|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: BCBS Complete |
$284.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Healthscope Commercial |
$786.60
|
| Rate for Payer: Healthscope Commercial |
$786.60
|
| Rate for Payer: Healthscope Commercial |
$680.30
|
| Rate for Payer: Healthscope Commercial |
$680.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.50
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.50
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,793.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$717.20 |
| Max. Negotiated Rate |
$1,165.45 |
| Rate for Payer: Aetna Medicare |
$896.50
|
| Rate for Payer: BCBS Complete |
$717.20
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.45
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,703.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$1,472.16 |
| Max. Negotiated Rate |
$4,356.95 |
| Rate for Payer: Aetna Commercial |
$1,972.69
|
| Rate for Payer: Aetna Medicare |
$1,531.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,119.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,972.69
|
| Rate for Payer: BCBS Complete |
$2,681.20
|
| Rate for Payer: BCBS MAPPO |
$1,472.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,472.16
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,972.69
|
| Rate for Payer: Cofinity Commercial |
$2,119.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,472.16
|
| Rate for Payer: Healthscope Commercial |
$2,723.50
|
| Rate for Payer: Healthscope Commercial |
$2,355.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,545.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,356.95
|
| Rate for Payer: Nomi Health Commercial |
$1,766.59
|
| Rate for Payer: PACE SWMI |
$1,472.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,472.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,356.95
|
| Rate for Payer: Priority Health Medicare |
$1,472.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,472.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.16
|
|
|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$5,000.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$1,275.97 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Aetna Commercial |
$1,709.80
|
| Rate for Payer: Aetna Medicare |
$1,327.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.80
|
| Rate for Payer: BCBS Complete |
$2,000.00
|
| Rate for Payer: BCBS MAPPO |
$1,275.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.97
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,837.40
|
| Rate for Payer: Cofinity Commercial |
$1,709.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.97
|
| Rate for Payer: Healthscope Commercial |
$2,360.54
|
| Rate for Payer: Healthscope Commercial |
$2,041.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,250.00
|
| Rate for Payer: Nomi Health Commercial |
$1,531.16
|
| Rate for Payer: PACE SWMI |
$1,275.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,250.00
|
| Rate for Payer: Priority Health Medicare |
$1,275.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.97
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,043.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$417.20 |
| Max. Negotiated Rate |
$1,111.22 |
| Rate for Payer: Aetna Commercial |
$804.88
|
| Rate for Payer: Aetna Medicare |
$624.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.88
|
| Rate for Payer: BCBS Complete |
$417.20
|
| Rate for Payer: BCBS MAPPO |
$600.66
|
| Rate for Payer: BCN Medicare Advantage |
$600.66
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cofinity Commercial |
$864.95
|
| Rate for Payer: Cofinity Commercial |
$804.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.66
|
| Rate for Payer: Healthscope Commercial |
$1,111.22
|
| Rate for Payer: Healthscope Commercial |
$961.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$677.95
|
| Rate for Payer: Nomi Health Commercial |
$720.79
|
| Rate for Payer: PACE SWMI |
$600.66
|
| Rate for Payer: PHP Medicare Advantage |
$600.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.95
|
| Rate for Payer: Priority Health Medicare |
$600.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.66
|
| Rate for Payer: UHC Medicare Advantage |
$600.66
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,326.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$661.61 |
| Max. Negotiated Rate |
$1,511.90 |
| Rate for Payer: Aetna Commercial |
$886.56
|
| Rate for Payer: Aetna Medicare |
$688.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.56
|
| Rate for Payer: BCBS Complete |
$930.40
|
| Rate for Payer: BCBS MAPPO |
$661.61
|
| Rate for Payer: BCN Medicare Advantage |
$661.61
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cofinity Commercial |
$952.72
|
| Rate for Payer: Cofinity Commercial |
$886.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.61
|
| Rate for Payer: Healthscope Commercial |
$1,223.98
|
| Rate for Payer: Healthscope Commercial |
$1,058.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,511.90
|
| Rate for Payer: Nomi Health Commercial |
$793.93
|
| Rate for Payer: PACE SWMI |
$661.61
|
| Rate for Payer: PHP Medicare Advantage |
$661.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.90
|
| Rate for Payer: Priority Health Medicare |
$661.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.61
|
| Rate for Payer: UHC Medicare Advantage |
$661.61
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$347.15 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$465.18
|
| Rate for Payer: Aetna Medicare |
$361.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.18
|
| Rate for Payer: BCBS Complete |
$553.60
|
| Rate for Payer: BCBS MAPPO |
$347.15
|
| Rate for Payer: BCN Medicare Advantage |
$347.15
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$499.90
|
| Rate for Payer: Cofinity Commercial |
$465.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.15
|
| Rate for Payer: Healthscope Commercial |
$555.44
|
| Rate for Payer: Healthscope Commercial |
$642.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.60
|
| Rate for Payer: Nomi Health Commercial |
$416.58
|
| Rate for Payer: PACE SWMI |
$347.15
|
| Rate for Payer: PHP Medicare Advantage |
$347.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health Medicare |
$347.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$347.15
|
| Rate for Payer: UHC Medicare Advantage |
$347.15
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$629.51 |
| Max. Negotiated Rate |
$1,164.59 |
| Rate for Payer: Aetna Commercial |
$843.54
|
| Rate for Payer: Aetna Medicare |
$654.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.54
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$629.51
|
| Rate for Payer: BCN Medicare Advantage |
$629.51
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$906.49
|
| Rate for Payer: Cofinity Commercial |
$843.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.51
|
| Rate for Payer: Healthscope Commercial |
$1,164.59
|
| Rate for Payer: Healthscope Commercial |
$1,007.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$660.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.90
|
| Rate for Payer: Nomi Health Commercial |
$755.41
|
| Rate for Payer: PACE SWMI |
$629.51
|
| Rate for Payer: PHP Medicare Advantage |
$629.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$629.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.51
|
| Rate for Payer: UHC Medicare Advantage |
$629.51
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$882.05 |
| Rate for Payer: Aetna Commercial |
$519.12
|
| Rate for Payer: Aetna Medicare |
$402.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.12
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$387.40
|
| Rate for Payer: BCN Medicare Advantage |
$387.40
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$557.86
|
| Rate for Payer: Cofinity Commercial |
$519.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.40
|
| Rate for Payer: Healthscope Commercial |
$619.84
|
| Rate for Payer: Healthscope Commercial |
$716.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$882.05
|
| Rate for Payer: Nomi Health Commercial |
$464.88
|
| Rate for Payer: PACE SWMI |
$387.40
|
| Rate for Payer: PHP Medicare Advantage |
$387.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health Medicare |
$387.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.40
|
| Rate for Payer: UHC Medicare Advantage |
$387.40
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$324.53 |
| Max. Negotiated Rate |
$748.15 |
| Rate for Payer: Aetna Commercial |
$434.87
|
| Rate for Payer: Aetna Medicare |
$337.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.87
|
| Rate for Payer: BCBS Complete |
$460.40
|
| Rate for Payer: BCBS MAPPO |
$324.53
|
| Rate for Payer: BCN Medicare Advantage |
$324.53
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$467.32
|
| Rate for Payer: Cofinity Commercial |
$434.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.53
|
| Rate for Payer: Healthscope Commercial |
$600.38
|
| Rate for Payer: Healthscope Commercial |
$519.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$748.15
|
| Rate for Payer: Nomi Health Commercial |
$389.44
|
| Rate for Payer: PACE SWMI |
$324.53
|
| Rate for Payer: PHP Medicare Advantage |
$324.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health Medicare |
$324.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.53
|
| Rate for Payer: UHC Medicare Advantage |
$324.53
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$101.36 |
| Rate for Payer: Aetna Commercial |
$73.42
|
| Rate for Payer: Aetna Medicare |
$56.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.42
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$54.79
|
| Rate for Payer: BCN Medicare Advantage |
$54.79
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$78.90
|
| Rate for Payer: Cofinity Commercial |
$73.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.79
|
| Rate for Payer: Healthscope Commercial |
$101.36
|
| Rate for Payer: Healthscope Commercial |
$87.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$65.75
|
| Rate for Payer: PACE SWMI |
$54.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$54.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.79
|
| Rate for Payer: UHC Medicare Advantage |
$54.79
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$150.80 |
| Rate for Payer: Aetna Medicare |
$116.00
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.80
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$51.24 |
| Rate for Payer: Aetna Commercial |
$37.12
|
| Rate for Payer: Aetna Medicare |
$28.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.89
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$27.70
|
| Rate for Payer: BCN Medicare Advantage |
$27.70
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Cofinity Commercial |
$37.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.70
|
| Rate for Payer: Healthscope Commercial |
$51.24
|
| Rate for Payer: Healthscope Commercial |
$44.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.30
|
| Rate for Payer: Nomi Health Commercial |
$33.24
|
| Rate for Payer: PACE SWMI |
$27.70
|
| Rate for Payer: PHP Medicare Advantage |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$27.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.70
|
| Rate for Payer: UHC Medicare Advantage |
$27.70
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$23.81
|
| Rate for Payer: Aetna Medicare |
$18.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.59
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$17.77
|
| Rate for Payer: BCN Medicare Advantage |
$17.77
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$23.81
|
| Rate for Payer: Cofinity Commercial |
$25.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.77
|
| Rate for Payer: Healthscope Commercial |
$28.43
|
| Rate for Payer: Healthscope Commercial |
$32.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$21.32
|
| Rate for Payer: PACE SWMI |
$17.77
|
| Rate for Payer: PHP Medicare Advantage |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.77
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$168.04 |
| Rate for Payer: Aetna Commercial |
$121.71
|
| Rate for Payer: Aetna Medicare |
$94.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.71
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$90.83
|
| Rate for Payer: BCN Medicare Advantage |
$90.83
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$130.80
|
| Rate for Payer: Cofinity Commercial |
$121.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.83
|
| Rate for Payer: Healthscope Commercial |
$168.04
|
| Rate for Payer: Healthscope Commercial |
$145.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Nomi Health Commercial |
$109.00
|
| Rate for Payer: PACE SWMI |
$90.83
|
| Rate for Payer: PHP Medicare Advantage |
$90.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$90.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.83
|
| Rate for Payer: UHC Medicare Advantage |
$90.83
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$72.67 |
| Rate for Payer: Aetna Commercial |
$52.64
|
| Rate for Payer: Aetna Medicare |
$40.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.64
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$39.28
|
| Rate for Payer: BCN Medicare Advantage |
$39.28
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$56.56
|
| Rate for Payer: Cofinity Commercial |
$52.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.28
|
| Rate for Payer: Healthscope Commercial |
$62.85
|
| Rate for Payer: Healthscope Commercial |
$72.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.15
|
| Rate for Payer: Nomi Health Commercial |
$47.14
|
| Rate for Payer: PACE SWMI |
$39.28
|
| Rate for Payer: PHP Medicare Advantage |
$39.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$39.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.28
|
| Rate for Payer: UHC Medicare Advantage |
$39.28
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$33.56 |
| Rate for Payer: Aetna Commercial |
$24.31
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.31
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$18.14
|
| Rate for Payer: BCN Medicare Advantage |
$18.14
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$26.12
|
| Rate for Payer: Cofinity Commercial |
$24.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$33.56
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$21.77
|
| Rate for Payer: PACE SWMI |
$18.14
|
| Rate for Payer: PHP Medicare Advantage |
$18.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$18.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.14
|
| Rate for Payer: UHC Medicare Advantage |
$18.14
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$33.55 |
| Max. Negotiated Rate |
$65.65 |
| Rate for Payer: Aetna Commercial |
$44.96
|
| Rate for Payer: Aetna Medicare |
$34.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.96
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$33.55
|
| Rate for Payer: BCN Medicare Advantage |
$33.55
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Cofinity Commercial |
$44.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.55
|
| Rate for Payer: Healthscope Commercial |
$53.68
|
| Rate for Payer: Healthscope Commercial |
$62.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.65
|
| Rate for Payer: Nomi Health Commercial |
$40.26
|
| Rate for Payer: PACE SWMI |
$33.55
|
| Rate for Payer: PHP Medicare Advantage |
$33.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health Medicare |
$33.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.55
|
| Rate for Payer: UHC Medicare Advantage |
$33.55
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$29.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.95
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Healthscope Commercial |
$52.39
|
| Rate for Payer: Healthscope Commercial |
$45.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.00
|
| Rate for Payer: Nomi Health Commercial |
$33.98
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health Medicare |
$28.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$28.32
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$29.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.95
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Healthscope Commercial |
$45.31
|
| Rate for Payer: Healthscope Commercial |
$52.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Nomi Health Commercial |
$33.98
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$28.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$28.32
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$15.84 |
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Medicare |
$8.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.47
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$8.56
|
| Rate for Payer: BCN Medicare Advantage |
$8.56
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Cofinity Commercial |
$11.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.56
|
| Rate for Payer: Healthscope Commercial |
$15.84
|
| Rate for Payer: Healthscope Commercial |
$13.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.60
|
| Rate for Payer: Nomi Health Commercial |
$10.27
|
| Rate for Payer: PACE SWMI |
$8.56
|
| Rate for Payer: PHP Medicare Advantage |
$8.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$8.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.56
|
| Rate for Payer: UHC Medicare Advantage |
$8.56
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$156.65 |
| Rate for Payer: Aetna Commercial |
$111.89
|
| Rate for Payer: Aetna Medicare |
$86.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.89
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: BCBS MAPPO |
$83.50
|
| Rate for Payer: BCN Medicare Advantage |
$83.50
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$120.24
|
| Rate for Payer: Cofinity Commercial |
$111.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.50
|
| Rate for Payer: Healthscope Commercial |
$133.60
|
| Rate for Payer: Healthscope Commercial |
$154.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.65
|
| Rate for Payer: Nomi Health Commercial |
$100.20
|
| Rate for Payer: PACE SWMI |
$83.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health Medicare |
$83.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.50
|
| Rate for Payer: UHC Medicare Advantage |
$83.50
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,822.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$543.42 |
| Max. Negotiated Rate |
$1,184.30 |
| Rate for Payer: Aetna Commercial |
$728.18
|
| Rate for Payer: Aetna Medicare |
$565.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.18
|
| Rate for Payer: BCBS Complete |
$728.80
|
| Rate for Payer: BCBS MAPPO |
$543.42
|
| Rate for Payer: BCN Medicare Advantage |
$543.42
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cofinity Commercial |
$782.52
|
| Rate for Payer: Cofinity Commercial |
$728.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.42
|
| Rate for Payer: Healthscope Commercial |
$869.47
|
| Rate for Payer: Healthscope Commercial |
$1,005.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,184.30
|
| Rate for Payer: Nomi Health Commercial |
$652.10
|
| Rate for Payer: PACE SWMI |
$543.42
|
| Rate for Payer: PHP Medicare Advantage |
$543.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,184.30
|
| Rate for Payer: Priority Health Medicare |
$543.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.42
|
| Rate for Payer: UHC Medicare Advantage |
$543.42
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$1,083.15 |
| Max. Negotiated Rate |
$2,627.95 |
| Rate for Payer: Aetna Commercial |
$1,451.42
|
| Rate for Payer: Aetna Medicare |
$1,126.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,559.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.42
|
| Rate for Payer: BCBS Complete |
$1,617.20
|
| Rate for Payer: BCBS MAPPO |
$1,083.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.15
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,559.74
|
| Rate for Payer: Cofinity Commercial |
$1,451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.15
|
| Rate for Payer: Healthscope Commercial |
$1,733.04
|
| Rate for Payer: Healthscope Commercial |
$2,003.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,627.95
|
| Rate for Payer: Nomi Health Commercial |
$1,299.78
|
| Rate for Payer: PACE SWMI |
$1,083.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health Medicare |
$1,083.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.15
|
|
