate for Payer: BCN Medicare Advantage |
$192.01
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cofinity Commercial |
$276.49
|
| Rate for Payer: Cofinity Commercial |
$257.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.01
|
| Rate for Payer: Healthscope Commercial |
$307.22
|
| Rate for Payer: Healthscope Commercial |
$355.22
|
| Rate for Payer: Mclaren Medicaid |
$128.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.61
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,804.00
|
| Rate for Payer: Nomi Health Commercial |
$230.41
|
| Rate for Payer: PACE SWMI |
$192.01
|
| Rate for Payer: PHP Medicare Advantage |
$192.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.42
|
| Rate for Payer: Priority Health Medicare |
$192.01
|
| Rate for Payer: Priority Health Narrow Network |
$317.42
|
| Rate for Payer: Priority Health SBD |
$317.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.01
|
| Rate for Payer: UHC Medicare Advantage |
$192.01
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 33883
|
| Min. Negotiated Rate |
$692.68 |
| Max. Negotiated Rate |
$196,726.00 |
| Rate for Payer: Aetna Commercial |
$1,422.81
|
| Rate for Payer: Aetna Medicare |
$1,104.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,422.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,528.99
|
| Rate for Payer: BCBS Complete |
$727.31
|
| Rate for Payer: BCBS MAPPO |
$1,061.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$1,586.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.80
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$1,528.99
|
| Rate for Payer: Cofinity Commercial |
$1,422.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.80
|
| Rate for Payer: Healthscope Commercial |
$1,964.33
|
| Rate for Payer: Healthscope Commercial |
$1,698.88
|
| Rate for Payer: Mclaren Medicaid |
$692.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.89
|
| Rate for Payer: Meridian Medicaid |
$727.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196,726.00
|
| Rate for Payer: Nomi Health Commercial |
$1,274.16
|
| Rate for Payer: PACE SWMI |
$1,061.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,732.69
|
| Rate for Payer: Priority Health Medicare |
$1,061.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,732.69
|
| Rate for Payer: Priority Health SBD |
$1,732.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.80
|
| Rate for Payer: UHC Exchange |
$1,272.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.80
|
| Rate for Payer: UHCCP Medicaid |
$692.68
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 33884
|
| Min. Negotiated Rate |
$245.80 |
| Max. Negotiated Rate |
$70,247.00 |
| Rate for Payer: Aetna Commercial |
$510.25
|
| Rate for Payer: Aetna Medicare |
$396.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.32
|
| Rate for Payer: BCBS Complete |
$258.09
|
| Rate for Payer: BCBS MAPPO |
$380.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.58
|
| Rate for Payer: BCN Commercial |
$561.00
|
| Rate for Payer: BCN Medicare Advantage |
$380.78
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$548.32
|
| Rate for Payer: Cofinity Commercial |
$510.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.78
|
| Rate for Payer: Healthscope Commercial |
$704.44
|
| Rate for Payer: Healthscope Commercial |
$609.25
|
| Rate for Payer: Mclaren Medicaid |
$245.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.82
|
| Rate for Payer: Meridian Medicaid |
$258.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70,247.00
|
| Rate for Payer: Nomi Health Commercial |
$456.94
|
| Rate for Payer: PACE SWMI |
$380.78
|
| Rate for Payer: PHP Medicare Advantage |
$380.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.66
|
| Rate for Payer: Priority Health Medicare |
$380.78
|
| Rate for Payer: Priority Health Narrow Network |
$612.66
|
| Rate for Payer: Priority Health SBD |
$612.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.78
|
| Rate for Payer: UHC Exchange |
$477.31
|
| Rate for Payer: UHC Medicare Advantage |
$380.78
|
| Rate for Payer: UHCCP Medicaid |
$245.80
|
|
|
PR PLMT SFT TISS LOCLZJ DEV PERQ 1ST LESION
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 10035
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$14,996.00 |
| Rate for Payer: Aetna Commercial |
$106.30
|
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.24
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$79.33
|
| Rate for Payer: BCN Commercial |
$543.90
|
| Rate for Payer: BCN Medicare Advantage |
$79.33
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$114.24
|
| Rate for Payer: Cofinity Commercial |
$106.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.33
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Healthscope Commercial |
$146.76
|
| Rate for Payer: Mclaren Medicaid |
$52.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.30
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,996.00
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: PACE SWMI |
$79.33
|
| Rate for Payer: PHP Medicare Advantage |
$79.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.52
|
| Rate for Payer: Priority Health Medicare |
$79.33
|
| Rate for Payer: Priority Health Narrow Network |
$111.52
|
| Rate for Payer: Priority Health SBD |
$111.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.33
|
| Rate for Payer: UHC Medicare Advantage |
$79.33
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
|
|
PR PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 50693
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$35,483.00 |
| Rate for Payer: Aetna Commercial |
$255.95
|
| Rate for Payer: Aetna Medicare |
$198.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.05
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS MAPPO |
$191.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,785.27
|
| Rate for Payer: BCN Commercial |
$1,468.96
|
| Rate for Payer: BCN Medicare Advantage |
$191.01
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$275.05
|
| Rate for Payer: Cofinity Commercial |
$255.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.01
|
| Rate for Payer: Healthscope Commercial |
$305.62
|
| Rate for Payer: Healthscope Commercial |
$353.37
|
| Rate for Payer: Mclaren Medicaid |
$127.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.56
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,483.00
|
| Rate for Payer: Nomi Health Commercial |
$229.21
|
| Rate for Payer: PACE SWMI |
$191.01
|
| Rate for Payer: PHP Medicare Advantage |
$191.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.82
|
| Rate for Payer: Priority Health Medicare |
$191.01
|
| Rate for Payer: Priority Health Narrow Network |
$315.82
|
| Rate for Payer: Priority Health SBD |
$315.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.01
|
| Rate for Payer: UHC Medicare Advantage |
$191.01
|
| Rate for Payer: UHCCP Medicaid |
$127.37
|
|
|
PR PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 35685
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$35,186.00 |
| Rate for Payer: Aetna Commercial |
$255.56
|
| Rate for Payer: Aetna Medicare |
$198.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.64
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$190.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,230.82
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$190.72
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$274.64
|
| Rate for Payer: Cofinity Commercial |
$255.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.72
|
| Rate for Payer: Healthscope Commercial |
$352.83
|
| Rate for Payer: Healthscope Commercial |
$305.15
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.26
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,186.00
|
| Rate for Payer: Nomi Health Commercial |
$228.86
|
| Rate for Payer: PACE SWMI |
$190.72
|
| Rate for Payer: PHP Medicare Advantage |
$190.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.86
|
| Rate for Payer: Priority Health Medicare |
$190.72
|
| Rate for Payer: Priority Health Narrow Network |
$306.86
|
| Rate for Payer: Priority Health SBD |
$306.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.72
|
| Rate for Payer: UHC Exchange |
$258.52
|
| Rate for Payer: UHC Medicare Advantage |
$190.72
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 34839
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: BCN Commercial |
$145.07
|
| Rate for Payer: Cash Price |
$163.20
|
| 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 PL REJUV/PERFECT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 00071
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
|
|
PR PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 40720
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$181,273.00 |
| Rate for Payer: Aetna Commercial |
$1,315.25
|
| Rate for Payer: Aetna Medicare |
$1,020.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.40
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$981.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.69
|
| Rate for Payer: BCN Commercial |
$1,500.24
|
| Rate for Payer: BCN Medicare Advantage |
$981.53
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,413.40
|
| Rate for Payer: Cofinity Commercial |
$1,315.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.53
|
| Rate for Payer: Healthscope Commercial |
$1,815.83
|
| Rate for Payer: Healthscope Commercial |
$1,570.45
|
| Rate for Payer: Mclaren Medicaid |
$662.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.61
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181,273.00
|
| Rate for Payer: Nomi Health Commercial |
$1,177.84
|
| Rate for Payer: PACE SWMI |
$981.53
|
| Rate for Payer: PHP Medicare Advantage |
$981.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,837.52
|
| Rate for Payer: Priority Health Medicare |
$981.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,837.52
|
| Rate for Payer: Priority Health SBD |
$1,837.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.53
|
| Rate for Payer: UHC Exchange |
$1,174.97
|
| Rate for Payer: UHC Medicare Advantage |
$981.53
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 42500
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$60,896.00 |
| Rate for Payer: Aetna Commercial |
$438.98
|
| Rate for Payer: Aetna Medicare |
$340.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.74
|
| Rate for Payer: BCBS Complete |
$235.05
|
| Rate for Payer: BCBS MAPPO |
$327.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,052.90
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$327.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$471.74
|
| Rate for Payer: Cofinity Commercial |
$438.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.60
|
| Rate for Payer: Healthscope Commercial |
$606.06
|
| Rate for Payer: Healthscope Commercial |
$524.16
|
| Rate for Payer: Mclaren Medicaid |
$223.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.98
|
| Rate for Payer: Meridian Medicaid |
$235.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,896.00
|
| Rate for Payer: Nomi Health Commercial |
$393.12
|
| Rate for Payer: PACE SWMI |
$327.60
|
| Rate for Payer: PHP Medicare Advantage |
$327.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.63
|
| Rate for Payer: Priority Health Medicare |
$327.60
|
| Rate for Payer: Priority Health Narrow Network |
$624.63
|
| Rate for Payer: Priority Health SBD |
$624.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.60
|
| Rate for Payer: UHC Exchange |
$436.89
|
| Rate for Payer: UHC Medicare Advantage |
$327.60
|
| Rate for Payer: UHCCP Medicaid |
$223.86
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 42505
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$81,122.00 |
| Rate for Payer: Aetna Commercial |
$583.24
|
| Rate for Payer: Aetna Medicare |
$452.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.76
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$435.25
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$848.84
|
| Rate for Payer: BCN Medicare Advantage |
$435.25
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$626.76
|
| Rate for Payer: Cofinity Commercial |
$583.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.25
|
| Rate for Payer: Healthscope Commercial |
$805.21
|
| Rate for Payer: Healthscope Commercial |
$696.40
|
| Rate for Payer: Mclaren Medicaid |
$296.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.01
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,122.00
|
| Rate for Payer: Nomi Health Commercial |
$522.30
|
| Rate for Payer: PACE SWMI |
$435.25
|
| Rate for Payer: PHP Medicare Advantage |
$435.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.27
|
| Rate for Payer: Priority Health Medicare |
$435.25
|
| Rate for Payer: Priority Health Narrow Network |
$829.27
|
| Rate for Payer: Priority Health SBD |
$829.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.25
|
| Rate for Payer: UHC Exchange |
$572.62
|
| Rate for Payer: UHC Medicare Advantage |
$435.25
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
|
|
PR PL VITALIZE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 00070
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
|
|
PR PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY
|
Professional
|
Both
|
$3,664.00
|
|
|
Service Code
|
HCPCS 48140
|
| Min. Negotiated Rate |
$1,005.57 |
| Max. Negotiated Rate |
$280,501.00 |
| Rate for Payer: Aetna Commercial |
$2,039.06
|
| Rate for Payer: Aetna Medicare |
$1,582.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,039.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,191.23
|
| Rate for Payer: BCBS Complete |
$1,055.85
|
| Rate for Payer: BCBS MAPPO |
$1,521.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.30
|
| Rate for Payer: BCN Commercial |
$2,284.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,521.69
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cofinity Commercial |
$2,191.23
|
| Rate for Payer: Cofinity Commercial |
$2,039.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,521.69
|
| Rate for Payer: Healthscope Commercial |
$2,815.13
|
| Rate for Payer: Healthscope Commercial |
$2,434.70
|
| Rate for Payer: Mclaren Medicaid |
$1,005.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,597.77
|
| Rate for Payer: Meridian Medicaid |
$1,055.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280,501.00
|
| Rate for Payer: Nomi Health Commercial |
$1,826.03
|
| Rate for Payer: PACE SWMI |
$1,521.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,521.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,005.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,802.80
|
| Rate for Payer: Priority Health Medicare |
$1,521.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,802.80
|
| Rate for Payer: Priority Health SBD |
$2,802.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,671.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,521.69
|
| Rate for Payer: UHC Exchange |
$1,671.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,521.69
|
| Rate for Payer: UHCCP Medicaid |
$1,005.57
|
|
|
PR PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$5,562.00
|
|
|
Service Code
|
HCPCS 48150
|
| Min. Negotiated Rate |
$711.62 |
| Max. Negotiated Rate |
$557,181.00 |
| Rate for Payer: Aetna Commercial |
$4,046.92
|
| Rate for Payer: Aetna Medicare |
$3,140.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,046.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,348.93
|
| Rate for Payer: BCBS Complete |
$2,092.69
|
| Rate for Payer: BCBS MAPPO |
$3,020.09
|
| Rate for Payer: BCBS Trust/PPO |
$711.62
|
| Rate for Payer: BCN Commercial |
$4,533.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,020.09
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cofinity Commercial |
$4,348.93
|
| Rate for Payer: Cofinity Commercial |
$4,046.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,020.09
|
| Rate for Payer: Healthscope Commercial |
$5,587.17
|
| Rate for Payer: Healthscope Commercial |
$4,832.14
|
| Rate for Payer: Mclaren Medicaid |
$1,993.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,171.09
|
| Rate for Payer: Meridian Medicaid |
$2,092.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557,181.00
|
| Rate for Payer: Nomi Health Commercial |
$3,624.11
|
| Rate for Payer: PACE SWMI |
$3,020.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,020.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,993.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,615.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,560.26
|
| Rate for Payer: Priority Health Medicare |
$3,020.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,560.26
|
| Rate for Payer: Priority Health SBD |
$5,560.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,020.09
|
| Rate for Payer: UHC Exchange |
$3,455.92
|
| Rate for Payer: UHC Medicare Advantage |
$3,020.09
|
| Rate for Payer: UHCCP Medicaid |
$1,993.04
|
|
|
PR PNCRTECT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$8,303.00
|
|
|
Service Code
|
HCPCS 48153
|
| Min. Negotiated Rate |
$747.02 |
| Max. Negotiated Rate |
$555,667.00 |
| Rate for Payer: Aetna Commercial |
$4,026.36
|
| Rate for Payer: Aetna Medicare |
$3,124.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,026.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,326.84
|
| Rate for Payer: BCBS Complete |
$2,080.40
|
| Rate for Payer: BCBS MAPPO |
$3,004.75
|
| Rate for Payer: BCBS Trust/PPO |
$747.02
|
| Rate for Payer: BCN Commercial |
$4,519.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,004.75
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cofinity Commercial |
$4,326.84
|
| Rate for Payer: Cofinity Commercial |
$4,026.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,004.75
|
| Rate for Payer: Healthscope Commercial |
$5,558.79
|
| Rate for Payer: Healthscope Commercial |
$4,807.60
|
| Rate for Payer: Mclaren Medicaid |
$1,981.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,154.99
|
| Rate for Payer: Meridian Medicaid |
$2,080.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555,667.00
|
| Rate for Payer: Nomi Health Commercial |
$3,605.70
|
| Rate for Payer: PACE SWMI |
$3,004.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,004.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,981.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,396.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,536.98
|
| Rate for Payer: Priority Health Medicare |
$3,004.75
|
| Rate for Payer: Priority Health Narrow Network |
$5,536.98
|
| Rate for Payer: Priority Health SBD |
$5,536.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,271.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,004.75
|
| Rate for Payer: UHC Exchange |
$3,271.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,004.75
|
| Rate for Payer: UHCCP Medicaid |
$1,981.33
|
|
|
PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 90669
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
|
|
PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 32940
|
| Min. Negotiated Rate |
$780.86 |
| Max. Negotiated Rate |
$218,581.00 |
| Rate for Payer: Aetna Commercial |
$1,589.19
|
| Rate for Payer: Aetna Medicare |
$1,233.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,707.78
|
| Rate for Payer: BCBS Complete |
$819.90
|
| Rate for Payer: BCBS MAPPO |
$1,185.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,185.96
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,707.78
|
| Rate for Payer: Cofinity Commercial |
$1,589.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,185.96
|
| Rate for Payer: Healthscope Commercial |
$2,194.03
|
| Rate for Payer: Healthscope Commercial |
$1,897.54
|
| Rate for Payer: Mclaren Medicaid |
$780.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,245.26
|
| Rate for Payer: Meridian Medicaid |
$819.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218,581.00
|
| Rate for Payer: Nomi Health Commercial |
$1,423.15
|
| Rate for Payer: PACE SWMI |
$1,185.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,185.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,691.65
|
| Rate for Payer: Priority Health Medicare |
$1,185.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.65
|
| Rate for Payer: Priority Health SBD |
$1,691.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,185.96
|
| Rate for Payer: UHC Exchange |
$1,340.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,185.96
|
| Rate for Payer: UHCCP Medicaid |
$780.86
|
|
|
PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST
|
Professional
|
Both
|
$2,729.00
|
|
|
Service Code
|
HCPCS 32200
|
| Min. Negotiated Rate |
$725.48 |
| Max. Negotiated Rate |
$201,658.00 |
| Rate for Payer: Aetna Commercial |
$1,468.76
|
| Rate for Payer: Aetna Medicare |
$1,139.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.37
|
| Rate for Payer: BCBS Complete |
$761.75
|
| Rate for Payer: BCBS MAPPO |
$1,096.09
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.09
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,578.37
|
| Rate for Payer: Cofinity Commercial |
$1,468.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.09
|
| Rate for Payer: Healthscope Commercial |
$2,027.77
|
| Rate for Payer: Healthscope Commercial |
$1,753.74
|
| Rate for Payer: Mclaren Medicaid |
$725.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.89
|
| Rate for Payer: Meridian Medicaid |
$761.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201,658.00
|
| Rate for Payer: Nomi Health Commercial |
$1,315.31
|
| Rate for Payer: PACE SWMI |
$1,096.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,570.68
|
| Rate for Payer: Priority Health Medicare |
$1,096.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,570.68
|
| Rate for Payer: Priority Health SBD |
$1,570.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,140.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.09
|
| Rate for Payer: UHC Exchange |
$1,140.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.09
|
| Rate for Payer: UHCCP Medicaid |
$725.48
|
|
|
PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 32960
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$16,061.00 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Medicare |
$89.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.72
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$85.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.07
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$85.92
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$123.72
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.92
|
| Rate for Payer: Healthscope Commercial |
$158.95
|
| Rate for Payer: Healthscope Commercial |
$137.47
|
| Rate for Payer: Mclaren Medicaid |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.22
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,061.00
|
| Rate for Payer: Nomi Health Commercial |
$103.10
|
| Rate for Payer: PACE SWMI |
$85.92
|
| Rate for Payer: PHP Medicare Advantage |
$85.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.75
|
| Rate for Payer: Priority Health Medicare |
$85.92
|
| Rate for Payer: Priority Health Narrow Network |
$123.75
|
| Rate for Payer: Priority Health SBD |
$123.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.92
|
| Rate for Payer: UHC Exchange |
$157.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.92
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
|
|
PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 55000
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$14,794.00 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.79
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$175.44
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Healthscope Commercial |
$148.76
|
| Rate for Payer: Healthscope Commercial |
$128.66
|
| Rate for Payer: Mclaren Medicaid |
$54.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,794.00
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.75
|
| Rate for Payer: Priority Health Medicare |
$80.41
|
| Rate for Payer: Priority Health Narrow Network |
$134.75
|
| Rate for Payer: Priority Health SBD |
$134.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.41
|
| Rate for Payer: UHC Exchange |
$153.07
|
| Rate for Payer: UHC Medicare Advantage |
$80.41
|
| Rate for Payer: UHCCP Medicaid |
$54.10
|
|
|
PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90713
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$4,133.00 |
| Rate for Payer: Aetna Commercial |
$43.27
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.27
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,133.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.46
|
| Rate for Payer: UHC Exchange |
$47.46
|
|
|
PR POLLICIZATION DIGIT
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 26550
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$292,932.00 |
| Rate for Payer: Aetna Commercial |
$2,100.16
|
| Rate for Payer: Aetna Medicare |
$1,629.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,100.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,256.88
|
| Rate for Payer: BCBS Complete |
$1,113.78
|
| Rate for Payer: BCBS MAPPO |
$1,567.28
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$2,434.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.28
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$2,256.88
|
| Rate for Payer: Cofinity Commercial |
$2,100.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.28
|
| Rate for Payer: Healthscope Commercial |
$2,899.47
|
| Rate for Payer: Healthscope Commercial |
$2,507.65
|
| Rate for Payer: Mclaren Medicaid |
$1,060.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.64
|
| Rate for Payer: Meridian Medicaid |
$1,113.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292,932.00
|
| Rate for Payer: Nomi Health Commercial |
$1,880.74
|
| Rate for Payer: PACE SWMI |
$1,567.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,060.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,534.63
|
| Rate for Payer: Priority Health Medicare |
$1,567.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,534.63
|
| Rate for Payer: Priority Health SBD |
$2,534.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,567.28
|
| Rate for Payer: UHC Exchange |
$2,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,567.28
|
| Rate for Payer: UHCCP Medicaid |
$1,060.74
|
|
