|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Healthscope Commercial |
$65.71
|
| Rate for Payer: Healthscope Commercial |
$56.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.65
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$61.87
|
| Rate for Payer: Aetna Medicare |
$48.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: BCBS Complete |
$80.00
|
| Rate for Payer: BCBS MAPPO |
$46.17
|
| Rate for Payer: BCN Medicare Advantage |
$46.17
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$66.48
|
| Rate for Payer: Cofinity Commercial |
$61.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.17
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Healthscope Commercial |
$85.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.00
|
| Rate for Payer: Nomi Health Commercial |
$55.40
|
| Rate for Payer: PACE SWMI |
$46.17
|
| Rate for Payer: PHP Medicare Advantage |
$46.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health Medicare |
$46.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.17
|
| Rate for Payer: UHC Medicare Advantage |
$46.17
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$58.69 |
| Max. Negotiated Rate |
$154.05 |
| Rate for Payer: Aetna Commercial |
$78.64
|
| Rate for Payer: Aetna Medicare |
$61.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.64
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$58.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.69
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$84.51
|
| Rate for Payer: Cofinity Commercial |
$78.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.69
|
| Rate for Payer: Healthscope Commercial |
$93.90
|
| Rate for Payer: Healthscope Commercial |
$108.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.05
|
| Rate for Payer: Nomi Health Commercial |
$70.43
|
| Rate for Payer: PACE SWMI |
$58.69
|
| Rate for Payer: PHP Medicare Advantage |
$58.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$58.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.69
|
| Rate for Payer: UHC Medicare Advantage |
$58.69
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$66.01 |
| Max. Negotiated Rate |
$163.15 |
| Rate for Payer: Aetna Commercial |
$88.45
|
| Rate for Payer: Aetna Medicare |
$68.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.45
|
| Rate for Payer: BCBS Complete |
$100.40
|
| Rate for Payer: BCBS MAPPO |
$66.01
|
| Rate for Payer: BCN Medicare Advantage |
$66.01
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$95.05
|
| Rate for Payer: Cofinity Commercial |
$88.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.01
|
| Rate for Payer: Healthscope Commercial |
$105.62
|
| Rate for Payer: Healthscope Commercial |
$122.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.15
|
| Rate for Payer: Nomi Health Commercial |
$79.21
|
| Rate for Payer: PACE SWMI |
$66.01
|
| Rate for Payer: PHP Medicare Advantage |
$66.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health Medicare |
$66.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.01
|
| Rate for Payer: UHC Medicare Advantage |
$66.01
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$42.88
|
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.88
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$32.00
|
| Rate for Payer: BCN Medicare Advantage |
$32.00
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Cofinity Commercial |
$42.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$59.20
|
| Rate for Payer: Healthscope Commercial |
$51.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.65
|
| Rate for Payer: Nomi Health Commercial |
$38.40
|
| Rate for Payer: PACE SWMI |
$32.00
|
| Rate for Payer: PHP Medicare Advantage |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$32.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$32.00
|
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$85.01 |
| Rate for Payer: Aetna Commercial |
$61.57
|
| Rate for Payer: Aetna Medicare |
$47.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.57
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$45.95
|
| Rate for Payer: BCN Medicare Advantage |
$45.95
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.95
|
| Rate for Payer: Healthscope Commercial |
$73.52
|
| Rate for Payer: Healthscope Commercial |
$85.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.25
|
| Rate for Payer: Nomi Health Commercial |
$55.14
|
| Rate for Payer: PACE SWMI |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health Medicare |
$45.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.95
|
| Rate for Payer: UHC Medicare Advantage |
$45.95
|
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$483.20 |
| Max. Negotiated Rate |
$1,082.36 |
| Rate for Payer: Aetna Commercial |
$783.98
|
| Rate for Payer: Aetna Medicare |
$608.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.98
|
| Rate for Payer: BCBS Complete |
$483.20
|
| Rate for Payer: BCBS MAPPO |
$585.06
|
| Rate for Payer: BCN Medicare Advantage |
$585.06
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cofinity Commercial |
$842.49
|
| Rate for Payer: Cofinity Commercial |
$783.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.06
|
| Rate for Payer: Healthscope Commercial |
$936.10
|
| Rate for Payer: Healthscope Commercial |
$1,082.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.20
|
| Rate for Payer: Nomi Health Commercial |
$702.07
|
| Rate for Payer: PACE SWMI |
$585.06
|
| Rate for Payer: PHP Medicare Advantage |
$585.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.20
|
| Rate for Payer: Priority Health Medicare |
$585.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.06
|
| Rate for Payer: UHC Medicare Advantage |
$585.06
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$233.17 |
| Rate for Payer: Aetna Commercial |
$168.89
|
| Rate for Payer: Aetna Medicare |
$131.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.89
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS MAPPO |
$126.04
|
| Rate for Payer: BCN Medicare Advantage |
$126.04
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$181.50
|
| Rate for Payer: Cofinity Commercial |
$168.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.04
|
| Rate for Payer: Healthscope Commercial |
$201.66
|
| Rate for Payer: Healthscope Commercial |
$233.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.05
|
| Rate for Payer: Nomi Health Commercial |
$151.25
|
| Rate for Payer: PACE SWMI |
$126.04
|
| Rate for Payer: PHP Medicare Advantage |
$126.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health Medicare |
$126.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.04
|
| Rate for Payer: UHC Medicare Advantage |
$126.04
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$115.20 |
| Max. Negotiated Rate |
$292.21 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.45
|
| Rate for Payer: BCBS Complete |
$115.20
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Healthscope Commercial |
$292.21
|
| Rate for Payer: Healthscope Commercial |
$292.21
|
| Rate for Payer: Healthscope Commercial |
$252.72
|
| Rate for Payer: Healthscope Commercial |
$252.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.65
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$130.80 |
| Max. Negotiated Rate |
$254.58 |
| Rate for Payer: Aetna Commercial |
$184.40
|
| Rate for Payer: Aetna Medicare |
$143.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.40
|
| Rate for Payer: BCBS Complete |
$130.80
|
| Rate for Payer: BCBS MAPPO |
$137.61
|
| Rate for Payer: BCN Medicare Advantage |
$137.61
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$198.16
|
| Rate for Payer: Cofinity Commercial |
$184.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.61
|
| Rate for Payer: Healthscope Commercial |
$254.58
|
| Rate for Payer: Healthscope Commercial |
$220.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.55
|
| Rate for Payer: Nomi Health Commercial |
$165.13
|
| Rate for Payer: PACE SWMI |
$137.61
|
| Rate for Payer: PHP Medicare Advantage |
$137.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.55
|
| Rate for Payer: Priority Health Medicare |
$137.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.61
|
| Rate for Payer: UHC Medicare Advantage |
$137.61
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$614.77 |
| Rate for Payer: Aetna Commercial |
$445.30
|
| Rate for Payer: Aetna Medicare |
$345.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.30
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$332.31
|
| Rate for Payer: BCN Medicare Advantage |
$332.31
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Cofinity Commercial |
$445.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.31
|
| Rate for Payer: Healthscope Commercial |
$531.70
|
| Rate for Payer: Healthscope Commercial |
$614.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: Nomi Health Commercial |
$398.77
|
| Rate for Payer: PACE SWMI |
$332.31
|
| Rate for Payer: PHP Medicare Advantage |
$332.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$332.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.31
|
| Rate for Payer: UHC Medicare Advantage |
$332.31
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$120.25 |
| Rate for Payer: Aetna Commercial |
$79.96
|
| Rate for Payer: Aetna Medicare |
$62.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.96
|
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: BCBS MAPPO |
$59.67
|
| Rate for Payer: BCN Medicare Advantage |
$59.67
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$85.92
|
| Rate for Payer: Cofinity Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$110.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.25
|
| Rate for Payer: Nomi Health Commercial |
$71.60
|
| Rate for Payer: PACE SWMI |
$59.67
|
| Rate for Payer: PHP Medicare Advantage |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health Medicare |
$59.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.67
|
| Rate for Payer: UHC Medicare Advantage |
$59.67
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$172.90 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Medicare |
$73.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.85
|
| Rate for Payer: BCBS Complete |
$106.40
|
| Rate for Payer: BCBS MAPPO |
$70.73
|
| Rate for Payer: BCN Medicare Advantage |
$70.73
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$101.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.73
|
| Rate for Payer: Healthscope Commercial |
$113.17
|
| Rate for Payer: Healthscope Commercial |
$130.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.90
|
| Rate for Payer: Nomi Health Commercial |
$84.88
|
| Rate for Payer: PACE SWMI |
$70.73
|
| Rate for Payer: PHP Medicare Advantage |
$70.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health Medicare |
$70.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.73
|
| Rate for Payer: UHC Medicare Advantage |
$70.73
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.74 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.70
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health SBD |
$124.74
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.42
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Healthscope Commercial |
$90.32
|
| Rate for Payer: Healthscope Commercial |
$78.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.70
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$124.74
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.30
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Healthscope Commercial |
$90.32
|
| Rate for Payer: Healthscope Commercial |
$78.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.70
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$67.93 |
| Max. Negotiated Rate |
$167.05 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$70.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.03
|
| Rate for Payer: BCBS Complete |
$102.80
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Healthscope Commercial |
$108.69
|
| Rate for Payer: Healthscope Commercial |
$125.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.05
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.05
|
| Rate for Payer: Priority Health Medicare |
$67.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: Aetna Medicare |
$59.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.10
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: BCBS MAPPO |
$56.79
|
| Rate for Payer: BCN Medicare Advantage |
$56.79
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Cofinity Commercial |
$76.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.79
|
| Rate for Payer: Healthscope Commercial |
$90.86
|
| Rate for Payer: Healthscope Commercial |
$105.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.10
|
| Rate for Payer: Nomi Health Commercial |
$68.15
|
| Rate for Payer: PACE SWMI |
$56.79
|
| Rate for Payer: PHP Medicare Advantage |
$56.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health Medicare |
$56.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.79
|
| Rate for Payer: UHC Medicare Advantage |
$56.79
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$607.50 |
| Rate for Payer: Aetna Commercial |
$440.03
|
| Rate for Payer: Aetna Medicare |
$341.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.03
|
| Rate for Payer: BCBS Complete |
$312.80
|
| Rate for Payer: BCBS MAPPO |
$328.38
|
| Rate for Payer: BCN Medicare Advantage |
$328.38
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$472.87
|
| Rate for Payer: Cofinity Commercial |
$440.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.38
|
| Rate for Payer: Healthscope Commercial |
$525.41
|
| Rate for Payer: Healthscope Commercial |
$607.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$508.30
|
| Rate for Payer: Nomi Health Commercial |
$394.06
|
| Rate for Payer: PACE SWMI |
$328.38
|
| Rate for Payer: PHP Medicare Advantage |
$328.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.30
|
| Rate for Payer: Priority Health Medicare |
$328.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.38
|
| Rate for Payer: UHC Medicare Advantage |
$328.38
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,021.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$251.27 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna Commercial |
$336.70
|
| Rate for Payer: Aetna Medicare |
$261.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.70
|
| Rate for Payer: BCBS Complete |
$408.40
|
| Rate for Payer: BCBS MAPPO |
$251.27
|
| Rate for Payer: BCN Medicare Advantage |
$251.27
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cofinity Commercial |
$361.83
|
| Rate for Payer: Cofinity Commercial |
$336.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.27
|
| Rate for Payer: Healthscope Commercial |
$464.85
|
| Rate for Payer: Healthscope Commercial |
$402.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.65
|
| Rate for Payer: Nomi Health Commercial |
$301.52
|
| Rate for Payer: PACE SWMI |
$251.27
|
| Rate for Payer: PHP Medicare Advantage |
$251.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.65
|
| Rate for Payer: Priority Health Medicare |
$251.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.27
|
| Rate for Payer: UHC Medicare Advantage |
$251.27
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$156.98 |
| Max. Negotiated Rate |
$290.41 |
| Rate for Payer: Aetna Commercial |
$210.35
|
| Rate for Payer: Aetna Medicare |
$163.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.35
|
| Rate for Payer: BCBS Complete |
$167.60
|
| Rate for Payer: BCBS MAPPO |
$156.98
|
| Rate for Payer: BCN Medicare Advantage |
$156.98
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Cofinity Commercial |
$210.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.98
|
| Rate for Payer: Healthscope Commercial |
$251.17
|
| Rate for Payer: Healthscope Commercial |
$290.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.35
|
| Rate for Payer: Nomi Health Commercial |
$188.38
|
| Rate for Payer: PACE SWMI |
$156.98
|
| Rate for Payer: PHP Medicare Advantage |
$156.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health Medicare |
$156.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.98
|
| Rate for Payer: UHC Medicare Advantage |
$156.98
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Medicare |
$375.50
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$202.38
|
| Rate for Payer: Aetna Medicare |
$157.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.48
|
| Rate for Payer: BCBS Complete |
$302.40
|
| Rate for Payer: BCBS MAPPO |
$151.03
|
| Rate for Payer: BCN Medicare Advantage |
$151.03
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$217.48
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.03
|
| Rate for Payer: Healthscope Commercial |
$279.41
|
| Rate for Payer: Healthscope Commercial |
$241.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$491.40
|
| Rate for Payer: Nomi Health Commercial |
$181.24
|
| Rate for Payer: PACE SWMI |
$151.03
|
| Rate for Payer: PHP Medicare Advantage |
$151.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health Medicare |
$151.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.03
|
| Rate for Payer: UHC Medicare Advantage |
$151.03
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$110.63 |
| Max. Negotiated Rate |
$433.55 |
| Rate for Payer: Aetna Commercial |
$148.24
|
| Rate for Payer: Aetna Medicare |
$115.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.31
|
| Rate for Payer: BCBS Complete |
$266.80
|
| Rate for Payer: BCBS MAPPO |
$110.63
|
| Rate for Payer: BCN Medicare Advantage |
$110.63
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.63
|
| Rate for Payer: Healthscope Commercial |
$177.01
|
| Rate for Payer: Healthscope Commercial |
$204.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.55
|
| Rate for Payer: Nomi Health Commercial |
$132.76
|
| Rate for Payer: PACE SWMI |
$110.63
|
| Rate for Payer: PHP Medicare Advantage |
$110.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.55
|
| Rate for Payer: Priority Health Medicare |
$110.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.63
|
| Rate for Payer: UHC Medicare Advantage |
$110.63
|
|
