|
PR VOID PRESSURE STUDIES INTRAABDOMINAL
|
Professional
|
Both
|
$534.00
|
|
|
Service Code
|
HCPCS 51797
|
| Min. Negotiated Rate |
$144.27 |
| Max. Negotiated Rate |
$400.50 |
| Rate for Payer: Aetna Commercial |
$193.32
|
| Rate for Payer: Aetna Medicare |
$150.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.32
|
| Rate for Payer: BCBS MAPPO |
$144.27
|
| Rate for Payer: BCN Commercial |
$247.99
|
| Rate for Payer: BCN Medicare Advantage |
$144.27
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cofinity Commercial |
$207.75
|
| Rate for Payer: Cofinity Commercial |
$193.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.27
|
| Rate for Payer: Healthscope Commercial |
$266.90
|
| Rate for Payer: Healthscope Commercial |
$230.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.34
|
| Rate for Payer: Nomi Health Commercial |
$173.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$400.50
|
| Rate for Payer: PACE SWMI |
$144.27
|
| Rate for Payer: PHP Medicare Advantage |
$144.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.15
|
| Rate for Payer: Priority Health Medicare |
$144.27
|
| Rate for Payer: Priority Health SBD |
$270.15
|
| Rate for Payer: Priority Health Tiered Network |
$270.15
|
| Rate for Payer: Railroad Medicare Medicare |
$144.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.58
|
| Rate for Payer: UHC Core |
$269.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.27
|
| Rate for Payer: UHC Exchange |
$269.58
|
|
|
PR VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 92540
|
| Min. Negotiated Rate |
$98.92 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Aetna Commercial |
$132.55
|
| Rate for Payer: Aetna Medicare |
$102.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.44
|
| Rate for Payer: BCBS MAPPO |
$98.92
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$98.92
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$142.44
|
| Rate for Payer: Cofinity Commercial |
$132.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.92
|
| Rate for Payer: Healthscope Commercial |
$183.00
|
| Rate for Payer: Healthscope Commercial |
$158.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.25
|
| Rate for Payer: Nomi Health Commercial |
$118.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.00
|
| Rate for Payer: PACE SWMI |
$98.92
|
| Rate for Payer: PHP Medicare Advantage |
$98.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$144.21
|
| Rate for Payer: Priority Health Medicare |
$98.92
|
| Rate for Payer: Priority Health SBD |
$144.21
|
| Rate for Payer: Priority Health Tiered Network |
$144.21
|
| Rate for Payer: Railroad Medicare Medicare |
$98.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.32
|
| Rate for Payer: UHC Core |
$169.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.92
|
| Rate for Payer: UHC Exchange |
$169.32
|
|
|
PR VULVECTOMY RADICAL PARTIAL
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 56630
|
| Min. Negotiated Rate |
$572.54 |
| Max. Negotiated Rate |
$1,706.47 |
| Rate for Payer: Aetna Commercial |
$1,185.34
|
| Rate for Payer: Aetna Medicare |
$919.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.80
|
| Rate for Payer: BCBS Complete |
$601.17
|
| Rate for Payer: BCBS MAPPO |
$884.58
|
| Rate for Payer: BCN Commercial |
$1,444.14
|
| Rate for Payer: BCN Medicare Advantage |
$884.58
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Cofinity Commercial |
$1,273.80
|
| Rate for Payer: Cofinity Commercial |
$1,185.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.58
|
| Rate for Payer: Healthscope Commercial |
$1,636.47
|
| Rate for Payer: Healthscope Commercial |
$1,415.33
|
| Rate for Payer: Mclaren Medicaid |
$572.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.81
|
| Rate for Payer: Meridian Medicaid |
$601.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$973.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,706.47
|
| Rate for Payer: Nomi Health Commercial |
$1,061.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,254.00
|
| Rate for Payer: PACE SWMI |
$884.58
|
| Rate for Payer: PHP Medicare Advantage |
$884.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,462.61
|
| Rate for Payer: Priority Health Medicare |
$884.58
|
| Rate for Payer: Priority Health SBD |
$1,462.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,462.61
|
| Rate for Payer: Railroad Medicare Medicare |
$884.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,647.36
|
| Rate for Payer: UHC Core |
$1,647.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$884.58
|
| Rate for Payer: UHC Exchange |
$1,647.36
|
| Rate for Payer: UHC Medicaid |
$572.54
|
| Rate for Payer: UHCCP Medicaid |
$572.54
|
|
|
PR VULVECTOMY SIMPLE PARTIAL
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 56620
|
| Min. Negotiated Rate |
$348.68 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$712.12
|
| Rate for Payer: Aetna Medicare |
$552.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.26
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$531.43
|
| Rate for Payer: BCN Commercial |
$883.42
|
| Rate for Payer: BCN Medicare Advantage |
$531.43
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$765.26
|
| Rate for Payer: Cofinity Commercial |
$712.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.43
|
| Rate for Payer: Healthscope Commercial |
$983.15
|
| Rate for Payer: Healthscope Commercial |
$850.29
|
| Rate for Payer: Mclaren Medicaid |
$348.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.00
|
| Rate for Payer: Meridian Medicaid |
$366.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$584.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.24
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: PACE SWMI |
$531.43
|
| Rate for Payer: PHP Medicare Advantage |
$531.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$894.72
|
| Rate for Payer: Priority Health Medicare |
$531.43
|
| Rate for Payer: Priority Health SBD |
$894.72
|
| Rate for Payer: Priority Health Tiered Network |
$894.72
|
| Rate for Payer: Railroad Medicare Medicare |
$531.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.16
|
| Rate for Payer: UHC Core |
$961.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$531.43
|
| Rate for Payer: UHC Exchange |
$961.16
|
| Rate for Payer: UHC Medicaid |
$348.68
|
| Rate for Payer: UHCCP Medicaid |
$348.68
|
|
|
PR WEDGE EXCISION SKIN NAIL FOLD
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 11765
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Medicare |
$88.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.16
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: BCN Medicare Advantage |
$85.53
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$123.16
|
| Rate for Payer: Cofinity Commercial |
$114.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.53
|
| Rate for Payer: Healthscope Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$136.85
|
| Rate for Payer: Mclaren Medicaid |
$56.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.81
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.89
|
| Rate for Payer: Nomi Health Commercial |
$102.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$85.53
|
| Rate for Payer: PHP Medicare Advantage |
$85.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$128.53
|
| Rate for Payer: Priority Health Medicare |
$85.53
|
| Rate for Payer: Priority Health SBD |
$128.53
|
| Rate for Payer: Priority Health Tiered Network |
$128.53
|
| Rate for Payer: Railroad Medicare Medicare |
$85.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.67
|
| Rate for Payer: UHC Core |
$158.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.53
|
| Rate for Payer: UHC Exchange |
$158.67
|
| Rate for Payer: UHC Medicaid |
$56.87
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
|
|
PR WEDGE RESCJ/BISCTJ OVARY UNI/BI
|
Professional
|
Both
|
$1,987.00
|
|
|
Service Code
|
HCPCS 58920
|
| Min. Negotiated Rate |
$402.57 |
| Max. Negotiated Rate |
$1,490.25 |
| Rate for Payer: Mclaren Medicaid |
$402.57
|
| Rate for Payer: Aetna Commercial |
$837.50
|
| Rate for Payer: Aetna Medicare |
$650.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.00
|
| Rate for Payer: BCBS Complete |
$422.70
|
| Rate for Payer: BCBS MAPPO |
$625.00
|
| Rate for Payer: BCN Commercial |
$1,070.66
|
| Rate for Payer: BCN Medicare Advantage |
$625.00
|
| Rate for Payer: Cash Price |
$1,589.60
|
| Rate for Payer: Cash Price |
$1,589.60
|
| Rate for Payer: Cofinity Commercial |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$837.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.00
|
| Rate for Payer: Healthscope Commercial |
$1,156.25
|
| Rate for Payer: Healthscope Commercial |
$1,000.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.25
|
| Rate for Payer: Meridian Medicaid |
$422.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,278.86
|
| Rate for Payer: Nomi Health Commercial |
$750.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,490.25
|
| Rate for Payer: PACE SWMI |
$625.00
|
| Rate for Payer: PHP Medicare Advantage |
$625.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,084.35
|
| Rate for Payer: Priority Health Medicare |
$625.00
|
| Rate for Payer: Priority Health SBD |
$1,084.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,084.35
|
| Rate for Payer: Railroad Medicare Medicare |
$625.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.97
|
| Rate for Payer: UHC Core |
$1,257.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.00
|
| Rate for Payer: UHC Exchange |
$1,257.97
|
| Rate for Payer: UHC Medicaid |
$402.57
|
| Rate for Payer: UHCCP Medicaid |
$402.57
|
|
|
PR WEDGING CAST EXCEPT CLUBFOOT CASTS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29740
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$123.26 |
| Rate for Payer: Aetna Commercial |
$80.33
|
| Rate for Payer: Aetna Medicare |
$62.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.33
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$59.95
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$59.95
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$86.33
|
| Rate for Payer: Cofinity Commercial |
$80.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.95
|
| Rate for Payer: Healthscope Commercial |
$95.92
|
| Rate for Payer: Healthscope Commercial |
$110.91
|
| Rate for Payer: Mclaren Medicaid |
$38.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.95
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.20
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$59.95
|
| Rate for Payer: PHP Medicare Advantage |
$59.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.20
|
| Rate for Payer: Priority Health Medicare |
$59.95
|
| Rate for Payer: Priority Health SBD |
$110.20
|
| Rate for Payer: Priority Health Tiered Network |
$110.20
|
| Rate for Payer: Railroad Medicare Medicare |
$59.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.26
|
| Rate for Payer: UHC Core |
$123.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.95
|
| Rate for Payer: UHC Exchange |
$123.26
|
| Rate for Payer: UHC Medicaid |
$38.55
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
PR WESTONE MUSICIAN EAR PLUGS
|
Professional
|
Both
|
$305.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$228.75 |
| Rate for Payer: Aetna Medicare |
$152.50
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.75
|
|
|
PR WET MOUNTS/ W PREPARATIONS
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS Q0111
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$34.30 |
| Rate for Payer: Aetna Commercial |
$24.84
|
| Rate for Payer: Aetna Medicare |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.70
|
| Rate for Payer: BCBS MAPPO |
$18.54
|
| Rate for Payer: BCN Commercial |
$12.75
|
| Rate for Payer: BCN Medicare Advantage |
$18.54
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$24.84
|
| Rate for Payer: Cofinity Commercial |
$26.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.54
|
| Rate for Payer: Healthscope Commercial |
$29.66
|
| Rate for Payer: Healthscope Commercial |
$34.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.97
|
| Rate for Payer: Nomi Health Commercial |
$22.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$18.54
|
| Rate for Payer: PHP Medicare Advantage |
$18.54
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Railroad Medicare Medicare |
$18.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.07
|
| Rate for Payer: UHC Core |
$9.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.54
|
| Rate for Payer: UHC Exchange |
$9.07
|
|
|
PR WHFO, RIGID W/O JOINTS
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS L3808
|
| Min. Negotiated Rate |
$129.91 |
| Max. Negotiated Rate |
$737.10 |
| Rate for Payer: Aetna Commercial |
$533.90
|
| Rate for Payer: Aetna Medicare |
$414.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.74
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$398.43
|
| Rate for Payer: BCN Commercial |
$381.46
|
| Rate for Payer: BCN Medicare Advantage |
$398.43
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$573.74
|
| Rate for Payer: Cofinity Commercial |
$533.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.43
|
| Rate for Payer: Healthscope Commercial |
$637.49
|
| Rate for Payer: Healthscope Commercial |
$737.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.79
|
| Rate for Payer: Nomi Health Commercial |
$478.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$398.43
|
| Rate for Payer: PHP Medicare Advantage |
$398.43
|
| Rate for Payer: Priority Health Medicare |
$398.43
|
| Rate for Payer: Railroad Medicare Medicare |
$398.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.91
|
| Rate for Payer: UHC Core |
$129.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.43
|
| Rate for Payer: UHC Exchange |
$129.91
|
|
|
PR WHFO W/O JOINTS PRE CST
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS L3807
|
| Min. Negotiated Rate |
$91.19 |
| Max. Negotiated Rate |
$517.39 |
| Rate for Payer: Aetna Commercial |
$374.76
|
| Rate for Payer: Aetna Medicare |
$290.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.72
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: BCBS MAPPO |
$279.67
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$279.67
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$402.72
|
| Rate for Payer: Cofinity Commercial |
$374.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.67
|
| Rate for Payer: Healthscope Commercial |
$447.47
|
| Rate for Payer: Healthscope Commercial |
$517.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.97
|
| Rate for Payer: Nomi Health Commercial |
$335.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.75
|
| Rate for Payer: PACE SWMI |
$279.67
|
| Rate for Payer: PHP Medicare Advantage |
$279.67
|
| Rate for Payer: Priority Health Medicare |
$279.67
|
| Rate for Payer: Railroad Medicare Medicare |
$279.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.19
|
| Rate for Payer: UHC Core |
$91.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.67
|
| Rate for Payer: UHC Exchange |
$91.19
|
|
|
PR WHO COCK-UP NONMOLDE PRE OTS
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS L3908
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$151.70 |
| Rate for Payer: Aetna Commercial |
$109.88
|
| Rate for Payer: Aetna Medicare |
$85.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.08
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$82.00
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: BCN Medicare Advantage |
$82.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$118.08
|
| Rate for Payer: Cofinity Commercial |
$109.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.00
|
| Rate for Payer: Healthscope Commercial |
$131.20
|
| Rate for Payer: Healthscope Commercial |
$151.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.52
|
| Rate for Payer: Nomi Health Commercial |
$98.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PACE SWMI |
$82.00
|
| Rate for Payer: PHP Medicare Advantage |
$82.00
|
| Rate for Payer: Priority Health Medicare |
$82.00
|
| Rate for Payer: Railroad Medicare Medicare |
$82.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.74
|
| Rate for Payer: UHC Core |
$26.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.00
|
| Rate for Payer: UHC Exchange |
$26.74
|
|
|
PR WHO W/NONTORSION JNT(S) CF
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS L3905
|
| Min. Negotiated Rate |
$361.66 |
| Max. Negotiated Rate |
$2,051.95 |
| Rate for Payer: Aetna Commercial |
$1,486.27
|
| Rate for Payer: Aetna Medicare |
$1,153.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.19
|
| Rate for Payer: BCBS Complete |
$381.60
|
| Rate for Payer: BCBS MAPPO |
$1,109.16
|
| Rate for Payer: BCN Commercial |
$1,061.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.16
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$1,597.19
|
| Rate for Payer: Cofinity Commercial |
$1,486.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.16
|
| Rate for Payer: Healthscope Commercial |
$1,774.66
|
| Rate for Payer: Healthscope Commercial |
$2,051.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,164.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,220.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.01
|
| Rate for Payer: Nomi Health Commercial |
$1,330.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.50
|
| Rate for Payer: PACE SWMI |
$1,109.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.16
|
| Rate for Payer: Priority Health Medicare |
$1,109.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,109.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.66
|
| Rate for Payer: UHC Core |
$361.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,109.16
|
| Rate for Payer: UHC Exchange |
$361.66
|
|
|
PR WHO W/O JOINTS CF
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS L3906
|
| Min. Negotiated Rate |
$184.82 |
| Max. Negotiated Rate |
$1,048.56 |
| Rate for Payer: Aetna Commercial |
$759.50
|
| Rate for Payer: Aetna Medicare |
$589.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.18
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: BCBS MAPPO |
$566.79
|
| Rate for Payer: BCN Commercial |
$542.66
|
| Rate for Payer: BCN Medicare Advantage |
$566.79
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$816.18
|
| Rate for Payer: Cofinity Commercial |
$759.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.79
|
| Rate for Payer: Healthscope Commercial |
$906.86
|
| Rate for Payer: Healthscope Commercial |
$1,048.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$623.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$528.91
|
| Rate for Payer: Nomi Health Commercial |
$680.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.25
|
| Rate for Payer: PACE SWMI |
$566.79
|
| Rate for Payer: PHP Medicare Advantage |
$566.79
|
| Rate for Payer: Priority Health Medicare |
$566.79
|
| Rate for Payer: Railroad Medicare Medicare |
$566.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.82
|
| Rate for Payer: UHC Core |
$184.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$566.79
|
| Rate for Payer: UHC Exchange |
$184.82
|
|
|
PR WINDOWING CAST
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29730
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Medicare |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.24
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$38.36
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: BCN Medicare Advantage |
$38.36
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$55.24
|
| Rate for Payer: Cofinity Commercial |
$51.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.36
|
| Rate for Payer: Healthscope Commercial |
$70.97
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Mclaren Medicaid |
$24.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.28
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.62
|
| Rate for Payer: Nomi Health Commercial |
$46.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$38.36
|
| Rate for Payer: PHP Medicare Advantage |
$38.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.32
|
| Rate for Payer: Priority Health Medicare |
$38.36
|
| Rate for Payer: Priority Health SBD |
$71.32
|
| Rate for Payer: Priority Health Tiered Network |
$71.32
|
| Rate for Payer: Railroad Medicare Medicare |
$38.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.40
|
| Rate for Payer: UHC Core |
$76.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.36
|
| Rate for Payer: UHC Exchange |
$76.40
|
| Rate for Payer: UHC Medicaid |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$24.71
|
|
|
PR WORK HARDENING/CONDITIONING 1ST 2 HR
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 97545
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$241.02 |
| Rate for Payer: Aetna Commercial |
$119.94
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.94
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCN Commercial |
$189.41
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.21
|
| Rate for Payer: UHC Core |
$142.21
|
| Rate for Payer: UHC Exchange |
$142.21
|
|
|
PR WORK HARDENING/CONDITIONING EACH HOUR
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 97546
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$47.77
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.77
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCN Commercial |
$94.44
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.83
|
| Rate for Payer: UHC Core |
$56.83
|
| Rate for Payer: UHC Exchange |
$56.83
|
|
|
PR WORK RELATED/MED DBLT XM TREATING PHYS
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 99455
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Aetna Commercial |
$84.95
|
| Rate for Payer: Aetna Medicare |
$57.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.95
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
|
|
PR WOUND CLOSURE BY ADHESIVE
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS G0168
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Medicare |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.42
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$19.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$26.23
|
| Rate for Payer: Healthscope Commercial |
$22.69
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.28
|
| Rate for Payer: Nomi Health Commercial |
$17.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.00
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.60
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health SBD |
$19.60
|
| Rate for Payer: Priority Health Tiered Network |
$19.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.99
|
| Rate for Payer: UHC Core |
$32.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.18
|
| Rate for Payer: UHC Exchange |
$32.99
|
| Rate for Payer: UHC Medicaid |
$8.95
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 66984
|
| Min. Negotiated Rate |
$295.01 |
| Max. Negotiated Rate |
$948.75 |
| Rate for Payer: Aetna Commercial |
$599.10
|
| Rate for Payer: Aetna Medicare |
$464.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.81
|
| Rate for Payer: BCBS Complete |
$309.76
|
| Rate for Payer: BCBS MAPPO |
$447.09
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: BCN Medicare Advantage |
$447.09
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$643.81
|
| Rate for Payer: Cofinity Commercial |
$599.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.09
|
| Rate for Payer: Healthscope Commercial |
$827.12
|
| Rate for Payer: Healthscope Commercial |
$715.34
|
| Rate for Payer: Mclaren Medicaid |
$295.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.44
|
| Rate for Payer: Meridian Medicaid |
$309.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.97
|
| Rate for Payer: Nomi Health Commercial |
$536.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.75
|
| Rate for Payer: PACE SWMI |
$447.09
|
| Rate for Payer: PHP Medicare Advantage |
$447.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$940.87
|
| Rate for Payer: Priority Health Medicare |
$447.09
|
| Rate for Payer: Priority Health SBD |
$940.87
|
| Rate for Payer: Priority Health Tiered Network |
$940.87
|
| Rate for Payer: Railroad Medicare Medicare |
$447.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.75
|
| Rate for Payer: UHC Core |
$929.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.09
|
| Rate for Payer: UHC Exchange |
$929.75
|
| Rate for Payer: UHC Medicaid |
$295.01
|
| Rate for Payer: UHCCP Medicaid |
$295.01
|
|
|
PR XEOMIN
|
Professional
|
Both
|
$10.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| 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: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 94617
|
| Min. Negotiated Rate |
$87.35 |
| Max. Negotiated Rate |
$161.60 |
| Rate for Payer: Aetna Commercial |
$117.05
|
| Rate for Payer: Aetna Commercial |
$117.05
|
| Rate for Payer: Aetna Medicare |
$90.84
|
| Rate for Payer: Aetna Medicare |
$90.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.05
|
| Rate for Payer: BCBS MAPPO |
$87.35
|
| Rate for Payer: BCBS MAPPO |
$87.35
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$87.35
|
| Rate for Payer: BCN Medicare Advantage |
$87.35
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Cofinity Commercial |
$125.78
|
| Rate for Payer: Cofinity Commercial |
$125.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.35
|
| Rate for Payer: Healthscope Commercial |
$139.76
|
| Rate for Payer: Healthscope Commercial |
$161.60
|
| Rate for Payer: Healthscope Commercial |
$139.76
|
| Rate for Payer: Healthscope Commercial |
$161.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Nomi Health Commercial |
$104.82
|
| Rate for Payer: Nomi Health Commercial |
$104.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.75
|
| Rate for Payer: PACE SWMI |
$87.35
|
| Rate for Payer: PACE SWMI |
$87.35
|
| Rate for Payer: PHP Medicare Advantage |
$87.35
|
| Rate for Payer: PHP Medicare Advantage |
$87.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$123.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$123.08
|
| Rate for Payer: Priority Health Medicare |
$87.35
|
| Rate for Payer: Priority Health Medicare |
$87.35
|
| Rate for Payer: Priority Health SBD |
$123.08
|
| Rate for Payer: Priority Health SBD |
$123.08
|
| Rate for Payer: Priority Health Tiered Network |
$123.08
|
| Rate for Payer: Priority Health Tiered Network |
$123.08
|
| Rate for Payer: Railroad Medicare Medicare |
$87.35
|
| Rate for Payer: Railroad Medicare Medicare |
$87.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.88
|
| Rate for Payer: UHC Core |
$140.88
|
| Rate for Payer: UHC Core |
$140.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.35
|
| Rate for Payer: UHC Exchange |
$140.88
|
| Rate for Payer: UHC Exchange |
$140.88
|
|
|
PR XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 94619
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$83.88
|
| Rate for Payer: Aetna Medicare |
$65.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.88
|
| Rate for Payer: BCBS MAPPO |
$62.60
|
| Rate for Payer: BCN Commercial |
$97.60
|
| Rate for Payer: BCN Medicare Advantage |
$62.60
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$90.14
|
| Rate for Payer: Cofinity Commercial |
$83.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.60
|
| Rate for Payer: Healthscope Commercial |
$115.81
|
| Rate for Payer: Healthscope Commercial |
$100.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.14
|
| Rate for Payer: Nomi Health Commercial |
$75.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.75
|
| Rate for Payer: PACE SWMI |
$62.60
|
| Rate for Payer: PHP Medicare Advantage |
$62.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$90.01
|
| Rate for Payer: Priority Health Medicare |
$62.60
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: Priority Health Tiered Network |
$90.01
|
| Rate for Payer: Railroad Medicare Medicare |
$62.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.45
|
| Rate for Payer: UHC Core |
$117.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.60
|
| Rate for Payer: UHC Exchange |
$117.45
|
|
|
PR XTRNL ECG REC>48HR<7D RECORDING SCAN A/R R&I
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 93241
|
| Min. Negotiated Rate |
$121.30 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Aetna Commercial |
$343.91
|
| Rate for Payer: Aetna Medicare |
$266.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.58
|
| Rate for Payer: BCBS MAPPO |
$256.65
|
| Rate for Payer: BCN Commercial |
$315.34
|
| Rate for Payer: BCN Medicare Advantage |
$256.65
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$369.58
|
| Rate for Payer: Cofinity Commercial |
$343.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.65
|
| Rate for Payer: Healthscope Commercial |
$474.80
|
| Rate for Payer: Healthscope Commercial |
$410.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$282.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.97
|
| Rate for Payer: Nomi Health Commercial |
$307.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE SWMI |
$256.65
|
| Rate for Payer: PHP Medicare Advantage |
$256.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$380.06
|
| Rate for Payer: Priority Health Medicare |
$256.65
|
| Rate for Payer: Priority Health SBD |
$380.06
|
| Rate for Payer: Priority Health Tiered Network |
$380.06
|
| Rate for Payer: Railroad Medicare Medicare |
$256.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.30
|
| Rate for Payer: UHC Core |
$121.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$256.65
|
| Rate for Payer: UHC Exchange |
$121.30
|
|
|
PR XTRNL ECG REC<48 HRS RECORDING
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 93225
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$22.16
|
| Rate for Payer: Aetna Medicare |
$17.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.16
|
| Rate for Payer: BCBS MAPPO |
$16.54
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$16.54
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$22.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.54
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$26.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.56
|
| Rate for Payer: Nomi Health Commercial |
$19.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.56
|
| Rate for Payer: Priority Health Medicare |
$16.54
|
| Rate for Payer: Priority Health SBD |
$25.56
|
| Rate for Payer: Priority Health Tiered Network |
$25.56
|
| Rate for Payer: Railroad Medicare Medicare |
$16.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.33
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.54
|
| Rate for Payer: UHC Exchange |
$38.33
|
|
