|
PR SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP
|
Professional
|
Both
|
$9,939.00
|
|
|
Service Code
|
HCPCS 61619
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$256,995.00 |
| Rate for Payer: Aetna Commercial |
$1,861.97
|
| Rate for Payer: Aetna Medicare |
$1,445.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,000.92
|
| Rate for Payer: BCBS Complete |
$968.18
|
| Rate for Payer: BCBS MAPPO |
$1,389.53
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCN Commercial |
$2,915.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.53
|
| Rate for Payer: Cash Price |
$7,951.20
|
| Rate for Payer: Cash Price |
$7,951.20
|
| Rate for Payer: Cofinity Commercial |
$2,000.92
|
| Rate for Payer: Cofinity Commercial |
$1,861.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.53
|
| Rate for Payer: Healthscope Commercial |
$2,570.63
|
| Rate for Payer: Healthscope Commercial |
$2,223.25
|
| Rate for Payer: Mclaren Medicaid |
$922.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,459.01
|
| Rate for Payer: Meridian Medicaid |
$968.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256,995.00
|
| Rate for Payer: Nomi Health Commercial |
$1,667.44
|
| Rate for Payer: PACE SWMI |
$1,389.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$922.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,460.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,464.81
|
| Rate for Payer: Priority Health Medicare |
$1,389.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,464.81
|
| Rate for Payer: Priority Health SBD |
$2,464.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,767.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.53
|
| Rate for Payer: UHC Exchange |
$1,767.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.53
|
| Rate for Payer: UHCCP Medicaid |
$922.08
|
|
|
PR SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97535
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$4,751.00 |
| Rate for Payer: Aetna Commercial |
$40.94
|
| Rate for Payer: Aetna Medicare |
$31.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.99
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$30.55
|
| Rate for Payer: BCBS Trust/PPO |
$88.75
|
| Rate for Payer: BCN Commercial |
$31.97
|
| Rate for Payer: BCN Medicare Advantage |
$30.55
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.55
|
| Rate for Payer: Healthscope Commercial |
$48.88
|
| Rate for Payer: Healthscope Commercial |
$56.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,751.00
|
| Rate for Payer: Nomi Health Commercial |
$36.66
|
| Rate for Payer: PACE SWMI |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$30.55
|
| Rate for Payer: Priority Health Narrow Network |
$77.25
|
| Rate for Payer: Priority Health SBD |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.55
|
| Rate for Payer: UHC Exchange |
$31.88
|
| Rate for Payer: UHC Medicare Advantage |
$30.55
|
|
|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$9,035.00 |
| Rate for Payer: Aetna Commercial |
$78.31
|
| Rate for Payer: Aetna Medicare |
$60.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.15
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$58.44
|
| Rate for Payer: BCBS Trust/PPO |
$970.49
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$58.44
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$84.15
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.44
|
| Rate for Payer: Healthscope Commercial |
$93.50
|
| Rate for Payer: Healthscope Commercial |
$108.11
|
| Rate for Payer: Mclaren Medicaid |
$23.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.36
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,035.00
|
| Rate for Payer: Nomi Health Commercial |
$70.13
|
| Rate for Payer: PACE SWMI |
$58.44
|
| Rate for Payer: PHP Medicare Advantage |
$58.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.31
|
| Rate for Payer: Priority Health Medicare |
$58.44
|
| Rate for Payer: Priority Health Narrow Network |
$79.31
|
| Rate for Payer: Priority Health SBD |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.44
|
| Rate for Payer: UHC Exchange |
$58.24
|
| Rate for Payer: UHC Medicare Advantage |
$58.44
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$118,505.00 |
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.66
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Healthscope Commercial |
$1,155.08
|
| Rate for Payer: Healthscope Commercial |
$998.99
|
| Rate for Payer: Healthscope Commercial |
$1,155.08
|
| Rate for Payer: Healthscope Commercial |
$998.99
|
| Rate for Payer: Mclaren Medicaid |
$430.47
|
| Rate for Payer: Mclaren Medicaid |
$430.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,505.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,505.00
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$946.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$946.86
|
| Rate for Payer: Priority Health Medicare |
$624.37
|
| Rate for Payer: Priority Health Medicare |
$624.37
|
| Rate for Payer: Priority Health Narrow Network |
$946.86
|
| Rate for Payer: Priority Health Narrow Network |
$946.86
|
| Rate for Payer: Priority Health SBD |
$946.86
|
| Rate for Payer: Priority Health SBD |
$946.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Exchange |
$550.15
|
| Rate for Payer: UHC Exchange |
$550.15
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$334.94 |
| Max. Negotiated Rate |
$92,722.00 |
| Rate for Payer: Aetna Commercial |
$677.88
|
| Rate for Payer: Aetna Medicare |
$526.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.47
|
| Rate for Payer: BCBS Complete |
$360.97
|
| Rate for Payer: BCBS MAPPO |
$505.88
|
| Rate for Payer: BCBS Trust/PPO |
$334.94
|
| Rate for Payer: BCN Commercial |
$772.60
|
| Rate for Payer: BCN Medicare Advantage |
$505.88
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$728.47
|
| Rate for Payer: Cofinity Commercial |
$677.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.88
|
| Rate for Payer: Healthscope Commercial |
$935.88
|
| Rate for Payer: Healthscope Commercial |
$809.41
|
| Rate for Payer: Mclaren Medicaid |
$343.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.17
|
| Rate for Payer: Meridian Medicaid |
$360.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,722.00
|
| Rate for Payer: Nomi Health Commercial |
$607.06
|
| Rate for Payer: PACE SWMI |
$505.88
|
| Rate for Payer: PHP Medicare Advantage |
$505.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.67
|
| Rate for Payer: Priority Health Medicare |
$505.88
|
| Rate for Payer: Priority Health Narrow Network |
$813.67
|
| Rate for Payer: Priority Health SBD |
$813.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.88
|
| Rate for Payer: UHC Exchange |
$873.20
|
| Rate for Payer: UHC Medicare Advantage |
$505.88
|
| Rate for Payer: UHCCP Medicaid |
$343.78
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$175.92 |
| Max. Negotiated Rate |
$132,917.00 |
| Rate for Payer: Aetna Commercial |
$970.40
|
| Rate for Payer: Aetna Medicare |
$753.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.40
|
| Rate for Payer: BCBS Complete |
$513.72
|
| Rate for Payer: BCBS MAPPO |
$724.18
|
| Rate for Payer: BCBS Trust/PPO |
$175.92
|
| Rate for Payer: BCN Commercial |
$1,101.97
|
| Rate for Payer: BCN Medicare Advantage |
$724.18
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$970.40
|
| Rate for Payer: Cofinity Commercial |
$1,042.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.18
|
| Rate for Payer: Healthscope Commercial |
$1,339.73
|
| Rate for Payer: Healthscope Commercial |
$1,158.69
|
| Rate for Payer: Mclaren Medicaid |
$489.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.39
|
| Rate for Payer: Meridian Medicaid |
$513.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,917.00
|
| Rate for Payer: Nomi Health Commercial |
$869.02
|
| Rate for Payer: PACE SWMI |
$724.18
|
| Rate for Payer: PHP Medicare Advantage |
$724.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,157.66
|
| Rate for Payer: Priority Health Medicare |
$724.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,157.66
|
| Rate for Payer: Priority Health SBD |
$1,157.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.18
|
| Rate for Payer: UHC Exchange |
$1,060.54
|
| Rate for Payer: UHC Medicare Advantage |
$724.18
|
| Rate for Payer: UHCCP Medicaid |
$489.26
|
|
|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$2,595.00 |
| Rate for Payer: Aetna Commercial |
$23.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.60
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,595.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.43
|
| Rate for Payer: Priority Health Narrow Network |
$24.43
|
| Rate for Payer: Priority Health SBD |
$24.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.00
|
| Rate for Payer: UHC Exchange |
$10.00
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$57,407.00 |
| Rate for Payer: Aetna Commercial |
$419.15
|
| Rate for Payer: Aetna Medicare |
$325.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.43
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$312.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$697.34
|
| Rate for Payer: BCN Medicare Advantage |
$312.80
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$450.43
|
| Rate for Payer: Cofinity Commercial |
$419.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.80
|
| Rate for Payer: Healthscope Commercial |
$578.68
|
| Rate for Payer: Healthscope Commercial |
$500.48
|
| Rate for Payer: Mclaren Medicaid |
$212.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.44
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57,407.00
|
| Rate for Payer: Nomi Health Commercial |
$375.36
|
| Rate for Payer: PACE SWMI |
$312.80
|
| Rate for Payer: PHP Medicare Advantage |
$312.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.25
|
| Rate for Payer: Priority Health Medicare |
$312.80
|
| Rate for Payer: Priority Health Narrow Network |
$502.25
|
| Rate for Payer: Priority Health SBD |
$502.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$518.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.80
|
| Rate for Payer: UHC Exchange |
$518.68
|
| Rate for Payer: UHC Medicare Advantage |
$312.80
|
| Rate for Payer: UHCCP Medicaid |
$212.57
|
|
|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$369.13 |
| Max. Negotiated Rate |
$98,768.00 |
| Rate for Payer: Aetna Commercial |
$724.79
|
| Rate for Payer: Aetna Medicare |
$562.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.88
|
| Rate for Payer: BCBS Complete |
$387.59
|
| Rate for Payer: BCBS MAPPO |
$540.89
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$825.87
|
| Rate for Payer: BCN Medicare Advantage |
$540.89
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$778.88
|
| Rate for Payer: Cofinity Commercial |
$724.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.89
|
| Rate for Payer: Healthscope Commercial |
$865.42
|
| Rate for Payer: Healthscope Commercial |
$1,000.65
|
| Rate for Payer: Mclaren Medicaid |
$369.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.93
|
| Rate for Payer: Meridian Medicaid |
$387.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,768.00
|
| Rate for Payer: Nomi Health Commercial |
$649.07
|
| Rate for Payer: PACE SWMI |
$540.89
|
| Rate for Payer: PHP Medicare Advantage |
$540.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.67
|
| Rate for Payer: Priority Health Medicare |
$540.89
|
| Rate for Payer: Priority Health Narrow Network |
$871.67
|
| Rate for Payer: Priority Health SBD |
$871.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.89
|
| Rate for Payer: UHC Exchange |
$473.35
|
| Rate for Payer: UHC Medicare Advantage |
$540.89
|
| Rate for Payer: UHCCP Medicaid |
$369.13
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$11,653.00 |
| 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 |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,653.00
|
| 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 |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.72
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow Network |
$118.72
|
| Rate for Payer: Priority Health SBD |
$118.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$197.10
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$409.50 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health SBD |
$409.50
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$11,653.00 |
| 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 |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,653.00
|
| 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 |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.72
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow Network |
$118.72
|
| Rate for Payer: Priority Health SBD |
$118.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$197.10
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$69.95 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$322.51
|
| Rate for Payer: BCN Commercial |
$322.51
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.95
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$502.92
|
| Rate for Payer: VA VA |
$893.28
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$20,990.00 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.70
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Healthscope Commercial |
$181.89
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,990.00
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.38
|
| Rate for Payer: Priority Health Medicare |
$113.68
|
| Rate for Payer: Priority Health Narrow Network |
$212.38
|
| Rate for Payer: Priority Health SBD |
$212.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$315.26
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$20,990.00 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.70
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Healthscope Commercial |
$181.89
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,990.00
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.38
|
| Rate for Payer: Priority Health Medicare |
$113.68
|
| Rate for Payer: Priority Health Narrow Network |
$212.38
|
| Rate for Payer: Priority Health SBD |
$212.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$315.26
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$473.13 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health SBD |
$473.13
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$125.84 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$851.45
|
| Rate for Payer: BCN Commercial |
$851.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$473.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.84
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$20,083.00 |
| Rate for Payer: Aetna Commercial |
$145.03
|
| Rate for Payer: Aetna Medicare |
$112.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.85
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$108.23
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$108.23
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$155.85
|
| Rate for Payer: Cofinity Commercial |
$145.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.23
|
| Rate for Payer: Healthscope Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$173.17
|
| Rate for Payer: Mclaren Medicaid |
$72.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.64
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,083.00
|
| Rate for Payer: Nomi Health Commercial |
$129.88
|
| Rate for Payer: PACE SWMI |
$108.23
|
| Rate for Payer: PHP Medicare Advantage |
$108.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.65
|
| Rate for Payer: Priority Health Medicare |
$108.23
|
| Rate for Payer: Priority Health Narrow Network |
$201.65
|
| Rate for Payer: Priority Health SBD |
$201.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.23
|
| Rate for Payer: UHC Exchange |
$147.20
|
| Rate for Payer: UHC Medicare Advantage |
$108.23
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$34,675.00 |
| Rate for Payer: Aetna Commercial |
$249.74
|
| Rate for Payer: Aetna Medicare |
$193.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.37
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$186.37
|
| Rate for Payer: BCBS Trust/PPO |
$380.90
|
| Rate for Payer: BCN Commercial |
$284.41
|
| Rate for Payer: BCN Medicare Advantage |
$186.37
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$268.37
|
| Rate for Payer: Cofinity Commercial |
$249.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.37
|
| Rate for Payer: Healthscope Commercial |
$298.19
|
| Rate for Payer: Healthscope Commercial |
$344.78
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.69
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,675.00
|
| Rate for Payer: Nomi Health Commercial |
$223.64
|
| Rate for Payer: PACE SWMI |
$186.37
|
| Rate for Payer: PHP Medicare Advantage |
$186.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.41
|
| Rate for Payer: Priority Health Medicare |
$186.37
|
| Rate for Payer: Priority Health Narrow Network |
$348.41
|
| Rate for Payer: Priority Health SBD |
$348.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.37
|
| Rate for Payer: UHC Medicare Advantage |
$186.37
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$8,093.00 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$44.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.57
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$42.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$137.83
|
| Rate for Payer: BCN Medicare Advantage |
$42.76
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Cofinity Commercial |
$57.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.76
|
| Rate for Payer: Healthscope Commercial |
$79.11
|
| Rate for Payer: Healthscope Commercial |
$68.42
|
| Rate for Payer: Mclaren Medicaid |
$28.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.90
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,093.00
|
| Rate for Payer: Nomi Health Commercial |
$51.31
|
| Rate for Payer: PACE SWMI |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$42.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.96
|
| Rate for Payer: Priority Health Medicare |
$42.76
|
| Rate for Payer: Priority Health Narrow Network |
$60.96
|
| Rate for Payer: Priority Health SBD |
$60.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.76
|
| Rate for Payer: UHC Exchange |
$75.20
|
| Rate for Payer: UHC Medicare Advantage |
$42.76
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$16,828.00 |
| Rate for Payer: Aetna Commercial |
$121.46
|
| Rate for Payer: Aetna Medicare |
$94.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.52
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$90.64
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$214.00
|
| Rate for Payer: BCN Medicare Advantage |
$90.64
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Commercial |
$121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$167.68
|
| Rate for Payer: Healthscope Commercial |
$145.02
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.17
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,828.00
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: PACE SWMI |
$90.64
|
| Rate for Payer: PHP Medicare Advantage |
$90.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.68
|
| Rate for Payer: Priority Health Medicare |
$90.64
|
| Rate for Payer: Priority Health Narrow Network |
$128.68
|
| Rate for Payer: Priority Health SBD |
$128.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.64
|
| Rate for Payer: UHC Exchange |
$146.13
|
| Rate for Payer: UHC Medicare Advantage |
$90.64
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
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 |
$23.64 |
| Max. Negotiated Rate |
$6,673.00 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.15
|
| Rate for Payer: BCBS Complete |
$24.82
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$450.00
|
| Rate for Payer: BCN Commercial |
$124.87
|
| 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: Mclaren Medicaid |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,673.00
|
| 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 Choice Medicaid |
$23.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.12
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: Priority Health Narrow Network |
$50.12
|
| Rate for Payer: Priority Health SBD |
$50.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Exchange |
$61.75
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHCCP Medicaid |
$23.64
|
|
|
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 |
$28.95 |
| Max. Negotiated Rate |
$8,735.00 |
| Rate for Payer: Aetna Commercial |
$61.87
|
| Rate for Payer: Aetna Medicare |
$48.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.48
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$46.17
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$145.29
|
| 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 |
$85.41
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.48
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,735.00
|
| 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 Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.47
|
| Rate for Payer: Priority Health Medicare |
$46.17
|
| Rate for Payer: Priority Health Narrow Network |
$65.47
|
| Rate for Payer: Priority Health SBD |
$65.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.17
|
| Rate for Payer: UHC Exchange |
$85.49
|
| Rate for Payer: UHC Medicare Advantage |
$46.17
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
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 |
$39.19 |
| Max. Negotiated Rate |
$11,108.00 |
| Rate for Payer: Aetna Commercial |
$78.64
|
| Rate for Payer: Aetna Medicare |
$61.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.51
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$58.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: BCN Commercial |
$164.53
|
| 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: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.62
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,108.00
|
| 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 Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.53
|
| Rate for Payer: Priority Health Medicare |
$58.69
|
| Rate for Payer: Priority Health Narrow Network |
$83.53
|
| Rate for Payer: Priority Health SBD |
$83.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.69
|
| Rate for Payer: UHC Exchange |
$100.81
|
| Rate for Payer: UHC Medicare Advantage |
$58.69
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
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 |
$43.88 |
| Max. Negotiated Rate |
$12,416.00 |
| Rate for Payer: Aetna Commercial |
$88.45
|
| Rate for Payer: Aetna Medicare |
$68.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.05
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$66.01
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$173.16
|
| 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 |
$122.12
|
| Rate for Payer: Healthscope Commercial |
$105.62
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.31
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,416.00
|
| 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 Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.47
|
| Rate for Payer: Priority Health Medicare |
$66.01
|
| Rate for Payer: Priority Health Narrow Network |
$93.47
|
| Rate for Payer: Priority Health SBD |
$93.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.01
|
| Rate for Payer: UHC Exchange |
$121.66
|
| Rate for Payer: UHC Medicare Advantage |
$66.01
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
