|
PR SPLT AGRFT T/A/L EA ADD 100 SQCM/EA 1% INFT/CHLD
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 15101
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$19,579.00 |
| Rate for Payer: Aetna Commercial |
$141.76
|
| Rate for Payer: Aetna Medicare |
$110.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.34
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$105.79
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$273.17
|
| Rate for Payer: BCN Medicare Advantage |
$105.79
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cofinity Commercial |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$141.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.79
|
| Rate for Payer: Healthscope Commercial |
$195.71
|
| Rate for Payer: Healthscope Commercial |
$169.26
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.08
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,579.00
|
| Rate for Payer: Nomi Health Commercial |
$126.95
|
| Rate for Payer: PACE SWMI |
$105.79
|
| Rate for Payer: PHP Medicare Advantage |
$105.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$896.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.00
|
| Rate for Payer: Priority Health Medicare |
$105.79
|
| Rate for Payer: Priority Health Narrow Network |
$149.00
|
| Rate for Payer: Priority Health SBD |
$149.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.79
|
| Rate for Payer: UHC Exchange |
$228.37
|
| Rate for Payer: UHC Medicare Advantage |
$105.79
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 94010
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$3,798.00 |
| Rate for Payer: Aetna Commercial |
$33.26
|
| Rate for Payer: Aetna Commercial |
$33.26
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Aetna Medicare |
$25.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$24.82
|
| Rate for Payer: BCBS MAPPO |
$24.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.47
|
| Rate for Payer: BCN Commercial |
$39.09
|
| Rate for Payer: BCN Commercial |
$39.09
|
| Rate for Payer: BCN Medicare Advantage |
$24.82
|
| Rate for Payer: BCN Medicare Advantage |
$24.82
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$35.74
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Commercial |
$35.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.82
|
| Rate for Payer: Healthscope Commercial |
$39.71
|
| Rate for Payer: Healthscope Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$39.71
|
| Rate for Payer: Healthscope Commercial |
$45.92
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.06
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,798.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,798.00
|
| Rate for Payer: Nomi Health Commercial |
$29.78
|
| Rate for Payer: Nomi Health Commercial |
$29.78
|
| Rate for Payer: PACE SWMI |
$24.82
|
| Rate for Payer: PACE SWMI |
$24.82
|
| Rate for Payer: PHP Medicare Advantage |
$24.82
|
| Rate for Payer: PHP Medicare Advantage |
$24.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.10
|
| Rate for Payer: Priority Health Medicare |
$24.82
|
| Rate for Payer: Priority Health Medicare |
$24.82
|
| Rate for Payer: Priority Health Narrow Network |
$37.10
|
| Rate for Payer: Priority Health Narrow Network |
$37.10
|
| Rate for Payer: Priority Health SBD |
$10.86
|
| Rate for Payer: Priority Health SBD |
$10.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.82
|
| Rate for Payer: UHC Exchange |
$52.00
|
| Rate for Payer: UHC Exchange |
$52.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.82
|
| Rate for Payer: UHC Medicare Advantage |
$24.82
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
PR SPONTANEOUS NYSTAGMUS TEST
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 92541
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$3,671.00 |
| Rate for Payer: Aetna Commercial |
$31.38
|
| Rate for Payer: Aetna Medicare |
$24.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.72
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$23.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.99
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: BCN Medicare Advantage |
$23.42
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Cofinity Commercial |
$31.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$43.33
|
| Rate for Payer: Healthscope Commercial |
$37.47
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.59
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,671.00
|
| Rate for Payer: Nomi Health Commercial |
$28.10
|
| Rate for Payer: PACE SWMI |
$23.42
|
| Rate for Payer: PHP Medicare Advantage |
$23.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.93
|
| Rate for Payer: Priority Health Medicare |
$23.42
|
| Rate for Payer: Priority Health Narrow Network |
$33.93
|
| Rate for Payer: Priority Health SBD |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.42
|
| Rate for Payer: UHC Exchange |
$77.03
|
| Rate for Payer: UHC Medicare Advantage |
$23.42
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
|
PR SPORTS PHYSICAL
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 00099
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS
|
Professional
|
Both
|
$1,214.00
|
|
|
Service Code
|
HCPCS 37765
|
| Min. Negotiated Rate |
$169.55 |
| Max. Negotiated Rate |
$47,905.00 |
| Rate for Payer: Aetna Commercial |
$344.98
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.73
|
| Rate for Payer: BCBS Complete |
$178.03
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$463.85
|
| Rate for Payer: BCN Commercial |
$618.67
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Cash Price |
$971.20
|
| Rate for Payer: Cofinity Commercial |
$370.73
|
| Rate for Payer: Cofinity Commercial |
$344.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$476.28
|
| Rate for Payer: Healthscope Commercial |
$411.92
|
| Rate for Payer: Mclaren Medicaid |
$169.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: Meridian Medicaid |
$178.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,905.00
|
| Rate for Payer: Nomi Health Commercial |
$308.94
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$789.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$424.39
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health Narrow Network |
$424.39
|
| Rate for Payer: Priority Health SBD |
$424.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.45
|
| Rate for Payer: UHC Exchange |
$530.27
|
| Rate for Payer: UHC Medicare Advantage |
$257.45
|
| Rate for Payer: UHCCP Medicaid |
$169.55
|
|
|
PR STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 37766
|
| Min. Negotiated Rate |
$209.17 |
| Max. Negotiated Rate |
$58,678.00 |
| Rate for Payer: Aetna Commercial |
$426.47
|
| Rate for Payer: Aetna Medicare |
$330.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.29
|
| Rate for Payer: BCBS Complete |
$219.63
|
| Rate for Payer: BCBS MAPPO |
$318.26
|
| Rate for Payer: BCBS Trust/PPO |
$327.02
|
| Rate for Payer: BCN Commercial |
$725.69
|
| Rate for Payer: BCN Medicare Advantage |
$318.26
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cofinity Commercial |
$458.29
|
| Rate for Payer: Cofinity Commercial |
$426.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.26
|
| Rate for Payer: Healthscope Commercial |
$588.78
|
| Rate for Payer: Healthscope Commercial |
$509.22
|
| Rate for Payer: Mclaren Medicaid |
$209.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.17
|
| Rate for Payer: Meridian Medicaid |
$219.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,678.00
|
| Rate for Payer: Nomi Health Commercial |
$381.91
|
| Rate for Payer: PACE SWMI |
$318.26
|
| Rate for Payer: PHP Medicare Advantage |
$318.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$812.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.12
|
| Rate for Payer: Priority Health Medicare |
$318.26
|
| Rate for Payer: Priority Health Narrow Network |
$520.12
|
| Rate for Payer: Priority Health SBD |
$520.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.26
|
| Rate for Payer: UHC Exchange |
$654.09
|
| Rate for Payer: UHC Medicare Advantage |
$318.26
|
| Rate for Payer: UHCCP Medicaid |
$209.17
|
|
|
PR STAGING CELIOTOMY,HODGKIN'S DIS/LYMPHOMA
|
Professional
|
Both
|
$1,743.00
|
|
|
Service Code
|
HCPCS 49220
|
| Min. Negotiated Rate |
$697.20 |
| Max. Negotiated Rate |
$1,132.95 |
| Rate for Payer: Aetna Medicare |
$871.50
|
| Rate for Payer: BCBS Complete |
$697.20
|
| Rate for Payer: Cash Price |
$1,394.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.95
|
|
|
PR STANDARDIZED COGNITIVE PERFORMANCE TESTING
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 96125
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$14,943.00 |
| Rate for Payer: Aetna Commercial |
$128.75
|
| Rate for Payer: Aetna Medicare |
$99.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.36
|
| Rate for Payer: BCBS Complete |
$74.80
|
| Rate for Payer: BCBS MAPPO |
$96.08
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$149.05
|
| Rate for Payer: BCN Medicare Advantage |
$96.08
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$128.75
|
| Rate for Payer: Cofinity Commercial |
$138.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.08
|
| Rate for Payer: Healthscope Commercial |
$177.75
|
| Rate for Payer: Healthscope Commercial |
$153.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,943.00
|
| Rate for Payer: Nomi Health Commercial |
$115.30
|
| Rate for Payer: PACE SWMI |
$96.08
|
| Rate for Payer: PHP Medicare Advantage |
$96.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.86
|
| Rate for Payer: Priority Health Medicare |
$96.08
|
| Rate for Payer: Priority Health Narrow Network |
$138.86
|
| Rate for Payer: Priority Health SBD |
$138.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.08
|
| Rate for Payer: UHC Medicare Advantage |
$96.08
|
|
|
PR STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 69660
|
| Min. Negotiated Rate |
$590.44 |
| Max. Negotiated Rate |
$163,595.00 |
| Rate for Payer: Aetna Commercial |
$1,160.86
|
| Rate for Payer: Aetna Medicare |
$900.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,160.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.49
|
| Rate for Payer: BCBS Complete |
$619.96
|
| Rate for Payer: BCBS MAPPO |
$866.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,545.81
|
| Rate for Payer: BCN Commercial |
$1,365.86
|
| Rate for Payer: BCN Medicare Advantage |
$866.31
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,247.49
|
| Rate for Payer: Cofinity Commercial |
$1,160.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.31
|
| Rate for Payer: Healthscope Commercial |
$1,602.67
|
| Rate for Payer: Healthscope Commercial |
$1,386.10
|
| Rate for Payer: Mclaren Medicaid |
$590.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.63
|
| Rate for Payer: Meridian Medicaid |
$619.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163,595.00
|
| Rate for Payer: Nomi Health Commercial |
$1,039.57
|
| Rate for Payer: PACE SWMI |
$866.31
|
| Rate for Payer: PHP Medicare Advantage |
$866.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,356.02
|
| Rate for Payer: Priority Health Medicare |
$866.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,356.02
|
| Rate for Payer: Priority Health SBD |
$1,356.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,226.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.31
|
| Rate for Payer: UHC Exchange |
$1,226.93
|
| Rate for Payer: UHC Medicare Advantage |
$866.31
|
| Rate for Payer: UHCCP Medicaid |
$590.44
|
|
|
PR STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT
|
Professional
|
Both
|
$2,433.00
|
|
|
Service Code
|
HCPCS 69661
|
| Min. Negotiated Rate |
$768.93 |
| Max. Negotiated Rate |
$213,206.00 |
| Rate for Payer: Aetna Commercial |
$1,513.11
|
| Rate for Payer: Aetna Medicare |
$1,174.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.03
|
| Rate for Payer: BCBS Complete |
$807.38
|
| Rate for Payer: BCBS MAPPO |
$1,129.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.16
|
| Rate for Payer: BCN Commercial |
$1,778.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.19
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cofinity Commercial |
$1,626.03
|
| Rate for Payer: Cofinity Commercial |
$1,513.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.19
|
| Rate for Payer: Healthscope Commercial |
$2,089.00
|
| Rate for Payer: Healthscope Commercial |
$1,806.70
|
| Rate for Payer: Mclaren Medicaid |
$768.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.65
|
| Rate for Payer: Meridian Medicaid |
$807.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213,206.00
|
| Rate for Payer: Nomi Health Commercial |
$1,355.03
|
| Rate for Payer: PACE SWMI |
$1,129.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,581.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,766.03
|
| Rate for Payer: Priority Health Medicare |
$1,129.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,766.03
|
| Rate for Payer: Priority Health SBD |
$1,766.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,605.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,129.19
|
| Rate for Payer: UHC Exchange |
$1,605.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,129.19
|
| Rate for Payer: UHCCP Medicaid |
$768.93
|
|
|
PR STAPES MOBILIZATION
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 69650
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$141,683.00 |
| Rate for Payer: Aetna Commercial |
$1,004.77
|
| Rate for Payer: Aetna Medicare |
$779.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.76
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS MAPPO |
$749.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.47
|
| Rate for Payer: BCN Commercial |
$1,187.00
|
| Rate for Payer: BCN Medicare Advantage |
$749.83
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$1,079.76
|
| Rate for Payer: Cofinity Commercial |
$1,004.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.83
|
| Rate for Payer: Healthscope Commercial |
$1,387.19
|
| Rate for Payer: Healthscope Commercial |
$1,199.73
|
| Rate for Payer: Mclaren Medicaid |
$512.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$787.32
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,683.00
|
| Rate for Payer: Nomi Health Commercial |
$899.80
|
| Rate for Payer: PACE SWMI |
$749.83
|
| Rate for Payer: PHP Medicare Advantage |
$749.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,180.43
|
| Rate for Payer: Priority Health Medicare |
$749.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,180.43
|
| Rate for Payer: Priority Health SBD |
$1,180.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,026.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$749.83
|
| Rate for Payer: UHC Exchange |
$1,026.69
|
| Rate for Payer: UHC Medicare Advantage |
$749.83
|
| Rate for Payer: UHCCP Medicaid |
$512.90
|
|
|
PR STENGER TEST PURE TONE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92565
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$2,787.00 |
| Rate for Payer: Aetna Commercial |
$26.17
|
| Rate for Payer: Aetna Medicare |
$20.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.12
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$19.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.60
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: BCN Medicare Advantage |
$19.53
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$28.12
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.53
|
| Rate for Payer: Healthscope Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,787.00
|
| Rate for Payer: Nomi Health Commercial |
$23.44
|
| Rate for Payer: PACE SWMI |
$19.53
|
| Rate for Payer: PHP Medicare Advantage |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.49
|
| Rate for Payer: Priority Health Medicare |
$19.53
|
| Rate for Payer: Priority Health Narrow Network |
$28.49
|
| Rate for Payer: Priority Health SBD |
$28.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.53
|
| Rate for Payer: UHC Exchange |
$17.57
|
| Rate for Payer: UHC Medicare Advantage |
$19.53
|
|
|
PR STENGER TEST SPEECH
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 92577
|
| Min. Negotiated Rate |
$20.42 |
| Max. Negotiated Rate |
$2,834.00 |
| Rate for Payer: Aetna Commercial |
$27.36
|
| Rate for Payer: Aetna Medicare |
$21.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.40
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$20.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.03
|
| Rate for Payer: BCN Commercial |
$29.81
|
| Rate for Payer: BCN Medicare Advantage |
$20.42
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$29.40
|
| Rate for Payer: Cofinity Commercial |
$27.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.42
|
| Rate for Payer: Healthscope Commercial |
$32.67
|
| Rate for Payer: Healthscope Commercial |
$37.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,834.00
|
| Rate for Payer: Nomi Health Commercial |
$24.50
|
| Rate for Payer: PACE SWMI |
$20.42
|
| Rate for Payer: PHP Medicare Advantage |
$20.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$20.42
|
| Rate for Payer: Priority Health Narrow Network |
$29.85
|
| Rate for Payer: Priority Health SBD |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.42
|
| Rate for Payer: UHC Exchange |
$31.97
|
| Rate for Payer: UHC Medicare Advantage |
$20.42
|
|
|
PR STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 36908
|
| Min. Negotiated Rate |
$129.29 |
| Max. Negotiated Rate |
$36,378.00 |
| Rate for Payer: Aetna Commercial |
$264.14
|
| Rate for Payer: Aetna Medicare |
$205.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.85
|
| Rate for Payer: BCBS Complete |
$135.75
|
| Rate for Payer: BCBS MAPPO |
$197.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.07
|
| Rate for Payer: BCN Commercial |
$2,085.19
|
| Rate for Payer: BCN Medicare Advantage |
$197.12
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$283.85
|
| Rate for Payer: Cofinity Commercial |
$264.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.12
|
| Rate for Payer: Healthscope Commercial |
$315.39
|
| Rate for Payer: Healthscope Commercial |
$364.67
|
| Rate for Payer: Mclaren Medicaid |
$129.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.98
|
| Rate for Payer: Meridian Medicaid |
$135.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,378.00
|
| Rate for Payer: Nomi Health Commercial |
$236.54
|
| Rate for Payer: PACE SWMI |
$197.12
|
| Rate for Payer: PHP Medicare Advantage |
$197.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.68
|
| Rate for Payer: Priority Health Medicare |
$197.12
|
| Rate for Payer: Priority Health Narrow Network |
$320.68
|
| Rate for Payer: Priority Health SBD |
$320.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.12
|
| Rate for Payer: UHC Medicare Advantage |
$197.12
|
| Rate for Payer: UHCCP Medicaid |
$129.29
|
|
|
PR STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS G6002
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$10,529.00 |
| Rate for Payer: Aetna Commercial |
$91.48
|
| Rate for Payer: Aetna Commercial |
$91.48
|
| Rate for Payer: Aetna Medicare |
$71.00
|
| Rate for Payer: Aetna Medicare |
$71.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.48
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$68.27
|
| Rate for Payer: BCBS MAPPO |
$68.27
|
| Rate for Payer: BCBS Trust/PPO |
$590.64
|
| Rate for Payer: BCBS Trust/PPO |
$590.64
|
| Rate for Payer: BCN Commercial |
$108.97
|
| Rate for Payer: BCN Commercial |
$108.97
|
| Rate for Payer: BCN Medicare Advantage |
$68.27
|
| Rate for Payer: BCN Medicare Advantage |
$68.27
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$91.48
|
| Rate for Payer: Cofinity Commercial |
$98.31
|
| Rate for Payer: Cofinity Commercial |
$91.48
|
| Rate for Payer: Cofinity Commercial |
$98.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.27
|
| Rate for Payer: Healthscope Commercial |
$109.23
|
| Rate for Payer: Healthscope Commercial |
$126.30
|
| Rate for Payer: Healthscope Commercial |
$126.30
|
| Rate for Payer: Healthscope Commercial |
$109.23
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.68
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,529.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,529.00
|
| Rate for Payer: Nomi Health Commercial |
$81.92
|
| Rate for Payer: Nomi Health Commercial |
$81.92
|
| Rate for Payer: PACE SWMI |
$68.27
|
| Rate for Payer: PACE SWMI |
$68.27
|
| Rate for Payer: PHP Medicare Advantage |
$68.27
|
| Rate for Payer: PHP Medicare Advantage |
$68.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.00
|
| Rate for Payer: Priority Health Medicare |
$68.27
|
| Rate for Payer: Priority Health Medicare |
$68.27
|
| Rate for Payer: Priority Health Narrow Network |
$116.00
|
| Rate for Payer: Priority Health Narrow Network |
$116.00
|
| Rate for Payer: Priority Health SBD |
$31.32
|
| Rate for Payer: Priority Health SBD |
$31.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.27
|
| Rate for Payer: UHC Medicare Advantage |
$68.27
|
| Rate for Payer: UHC Medicare Advantage |
$68.27
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
|
PR STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES
|
Professional
|
Both
|
$2,976.00
|
|
|
Service Code
|
HCPCS 61750
|
| Min. Negotiated Rate |
$662.49 |
| Max. Negotiated Rate |
$255,274.00 |
| Rate for Payer: Aetna Commercial |
$1,876.23
|
| Rate for Payer: Aetna Medicare |
$1,456.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,876.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,016.24
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: BCBS MAPPO |
$1,400.17
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$2,885.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,400.17
|
| Rate for Payer: Cash Price |
$2,380.80
|
| Rate for Payer: Cash Price |
$2,380.80
|
| Rate for Payer: Cofinity Commercial |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$1,876.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,400.17
|
| Rate for Payer: Healthscope Commercial |
$2,590.31
|
| Rate for Payer: Healthscope Commercial |
$2,240.27
|
| Rate for Payer: Mclaren Medicaid |
$921.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,470.18
|
| Rate for Payer: Meridian Medicaid |
$967.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255,274.00
|
| Rate for Payer: Nomi Health Commercial |
$1,680.20
|
| Rate for Payer: PACE SWMI |
$1,400.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,400.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,934.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,443.20
|
| Rate for Payer: Priority Health Medicare |
$1,400.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,443.20
|
| Rate for Payer: Priority Health SBD |
$2,443.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,555.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,400.17
|
| Rate for Payer: UHC Exchange |
$1,555.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,400.17
|
| Rate for Payer: UHCCP Medicaid |
$921.01
|
|
|
PR STEREOTACTIC COMPUTER ASSISTED PX SPINAL
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 61783
|
| Min. Negotiated Rate |
$148.46 |
| Max. Negotiated Rate |
$41,762.00 |
| Rate for Payer: Aetna Commercial |
$304.90
|
| Rate for Payer: Aetna Medicare |
$236.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.66
|
| Rate for Payer: BCBS Complete |
$155.88
|
| Rate for Payer: BCBS MAPPO |
$227.54
|
| Rate for Payer: BCBS Trust/PPO |
$707.92
|
| Rate for Payer: BCN Commercial |
$337.68
|
| Rate for Payer: BCN Medicare Advantage |
$227.54
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$327.66
|
| Rate for Payer: Cofinity Commercial |
$304.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.54
|
| Rate for Payer: Healthscope Commercial |
$364.06
|
| Rate for Payer: Healthscope Commercial |
$420.95
|
| Rate for Payer: Mclaren Medicaid |
$148.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.92
|
| Rate for Payer: Meridian Medicaid |
$155.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,762.00
|
| Rate for Payer: Nomi Health Commercial |
$273.05
|
| Rate for Payer: PACE SWMI |
$227.54
|
| Rate for Payer: PHP Medicare Advantage |
$227.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.12
|
| Rate for Payer: Priority Health Medicare |
$227.54
|
| Rate for Payer: Priority Health Narrow Network |
$394.12
|
| Rate for Payer: Priority Health SBD |
$394.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.54
|
| Rate for Payer: UHC Medicare Advantage |
$227.54
|
| Rate for Payer: UHCCP Medicaid |
$148.46
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES
|
Professional
|
Both
|
$8,316.00
|
|
|
Service Code
|
HCPCS 61798
|
| Min. Negotiated Rate |
$900.78 |
| Max. Negotiated Rate |
$250,254.00 |
| Rate for Payer: Aetna Commercial |
$1,836.63
|
| Rate for Payer: Aetna Medicare |
$1,425.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,836.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.69
|
| Rate for Payer: BCBS Complete |
$945.82
|
| Rate for Payer: BCBS MAPPO |
$1,370.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.47
|
| Rate for Payer: BCN Commercial |
$2,036.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,370.62
|
| Rate for Payer: Cash Price |
$6,652.80
|
| Rate for Payer: Cash Price |
$6,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,973.69
|
| Rate for Payer: Cofinity Commercial |
$1,836.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,370.62
|
| Rate for Payer: Healthscope Commercial |
$2,192.99
|
| Rate for Payer: Healthscope Commercial |
$2,535.65
|
| Rate for Payer: Mclaren Medicaid |
$900.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,439.15
|
| Rate for Payer: Meridian Medicaid |
$945.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250,254.00
|
| Rate for Payer: Nomi Health Commercial |
$1,644.74
|
| Rate for Payer: PACE SWMI |
$1,370.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,370.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$900.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,405.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,394.29
|
| Rate for Payer: Priority Health Medicare |
$1,370.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,394.29
|
| Rate for Payer: Priority Health SBD |
$2,394.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,370.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,370.62
|
| Rate for Payer: UHCCP Medicaid |
$900.78
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES
|
Professional
|
Both
|
$8,316.00
|
|
|
Service Code
|
HCPCS 61796
|
| Min. Negotiated Rate |
$667.97 |
| Max. Negotiated Rate |
$184,514.00 |
| Rate for Payer: Aetna Commercial |
$1,356.66
|
| Rate for Payer: Aetna Medicare |
$1,052.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,457.90
|
| Rate for Payer: BCBS Complete |
$701.37
|
| Rate for Payer: BCBS MAPPO |
$1,012.43
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,506.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.43
|
| Rate for Payer: Cash Price |
$6,652.80
|
| Rate for Payer: Cash Price |
$6,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,457.90
|
| Rate for Payer: Cofinity Commercial |
$1,356.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.43
|
| Rate for Payer: Healthscope Commercial |
$1,619.89
|
| Rate for Payer: Healthscope Commercial |
$1,873.00
|
| Rate for Payer: Mclaren Medicaid |
$667.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,063.05
|
| Rate for Payer: Meridian Medicaid |
$701.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184,514.00
|
| Rate for Payer: Nomi Health Commercial |
$1,214.92
|
| Rate for Payer: PACE SWMI |
$1,012.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,405.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,771.56
|
| Rate for Payer: Priority Health Medicare |
$1,012.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.56
|
| Rate for Payer: Priority Health SBD |
$1,771.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,012.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,012.43
|
| Rate for Payer: UHCCP Medicaid |
$667.97
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SPINAL LESION
|
Professional
|
Both
|
$2,336.00
|
|
|
Service Code
|
HCPCS 63620
|
| Min. Negotiated Rate |
$737.41 |
| Max. Negotiated Rate |
$204,206.00 |
| Rate for Payer: Aetna Commercial |
$1,500.12
|
| Rate for Payer: Aetna Medicare |
$1,164.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,500.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,612.07
|
| Rate for Payer: BCBS Complete |
$774.28
|
| Rate for Payer: BCBS MAPPO |
$1,119.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.05
|
| Rate for Payer: BCN Commercial |
$1,665.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.49
|
| Rate for Payer: Cash Price |
$1,868.80
|
| Rate for Payer: Cash Price |
$1,868.80
|
| Rate for Payer: Cofinity Commercial |
$1,612.07
|
| Rate for Payer: Cofinity Commercial |
$1,500.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.49
|
| Rate for Payer: Healthscope Commercial |
$1,791.18
|
| Rate for Payer: Healthscope Commercial |
$2,071.06
|
| Rate for Payer: Mclaren Medicaid |
$737.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,175.46
|
| Rate for Payer: Meridian Medicaid |
$774.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204,206.00
|
| Rate for Payer: Nomi Health Commercial |
$1,343.39
|
| Rate for Payer: PACE SWMI |
$1,119.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,518.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,957.53
|
| Rate for Payer: Priority Health Medicare |
$1,119.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,957.53
|
| Rate for Payer: Priority Health SBD |
$1,957.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,119.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.49
|
| Rate for Payer: UHCCP Medicaid |
$737.41
|
|
|
PR STERILE SALINE OR WATER
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS A4218
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna Commercial |
$1.75
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.75
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCN Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
|
|
PR STERNAL DEBRIDEMENT
|
Professional
|
Both
|
$4,148.00
|
|
|
Service Code
|
HCPCS 21627
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$96,403.00 |
| Rate for Payer: Aetna Commercial |
$705.48
|
| Rate for Payer: Aetna Medicare |
$547.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.13
|
| Rate for Payer: BCBS Complete |
$372.82
|
| Rate for Payer: BCBS MAPPO |
$526.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$798.50
|
| Rate for Payer: BCN Medicare Advantage |
$526.48
|
| Rate for Payer: Cash Price |
$3,318.40
|
| Rate for Payer: Cash Price |
$3,318.40
|
| Rate for Payer: Cofinity Commercial |
$705.48
|
| Rate for Payer: Cofinity Commercial |
$758.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.48
|
| Rate for Payer: Healthscope Commercial |
$842.37
|
| Rate for Payer: Healthscope Commercial |
$973.99
|
| Rate for Payer: Mclaren Medicaid |
$355.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.80
|
| Rate for Payer: Meridian Medicaid |
$372.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96,403.00
|
| Rate for Payer: Nomi Health Commercial |
$631.78
|
| Rate for Payer: PACE SWMI |
$526.48
|
| Rate for Payer: PHP Medicare Advantage |
$526.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,696.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.66
|
| Rate for Payer: Priority Health Medicare |
$526.48
|
| Rate for Payer: Priority Health Narrow Network |
$841.66
|
| Rate for Payer: Priority Health SBD |
$841.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.48
|
| Rate for Payer: UHC Exchange |
$840.90
|
| Rate for Payer: UHC Medicare Advantage |
$526.48
|
| Rate for Payer: UHCCP Medicaid |
$355.07
|
|
|
PR STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 59525
|
| Min. Negotiated Rate |
$106.19 |
| Max. Negotiated Rate |
$87,048.00 |
| Rate for Payer: Aetna Commercial |
$631.33
|
| Rate for Payer: Aetna Medicare |
$489.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.44
|
| Rate for Payer: BCBS Complete |
$322.28
|
| Rate for Payer: BCBS MAPPO |
$471.14
|
| Rate for Payer: BCBS Trust/PPO |
$106.19
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: BCN Medicare Advantage |
$471.14
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$678.44
|
| Rate for Payer: Cofinity Commercial |
$631.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.14
|
| Rate for Payer: Healthscope Commercial |
$871.61
|
| Rate for Payer: Healthscope Commercial |
$753.82
|
| Rate for Payer: Mclaren Medicaid |
$306.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.70
|
| Rate for Payer: Meridian Medicaid |
$322.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87,048.00
|
| Rate for Payer: Nomi Health Commercial |
$565.37
|
| Rate for Payer: PACE SWMI |
$471.14
|
| Rate for Payer: PHP Medicare Advantage |
$471.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.56
|
| Rate for Payer: Priority Health Medicare |
$471.14
|
| Rate for Payer: Priority Health Narrow Network |
$672.56
|
| Rate for Payer: Priority Health SBD |
$672.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.14
|
| Rate for Payer: UHC Exchange |
$702.00
|
| Rate for Payer: UHC Medicare Advantage |
$471.14
|
| Rate for Payer: UHCCP Medicaid |
$306.93
|
|
|
PR STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC
|
Professional
|
Both
|
$1,445.00
|
|
|
Service Code
|
HCPCS 67311
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$78,068.00 |
| Rate for Payer: Aetna Commercial |
$564.56
|
| Rate for Payer: Aetna Medicare |
$438.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.69
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$421.31
|
| Rate for Payer: BCBS Trust/PPO |
$310.11
|
| Rate for Payer: BCN Commercial |
$654.34
|
| Rate for Payer: BCN Medicare Advantage |
$421.31
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cofinity Commercial |
$606.69
|
| Rate for Payer: Cofinity Commercial |
$564.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.31
|
| Rate for Payer: Healthscope Commercial |
$779.42
|
| Rate for Payer: Healthscope Commercial |
$674.10
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.38
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,068.00
|
| Rate for Payer: Nomi Health Commercial |
$505.57
|
| Rate for Payer: PACE SWMI |
$421.31
|
| Rate for Payer: PHP Medicare Advantage |
$421.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$792.55
|
| Rate for Payer: Priority Health Medicare |
$421.31
|
| Rate for Payer: Priority Health Narrow Network |
$792.55
|
| Rate for Payer: Priority Health SBD |
$792.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.31
|
| Rate for Payer: UHC Exchange |
$754.72
|
| Rate for Payer: UHC Medicare Advantage |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR STRAIGHT TIP URINE CATHETER
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4351
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$241.00 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
|
