|
PR TENOTOMY FLEXOR FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 26455
|
| Min. Negotiated Rate |
$396.40 |
| Max. Negotiated Rate |
$796.00 |
| Rate for Payer: Aetna Commercial |
$576.56
|
| Rate for Payer: Aetna Medicare |
$447.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.56
|
| Rate for Payer: BCBS Complete |
$396.40
|
| Rate for Payer: BCBS MAPPO |
$430.27
|
| Rate for Payer: BCN Medicare Advantage |
$430.27
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$619.59
|
| Rate for Payer: Cofinity Commercial |
$576.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.27
|
| Rate for Payer: Healthscope Commercial |
$796.00
|
| Rate for Payer: Healthscope Commercial |
$688.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.15
|
| Rate for Payer: Nomi Health Commercial |
$516.32
|
| Rate for Payer: PACE SWMI |
$430.27
|
| Rate for Payer: PHP Medicare Advantage |
$430.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.15
|
| Rate for Payer: Priority Health Medicare |
$430.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.27
|
| Rate for Payer: UHC Medicare Advantage |
$430.27
|
|
|
PR TENOTOMY FLEXOR PALM OPEN EACH TENDON
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 26450
|
| Min. Negotiated Rate |
$433.31 |
| Max. Negotiated Rate |
$801.62 |
| Rate for Payer: Aetna Commercial |
$580.64
|
| Rate for Payer: Aetna Medicare |
$450.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.64
|
| Rate for Payer: BCBS Complete |
$450.80
|
| Rate for Payer: BCBS MAPPO |
$433.31
|
| Rate for Payer: BCN Medicare Advantage |
$433.31
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$623.97
|
| Rate for Payer: Cofinity Commercial |
$580.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.31
|
| Rate for Payer: Healthscope Commercial |
$693.30
|
| Rate for Payer: Healthscope Commercial |
$801.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.55
|
| Rate for Payer: Nomi Health Commercial |
$519.97
|
| Rate for Payer: PACE SWMI |
$433.31
|
| Rate for Payer: PHP Medicare Advantage |
$433.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health Medicare |
$433.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.31
|
| Rate for Payer: UHC Medicare Advantage |
$433.31
|
|
|
PR TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 27005
|
| Min. Negotiated Rate |
$564.40 |
| Max. Negotiated Rate |
$1,291.80 |
| Rate for Payer: Aetna Commercial |
$935.68
|
| Rate for Payer: Aetna Medicare |
$726.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.51
|
| Rate for Payer: BCBS Complete |
$564.40
|
| Rate for Payer: BCBS MAPPO |
$698.27
|
| Rate for Payer: BCN Medicare Advantage |
$698.27
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$935.68
|
| Rate for Payer: Cofinity Commercial |
$1,005.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.27
|
| Rate for Payer: Healthscope Commercial |
$1,291.80
|
| Rate for Payer: Healthscope Commercial |
$1,117.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$917.15
|
| Rate for Payer: Nomi Health Commercial |
$837.92
|
| Rate for Payer: PACE SWMI |
$698.27
|
| Rate for Payer: PHP Medicare Advantage |
$698.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health Medicare |
$698.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.27
|
| Rate for Payer: UHC Medicare Advantage |
$698.27
|
|
|
PR TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 24310
|
| Min. Negotiated Rate |
$362.40 |
| Max. Negotiated Rate |
$843.27 |
| Rate for Payer: Aetna Commercial |
$610.80
|
| Rate for Payer: Aetna Medicare |
$474.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$610.80
|
| Rate for Payer: BCBS Complete |
$362.40
|
| Rate for Payer: BCBS MAPPO |
$455.82
|
| Rate for Payer: BCN Medicare Advantage |
$455.82
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$656.38
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.82
|
| Rate for Payer: Healthscope Commercial |
$729.31
|
| Rate for Payer: Healthscope Commercial |
$843.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$478.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.90
|
| Rate for Payer: Nomi Health Commercial |
$546.98
|
| Rate for Payer: PACE SWMI |
$455.82
|
| Rate for Payer: PHP Medicare Advantage |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.90
|
| Rate for Payer: Priority Health Medicare |
$455.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.82
|
| Rate for Payer: UHC Medicare Advantage |
$455.82
|
|
|
PR TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 28234
|
| Min. Negotiated Rate |
$257.82 |
| Max. Negotiated Rate |
$476.97 |
| Rate for Payer: Aetna Commercial |
$345.48
|
| Rate for Payer: Aetna Medicare |
$268.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.48
|
| Rate for Payer: BCBS Complete |
$265.60
|
| Rate for Payer: BCBS MAPPO |
$257.82
|
| Rate for Payer: BCN Medicare Advantage |
$257.82
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Cofinity Commercial |
$345.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.82
|
| Rate for Payer: Healthscope Commercial |
$476.97
|
| Rate for Payer: Healthscope Commercial |
$412.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.60
|
| Rate for Payer: Nomi Health Commercial |
$309.38
|
| Rate for Payer: PACE SWMI |
$257.82
|
| Rate for Payer: PHP Medicare Advantage |
$257.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health Medicare |
$257.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.82
|
| Rate for Payer: UHC Medicare Advantage |
$257.82
|
|
|
PR TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 27391
|
| Min. Negotiated Rate |
$461.20 |
| Max. Negotiated Rate |
$1,038.07 |
| Rate for Payer: Aetna Commercial |
$751.90
|
| Rate for Payer: Aetna Medicare |
$583.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.90
|
| Rate for Payer: BCBS Complete |
$461.20
|
| Rate for Payer: BCBS MAPPO |
$561.12
|
| Rate for Payer: BCN Medicare Advantage |
$561.12
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$808.01
|
| Rate for Payer: Cofinity Commercial |
$751.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.12
|
| Rate for Payer: Healthscope Commercial |
$1,038.07
|
| Rate for Payer: Healthscope Commercial |
$897.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.45
|
| Rate for Payer: Nomi Health Commercial |
$673.34
|
| Rate for Payer: PACE SWMI |
$561.12
|
| Rate for Payer: PHP Medicare Advantage |
$561.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health Medicare |
$561.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.12
|
| Rate for Payer: UHC Medicare Advantage |
$561.12
|
|
|
PR TENOTOMY PERCUTANEOUS TOE SINGLE TENDON
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 28010
|
| Min. Negotiated Rate |
$157.60 |
| Max. Negotiated Rate |
$368.09 |
| Rate for Payer: Aetna Commercial |
$266.62
|
| Rate for Payer: Aetna Medicare |
$206.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.62
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$198.97
|
| Rate for Payer: BCN Medicare Advantage |
$198.97
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$286.52
|
| Rate for Payer: Cofinity Commercial |
$266.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.97
|
| Rate for Payer: Healthscope Commercial |
$368.09
|
| Rate for Payer: Healthscope Commercial |
$318.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.10
|
| Rate for Payer: Nomi Health Commercial |
$238.76
|
| Rate for Payer: PACE SWMI |
$198.97
|
| Rate for Payer: PHP Medicare Advantage |
$198.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$198.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.97
|
| Rate for Payer: UHC Medicare Advantage |
$198.97
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 27606
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$563.55 |
| Rate for Payer: Aetna Commercial |
$349.45
|
| Rate for Payer: Aetna Medicare |
$271.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.45
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$260.78
|
| Rate for Payer: BCN Medicare Advantage |
$260.78
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$375.52
|
| Rate for Payer: Cofinity Commercial |
$349.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.78
|
| Rate for Payer: Healthscope Commercial |
$417.25
|
| Rate for Payer: Healthscope Commercial |
$482.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$312.94
|
| Rate for Payer: PACE SWMI |
$260.78
|
| Rate for Payer: PHP Medicare Advantage |
$260.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health Medicare |
$260.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.78
|
| Rate for Payer: UHC Medicare Advantage |
$260.78
|
|
|
PR TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 27605
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$495.30 |
| Rate for Payer: Aetna Commercial |
$234.50
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.50
|
| Rate for Payer: BCBS Complete |
$304.80
|
| Rate for Payer: BCBS MAPPO |
$175.00
|
| Rate for Payer: BCN Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cofinity Commercial |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$234.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.00
|
| Rate for Payer: Healthscope Commercial |
$323.75
|
| Rate for Payer: Healthscope Commercial |
$280.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.30
|
| Rate for Payer: Nomi Health Commercial |
$210.00
|
| Rate for Payer: PACE SWMI |
$175.00
|
| Rate for Payer: PHP Medicare Advantage |
$175.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: Priority Health Medicare |
$175.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$175.00
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX
|
Professional
|
Both
|
$1,181.00
|
|
|
Service Code
|
HCPCS 27306
|
| Min. Negotiated Rate |
$329.65 |
| Max. Negotiated Rate |
$767.65 |
| Rate for Payer: Aetna Commercial |
$441.73
|
| Rate for Payer: Aetna Medicare |
$342.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.73
|
| Rate for Payer: BCBS Complete |
$472.40
|
| Rate for Payer: BCBS MAPPO |
$329.65
|
| Rate for Payer: BCN Medicare Advantage |
$329.65
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cash Price |
$944.80
|
| Rate for Payer: Cofinity Commercial |
$474.70
|
| Rate for Payer: Cofinity Commercial |
$441.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.65
|
| Rate for Payer: Healthscope Commercial |
$527.44
|
| Rate for Payer: Healthscope Commercial |
$609.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$767.65
|
| Rate for Payer: Nomi Health Commercial |
$395.58
|
| Rate for Payer: PACE SWMI |
$329.65
|
| Rate for Payer: PHP Medicare Advantage |
$329.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.65
|
| Rate for Payer: Priority Health Medicare |
$329.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.65
|
| Rate for Payer: UHC Medicare Advantage |
$329.65
|
|
|
PR TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 27307
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$730.14 |
| Rate for Payer: Aetna Commercial |
$528.86
|
| Rate for Payer: Aetna Medicare |
$410.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.86
|
| Rate for Payer: BCBS Complete |
$338.00
|
| Rate for Payer: BCBS MAPPO |
$394.67
|
| Rate for Payer: BCN Medicare Advantage |
$394.67
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$568.32
|
| Rate for Payer: Cofinity Commercial |
$528.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.67
|
| Rate for Payer: Healthscope Commercial |
$730.14
|
| Rate for Payer: Healthscope Commercial |
$631.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.25
|
| Rate for Payer: Nomi Health Commercial |
$473.60
|
| Rate for Payer: PACE SWMI |
$394.67
|
| Rate for Payer: PHP Medicare Advantage |
$394.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health Medicare |
$394.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.67
|
| Rate for Payer: UHC Medicare Advantage |
$394.67
|
|
|
PR TENOTOMY SHOULDER AREA 1 TENDON
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 23405
|
| Min. Negotiated Rate |
$591.84 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$793.07
|
| Rate for Payer: Aetna Medicare |
$615.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.07
|
| Rate for Payer: BCBS Complete |
$692.80
|
| Rate for Payer: BCBS MAPPO |
$591.84
|
| Rate for Payer: BCN Medicare Advantage |
$591.84
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cofinity Commercial |
$852.25
|
| Rate for Payer: Cofinity Commercial |
$793.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.84
|
| Rate for Payer: Healthscope Commercial |
$1,094.90
|
| Rate for Payer: Healthscope Commercial |
$946.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,125.80
|
| Rate for Payer: Nomi Health Commercial |
$710.21
|
| Rate for Payer: PACE SWMI |
$591.84
|
| Rate for Payer: PHP Medicare Advantage |
$591.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health Medicare |
$591.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.84
|
| Rate for Payer: UHC Medicare Advantage |
$591.84
|
|
|
PR TERBUTALINE SULFATE INJ
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J3105
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Medicare |
$7.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.64
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$7.39
|
| Rate for Payer: BCN Medicare Advantage |
$7.39
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$10.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.39
|
| Rate for Payer: Healthscope Commercial |
$13.67
|
| Rate for Payer: Healthscope Commercial |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$8.87
|
| Rate for Payer: PACE SWMI |
$7.39
|
| Rate for Payer: PHP Medicare Advantage |
$7.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$7.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.39
|
| Rate for Payer: UHC Medicare Advantage |
$7.39
|
|
|
PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 95923
|
| Min. Negotiated Rate |
$107.04 |
| Max. Negotiated Rate |
$285.35 |
| Rate for Payer: Aetna Commercial |
$143.43
|
| Rate for Payer: Aetna Medicare |
$111.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.43
|
| Rate for Payer: BCBS Complete |
$175.60
|
| Rate for Payer: BCBS MAPPO |
$107.04
|
| Rate for Payer: BCN Medicare Advantage |
$107.04
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cofinity Commercial |
$154.14
|
| Rate for Payer: Cofinity Commercial |
$143.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.04
|
| Rate for Payer: Healthscope Commercial |
$171.26
|
| Rate for Payer: Healthscope Commercial |
$198.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.35
|
| Rate for Payer: Nomi Health Commercial |
$128.45
|
| Rate for Payer: PACE SWMI |
$107.04
|
| Rate for Payer: PHP Medicare Advantage |
$107.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.35
|
| Rate for Payer: Priority Health Medicare |
$107.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.04
|
| Rate for Payer: UHC Medicare Advantage |
$107.04
|
|
|
PR TESTOSTERONE CYPIONAT 100 MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1070
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
|
|
PR TESTOSTERONE CYPIONAT 200 MG
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J1080
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR TESTOSTERONE CYPIONATE 1 ML
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J1060
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
|
|
PR TESTOSTERONE ENANTHATE INJ
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J3130
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR TESTOSTERONE PELLET 75 MG
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS S0189
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
|
|
PR TESTOSTERONE UNDECANOATE 1MG
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3145
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.83 |
| Rate for Payer: Aetna Commercial |
$2.77
|
| Rate for Payer: Aetna Medicare |
$2.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.77
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$2.07
|
| Rate for Payer: BCN Medicare Advantage |
$2.07
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Cofinity Commercial |
$2.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.07
|
| Rate for Payer: Healthscope Commercial |
$3.83
|
| Rate for Payer: Healthscope Commercial |
$3.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.25
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: PACE SWMI |
$2.07
|
| Rate for Payer: PHP Medicare Advantage |
$2.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$2.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.07
|
| Rate for Payer: UHC Medicare Advantage |
$2.07
|
|
|
PR TETANUS IMMUNIZATION, IM
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 90703
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
|
|
PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97530
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$60.83 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$34.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.35
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$32.88
|
| Rate for Payer: BCN Medicare Advantage |
$32.88
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Cofinity Commercial |
$44.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.88
|
| Rate for Payer: Healthscope Commercial |
$60.83
|
| Rate for Payer: Healthscope Commercial |
$52.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.40
|
| Rate for Payer: Nomi Health Commercial |
$39.46
|
| Rate for Payer: PACE SWMI |
$32.88
|
| Rate for Payer: PHP Medicare Advantage |
$32.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$32.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.88
|
| Rate for Payer: UHC Medicare Advantage |
$32.88
|
|
|
PR THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 36514
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$564.85 |
| Rate for Payer: Aetna Commercial |
$118.17
|
| Rate for Payer: Aetna Medicare |
$91.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.99
|
| Rate for Payer: BCBS Complete |
$347.60
|
| Rate for Payer: BCBS MAPPO |
$88.19
|
| Rate for Payer: BCN Medicare Advantage |
$88.19
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$118.17
|
| Rate for Payer: Cofinity Commercial |
$126.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.19
|
| Rate for Payer: Healthscope Commercial |
$141.10
|
| Rate for Payer: Healthscope Commercial |
$163.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.85
|
| Rate for Payer: Nomi Health Commercial |
$105.83
|
| Rate for Payer: PACE SWMI |
$88.19
|
| Rate for Payer: PHP Medicare Advantage |
$88.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health Medicare |
$88.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.19
|
| Rate for Payer: UHC Medicare Advantage |
$88.19
|
|
|
PR THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 97150
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$31.14 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$22.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$26.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Nomi Health Commercial |
$20.20
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$16.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$16.83
|
|
|
PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 96372
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$17.75
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.75
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$21.20
|
| Rate for Payer: Healthscope Commercial |
$24.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
|
