|
PR PSYCHOLOGIC TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 96101
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$96.85 |
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
|
|
PR PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 90785
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$12.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.39
|
| Rate for Payer: BCBS Complete |
$57.60
|
| Rate for Payer: BCBS MAPPO |
$12.23
|
| Rate for Payer: BCN Medicare Advantage |
$12.23
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Cofinity Commercial |
$16.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.23
|
| Rate for Payer: Healthscope Commercial |
$22.63
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.60
|
| Rate for Payer: Nomi Health Commercial |
$14.68
|
| Rate for Payer: PACE SWMI |
$12.23
|
| Rate for Payer: PHP Medicare Advantage |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health Medicare |
$12.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.23
|
| Rate for Payer: UHC Medicare Advantage |
$12.23
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$118.71 |
| Rate for Payer: Aetna Commercial |
$85.99
|
| Rate for Payer: Aetna Medicare |
$66.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.99
|
| Rate for Payer: BCBS Complete |
$47.20
|
| Rate for Payer: BCBS MAPPO |
$64.17
|
| Rate for Payer: BCN Medicare Advantage |
$64.17
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$85.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.17
|
| Rate for Payer: Healthscope Commercial |
$102.67
|
| Rate for Payer: Healthscope Commercial |
$118.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.70
|
| Rate for Payer: Nomi Health Commercial |
$77.00
|
| Rate for Payer: PACE SWMI |
$64.17
|
| Rate for Payer: PHP Medicare Advantage |
$64.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health Medicare |
$64.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.17
|
| Rate for Payer: UHC Medicare Advantage |
$64.17
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 90839
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$239.54 |
| Rate for Payer: Aetna Commercial |
$173.50
|
| Rate for Payer: Aetna Medicare |
$134.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.50
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: BCBS MAPPO |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$129.48
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$186.45
|
| Rate for Payer: Cofinity Commercial |
$173.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.48
|
| Rate for Payer: Healthscope Commercial |
$239.54
|
| Rate for Payer: Healthscope Commercial |
$207.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.50
|
| Rate for Payer: Nomi Health Commercial |
$155.38
|
| Rate for Payer: PACE SWMI |
$129.48
|
| Rate for Payer: PHP Medicare Advantage |
$129.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health Medicare |
$129.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.48
|
| Rate for Payer: UHC Medicare Advantage |
$129.48
|
|
|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 90832
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$126.65 |
| Rate for Payer: Aetna Commercial |
$91.74
|
| Rate for Payer: Aetna Medicare |
$71.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$68.46
|
| Rate for Payer: BCN Medicare Advantage |
$68.46
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$91.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$109.54
|
| Rate for Payer: Healthscope Commercial |
$126.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.15
|
| Rate for Payer: Nomi Health Commercial |
$82.15
|
| Rate for Payer: PACE SWMI |
$68.46
|
| Rate for Payer: PHP Medicare Advantage |
$68.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$68.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.46
|
| Rate for Payer: UHC Medicare Advantage |
$68.46
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 90834
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$167.02 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: Aetna Medicare |
$93.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.98
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$90.28
|
| Rate for Payer: BCN Medicare Advantage |
$90.28
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$130.00
|
| Rate for Payer: Cofinity Commercial |
$120.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.28
|
| Rate for Payer: Healthscope Commercial |
$167.02
|
| Rate for Payer: Healthscope Commercial |
$144.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.50
|
| Rate for Payer: Nomi Health Commercial |
$108.34
|
| Rate for Payer: PACE SWMI |
$90.28
|
| Rate for Payer: PHP Medicare Advantage |
$90.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.28
|
| Rate for Payer: UHC Medicare Advantage |
$90.28
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 90837
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$247.36 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: Aetna Medicare |
$139.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.17
|
| Rate for Payer: BCBS Complete |
$95.20
|
| Rate for Payer: BCBS MAPPO |
$133.71
|
| Rate for Payer: BCN Medicare Advantage |
$133.71
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$192.54
|
| Rate for Payer: Cofinity Commercial |
$179.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.71
|
| Rate for Payer: Healthscope Commercial |
$213.94
|
| Rate for Payer: Healthscope Commercial |
$247.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.70
|
| Rate for Payer: Nomi Health Commercial |
$160.45
|
| Rate for Payer: PACE SWMI |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$133.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health Medicare |
$133.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.71
|
| Rate for Payer: UHC Medicare Advantage |
$133.71
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$118.16 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.59
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 90836
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$150.26 |
| Rate for Payer: Aetna Commercial |
$108.83
|
| Rate for Payer: Aetna Medicare |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: BCBS MAPPO |
$81.22
|
| Rate for Payer: BCN Medicare Advantage |
$81.22
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| Rate for Payer: Cofinity Commercial |
$108.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.22
|
| Rate for Payer: Healthscope Commercial |
$129.95
|
| Rate for Payer: Healthscope Commercial |
$150.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.80
|
| Rate for Payer: Nomi Health Commercial |
$97.46
|
| Rate for Payer: PACE SWMI |
$81.22
|
| Rate for Payer: PHP Medicare Advantage |
$81.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health Medicare |
$81.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$81.22
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 90838
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$200.89 |
| Rate for Payer: Aetna Commercial |
$145.51
|
| Rate for Payer: Aetna Medicare |
$112.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.51
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$108.59
|
| Rate for Payer: BCN Medicare Advantage |
$108.59
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$156.37
|
| Rate for Payer: Cofinity Commercial |
$145.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.59
|
| Rate for Payer: Healthscope Commercial |
$200.89
|
| Rate for Payer: Healthscope Commercial |
$173.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.05
|
| Rate for Payer: Nomi Health Commercial |
$130.31
|
| Rate for Payer: PACE SWMI |
$108.59
|
| Rate for Payer: PHP Medicare Advantage |
$108.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$108.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.59
|
| Rate for Payer: UHC Medicare Advantage |
$108.59
|
|
|
PR PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 96146
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.88
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.15
|
| Rate for Payer: BCN Medicare Advantage |
$2.15
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$2.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.15
|
| Rate for Payer: Healthscope Commercial |
$3.44
|
| Rate for Payer: Healthscope Commercial |
$3.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.60
|
| Rate for Payer: Nomi Health Commercial |
$2.58
|
| Rate for Payer: PACE SWMI |
$2.15
|
| Rate for Payer: PHP Medicare Advantage |
$2.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: Priority Health Medicare |
$2.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.15
|
| Rate for Payer: UHC Medicare Advantage |
$2.15
|
|
|
PR PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 96137
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Aetna Commercial |
$22.82
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.82
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$31.51
|
| Rate for Payer: Healthscope Commercial |
$27.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.90
|
| Rate for Payer: Nomi Health Commercial |
$20.44
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96138
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Healthscope Commercial |
$49.17
|
| Rate for Payer: Healthscope Commercial |
$56.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96139
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Healthscope Commercial |
$56.85
|
| Rate for Payer: Healthscope Commercial |
$49.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
|
|
PR PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 96136
|
| Min. Negotiated Rate |
$22.46 |
| Max. Negotiated Rate |
$61.10 |
| Rate for Payer: Aetna Commercial |
$30.10
|
| Rate for Payer: Aetna Medicare |
$23.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS MAPPO |
$22.46
|
| Rate for Payer: BCN Medicare Advantage |
$22.46
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$32.34
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.46
|
| Rate for Payer: Healthscope Commercial |
$35.94
|
| Rate for Payer: Healthscope Commercial |
$41.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.10
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| Rate for Payer: PACE SWMI |
$22.46
|
| Rate for Payer: PHP Medicare Advantage |
$22.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Medicare |
$22.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.46
|
| Rate for Payer: UHC Medicare Advantage |
$22.46
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,219.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$752.78 |
| Max. Negotiated Rate |
$1,442.35 |
| Rate for Payer: Aetna Commercial |
$1,008.73
|
| Rate for Payer: Aetna Medicare |
$782.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.73
|
| Rate for Payer: BCBS Complete |
$887.60
|
| Rate for Payer: BCBS MAPPO |
$752.78
|
| Rate for Payer: BCN Medicare Advantage |
$752.78
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cofinity Commercial |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,008.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.78
|
| Rate for Payer: Healthscope Commercial |
$1,392.64
|
| Rate for Payer: Healthscope Commercial |
$1,204.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,442.35
|
| Rate for Payer: Nomi Health Commercial |
$903.34
|
| Rate for Payer: PACE SWMI |
$752.78
|
| Rate for Payer: PHP Medicare Advantage |
$752.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.35
|
| Rate for Payer: Priority Health Medicare |
$752.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.78
|
| Rate for Payer: UHC Medicare Advantage |
$752.78
|
|
|
PR PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 96160
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$3.82
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Healthscope Commercial |
$4.24
|
| Rate for Payer: Healthscope Commercial |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$3.18
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
|
|
PR PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 33910
|
| Min. Negotiated Rate |
$2,229.60 |
| Max. Negotiated Rate |
$4,618.64 |
| Rate for Payer: Aetna Commercial |
$3,345.39
|
| Rate for Payer: Aetna Medicare |
$2,596.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,595.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,345.39
|
| Rate for Payer: BCBS Complete |
$2,229.60
|
| Rate for Payer: BCBS MAPPO |
$2,496.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,496.56
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$3,595.05
|
| Rate for Payer: Cofinity Commercial |
$3,345.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,496.56
|
| Rate for Payer: Healthscope Commercial |
$3,994.50
|
| Rate for Payer: Healthscope Commercial |
$4,618.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,621.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,623.10
|
| Rate for Payer: Nomi Health Commercial |
$2,995.87
|
| Rate for Payer: PACE SWMI |
$2,496.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,496.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health Medicare |
$2,496.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,496.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,496.56
|
|
|
PR PULMONARY COMPLIANCE STUDY
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 94750
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
|
|
PR PULMONARY STRESS TESTING
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 94618
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$59.18 |
| Rate for Payer: Aetna Commercial |
$42.87
|
| Rate for Payer: Aetna Medicare |
$33.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.07
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$31.99
|
| Rate for Payer: BCN Medicare Advantage |
$31.99
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$46.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.99
|
| Rate for Payer: Healthscope Commercial |
$51.18
|
| Rate for Payer: Healthscope Commercial |
$59.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE SWMI |
$31.99
|
| Rate for Payer: PHP Medicare Advantage |
$31.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Medicare |
$31.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.99
|
| Rate for Payer: UHC Medicare Advantage |
$31.99
|
|
|
PR PULMONARY STRESS TESTING,SIMPLE
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 94620
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$232.70 |
| Rate for Payer: Aetna Medicare |
$179.00
|
| Rate for Payer: BCBS Complete |
$143.20
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
|
|
PR PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 11105
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: Aetna Commercial |
$32.43
|
| Rate for Payer: Aetna Medicare |
$25.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.85
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS MAPPO |
$24.20
|
| Rate for Payer: BCN Medicare Advantage |
$24.20
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$32.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.20
|
| Rate for Payer: Healthscope Commercial |
$44.77
|
| Rate for Payer: Healthscope Commercial |
$38.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.30
|
| Rate for Payer: Nomi Health Commercial |
$29.04
|
| Rate for Payer: PACE SWMI |
$24.20
|
| Rate for Payer: PHP Medicare Advantage |
$24.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$24.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.20
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$44.49 |
| Max. Negotiated Rate |
$158.60 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare |
$46.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.07
|
| Rate for Payer: BCBS Complete |
$97.60
|
| Rate for Payer: BCBS MAPPO |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$44.49
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$59.62
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.49
|
| Rate for Payer: Healthscope Commercial |
$71.18
|
| Rate for Payer: Healthscope Commercial |
$82.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.60
|
| Rate for Payer: Nomi Health Commercial |
$53.39
|
| Rate for Payer: PACE SWMI |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.60
|
| Rate for Payer: Priority Health Medicare |
$44.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.49
|
| Rate for Payer: UHC Medicare Advantage |
$44.49
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$168.89 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.33
|
| Rate for Payer: BCBS Complete |
$86.00
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| Rate for Payer: Cofinity Commercial |
$122.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Healthscope Commercial |
$168.89
|
| Rate for Payer: Healthscope Commercial |
$146.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.75
|
| Rate for Payer: Nomi Health Commercial |
$109.55
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health Medicare |
$91.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.45 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
