|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 90832
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$9,879.00 |
| Rate for Payer: Aetna Commercial |
$91.74
|
| Rate for Payer: Aetna Medicare |
$71.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.58
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$68.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,348.22
|
| Rate for Payer: BCN Commercial |
$87.56
|
| 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: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.88
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,879.00
|
| 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 Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.97
|
| Rate for Payer: Priority Health Medicare |
$68.46
|
| Rate for Payer: Priority Health Narrow Network |
$66.97
|
| Rate for Payer: Priority Health SBD |
$66.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.46
|
| Rate for Payer: UHC Medicare Advantage |
$68.46
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 90834
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$13,104.00 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: Aetna Medicare |
$93.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.00
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$90.28
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$115.84
|
| 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 |
$144.45
|
| Rate for Payer: Healthscope Commercial |
$167.02
|
| Rate for Payer: Mclaren Medicaid |
$59.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.79
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,104.00
|
| 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 Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.96
|
| Rate for Payer: Priority Health Medicare |
$90.28
|
| Rate for Payer: Priority Health Narrow Network |
$103.96
|
| Rate for Payer: Priority Health SBD |
$103.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.28
|
| Rate for Payer: UHC Medicare Advantage |
$90.28
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 90837
|
| Min. Negotiated Rate |
$88.61 |
| Max. Negotiated Rate |
$19,254.00 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: Aetna Medicare |
$139.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.54
|
| Rate for Payer: BCBS Complete |
$93.04
|
| Rate for Payer: BCBS MAPPO |
$133.71
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$170.41
|
| 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: Mclaren Medicaid |
$88.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.40
|
| Rate for Payer: Meridian Medicaid |
$93.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,254.00
|
| 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 Choice Medicaid |
$88.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.60
|
| Rate for Payer: Priority Health Medicare |
$133.71
|
| Rate for Payer: Priority Health Narrow Network |
$151.60
|
| Rate for Payer: Priority Health SBD |
$151.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.71
|
| Rate for Payer: UHC Medicare Advantage |
$133.71
|
| Rate for Payer: UHCCP Medicaid |
$88.61
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$9,203.00 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.97
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$36.72
|
| 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 |
$102.19
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: Mclaren Medicaid |
$42.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,203.00
|
| 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 Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.27
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow Network |
$56.27
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 90836
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$11,670.00 |
| Rate for Payer: Aetna Commercial |
$108.83
|
| Rate for Payer: Aetna Medicare |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.96
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$81.22
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$46.57
|
| 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: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.28
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,670.00
|
| 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 Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.08
|
| Rate for Payer: Priority Health Medicare |
$81.22
|
| Rate for Payer: Priority Health Narrow Network |
$92.08
|
| Rate for Payer: Priority Health SBD |
$92.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$81.22
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 90838
|
| Min. Negotiated Rate |
$61.62 |
| Max. Negotiated Rate |
$15,486.00 |
| Rate for Payer: Aetna Commercial |
$145.51
|
| Rate for Payer: Aetna Medicare |
$112.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.37
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$108.59
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$61.62
|
| 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 |
$173.74
|
| Rate for Payer: Healthscope Commercial |
$200.89
|
| Rate for Payer: Mclaren Medicaid |
$71.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.02
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,486.00
|
| 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 Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.89
|
| Rate for Payer: Priority Health Medicare |
$108.59
|
| Rate for Payer: Priority Health Narrow Network |
$147.89
|
| Rate for Payer: Priority Health SBD |
$147.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.59
|
| Rate for Payer: UHC Medicare Advantage |
$108.59
|
| Rate for Payer: UHCCP Medicaid |
$71.99
|
|
|
PR PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 96146
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.10
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.15
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: BCN Commercial |
$3.42
|
| 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 |
$333.00
|
| 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 HMO/PPO/Tiered Network |
$3.17
|
| Rate for Payer: Priority Health Medicare |
$2.15
|
| Rate for Payer: Priority Health Narrow Network |
$3.17
|
| Rate for Payer: Priority Health SBD |
$3.17
|
| 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 |
$11.29 |
| Max. Negotiated Rate |
$2,672.00 |
| Rate for Payer: Aetna Commercial |
$22.82
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.52
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$308.53
|
| Rate for Payer: BCN Commercial |
$56.68
|
| 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 |
$27.25
|
| Rate for Payer: Healthscope Commercial |
$31.51
|
| Rate for Payer: Mclaren Medicaid |
$11.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,672.00
|
| 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 Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.97
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$23.97
|
| Rate for Payer: Priority Health SBD |
$23.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
|
|
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 |
$4,686.00 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$49.36
|
| 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 |
$4,686.00
|
| 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 HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: Priority Health SBD |
$46.59
|
| 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 |
$4,824.00 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$342.87
|
| Rate for Payer: BCN Commercial |
$50.82
|
| 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 |
$4,824.00
|
| 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 HMO/PPO/Tiered Network |
$47.94
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$47.94
|
| Rate for Payer: Priority Health SBD |
$47.94
|
| 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 |
$14.91 |
| Max. Negotiated Rate |
$3,461.00 |
| Rate for Payer: Aetna Commercial |
$30.10
|
| Rate for Payer: Aetna Medicare |
$23.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.34
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$22.46
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$61.58
|
| 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: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.58
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,461.00
|
| 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 Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$22.46
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: Priority Health SBD |
$31.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.46
|
| Rate for Payer: UHC Medicare Advantage |
$22.46
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,219.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$142,123.00 |
| Rate for Payer: Aetna Commercial |
$1,008.73
|
| Rate for Payer: Aetna Medicare |
$782.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.00
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$752.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| 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: Mclaren Medicaid |
$514.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.42
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,123.00
|
| 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 Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.54
|
| Rate for Payer: Priority Health Medicare |
$752.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.54
|
| Rate for Payer: Priority Health SBD |
$1,128.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.78
|
| Rate for Payer: UHC Exchange |
$841.51
|
| Rate for Payer: UHC Medicare Advantage |
$752.78
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
|
|
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 |
$371.00 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$3.91
|
| 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 |
$371.00
|
| 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 HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Priority Health SBD |
$5.43
|
| 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 |
$727.47 |
| Max. Negotiated Rate |
$467,107.00 |
| 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 |
$1,718.52
|
| Rate for Payer: BCBS MAPPO |
$2,496.56
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$3,777.48
|
| 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 |
$4,618.64
|
| Rate for Payer: Healthscope Commercial |
$3,994.50
|
| Rate for Payer: Mclaren Medicaid |
$1,636.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,621.39
|
| Rate for Payer: Meridian Medicaid |
$1,718.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467,107.00
|
| 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 Choice Medicaid |
$1,636.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,070.05
|
| Rate for Payer: Priority Health Medicare |
$2,496.56
|
| Rate for Payer: Priority Health Narrow Network |
$4,070.05
|
| Rate for Payer: Priority Health SBD |
$4,070.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,496.56
|
| Rate for Payer: UHC Exchange |
$1,899.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,496.56
|
| Rate for Payer: UHCCP Medicaid |
$1,636.69
|
|
|
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 |
$13.85 |
| Max. Negotiated Rate |
$4,874.00 |
| 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 |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$31.99
|
| Rate for Payer: BCBS Trust/PPO |
$442.72
|
| Rate for Payer: BCN Commercial |
$48.87
|
| 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 |
$46.07
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| 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: Mclaren Medicaid |
$13.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.59
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,874.00
|
| 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 Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.13
|
| Rate for Payer: Priority Health Medicare |
$31.99
|
| Rate for Payer: Priority Health Narrow Network |
$46.13
|
| Rate for Payer: Priority Health SBD |
$29.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.99
|
| Rate for Payer: UHC Medicare Advantage |
$31.99
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
|
|
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 |
$16.19 |
| Max. Negotiated Rate |
$4,527.00 |
| 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 |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$24.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.50
|
| Rate for Payer: BCN Commercial |
$69.89
|
| 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 |
$38.72
|
| Rate for Payer: Healthscope Commercial |
$44.77
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.41
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,527.00
|
| 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 Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.32
|
| Rate for Payer: Priority Health Medicare |
$24.20
|
| Rate for Payer: Priority Health Narrow Network |
$34.32
|
| Rate for Payer: Priority Health SBD |
$34.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.20
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$8,275.00 |
| 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 |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$148.43
|
| 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 |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$59.62
|
| 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: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.71
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,275.00
|
| 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 Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.76
|
| Rate for Payer: Priority Health Medicare |
$44.49
|
| Rate for Payer: Priority Health Narrow Network |
$62.76
|
| Rate for Payer: Priority Health SBD |
$62.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.49
|
| Rate for Payer: UHC Medicare Advantage |
$44.49
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$16,853.00 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.46
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| 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 |
$122.33
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| 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: Mclaren Medicaid |
$62.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,853.00
|
| 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 Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$91.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.40
|
| Rate for Payer: Priority Health SBD |
$131.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Exchange |
$81.56
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
|
|
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 |
$101.00 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$167.11
|
| Rate for Payer: BCN Commercial |
$167.11
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$172.00
|
| 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 |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.00
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$16,853.00 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.46
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| 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: Mclaren Medicaid |
$62.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,853.00
|
| 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 Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$91.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.40
|
| Rate for Payer: Priority Health SBD |
$131.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Exchange |
$81.56
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.45 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health SBD |
$135.45
|
|
|
PR PUNCTURE ASPIRATION CYST BREAST EACH ADDL CYST
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 19001
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$3,658.00 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.11
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Healthscope Commercial |
$36.11
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Mclaren Medicaid |
$12.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.00
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.00
|
| Rate for Payer: Priority Health Medicare |
$19.52
|
| Rate for Payer: Priority Health Narrow Network |
$28.00
|
| Rate for Payer: Priority Health SBD |
$28.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.52
|
| Rate for Payer: UHC Exchange |
$49.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.52
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
|
|
PR PUNCTURE ASPIRATION CYST OF BREAST
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$7,569.00 |
| Rate for Payer: Aetna Commercial |
$54.75
|
| Rate for Payer: Aetna Medicare |
$42.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.84
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$40.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$149.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.86
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$58.84
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.86
|
| Rate for Payer: Healthscope Commercial |
$75.59
|
| Rate for Payer: Healthscope Commercial |
$65.38
|
| Rate for Payer: Mclaren Medicaid |
$27.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.90
|
| Rate for Payer: Meridian Medicaid |
$28.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,569.00
|
| Rate for Payer: Nomi Health Commercial |
$49.03
|
| Rate for Payer: PACE SWMI |
$40.86
|
| Rate for Payer: PHP Medicare Advantage |
$40.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.44
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow Network |
$56.44
|
| Rate for Payer: Priority Health SBD |
$56.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.86
|
| Rate for Payer: UHC Exchange |
$116.76
|
| Rate for Payer: UHC Medicare Advantage |
$40.86
|
| Rate for Payer: UHCCP Medicaid |
$27.05
|
|
