|
PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$997.00
|
|
|
Service Code
|
HCPCS 95810
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$85,379.00 |
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.12
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Healthscope Commercial |
$1,042.51
|
| Rate for Payer: Healthscope Commercial |
$901.63
|
| Rate for Payer: Healthscope Commercial |
$1,042.51
|
| Rate for Payer: Healthscope Commercial |
$901.63
|
| Rate for Payer: Mclaren Medicaid |
$73.91
|
| Rate for Payer: Mclaren Medicaid |
$73.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,379.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,379.00
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.73
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: Priority Health Narrow Network |
$846.73
|
| Rate for Payer: Priority Health Narrow Network |
$846.73
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Exchange |
$843.60
|
| Rate for Payer: UHC Exchange |
$843.60
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
|
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 95782
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$132,965.00 |
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.04
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Healthscope Commercial |
$1,391.09
|
| Rate for Payer: Healthscope Commercial |
$1,608.45
|
| Rate for Payer: Healthscope Commercial |
$1,608.45
|
| Rate for Payer: Healthscope Commercial |
$1,391.09
|
| Rate for Payer: Mclaren Medicaid |
$76.89
|
| Rate for Payer: Mclaren Medicaid |
$76.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,965.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,965.00
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,328.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,328.90
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.90
|
| Rate for Payer: Priority Health SBD |
$164.18
|
| Rate for Payer: Priority Health SBD |
$164.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
|
|
PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 95811
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$89,340.00 |
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.87
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Healthscope Commercial |
$1,091.87
|
| Rate for Payer: Healthscope Commercial |
$944.32
|
| Rate for Payer: Healthscope Commercial |
$1,091.87
|
| Rate for Payer: Healthscope Commercial |
$944.32
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,340.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,340.00
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.18
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: Priority Health Narrow Network |
$885.18
|
| Rate for Payer: Priority Health Narrow Network |
$885.18
|
| Rate for Payer: Priority Health SBD |
$163.29
|
| Rate for Payer: Priority Health SBD |
$163.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Exchange |
$903.55
|
| Rate for Payer: UHC Exchange |
$903.55
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95783
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$140,919.00 |
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Medicare |
$958.40
|
| Rate for Payer: Aetna Medicare |
$958.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,327.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,327.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.86
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCBS Trust/PPO |
$686.79
|
| Rate for Payer: BCBS Trust/PPO |
$686.79
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Healthscope Commercial |
$1,474.46
|
| Rate for Payer: Healthscope Commercial |
$1,704.85
|
| Rate for Payer: Healthscope Commercial |
$1,704.85
|
| Rate for Payer: Healthscope Commercial |
$1,474.46
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,919.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,919.00
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,408.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,408.96
|
| Rate for Payer: Priority Health Medicare |
$921.54
|
| Rate for Payer: Priority Health Medicare |
$921.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.96
|
| Rate for Payer: Priority Health SBD |
$179.12
|
| Rate for Payer: Priority Health SBD |
$179.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 95808
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$76,928.00 |
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Medicare |
$458.17
|
| Rate for Payer: Aetna Medicare |
$458.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.34
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCN Commercial |
$644.36
|
| Rate for Payer: BCN Commercial |
$644.36
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Healthscope Commercial |
$704.88
|
| Rate for Payer: Healthscope Commercial |
$815.02
|
| Rate for Payer: Healthscope Commercial |
$704.88
|
| Rate for Payer: Healthscope Commercial |
$815.02
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,928.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,928.00
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.21
|
| Rate for Payer: Priority Health Medicare |
$440.55
|
| Rate for Payer: Priority Health Medicare |
$440.55
|
| Rate for Payer: Priority Health Narrow Network |
$695.21
|
| Rate for Payer: Priority Health Narrow Network |
$695.21
|
| Rate for Payer: Priority Health SBD |
$110.36
|
| Rate for Payer: Priority Health SBD |
$110.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Exchange |
$643.59
|
| Rate for Payer: UHC Exchange |
$643.59
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
|
|
PR PORTOENETEROSTOMY
|
Professional
|
Both
|
$4,815.00
|
|
|
Service Code
|
HCPCS 47701
|
| Min. Negotiated Rate |
$362.41 |
| Max. Negotiated Rate |
$311,020.00 |
| Rate for Payer: Aetna Commercial |
$2,255.96
|
| Rate for Payer: Aetna Medicare |
$1,750.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,424.31
|
| Rate for Payer: BCBS Complete |
$1,167.90
|
| Rate for Payer: BCBS MAPPO |
$1,683.55
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$2,534.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,683.55
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cofinity Commercial |
$2,424.31
|
| Rate for Payer: Cofinity Commercial |
$2,255.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,683.55
|
| Rate for Payer: Healthscope Commercial |
$3,114.57
|
| Rate for Payer: Healthscope Commercial |
$2,693.68
|
| Rate for Payer: Mclaren Medicaid |
$1,112.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,767.73
|
| Rate for Payer: Meridian Medicaid |
$1,167.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311,020.00
|
| Rate for Payer: Nomi Health Commercial |
$2,020.26
|
| Rate for Payer: PACE SWMI |
$1,683.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,683.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,112.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,129.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,104.67
|
| Rate for Payer: Priority Health Medicare |
$1,683.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,104.67
|
| Rate for Payer: Priority Health SBD |
$3,104.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,841.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,683.55
|
| Rate for Payer: UHC Exchange |
$1,841.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,683.55
|
| Rate for Payer: UHCCP Medicaid |
$1,112.29
|
|
|
PR POSITIONAL NYSTAGMUS TEST
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 92542
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$4,217.00 |
| Rate for Payer: Aetna Commercial |
$36.03
|
| Rate for Payer: Aetna Medicare |
$27.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.72
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$26.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$26.89
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$38.72
|
| Rate for Payer: Cofinity Commercial |
$36.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.89
|
| Rate for Payer: Healthscope Commercial |
$49.75
|
| Rate for Payer: Healthscope Commercial |
$43.02
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.23
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,217.00
|
| Rate for Payer: Nomi Health Commercial |
$32.27
|
| Rate for Payer: PACE SWMI |
$26.89
|
| Rate for Payer: PHP Medicare Advantage |
$26.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.90
|
| Rate for Payer: Priority Health Medicare |
$26.89
|
| Rate for Payer: Priority Health Narrow Network |
$38.90
|
| Rate for Payer: Priority Health SBD |
$33.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.89
|
| Rate for Payer: UHC Exchange |
$81.94
|
| Rate for Payer: UHC Medicare Advantage |
$26.89
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
|
|
PR POST-CATARACT LASER SURGERY
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 66821
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$53,176.00 |
| Rate for Payer: Aetna Commercial |
$380.90
|
| Rate for Payer: Aetna Medicare |
$295.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.32
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$284.25
|
| Rate for Payer: BCBS Trust/PPO |
$417.89
|
| Rate for Payer: BCN Commercial |
$483.30
|
| Rate for Payer: BCN Medicare Advantage |
$284.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$409.32
|
| Rate for Payer: Cofinity Commercial |
$380.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.25
|
| Rate for Payer: Healthscope Commercial |
$525.86
|
| Rate for Payer: Healthscope Commercial |
$454.80
|
| Rate for Payer: Mclaren Medicaid |
$196.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.46
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,176.00
|
| Rate for Payer: Nomi Health Commercial |
$341.10
|
| Rate for Payer: PACE SWMI |
$284.25
|
| Rate for Payer: PHP Medicare Advantage |
$284.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.38
|
| Rate for Payer: Priority Health Medicare |
$284.25
|
| Rate for Payer: Priority Health Narrow Network |
$543.38
|
| Rate for Payer: Priority Health SBD |
$543.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.25
|
| Rate for Payer: UHC Exchange |
$333.59
|
| Rate for Payer: UHC Medicare Advantage |
$284.25
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 57250
|
| Min. Negotiated Rate |
$395.33 |
| Max. Negotiated Rate |
$109,885.00 |
| Rate for Payer: Aetna Commercial |
$790.04
|
| Rate for Payer: Aetna Medicare |
$613.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.00
|
| Rate for Payer: BCBS Complete |
$415.10
|
| Rate for Payer: BCBS MAPPO |
$589.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.43
|
| Rate for Payer: BCN Commercial |
$904.06
|
| Rate for Payer: BCN Medicare Advantage |
$589.58
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$849.00
|
| Rate for Payer: Cofinity Commercial |
$790.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.58
|
| Rate for Payer: Healthscope Commercial |
$943.33
|
| Rate for Payer: Healthscope Commercial |
$1,090.72
|
| Rate for Payer: Mclaren Medicaid |
$395.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.06
|
| Rate for Payer: Meridian Medicaid |
$415.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109,885.00
|
| Rate for Payer: Nomi Health Commercial |
$707.50
|
| Rate for Payer: PACE SWMI |
$589.58
|
| Rate for Payer: PHP Medicare Advantage |
$589.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$922.14
|
| Rate for Payer: Priority Health Medicare |
$589.58
|
| Rate for Payer: Priority Health Narrow Network |
$922.14
|
| Rate for Payer: Priority Health SBD |
$922.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.58
|
| Rate for Payer: UHC Exchange |
$548.22
|
| Rate for Payer: UHC Medicare Advantage |
$589.58
|
| Rate for Payer: UHCCP Medicaid |
$395.33
|
|
|
PR POSTERIOR NON-SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$3,333.00
|
|
|
Service Code
|
HCPCS 22840
|
| Min. Negotiated Rate |
$482.23 |
| Max. Negotiated Rate |
$135,907.00 |
| Rate for Payer: Aetna Commercial |
$984.98
|
| Rate for Payer: Aetna Medicare |
$764.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,058.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.98
|
| Rate for Payer: BCBS Complete |
$506.34
|
| Rate for Payer: BCBS MAPPO |
$735.06
|
| Rate for Payer: BCBS Trust/PPO |
$21,897.63
|
| Rate for Payer: BCN Commercial |
$1,213.35
|
| Rate for Payer: BCN Medicare Advantage |
$735.06
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Cofinity Commercial |
$1,058.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.06
|
| Rate for Payer: Healthscope Commercial |
$1,359.86
|
| Rate for Payer: Healthscope Commercial |
$1,176.10
|
| Rate for Payer: Mclaren Medicaid |
$482.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.81
|
| Rate for Payer: Meridian Medicaid |
$506.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135,907.00
|
| Rate for Payer: Nomi Health Commercial |
$882.07
|
| Rate for Payer: PACE SWMI |
$735.06
|
| Rate for Payer: PHP Medicare Advantage |
$735.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,166.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$735.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.03
|
| Rate for Payer: Priority Health SBD |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.06
|
| Rate for Payer: UHC Exchange |
$1,211.06
|
| Rate for Payer: UHC Medicare Advantage |
$735.06
|
| Rate for Payer: UHCCP Medicaid |
$482.23
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE
|
Professional
|
Both
|
$3,929.00
|
|
|
Service Code
|
HCPCS 22844
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$176,348.00 |
| Rate for Payer: Aetna Commercial |
$1,286.20
|
| Rate for Payer: Aetna Medicare |
$998.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,382.18
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: BCBS MAPPO |
$959.85
|
| Rate for Payer: BCBS Trust/PPO |
$53.49
|
| Rate for Payer: BCN Commercial |
$1,576.55
|
| Rate for Payer: BCN Medicare Advantage |
$959.85
|
| Rate for Payer: Cash Price |
$3,143.20
|
| Rate for Payer: Cash Price |
$3,143.20
|
| Rate for Payer: Cofinity Commercial |
$1,382.18
|
| Rate for Payer: Cofinity Commercial |
$1,286.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.85
|
| Rate for Payer: Healthscope Commercial |
$1,775.72
|
| Rate for Payer: Healthscope Commercial |
$1,535.76
|
| Rate for Payer: Mclaren Medicaid |
$630.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.84
|
| Rate for Payer: Meridian Medicaid |
$662.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,348.00
|
| Rate for Payer: Nomi Health Commercial |
$1,151.82
|
| Rate for Payer: PACE SWMI |
$959.85
|
| Rate for Payer: PHP Medicare Advantage |
$959.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,553.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,493.51
|
| Rate for Payer: Priority Health Medicare |
$959.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.51
|
| Rate for Payer: Priority Health SBD |
$1,493.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,579.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.85
|
| Rate for Payer: UHC Exchange |
$1,579.49
|
| Rate for Payer: UHC Medicare Advantage |
$959.85
|
| Rate for Payer: UHCCP Medicaid |
$630.48
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG
|
Professional
|
Both
|
$3,720.00
|
|
|
Service Code
|
HCPCS 22842
|
| Min. Negotiated Rate |
$483.43 |
| Max. Negotiated Rate |
$136,994.00 |
| Rate for Payer: Aetna Commercial |
$998.69
|
| Rate for Payer: Aetna Medicare |
$775.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.69
|
| Rate for Payer: BCBS Complete |
$512.61
|
| Rate for Payer: BCBS MAPPO |
$745.29
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: BCN Commercial |
$1,222.50
|
| Rate for Payer: BCN Medicare Advantage |
$745.29
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cofinity Commercial |
$998.69
|
| Rate for Payer: Cofinity Commercial |
$1,073.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.29
|
| Rate for Payer: Healthscope Commercial |
$1,378.79
|
| Rate for Payer: Healthscope Commercial |
$1,192.46
|
| Rate for Payer: Mclaren Medicaid |
$488.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.55
|
| Rate for Payer: Meridian Medicaid |
$512.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136,994.00
|
| Rate for Payer: Nomi Health Commercial |
$894.35
|
| Rate for Payer: PACE SWMI |
$745.29
|
| Rate for Payer: PHP Medicare Advantage |
$745.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,418.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.71
|
| Rate for Payer: Priority Health Medicare |
$745.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,160.71
|
| Rate for Payer: Priority Health SBD |
$1,160.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.29
|
| Rate for Payer: UHC Exchange |
$1,215.15
|
| Rate for Payer: UHC Medicare Advantage |
$745.29
|
| Rate for Payer: UHCCP Medicaid |
$488.20
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG
|
Professional
|
Both
|
$4,091.00
|
|
|
Service Code
|
HCPCS 22843
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$146,646.00 |
| Rate for Payer: Aetna Commercial |
$1,070.35
|
| Rate for Payer: Aetna Medicare |
$830.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,070.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.23
|
| Rate for Payer: BCBS Complete |
$549.29
|
| Rate for Payer: BCBS MAPPO |
$798.77
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$1,308.59
|
| Rate for Payer: BCN Medicare Advantage |
$798.77
|
| Rate for Payer: Cash Price |
$3,272.80
|
| Rate for Payer: Cash Price |
$3,272.80
|
| Rate for Payer: Cofinity Commercial |
$1,150.23
|
| Rate for Payer: Cofinity Commercial |
$1,070.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.77
|
| Rate for Payer: Healthscope Commercial |
$1,477.72
|
| Rate for Payer: Healthscope Commercial |
$1,278.03
|
| Rate for Payer: Mclaren Medicaid |
$523.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$838.71
|
| Rate for Payer: Meridian Medicaid |
$549.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146,646.00
|
| Rate for Payer: Nomi Health Commercial |
$958.52
|
| Rate for Payer: PACE SWMI |
$798.77
|
| Rate for Payer: PHP Medicare Advantage |
$798.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,659.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,243.14
|
| Rate for Payer: Priority Health Medicare |
$798.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,243.14
|
| Rate for Payer: Priority Health SBD |
$1,243.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,273.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.77
|
| Rate for Payer: UHC Exchange |
$1,273.43
|
| Rate for Payer: UHC Medicare Advantage |
$798.77
|
| Rate for Payer: UHCCP Medicaid |
$523.13
|
|
|
PR POSTPARTUM CARE ONLY SEPARATE PROCEDURE
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 59430
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$32,539.00 |
| Rate for Payer: Aetna Commercial |
$233.83
|
| Rate for Payer: Aetna Medicare |
$181.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.28
|
| Rate for Payer: BCBS Complete |
$174.07
|
| Rate for Payer: BCBS MAPPO |
$174.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$309.12
|
| Rate for Payer: BCN Medicare Advantage |
$174.50
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$251.28
|
| Rate for Payer: Cofinity Commercial |
$233.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.50
|
| Rate for Payer: Healthscope Commercial |
$322.82
|
| Rate for Payer: Healthscope Commercial |
$279.20
|
| Rate for Payer: Mclaren Medicaid |
$165.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.22
|
| Rate for Payer: Meridian Medicaid |
$174.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,539.00
|
| Rate for Payer: Nomi Health Commercial |
$209.40
|
| Rate for Payer: PACE SWMI |
$174.50
|
| Rate for Payer: PHP Medicare Advantage |
$174.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.05
|
| Rate for Payer: Priority Health Medicare |
$174.50
|
| Rate for Payer: Priority Health Narrow Network |
$251.05
|
| Rate for Payer: Priority Health SBD |
$251.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.50
|
| Rate for Payer: UHC Exchange |
$153.97
|
| Rate for Payer: UHC Medicare Advantage |
$174.50
|
| Rate for Payer: UHCCP Medicaid |
$165.78
|
|
|
PR POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 64566
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$5,351.00 |
| Rate for Payer: Aetna Commercial |
$38.26
|
| Rate for Payer: Aetna Medicare |
$29.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$28.55
|
| Rate for Payer: BCBS Trust/PPO |
$861.13
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$28.55
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$41.11
|
| Rate for Payer: Cofinity Commercial |
$38.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.55
|
| Rate for Payer: Healthscope Commercial |
$45.68
|
| Rate for Payer: Healthscope Commercial |
$52.82
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.98
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,351.00
|
| Rate for Payer: Nomi Health Commercial |
$34.26
|
| Rate for Payer: PACE SWMI |
$28.55
|
| Rate for Payer: PHP Medicare Advantage |
$28.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$28.55
|
| Rate for Payer: Priority Health Narrow Network |
$51.19
|
| Rate for Payer: Priority Health SBD |
$51.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.55
|
| Rate for Payer: UHC Medicare Advantage |
$28.55
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR POTASSIUM HYDROXIDE PREPS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS Q0112
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$7.81
|
| Rate for Payer: Aetna Medicare |
$6.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.40
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$5.83
|
| Rate for Payer: BCBS Trust/PPO |
$334.41
|
| Rate for Payer: BCN Commercial |
$4.37
|
| Rate for Payer: BCN Medicare Advantage |
$5.83
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$7.81
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.83
|
| Rate for Payer: Healthscope Commercial |
$9.33
|
| Rate for Payer: Healthscope Commercial |
$10.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$875.00
|
| Rate for Payer: Nomi Health Commercial |
$7.00
|
| Rate for Payer: PACE SWMI |
$5.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Medicare |
$5.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.83
|
| Rate for Payer: UHC Exchange |
$11.84
|
| Rate for Payer: UHC Medicare Advantage |
$5.83
|
|
|
PR PPPS, INITIAL VISIT
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS G0438
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$24,065.00 |
| Rate for Payer: Aetna Commercial |
$207.70
|
| Rate for Payer: Aetna Medicare |
$161.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.20
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS MAPPO |
$155.00
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$239.95
|
| Rate for Payer: BCN Medicare Advantage |
$155.00
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$207.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.00
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$286.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,065.00
|
| Rate for Payer: Nomi Health Commercial |
$186.00
|
| Rate for Payer: PACE SWMI |
$155.00
|
| Rate for Payer: PHP Medicare Advantage |
$155.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.97
|
| Rate for Payer: Priority Health Medicare |
$155.00
|
| Rate for Payer: Priority Health Narrow Network |
$217.97
|
| Rate for Payer: Priority Health SBD |
$217.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.00
|
| Rate for Payer: UHC Medicare Advantage |
$155.00
|
|
|
PR PPPS, SUBSEQ VISIT
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS G0439
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$18,752.00 |
| Rate for Payer: Aetna Commercial |
$163.28
|
| Rate for Payer: Aetna Medicare |
$126.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.46
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$121.85
|
| Rate for Payer: BCBS Trust/PPO |
$728.00
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Medicare Advantage |
$121.85
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$175.46
|
| Rate for Payer: Cofinity Commercial |
$163.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.85
|
| Rate for Payer: Healthscope Commercial |
$225.42
|
| Rate for Payer: Healthscope Commercial |
$194.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,752.00
|
| Rate for Payer: Nomi Health Commercial |
$146.22
|
| Rate for Payer: PACE SWMI |
$121.85
|
| Rate for Payer: PHP Medicare Advantage |
$121.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.48
|
| Rate for Payer: Priority Health Medicare |
$121.85
|
| Rate for Payer: Priority Health Narrow Network |
$171.48
|
| Rate for Payer: Priority Health SBD |
$171.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.85
|
| Rate for Payer: UHC Medicare Advantage |
$121.85
|
|
|
PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 90732
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$11,943.00 |
| Rate for Payer: Aetna Commercial |
$178.85
|
| Rate for Payer: Aetna Medicare |
$138.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.20
|
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: BCBS MAPPO |
$133.47
|
| Rate for Payer: BCBS Trust/PPO |
$138.56
|
| Rate for Payer: BCN Commercial |
$218.03
|
| Rate for Payer: BCN Medicare Advantage |
$133.47
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$192.20
|
| Rate for Payer: Cofinity Commercial |
$178.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.47
|
| Rate for Payer: Healthscope Commercial |
$213.56
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,943.00
|
| Rate for Payer: Nomi Health Commercial |
$160.17
|
| Rate for Payer: PACE SWMI |
$133.47
|
| Rate for Payer: PHP Medicare Advantage |
$133.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health Medicare |
$133.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.47
|
| Rate for Payer: UHC Exchange |
$141.48
|
| Rate for Payer: UHC Medicare Advantage |
$133.47
|
|
|
PR PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 45112
|
| Min. Negotiated Rate |
$234.04 |
| Max. Negotiated Rate |
$320,499.00 |
| Rate for Payer: Aetna Commercial |
$2,313.01
|
| Rate for Payer: Aetna Medicare |
$1,795.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,313.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,485.63
|
| Rate for Payer: BCBS Complete |
$1,208.83
|
| Rate for Payer: BCBS MAPPO |
$1,726.13
|
| Rate for Payer: BCBS Trust/PPO |
$234.04
|
| Rate for Payer: BCN Commercial |
$2,621.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,726.13
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cofinity Commercial |
$2,485.63
|
| Rate for Payer: Cofinity Commercial |
$2,313.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,726.13
|
| Rate for Payer: Healthscope Commercial |
$3,193.34
|
| Rate for Payer: Healthscope Commercial |
$2,761.81
|
| Rate for Payer: Mclaren Medicaid |
$1,151.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,812.44
|
| Rate for Payer: Meridian Medicaid |
$1,208.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320,499.00
|
| Rate for Payer: Nomi Health Commercial |
$2,071.36
|
| Rate for Payer: PACE SWMI |
$1,726.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,726.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,151.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,211.47
|
| Rate for Payer: Priority Health Medicare |
$1,726.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,211.47
|
| Rate for Payer: Priority Health SBD |
$3,211.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,107.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,726.13
|
| Rate for Payer: UHC Exchange |
$2,107.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,726.13
|
| Rate for Payer: UHCCP Medicaid |
$1,151.27
|
|
|
PR PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST
|
Professional
|
Both
|
$4,725.00
|
|
|
Service Code
|
HCPCS 45110
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$322,434.00 |
| Rate for Payer: Aetna Commercial |
$2,319.65
|
| Rate for Payer: Aetna Medicare |
$1,800.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,319.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,492.76
|
| Rate for Payer: BCBS Complete |
$1,211.96
|
| Rate for Payer: BCBS MAPPO |
$1,731.08
|
| Rate for Payer: BCBS Trust/PPO |
$389.36
|
| Rate for Payer: BCN Commercial |
$2,639.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,731.08
|
| Rate for Payer: Cash Price |
$3,780.00
|
| Rate for Payer: Cash Price |
$3,780.00
|
| Rate for Payer: Cofinity Commercial |
$2,492.76
|
| Rate for Payer: Cofinity Commercial |
$2,319.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,731.08
|
| Rate for Payer: Healthscope Commercial |
$3,202.50
|
| Rate for Payer: Healthscope Commercial |
$2,769.73
|
| Rate for Payer: Mclaren Medicaid |
$1,154.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,817.63
|
| Rate for Payer: Meridian Medicaid |
$1,211.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322,434.00
|
| Rate for Payer: Nomi Health Commercial |
$2,077.30
|
| Rate for Payer: PACE SWMI |
$1,731.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,731.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,154.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,071.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,226.98
|
| Rate for Payer: Priority Health Medicare |
$1,731.08
|
| Rate for Payer: Priority Health Narrow Network |
$3,226.98
|
| Rate for Payer: Priority Health SBD |
$3,226.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,731.08
|
| Rate for Payer: UHC Exchange |
$2,013.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,731.08
|
| Rate for Payer: UHCCP Medicaid |
$1,154.25
|
|
|
PR PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS
|
Professional
|
Both
|
$4,993.00
|
|
|
Service Code
|
HCPCS 45120
|
| Min. Negotiated Rate |
$234.57 |
| Max. Negotiated Rate |
$286,499.00 |
| Rate for Payer: Aetna Commercial |
$2,084.18
|
| Rate for Payer: Aetna Medicare |
$1,617.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,084.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,239.72
|
| Rate for Payer: BCBS Complete |
$1,079.56
|
| Rate for Payer: BCBS MAPPO |
$1,555.36
|
| Rate for Payer: BCBS Trust/PPO |
$234.57
|
| Rate for Payer: BCN Commercial |
$2,334.90
|
| 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: Mclaren Medicaid |
$1,028.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,633.13
|
| Rate for Payer: Meridian Medicaid |
$1,079.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286,499.00
|
| 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 Choice Medicaid |
$1,028.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,245.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,864.24
|
| Rate for Payer: Priority Health Medicare |
$1,555.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,864.24
|
| Rate for Payer: Priority Health SBD |
$2,864.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,806.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,555.36
|
| Rate for Payer: UHC Exchange |
$1,806.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.36
|
| Rate for Payer: UHCCP Medicaid |
$1,028.15
|
|
|
PR PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS
|
Professional
|
Both
|
$4,900.00
|
|
|
Service Code
|
HCPCS 45121
|
| Min. Negotiated Rate |
$188.07 |
| Max. Negotiated Rate |
$312,800.00 |
| Rate for Payer: Aetna Commercial |
$2,273.89
|
| Rate for Payer: Aetna Medicare |
$1,764.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,273.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,443.58
|
| Rate for Payer: BCBS Complete |
$1,176.85
|
| Rate for Payer: BCBS MAPPO |
$1,696.93
|
| Rate for Payer: BCBS Trust/PPO |
$188.07
|
| Rate for Payer: BCN Commercial |
$2,547.48
|
| 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 |
$3,139.32
|
| Rate for Payer: Healthscope Commercial |
$2,715.09
|
| Rate for Payer: Mclaren Medicaid |
$1,120.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,781.78
|
| Rate for Payer: Meridian Medicaid |
$1,176.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312,800.00
|
| 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 Choice Medicaid |
$1,120.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,185.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,125.55
|
| Rate for Payer: Priority Health Medicare |
$1,696.93
|
| Rate for Payer: Priority Health Narrow Network |
$3,125.55
|
| Rate for Payer: Priority Health SBD |
$3,125.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,997.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,696.93
|
| Rate for Payer: UHC Exchange |
$1,997.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,696.93
|
| Rate for Payer: UHCCP Medicaid |
$1,120.81
|
|
|
PR PRCTECT PRTL RESCJ RECTUM TABDL APPR
|
Professional
|
Both
|
$1,973.00
|
|
|
Service Code
|
HCPCS 45111
|
| Min. Negotiated Rate |
$283.70 |
| Max. Negotiated Rate |
$192,467.00 |
| Rate for Payer: Aetna Commercial |
$1,396.43
|
| Rate for Payer: Aetna Medicare |
$1,083.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,396.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,500.64
|
| Rate for Payer: BCBS Complete |
$728.88
|
| Rate for Payer: BCBS MAPPO |
$1,042.11
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$1,575.99
|
| 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: Mclaren Medicaid |
$694.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.22
|
| Rate for Payer: Meridian Medicaid |
$728.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192,467.00
|
| 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 Choice Medicaid |
$694.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,282.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,941.92
|
| Rate for Payer: Priority Health Medicare |
$1,042.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,941.92
|
| Rate for Payer: Priority Health SBD |
$1,941.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,207.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,042.11
|
| Rate for Payer: UHC Exchange |
$1,207.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,042.11
|
| Rate for Payer: UHCCP Medicaid |
$694.17
|
|
|
PR PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH
|
Professional
|
Both
|
$3,259.00
|
|
|
Service Code
|
HCPCS 45114
|
| Min. Negotiated Rate |
$86.17 |
| Max. Negotiated Rate |
$325,508.00 |
| Rate for Payer: Aetna Commercial |
$2,367.44
|
| Rate for Payer: Aetna Medicare |
$1,837.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,544.12
|
| Rate for Payer: BCBS Complete |
$1,223.14
|
| Rate for Payer: BCBS MAPPO |
$1,766.75
|
| Rate for Payer: BCBS Trust/PPO |
$86.17
|
| Rate for Payer: BCN Commercial |
$2,647.17
|
| 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 |
$2,367.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,766.75
|
| Rate for Payer: Healthscope Commercial |
$3,268.49
|
| Rate for Payer: Healthscope Commercial |
$2,826.80
|
| Rate for Payer: Mclaren Medicaid |
$1,164.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,855.09
|
| Rate for Payer: Meridian Medicaid |
$1,223.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325,508.00
|
| 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 Choice Medicaid |
$1,164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,118.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,245.47
|
| Rate for Payer: Priority Health Medicare |
$1,766.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,245.47
|
| Rate for Payer: Priority Health SBD |
$3,245.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,923.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,766.75
|
| Rate for Payer: UHC Exchange |
$1,923.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,766.75
|
| Rate for Payer: UHCCP Medicaid |
$1,164.90
|
|
