|
PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF
|
Professional
|
Both
|
$9,458.00
|
|
|
Service Code
|
HCPCS 43116
|
| Min. Negotiated Rate |
$216.60 |
| Max. Negotiated Rate |
$883,181.00 |
| Rate for Payer: Aetna Commercial |
$6,397.70
|
| Rate for Payer: Aetna Medicare |
$4,965.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,397.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,875.14
|
| Rate for Payer: BCBS Complete |
$3,274.24
|
| Rate for Payer: BCBS MAPPO |
$4,774.40
|
| Rate for Payer: BCBS Trust/PPO |
$216.60
|
| Rate for Payer: BCN Commercial |
$7,124.91
|
| Rate for Payer: BCN Medicare Advantage |
$4,774.40
|
| Rate for Payer: Cash Price |
$7,566.40
|
| Rate for Payer: Cash Price |
$7,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,875.14
|
| Rate for Payer: Cofinity Commercial |
$6,397.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,774.40
|
| Rate for Payer: Healthscope Commercial |
$8,832.64
|
| Rate for Payer: Healthscope Commercial |
$7,639.04
|
| Rate for Payer: Mclaren Medicaid |
$3,118.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,013.12
|
| Rate for Payer: Meridian Medicaid |
$3,274.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$883,181.00
|
| Rate for Payer: Nomi Health Commercial |
$5,729.28
|
| Rate for Payer: PACE SWMI |
$4,774.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,774.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,118.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,719.22
|
| Rate for Payer: Priority Health Medicare |
$4,774.40
|
| Rate for Payer: Priority Health Narrow Network |
$8,719.22
|
| Rate for Payer: Priority Health SBD |
$8,719.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,529.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,774.40
|
| Rate for Payer: UHC Exchange |
$2,529.53
|
| Rate for Payer: UHC Medicare Advantage |
$4,774.40
|
| Rate for Payer: UHCCP Medicaid |
$3,118.32
|
|
|
PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY
|
Professional
|
Both
|
$6,010.00
|
|
|
Service Code
|
HCPCS 43121
|
| Min. Negotiated Rate |
$86.60 |
| Max. Negotiated Rate |
$507,209.00 |
| Rate for Payer: Aetna Commercial |
$3,681.72
|
| Rate for Payer: Aetna Medicare |
$2,857.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,681.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,956.47
|
| Rate for Payer: BCBS Complete |
$1,892.08
|
| Rate for Payer: BCBS MAPPO |
$2,747.55
|
| Rate for Payer: BCBS Trust/PPO |
$86.60
|
| Rate for Payer: BCN Commercial |
$4,105.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,747.55
|
| Rate for Payer: Cash Price |
$4,808.00
|
| Rate for Payer: Cash Price |
$4,808.00
|
| Rate for Payer: Cofinity Commercial |
$3,956.47
|
| Rate for Payer: Cofinity Commercial |
$3,681.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,747.55
|
| Rate for Payer: Healthscope Commercial |
$5,082.97
|
| Rate for Payer: Healthscope Commercial |
$4,396.08
|
| Rate for Payer: Mclaren Medicaid |
$1,801.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,884.93
|
| Rate for Payer: Meridian Medicaid |
$1,892.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507,209.00
|
| Rate for Payer: Nomi Health Commercial |
$3,297.06
|
| Rate for Payer: PACE SWMI |
$2,747.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,747.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,801.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,906.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,034.65
|
| Rate for Payer: Priority Health Medicare |
$2,747.55
|
| Rate for Payer: Priority Health Narrow Network |
$5,034.65
|
| Rate for Payer: Priority Health SBD |
$5,034.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,249.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,747.55
|
| Rate for Payer: UHC Exchange |
$2,249.43
|
| Rate for Payer: UHC Medicare Advantage |
$2,747.55
|
| Rate for Payer: UHCCP Medicaid |
$1,801.98
|
|
|
PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY
|
Professional
|
Both
|
$6,334.00
|
|
|
Service Code
|
HCPCS 43117
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$577,771.00 |
| Rate for Payer: Aetna Commercial |
$4,197.64
|
| Rate for Payer: Aetna Medicare |
$3,257.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,510.90
|
| Rate for Payer: BCBS Complete |
$2,161.58
|
| Rate for Payer: BCBS MAPPO |
$3,132.57
|
| Rate for Payer: BCBS Trust/PPO |
$147.40
|
| Rate for Payer: BCN Commercial |
$4,684.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,132.57
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cofinity Commercial |
$4,510.90
|
| Rate for Payer: Cofinity Commercial |
$4,197.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,132.57
|
| Rate for Payer: Healthscope Commercial |
$5,795.25
|
| Rate for Payer: Healthscope Commercial |
$5,012.11
|
| Rate for Payer: Mclaren Medicaid |
$2,058.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,289.20
|
| Rate for Payer: Meridian Medicaid |
$2,161.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577,771.00
|
| Rate for Payer: Nomi Health Commercial |
$3,759.08
|
| Rate for Payer: PACE SWMI |
$3,132.57
|
| Rate for Payer: PHP Medicare Advantage |
$3,132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,058.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,117.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,746.98
|
| Rate for Payer: Priority Health Medicare |
$3,132.57
|
| Rate for Payer: Priority Health Narrow Network |
$5,746.98
|
| Rate for Payer: Priority Health SBD |
$5,746.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,836.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,132.57
|
| Rate for Payer: UHC Exchange |
$2,836.24
|
| Rate for Payer: UHC Medicare Advantage |
$3,132.57
|
| Rate for Payer: UHCCP Medicaid |
$2,058.65
|
|
|
PR PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 28122
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$76,966.00 |
| Rate for Payer: Aetna Commercial |
$563.66
|
| Rate for Payer: Aetna Medicare |
$437.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.72
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS MAPPO |
$420.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.15
|
| Rate for Payer: BCN Commercial |
$859.58
|
| Rate for Payer: BCN Medicare Advantage |
$420.64
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cofinity Commercial |
$605.72
|
| Rate for Payer: Cofinity Commercial |
$563.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.64
|
| Rate for Payer: Healthscope Commercial |
$778.18
|
| Rate for Payer: Healthscope Commercial |
$673.02
|
| Rate for Payer: Mclaren Medicaid |
$285.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.67
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,966.00
|
| Rate for Payer: Nomi Health Commercial |
$504.77
|
| Rate for Payer: PACE SWMI |
$420.64
|
| Rate for Payer: PHP Medicare Advantage |
$420.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.78
|
| Rate for Payer: Priority Health Medicare |
$420.64
|
| Rate for Payer: Priority Health Narrow Network |
$676.78
|
| Rate for Payer: Priority Health SBD |
$676.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.64
|
| Rate for Payer: UHC Exchange |
$754.78
|
| Rate for Payer: UHC Medicare Advantage |
$420.64
|
| Rate for Payer: UHCCP Medicaid |
$285.63
|
|
|
PR PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA
|
Professional
|
Both
|
$3,303.00
|
|
|
Service Code
|
HCPCS 27360
|
| Min. Negotiated Rate |
$585.11 |
| Max. Negotiated Rate |
$159,939.00 |
| Rate for Payer: Aetna Commercial |
$1,155.36
|
| Rate for Payer: Aetna Medicare |
$896.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.58
|
| Rate for Payer: BCBS Complete |
$614.37
|
| Rate for Payer: BCBS MAPPO |
$862.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,958.41
|
| Rate for Payer: BCN Commercial |
$1,331.65
|
| Rate for Payer: BCN Medicare Advantage |
$862.21
|
| Rate for Payer: Cash Price |
$2,642.40
|
| Rate for Payer: Cash Price |
$2,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,241.58
|
| Rate for Payer: Cofinity Commercial |
$1,155.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.21
|
| Rate for Payer: Healthscope Commercial |
$1,595.09
|
| Rate for Payer: Healthscope Commercial |
$1,379.54
|
| Rate for Payer: Mclaren Medicaid |
$585.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.32
|
| Rate for Payer: Meridian Medicaid |
$614.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159,939.00
|
| Rate for Payer: Nomi Health Commercial |
$1,034.65
|
| Rate for Payer: PACE SWMI |
$862.21
|
| Rate for Payer: PHP Medicare Advantage |
$862.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$585.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,393.26
|
| Rate for Payer: Priority Health Medicare |
$862.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,393.26
|
| Rate for Payer: Priority Health SBD |
$1,393.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,189.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.21
|
| Rate for Payer: UHC Exchange |
$1,189.01
|
| Rate for Payer: UHC Medicare Advantage |
$862.21
|
| Rate for Payer: UHCCP Medicaid |
$585.11
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV
|
Professional
|
Both
|
$1,770.00
|
|
|
Service Code
|
HCPCS 22100
|
| Min. Negotiated Rate |
$621.96 |
| Max. Negotiated Rate |
$153,594.00 |
| Rate for Payer: Aetna Commercial |
$1,246.78
|
| Rate for Payer: Aetna Medicare |
$967.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,246.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.82
|
| Rate for Payer: BCBS Complete |
$653.06
|
| Rate for Payer: BCBS MAPPO |
$930.43
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$1,270.07
|
| Rate for Payer: BCN Medicare Advantage |
$930.43
|
| Rate for Payer: Cash Price |
$1,416.00
|
| Rate for Payer: Cash Price |
$1,416.00
|
| Rate for Payer: Cofinity Commercial |
$1,339.82
|
| Rate for Payer: Cofinity Commercial |
$1,246.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.43
|
| Rate for Payer: Healthscope Commercial |
$1,721.30
|
| Rate for Payer: Healthscope Commercial |
$1,488.69
|
| Rate for Payer: Mclaren Medicaid |
$621.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.95
|
| Rate for Payer: Meridian Medicaid |
$653.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153,594.00
|
| Rate for Payer: Nomi Health Commercial |
$1,116.52
|
| Rate for Payer: PACE SWMI |
$930.43
|
| Rate for Payer: PHP Medicare Advantage |
$930.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,150.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,474.17
|
| Rate for Payer: Priority Health Medicare |
$930.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,474.17
|
| Rate for Payer: Priority Health SBD |
$1,474.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$930.43
|
| Rate for Payer: UHC Exchange |
$779.71
|
| Rate for Payer: UHC Medicare Advantage |
$930.43
|
| Rate for Payer: UHCCP Medicaid |
$621.96
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA
|
Professional
|
Both
|
$656.00
|
|
|
Service Code
|
HCPCS 22103
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$24,203.00 |
| Rate for Payer: Aetna Commercial |
$172.94
|
| Rate for Payer: Aetna Medicare |
$134.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.85
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$129.06
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$129.06
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Cofinity Commercial |
$185.85
|
| Rate for Payer: Cofinity Commercial |
$172.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.06
|
| Rate for Payer: Healthscope Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$206.50
|
| Rate for Payer: Mclaren Medicaid |
$84.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.51
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.00
|
| Rate for Payer: Nomi Health Commercial |
$154.87
|
| Rate for Payer: PACE SWMI |
$129.06
|
| Rate for Payer: PHP Medicare Advantage |
$129.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.05
|
| Rate for Payer: Priority Health Medicare |
$129.06
|
| Rate for Payer: Priority Health Narrow Network |
$204.05
|
| Rate for Payer: Priority Health SBD |
$204.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.06
|
| Rate for Payer: UHC Exchange |
$172.49
|
| Rate for Payer: UHC Medicare Advantage |
$129.06
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 22102
|
| Min. Negotiated Rate |
$494.16 |
| Max. Negotiated Rate |
$138,098.00 |
| Rate for Payer: Aetna Commercial |
$982.90
|
| Rate for Payer: Aetna Medicare |
$762.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.90
|
| Rate for Payer: BCBS Complete |
$518.87
|
| Rate for Payer: BCBS MAPPO |
$733.51
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,141.55
|
| Rate for Payer: BCN Medicare Advantage |
$733.51
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cofinity Commercial |
$982.90
|
| Rate for Payer: Cofinity Commercial |
$1,056.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.51
|
| Rate for Payer: Healthscope Commercial |
$1,356.99
|
| Rate for Payer: Healthscope Commercial |
$1,173.62
|
| Rate for Payer: Mclaren Medicaid |
$494.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.19
|
| Rate for Payer: Meridian Medicaid |
$518.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,098.00
|
| Rate for Payer: Nomi Health Commercial |
$880.21
|
| Rate for Payer: PACE SWMI |
$733.51
|
| Rate for Payer: PHP Medicare Advantage |
$733.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,188.70
|
| Rate for Payer: Priority Health Medicare |
$733.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,188.70
|
| Rate for Payer: Priority Health SBD |
$1,188.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.51
|
| Rate for Payer: UHC Exchange |
$791.58
|
| Rate for Payer: UHC Medicare Advantage |
$733.51
|
| Rate for Payer: UHCCP Medicaid |
$494.16
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC
|
Professional
|
Both
|
$2,270.00
|
|
|
Service Code
|
HCPCS 22101
|
| Min. Negotiated Rate |
$116.11 |
| Max. Negotiated Rate |
$154,694.00 |
| Rate for Payer: Aetna Commercial |
$1,163.76
|
| Rate for Payer: Aetna Medicare |
$903.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.61
|
| Rate for Payer: BCBS Complete |
$611.46
|
| Rate for Payer: BCBS MAPPO |
$868.48
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$1,279.36
|
| Rate for Payer: BCN Medicare Advantage |
$868.48
|
| Rate for Payer: Cash Price |
$1,816.00
|
| Rate for Payer: Cash Price |
$1,816.00
|
| Rate for Payer: Cofinity Commercial |
$1,250.61
|
| Rate for Payer: Cofinity Commercial |
$1,163.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.48
|
| Rate for Payer: Healthscope Commercial |
$1,606.69
|
| Rate for Payer: Healthscope Commercial |
$1,389.57
|
| Rate for Payer: Mclaren Medicaid |
$582.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.90
|
| Rate for Payer: Meridian Medicaid |
$611.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,694.00
|
| Rate for Payer: Nomi Health Commercial |
$1,042.18
|
| Rate for Payer: PACE SWMI |
$868.48
|
| Rate for Payer: PHP Medicare Advantage |
$868.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,359.67
|
| Rate for Payer: Priority Health Medicare |
$868.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.67
|
| Rate for Payer: Priority Health SBD |
$1,359.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.48
|
| Rate for Payer: UHC Exchange |
$787.32
|
| Rate for Payer: UHC Medicare Advantage |
$868.48
|
| Rate for Payer: UHCCP Medicaid |
$582.34
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV
|
Professional
|
Both
|
$3,264.00
|
|
|
Service Code
|
HCPCS 22110
|
| Min. Negotiated Rate |
$689.48 |
| Max. Negotiated Rate |
$190,039.00 |
| Rate for Payer: Aetna Commercial |
$1,384.54
|
| Rate for Payer: Aetna Medicare |
$1,074.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.87
|
| Rate for Payer: BCBS Complete |
$723.95
|
| Rate for Payer: BCBS MAPPO |
$1,033.24
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,721.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.24
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Commercial |
$1,487.87
|
| Rate for Payer: Cofinity Commercial |
$1,384.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.24
|
| Rate for Payer: Healthscope Commercial |
$1,911.49
|
| Rate for Payer: Healthscope Commercial |
$1,653.18
|
| Rate for Payer: Mclaren Medicaid |
$689.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.90
|
| Rate for Payer: Meridian Medicaid |
$723.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190,039.00
|
| Rate for Payer: Nomi Health Commercial |
$1,239.89
|
| Rate for Payer: PACE SWMI |
$1,033.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$689.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,642.10
|
| Rate for Payer: Priority Health Medicare |
$1,033.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,642.10
|
| Rate for Payer: Priority Health SBD |
$1,642.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.24
|
| Rate for Payer: UHC Exchange |
$1,019.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,033.24
|
| Rate for Payer: UHCCP Medicaid |
$689.48
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 22116
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$25,353.00 |
| Rate for Payer: Aetna Commercial |
$186.93
|
| Rate for Payer: Aetna Medicare |
$145.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.88
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$139.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.18
|
| Rate for Payer: BCN Commercial |
$205.25
|
| Rate for Payer: BCN Medicare Advantage |
$139.50
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$186.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.50
|
| Rate for Payer: Healthscope Commercial |
$258.08
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Mclaren Medicaid |
$91.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.48
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,353.00
|
| Rate for Payer: Nomi Health Commercial |
$167.40
|
| Rate for Payer: PACE SWMI |
$139.50
|
| Rate for Payer: PHP Medicare Advantage |
$139.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.23
|
| Rate for Payer: Priority Health Medicare |
$139.50
|
| Rate for Payer: Priority Health Narrow Network |
$214.23
|
| Rate for Payer: Priority Health SBD |
$214.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.50
|
| Rate for Payer: UHC Exchange |
$171.65
|
| Rate for Payer: UHC Medicare Advantage |
$139.50
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 22114
|
| Min. Negotiated Rate |
$746.35 |
| Max. Negotiated Rate |
$204,352.00 |
| Rate for Payer: Aetna Commercial |
$1,503.53
|
| Rate for Payer: Aetna Medicare |
$1,166.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,503.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,615.74
|
| Rate for Payer: BCBS Complete |
$783.67
|
| Rate for Payer: BCBS MAPPO |
$1,122.04
|
| Rate for Payer: BCN Commercial |
$1,679.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,122.04
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cofinity Commercial |
$1,615.74
|
| Rate for Payer: Cofinity Commercial |
$1,503.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,122.04
|
| Rate for Payer: Healthscope Commercial |
$2,075.77
|
| Rate for Payer: Healthscope Commercial |
$1,795.26
|
| Rate for Payer: Mclaren Medicaid |
$746.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,178.14
|
| Rate for Payer: Meridian Medicaid |
$783.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204,352.00
|
| Rate for Payer: Nomi Health Commercial |
$1,346.45
|
| Rate for Payer: PACE SWMI |
$1,122.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,122.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$746.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,580.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,771.35
|
| Rate for Payer: Priority Health Medicare |
$1,122.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.35
|
| Rate for Payer: Priority Health SBD |
$1,771.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,122.04
|
| Rate for Payer: UHC Exchange |
$1,001.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,122.04
|
| Rate for Payer: UHCCP Medicaid |
$746.35
|
|
|
PR PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$3,968.00
|
|
|
Service Code
|
HCPCS 60210
|
| Min. Negotiated Rate |
$259.40 |
| Max. Negotiated Rate |
$126,211.00 |
| Rate for Payer: Aetna Commercial |
$916.99
|
| Rate for Payer: Aetna Medicare |
$711.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.42
|
| Rate for Payer: BCBS Complete |
$480.18
|
| Rate for Payer: BCBS MAPPO |
$684.32
|
| Rate for Payer: BCBS Trust/PPO |
$259.40
|
| Rate for Payer: BCN Commercial |
$1,036.48
|
| Rate for Payer: BCN Medicare Advantage |
$684.32
|
| Rate for Payer: Cash Price |
$3,174.40
|
| Rate for Payer: Cash Price |
$3,174.40
|
| Rate for Payer: Cofinity Commercial |
$985.42
|
| Rate for Payer: Cofinity Commercial |
$916.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.32
|
| Rate for Payer: Healthscope Commercial |
$1,265.99
|
| Rate for Payer: Healthscope Commercial |
$1,094.91
|
| Rate for Payer: Mclaren Medicaid |
$457.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.54
|
| Rate for Payer: Meridian Medicaid |
$480.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126,211.00
|
| Rate for Payer: Nomi Health Commercial |
$821.18
|
| Rate for Payer: PACE SWMI |
$684.32
|
| Rate for Payer: PHP Medicare Advantage |
$684.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,579.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.61
|
| Rate for Payer: Priority Health Medicare |
$684.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.61
|
| Rate for Payer: Priority Health SBD |
$1,148.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$951.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.32
|
| Rate for Payer: UHC Exchange |
$951.93
|
| Rate for Payer: UHC Medicare Advantage |
$684.32
|
| Rate for Payer: UHCCP Medicaid |
$457.31
|
|
|
PR PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC
|
Professional
|
Both
|
$1,831.00
|
|
|
Service Code
|
HCPCS 60212
|
| Min. Negotiated Rate |
$368.75 |
| Max. Negotiated Rate |
$183,838.00 |
| Rate for Payer: Aetna Commercial |
$1,336.13
|
| Rate for Payer: Aetna Medicare |
$1,036.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.84
|
| Rate for Payer: BCBS Complete |
$693.99
|
| Rate for Payer: BCBS MAPPO |
$997.11
|
| Rate for Payer: BCBS Trust/PPO |
$368.75
|
| Rate for Payer: BCN Commercial |
$1,501.71
|
| Rate for Payer: BCN Medicare Advantage |
$997.11
|
| Rate for Payer: Cash Price |
$1,464.80
|
| Rate for Payer: Cash Price |
$1,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,435.84
|
| Rate for Payer: Cofinity Commercial |
$1,336.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.11
|
| Rate for Payer: Healthscope Commercial |
$1,844.65
|
| Rate for Payer: Healthscope Commercial |
$1,595.38
|
| Rate for Payer: Mclaren Medicaid |
$660.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.97
|
| Rate for Payer: Meridian Medicaid |
$693.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,838.00
|
| Rate for Payer: Nomi Health Commercial |
$1,196.53
|
| Rate for Payer: PACE SWMI |
$997.11
|
| Rate for Payer: PHP Medicare Advantage |
$997.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,662.35
|
| Rate for Payer: Priority Health Medicare |
$997.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,662.35
|
| Rate for Payer: Priority Health SBD |
$1,662.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$997.11
|
| Rate for Payer: UHC Exchange |
$1,268.70
|
| Rate for Payer: UHC Medicare Advantage |
$997.11
|
| Rate for Payer: UHCCP Medicaid |
$660.94
|
|
|
PR PSA SCREENING
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS G0103
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$2,897.00 |
| Rate for Payer: Aetna Commercial |
$25.88
|
| Rate for Payer: Aetna Medicare |
$20.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.81
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: BCN Commercial |
$14.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Cofinity Commercial |
$25.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.31
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Healthscope Commercial |
$35.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,897.00
|
| Rate for Payer: Nomi Health Commercial |
$23.17
|
| Rate for Payer: PACE SWMI |
$19.31
|
| Rate for Payer: PHP Medicare Advantage |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: Priority Health Narrow Network |
$19.31
|
| Rate for Payer: Priority Health SBD |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.31
|
| Rate for Payer: UHC Exchange |
$27.24
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVALUATION
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 90791
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$22,428.00 |
| Rate for Payer: Aetna Commercial |
$190.48
|
| Rate for Payer: Aetna Medicare |
$147.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.48
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$142.15
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$202.61
|
| Rate for Payer: BCN Medicare Advantage |
$142.15
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$204.70
|
| Rate for Payer: Cofinity Commercial |
$190.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.15
|
| Rate for Payer: Healthscope Commercial |
$262.98
|
| Rate for Payer: Healthscope Commercial |
$227.44
|
| Rate for Payer: Mclaren Medicaid |
$94.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.26
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,428.00
|
| Rate for Payer: Nomi Health Commercial |
$170.58
|
| Rate for Payer: PACE SWMI |
$142.15
|
| Rate for Payer: PHP Medicare Advantage |
$142.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.98
|
| Rate for Payer: Priority Health Medicare |
$142.15
|
| Rate for Payer: Priority Health Narrow Network |
$159.98
|
| Rate for Payer: Priority Health SBD |
$159.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.15
|
| Rate for Payer: UHC Medicare Advantage |
$142.15
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 90792
|
| Min. Negotiated Rate |
$107.78 |
| Max. Negotiated Rate |
$25,557.00 |
| Rate for Payer: Aetna Commercial |
$217.67
|
| Rate for Payer: Aetna Medicare |
$168.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.91
|
| Rate for Payer: BCBS Complete |
$113.17
|
| Rate for Payer: BCBS MAPPO |
$162.44
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$227.74
|
| Rate for Payer: BCN Medicare Advantage |
$162.44
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$233.91
|
| Rate for Payer: Cofinity Commercial |
$217.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.44
|
| Rate for Payer: Healthscope Commercial |
$259.90
|
| Rate for Payer: Healthscope Commercial |
$300.51
|
| Rate for Payer: Mclaren Medicaid |
$107.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.56
|
| Rate for Payer: Meridian Medicaid |
$113.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,557.00
|
| Rate for Payer: Nomi Health Commercial |
$194.93
|
| Rate for Payer: PACE SWMI |
$162.44
|
| Rate for Payer: PHP Medicare Advantage |
$162.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.10
|
| Rate for Payer: Priority Health Medicare |
$162.44
|
| Rate for Payer: Priority Health Narrow Network |
$165.10
|
| Rate for Payer: Priority Health SBD |
$165.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.44
|
| Rate for Payer: UHC Medicare Advantage |
$162.44
|
| Rate for Payer: UHCCP Medicaid |
$107.78
|
|
|
PR PSYCHOANALYSIS
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 90845
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$12,438.00 |
| Rate for Payer: Aetna Commercial |
$116.16
|
| Rate for Payer: Aetna Medicare |
$90.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.83
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$86.69
|
| Rate for Payer: BCBS Trust/PPO |
$353.96
|
| Rate for Payer: BCN Commercial |
$99.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.69
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$124.83
|
| Rate for Payer: Cofinity Commercial |
$116.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.69
|
| Rate for Payer: Healthscope Commercial |
$138.70
|
| Rate for Payer: Healthscope Commercial |
$160.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,438.00
|
| Rate for Payer: Nomi Health Commercial |
$104.03
|
| Rate for Payer: PACE SWMI |
$86.69
|
| Rate for Payer: PHP Medicare Advantage |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.24
|
| Rate for Payer: Priority Health Medicare |
$86.69
|
| Rate for Payer: Priority Health Narrow Network |
$103.24
|
| Rate for Payer: Priority Health SBD |
$103.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.69
|
| Rate for Payer: UHC Exchange |
$99.30
|
| Rate for Payer: UHC Medicare Advantage |
$86.69
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 96131
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$11,385.00 |
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: Aetna Medicare |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.67
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$71.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.86
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: BCN Medicare Advantage |
$71.99
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$96.47
|
| Rate for Payer: Cofinity Commercial |
$103.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.99
|
| Rate for Payer: Healthscope Commercial |
$133.18
|
| Rate for Payer: Healthscope Commercial |
$115.18
|
| Rate for Payer: Mclaren Medicaid |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.59
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,385.00
|
| Rate for Payer: Nomi Health Commercial |
$86.39
|
| Rate for Payer: PACE SWMI |
$71.99
|
| Rate for Payer: PHP Medicare Advantage |
$71.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.77
|
| Rate for Payer: Priority Health Medicare |
$71.99
|
| Rate for Payer: Priority Health Narrow Network |
$101.77
|
| Rate for Payer: Priority Health SBD |
$101.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.99
|
| Rate for Payer: UHC Medicare Advantage |
$71.99
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 96130
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$16,107.00 |
| Rate for Payer: Aetna Commercial |
$140.87
|
| Rate for Payer: Aetna Medicare |
$109.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.39
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS MAPPO |
$105.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.94
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: BCN Medicare Advantage |
$105.13
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$151.39
|
| Rate for Payer: Cofinity Commercial |
$140.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.13
|
| Rate for Payer: Healthscope Commercial |
$168.21
|
| Rate for Payer: Healthscope Commercial |
$194.49
|
| Rate for Payer: Mclaren Medicaid |
$69.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.39
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,107.00
|
| Rate for Payer: Nomi Health Commercial |
$126.16
|
| Rate for Payer: PACE SWMI |
$105.13
|
| Rate for Payer: PHP Medicare Advantage |
$105.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.00
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow Network |
$147.00
|
| Rate for Payer: Priority Health SBD |
$147.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.13
|
| Rate for Payer: UHC Medicare Advantage |
$105.13
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
|
|
PR PSYCHOLOGIC TESTING ADMIN BY COMPUTER
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 96103
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$35.75 |
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
|
|
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 |
$6.51 |
| Max. Negotiated Rate |
$1,964.00 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$12.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.61
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$12.23
|
| Rate for Payer: BCBS Trust/PPO |
$294.26
|
| Rate for Payer: BCN Commercial |
$17.28
|
| 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: Mclaren Medicaid |
$8.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,964.00
|
| 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 Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.51
|
| Rate for Payer: Priority Health Medicare |
$12.23
|
| Rate for Payer: Priority Health Narrow Network |
$6.51
|
| Rate for Payer: Priority Health SBD |
$6.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.23
|
| Rate for Payer: UHC Medicare Advantage |
$12.23
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$9,312.00 |
| Rate for Payer: Aetna Commercial |
$85.99
|
| Rate for Payer: Aetna Medicare |
$66.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.40
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$64.17
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$81.28
|
| 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: Mclaren Medicaid |
$42.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.38
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,312.00
|
| 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 Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.28
|
| Rate for Payer: Priority Health Medicare |
$64.17
|
| Rate for Payer: Priority Health Narrow Network |
$56.28
|
| Rate for Payer: Priority Health SBD |
$56.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.17
|
| Rate for Payer: UHC Medicare Advantage |
$64.17
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 90839
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$18,587.00 |
| Rate for Payer: Aetna Commercial |
$173.50
|
| Rate for Payer: Aetna Medicare |
$134.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.45
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$129.48
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$163.74
|
| 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 |
$207.17
|
| Rate for Payer: Healthscope Commercial |
$239.54
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.95
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,587.00
|
| 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 Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.13
|
| Rate for Payer: Priority Health Medicare |
$129.48
|
| Rate for Payer: Priority Health Narrow Network |
$158.13
|
| Rate for Payer: Priority Health SBD |
$158.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.48
|
| Rate for Payer: UHC Medicare Advantage |
$129.48
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
