|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 99407
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$3,687.00 |
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Medicare |
$24.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$23.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$23.58
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$31.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.58
|
| Rate for Payer: Healthscope Commercial |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$43.62
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.76
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,687.00
|
| Rate for Payer: Nomi Health Commercial |
$28.30
|
| Rate for Payer: PACE SWMI |
$23.58
|
| Rate for Payer: PHP Medicare Advantage |
$23.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.20
|
| Rate for Payer: Priority Health Medicare |
$23.58
|
| Rate for Payer: Priority Health Narrow Network |
$33.20
|
| Rate for Payer: Priority Health SBD |
$33.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.58
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 99406
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$1,746.00 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.08
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
| Rate for Payer: BCN Commercial |
$15.76
|
| Rate for Payer: BCN Medicare Advantage |
$11.17
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Cofinity Commercial |
$14.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$17.87
|
| Rate for Payer: Healthscope Commercial |
$20.66
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.73
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,746.00
|
| Rate for Payer: Nomi Health Commercial |
$13.40
|
| Rate for Payer: PACE SWMI |
$11.17
|
| Rate for Payer: PHP Medicare Advantage |
$11.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.71
|
| Rate for Payer: Priority Health Medicare |
$11.17
|
| Rate for Payer: Priority Health Narrow Network |
$15.71
|
| Rate for Payer: Priority Health SBD |
$15.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.17
|
| Rate for Payer: UHC Medicare Advantage |
$11.17
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS G0437
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$32.16 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.16
|
| Rate for Payer: Priority Health Narrow Network |
$32.16
|
| Rate for Payer: Priority Health SBD |
$32.16
|
|
|
PR TOBACCO-USE COUNSEL 3-10 MIN
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G0436
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.42
|
| Rate for Payer: Priority Health Narrow Network |
$15.42
|
| Rate for Payer: Priority Health SBD |
$15.42
|
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 92563
|
| Min. Negotiated Rate |
$16.63 |
| Max. Negotiated Rate |
$4,593.00 |
| Rate for Payer: Aetna Commercial |
$42.37
|
| Rate for Payer: Aetna Medicare |
$32.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.37
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.79
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$42.37
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.00
|
| Rate for Payer: Nomi Health Commercial |
$37.94
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.04
|
| Rate for Payer: Priority Health Medicare |
$31.62
|
| Rate for Payer: Priority Health Narrow Network |
$47.04
|
| Rate for Payer: Priority Health SBD |
$47.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.62
|
| Rate for Payer: UHC Exchange |
$16.63
|
| Rate for Payer: UHC Medicare Advantage |
$31.62
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 42820
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$51,563.00 |
| Rate for Payer: Aetna Commercial |
$374.25
|
| Rate for Payer: Aetna Medicare |
$290.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.18
|
| Rate for Payer: BCBS Complete |
$198.83
|
| Rate for Payer: BCBS MAPPO |
$279.29
|
| Rate for Payer: BCBS Trust/PPO |
$652.98
|
| Rate for Payer: BCN Commercial |
$428.08
|
| Rate for Payer: BCN Medicare Advantage |
$279.29
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cofinity Commercial |
$402.18
|
| Rate for Payer: Cofinity Commercial |
$374.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.29
|
| Rate for Payer: Healthscope Commercial |
$516.69
|
| Rate for Payer: Healthscope Commercial |
$446.86
|
| Rate for Payer: Mclaren Medicaid |
$189.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.25
|
| Rate for Payer: Meridian Medicaid |
$198.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,563.00
|
| Rate for Payer: Nomi Health Commercial |
$335.15
|
| Rate for Payer: PACE SWMI |
$279.29
|
| Rate for Payer: PHP Medicare Advantage |
$279.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.98
|
| Rate for Payer: Priority Health Medicare |
$279.29
|
| Rate for Payer: Priority Health Narrow Network |
$527.98
|
| Rate for Payer: Priority Health SBD |
$527.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.29
|
| Rate for Payer: UHC Exchange |
$362.99
|
| Rate for Payer: UHC Medicare Advantage |
$279.29
|
| Rate for Payer: UHCCP Medicaid |
$189.36
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 42821
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$54,023.00 |
| Rate for Payer: Aetna Commercial |
$390.02
|
| Rate for Payer: Aetna Medicare |
$302.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.13
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$291.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.07
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$291.06
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$419.13
|
| Rate for Payer: Cofinity Commercial |
$390.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.06
|
| Rate for Payer: Healthscope Commercial |
$538.46
|
| Rate for Payer: Healthscope Commercial |
$465.70
|
| Rate for Payer: Mclaren Medicaid |
$197.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.61
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,023.00
|
| Rate for Payer: Nomi Health Commercial |
$349.27
|
| Rate for Payer: PACE SWMI |
$291.06
|
| Rate for Payer: PHP Medicare Advantage |
$291.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$376.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$551.26
|
| Rate for Payer: Priority Health Medicare |
$291.06
|
| Rate for Payer: Priority Health Narrow Network |
$551.26
|
| Rate for Payer: Priority Health SBD |
$551.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.06
|
| Rate for Payer: UHC Exchange |
$399.16
|
| Rate for Payer: UHC Medicare Advantage |
$291.06
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY <AGE 12
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 42825
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$47,419.00 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: Aetna Medicare |
$267.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.01
|
| Rate for Payer: BCBS Complete |
$184.06
|
| Rate for Payer: BCBS MAPPO |
$256.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.22
|
| Rate for Payer: BCN Commercial |
$395.83
|
| Rate for Payer: BCN Medicare Advantage |
$256.95
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$370.01
|
| Rate for Payer: Cofinity Commercial |
$344.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.95
|
| Rate for Payer: Healthscope Commercial |
$475.36
|
| Rate for Payer: Healthscope Commercial |
$411.12
|
| Rate for Payer: Mclaren Medicaid |
$175.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.80
|
| Rate for Payer: Meridian Medicaid |
$184.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,419.00
|
| Rate for Payer: Nomi Health Commercial |
$308.34
|
| Rate for Payer: PACE SWMI |
$256.95
|
| Rate for Payer: PHP Medicare Advantage |
$256.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$487.42
|
| Rate for Payer: Priority Health Medicare |
$256.95
|
| Rate for Payer: Priority Health Narrow Network |
$487.42
|
| Rate for Payer: Priority Health SBD |
$487.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.95
|
| Rate for Payer: UHC Exchange |
$359.94
|
| Rate for Payer: UHC Medicare Advantage |
$256.95
|
| Rate for Payer: UHCCP Medicaid |
$175.30
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 42826
|
| Min. Negotiated Rate |
$166.57 |
| Max. Negotiated Rate |
$45,220.00 |
| Rate for Payer: Aetna Commercial |
$327.78
|
| Rate for Payer: Aetna Medicare |
$254.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.24
|
| Rate for Payer: BCBS Complete |
$174.90
|
| Rate for Payer: BCBS MAPPO |
$244.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.94
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$244.61
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$352.24
|
| Rate for Payer: Cofinity Commercial |
$327.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.61
|
| Rate for Payer: Healthscope Commercial |
$452.53
|
| Rate for Payer: Healthscope Commercial |
$391.38
|
| Rate for Payer: Mclaren Medicaid |
$166.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.84
|
| Rate for Payer: Meridian Medicaid |
$174.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,220.00
|
| Rate for Payer: Nomi Health Commercial |
$293.53
|
| Rate for Payer: PACE SWMI |
$244.61
|
| Rate for Payer: PHP Medicare Advantage |
$244.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.16
|
| Rate for Payer: Priority Health Medicare |
$244.61
|
| Rate for Payer: Priority Health Narrow Network |
$464.16
|
| Rate for Payer: Priority Health SBD |
$464.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.61
|
| Rate for Payer: UHC Exchange |
$359.98
|
| Rate for Payer: UHC Medicare Advantage |
$244.61
|
| Rate for Payer: UHCCP Medicaid |
$166.57
|
|
|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 58200
|
| Min. Negotiated Rate |
$82.02 |
| Max. Negotiated Rate |
$239,794.00 |
| Rate for Payer: Aetna Commercial |
$1,741.24
|
| Rate for Payer: Aetna Medicare |
$1,351.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,741.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,871.18
|
| Rate for Payer: BCBS Complete |
$910.93
|
| Rate for Payer: BCBS MAPPO |
$1,299.43
|
| Rate for Payer: BCBS Trust/PPO |
$82.02
|
| Rate for Payer: BCN Commercial |
$1,964.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.43
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$1,871.18
|
| Rate for Payer: Cofinity Commercial |
$1,741.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.43
|
| Rate for Payer: Healthscope Commercial |
$2,403.95
|
| Rate for Payer: Healthscope Commercial |
$2,079.09
|
| Rate for Payer: Mclaren Medicaid |
$867.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.40
|
| Rate for Payer: Meridian Medicaid |
$910.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239,794.00
|
| Rate for Payer: Nomi Health Commercial |
$1,559.32
|
| Rate for Payer: PACE SWMI |
$1,299.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$867.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,013.95
|
| Rate for Payer: Priority Health Medicare |
$1,299.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,013.95
|
| Rate for Payer: Priority Health SBD |
$2,013.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,719.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.43
|
| Rate for Payer: UHC Exchange |
$1,719.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.43
|
| Rate for Payer: UHCCP Medicaid |
$867.55
|
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 58152
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$221,648.00 |
| Rate for Payer: Aetna Commercial |
$1,594.40
|
| Rate for Payer: Aetna Medicare |
$1,237.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,713.38
|
| Rate for Payer: BCBS Complete |
$831.76
|
| Rate for Payer: BCBS MAPPO |
$1,189.85
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$1,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.85
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,713.38
|
| Rate for Payer: Cofinity Commercial |
$1,594.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.85
|
| Rate for Payer: Healthscope Commercial |
$2,201.22
|
| Rate for Payer: Healthscope Commercial |
$1,903.76
|
| Rate for Payer: Mclaren Medicaid |
$792.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,249.34
|
| Rate for Payer: Meridian Medicaid |
$831.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221,648.00
|
| Rate for Payer: Nomi Health Commercial |
$1,427.82
|
| Rate for Payer: PACE SWMI |
$1,189.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$792.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,847.28
|
| Rate for Payer: Priority Health Medicare |
$1,189.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,847.28
|
| Rate for Payer: Priority Health SBD |
$1,847.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,637.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,189.85
|
| Rate for Payer: UHC Exchange |
$1,637.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.85
|
| Rate for Payer: UHCCP Medicaid |
$792.15
|
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$653.91 |
| Max. Negotiated Rate |
$180,981.00 |
| Rate for Payer: Aetna Commercial |
$1,311.95
|
| Rate for Payer: Aetna Medicare |
$1,018.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,311.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.86
|
| Rate for Payer: BCBS Complete |
$686.61
|
| Rate for Payer: BCBS MAPPO |
$979.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
| Rate for Payer: BCN Commercial |
$1,483.63
|
| Rate for Payer: BCN Medicare Advantage |
$979.07
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$1,409.86
|
| Rate for Payer: Cofinity Commercial |
$1,311.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.07
|
| Rate for Payer: Healthscope Commercial |
$1,811.28
|
| Rate for Payer: Healthscope Commercial |
$1,566.51
|
| Rate for Payer: Mclaren Medicaid |
$653.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.02
|
| Rate for Payer: Meridian Medicaid |
$686.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180,981.00
|
| Rate for Payer: Nomi Health Commercial |
$1,174.88
|
| Rate for Payer: PACE SWMI |
$979.07
|
| Rate for Payer: PHP Medicare Advantage |
$979.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,518.89
|
| Rate for Payer: Priority Health Medicare |
$979.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,518.89
|
| Rate for Payer: Priority Health SBD |
$1,518.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,550.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.07
|
| Rate for Payer: UHC Exchange |
$1,550.00
|
| Rate for Payer: UHC Medicare Advantage |
$979.07
|
| Rate for Payer: UHCCP Medicaid |
$653.91
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$90,722.00 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna Medicare |
$514.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.32
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS MAPPO |
$494.67
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: BCN Commercial |
$735.95
|
| Rate for Payer: BCN Medicare Advantage |
$494.67
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$712.32
|
| Rate for Payer: Cofinity Commercial |
$662.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.67
|
| Rate for Payer: Healthscope Commercial |
$791.47
|
| Rate for Payer: Healthscope Commercial |
$915.14
|
| Rate for Payer: Mclaren Medicaid |
$324.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.40
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90,722.00
|
| Rate for Payer: Nomi Health Commercial |
$593.60
|
| Rate for Payer: PACE SWMI |
$494.67
|
| Rate for Payer: PHP Medicare Advantage |
$494.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$494.67
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: Priority Health SBD |
$768.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.67
|
| Rate for Payer: UHC Medicare Advantage |
$494.67
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$132.08 |
| Max. Negotiated Rate |
$291,449.00 |
| Rate for Payer: Aetna Commercial |
$2,125.82
|
| Rate for Payer: Aetna Medicare |
$1,649.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,125.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,284.46
|
| Rate for Payer: BCBS Complete |
$1,104.16
|
| Rate for Payer: BCBS MAPPO |
$1,586.43
|
| Rate for Payer: BCBS Trust/PPO |
$132.08
|
| Rate for Payer: BCN Commercial |
$2,383.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.43
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$2,284.46
|
| Rate for Payer: Cofinity Commercial |
$2,125.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.43
|
| Rate for Payer: Healthscope Commercial |
$2,538.29
|
| Rate for Payer: Healthscope Commercial |
$2,934.90
|
| Rate for Payer: Mclaren Medicaid |
$1,051.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,665.75
|
| Rate for Payer: Meridian Medicaid |
$1,104.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291,449.00
|
| Rate for Payer: Nomi Health Commercial |
$1,903.72
|
| Rate for Payer: PACE SWMI |
$1,586.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,499.52
|
| Rate for Payer: Priority Health Medicare |
$1,586.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,499.52
|
| Rate for Payer: Priority Health SBD |
$2,499.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,586.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,586.43
|
| Rate for Payer: UHCCP Medicaid |
$1,051.58
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,045.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$313,234.00 |
| Rate for Payer: Aetna Commercial |
$2,254.27
|
| Rate for Payer: Aetna Medicare |
$1,749.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,254.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,422.50
|
| Rate for Payer: BCBS Complete |
$1,181.76
|
| Rate for Payer: BCBS MAPPO |
$1,682.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$2,576.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,682.29
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cofinity Commercial |
$2,422.50
|
| Rate for Payer: Cofinity Commercial |
$2,254.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,682.29
|
| Rate for Payer: Healthscope Commercial |
$3,112.24
|
| Rate for Payer: Healthscope Commercial |
$2,691.66
|
| Rate for Payer: Mclaren Medicaid |
$1,125.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,766.40
|
| Rate for Payer: Meridian Medicaid |
$1,181.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313,234.00
|
| Rate for Payer: Nomi Health Commercial |
$2,018.75
|
| Rate for Payer: PACE SWMI |
$1,682.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,682.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,125.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,579.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,667.45
|
| Rate for Payer: Priority Health Medicare |
$1,682.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,667.45
|
| Rate for Payer: Priority Health SBD |
$2,667.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,669.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,682.29
|
| Rate for Payer: UHC Exchange |
$1,669.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,682.29
|
| Rate for Payer: UHCCP Medicaid |
$1,125.49
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$616,900.00 |
| Rate for Payer: Aetna Commercial |
$4,405.92
|
| Rate for Payer: Aetna Medicare |
$3,419.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,405.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,734.72
|
| Rate for Payer: BCBS Complete |
$2,262.45
|
| Rate for Payer: BCBS MAPPO |
$3,288.00
|
| Rate for Payer: BCBS Trust/PPO |
$109.36
|
| Rate for Payer: BCN Commercial |
$4,996.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,288.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$4,734.72
|
| Rate for Payer: Cofinity Commercial |
$4,405.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,288.00
|
| Rate for Payer: Healthscope Commercial |
$6,082.80
|
| Rate for Payer: Healthscope Commercial |
$5,260.80
|
| Rate for Payer: Mclaren Medicaid |
$2,154.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,452.40
|
| Rate for Payer: Meridian Medicaid |
$2,262.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616,900.00
|
| Rate for Payer: Nomi Health Commercial |
$3,945.60
|
| Rate for Payer: PACE SWMI |
$3,288.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,288.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,154.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,094.80
|
| Rate for Payer: Priority Health Medicare |
$3,288.00
|
| Rate for Payer: Priority Health Narrow Network |
$6,094.80
|
| Rate for Payer: Priority Health SBD |
$6,094.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,777.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,288.00
|
| Rate for Payer: UHC Exchange |
$2,777.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,288.00
|
| Rate for Payer: UHCCP Medicaid |
$2,154.71
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,603.35 |
| Max. Negotiated Rate |
$2,290.50 |
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.25
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$1,781.50
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health SBD |
$1,603.35
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$125,982.00 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.45
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Healthscope Commercial |
$1,259.61
|
| Rate for Payer: Healthscope Commercial |
$1,089.39
|
| Rate for Payer: Mclaren Medicaid |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125,982.00
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.54
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.54
|
| Rate for Payer: Priority Health SBD |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$1,027.15
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$755.32 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,479.23
|
| Rate for Payer: BCN Commercial |
$3,479.23
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$1,603.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.32
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,218.33
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$125,982.00 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.45
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Healthscope Commercial |
$1,259.61
|
| Rate for Payer: Healthscope Commercial |
$1,089.39
|
| Rate for Payer: Mclaren Medicaid |
$455.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125,982.00
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.54
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.54
|
| Rate for Payer: Priority Health SBD |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$1,027.15
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$566.87 |
| Max. Negotiated Rate |
$166,453.00 |
| Rate for Payer: Aetna Commercial |
$1,212.03
|
| Rate for Payer: Aetna Medicare |
$940.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.48
|
| Rate for Payer: BCBS Complete |
$635.39
|
| Rate for Payer: BCBS MAPPO |
$904.50
|
| Rate for Payer: BCBS Trust/PPO |
$566.87
|
| Rate for Payer: BCN Commercial |
$1,368.79
|
| Rate for Payer: BCN Medicare Advantage |
$904.50
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.48
|
| Rate for Payer: Cofinity Commercial |
$1,212.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.50
|
| Rate for Payer: Healthscope Commercial |
$1,673.32
|
| Rate for Payer: Healthscope Commercial |
$1,447.20
|
| Rate for Payer: Mclaren Medicaid |
$605.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.72
|
| Rate for Payer: Meridian Medicaid |
$635.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166,453.00
|
| Rate for Payer: Nomi Health Commercial |
$1,085.40
|
| Rate for Payer: PACE SWMI |
$904.50
|
| Rate for Payer: PHP Medicare Advantage |
$904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,521.79
|
| Rate for Payer: Priority Health Medicare |
$904.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,521.79
|
| Rate for Payer: Priority Health SBD |
$1,521.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,208.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.50
|
| Rate for Payer: UHC Exchange |
$1,208.33
|
| Rate for Payer: UHC Medicare Advantage |
$904.50
|
| Rate for Payer: UHCCP Medicaid |
$605.13
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$528,671.00 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,973.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,831.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,117.75
|
| Rate for Payer: BCBS Complete |
$1,975.28
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$4,291.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Healthscope Commercial |
$5,290.17
|
| Rate for Payer: Healthscope Commercial |
$4,575.28
|
| Rate for Payer: Mclaren Medicaid |
$1,881.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Meridian Medicaid |
$1,975.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$528,671.00
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,881.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,260.17
|
| Rate for Payer: Priority Health Medicare |
$2,859.55
|
| Rate for Payer: Priority Health Narrow Network |
$5,260.17
|
| Rate for Payer: Priority Health SBD |
$5,260.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,734.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Exchange |
$2,734.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
| Rate for Payer: UHCCP Medicaid |
$1,881.22
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$79.81 |
| Max. Negotiated Rate |
$675,830.00 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,805.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,903.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,269.26
|
| Rate for Payer: BCBS Complete |
$2,517.63
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: BCN Commercial |
$5,466.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Healthscope Commercial |
$6,769.54
|
| Rate for Payer: Healthscope Commercial |
$5,854.74
|
| Rate for Payer: Mclaren Medicaid |
$2,397.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Meridian Medicaid |
$2,517.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$675,830.00
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,397.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,699.15
|
| Rate for Payer: Priority Health Medicare |
$3,659.21
|
| Rate for Payer: Priority Health Narrow Network |
$6,699.15
|
| Rate for Payer: Priority Health SBD |
$6,699.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,194.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Exchange |
$2,194.34
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
| Rate for Payer: UHCCP Medicaid |
$2,397.74
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$35,424.00 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$197.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.66
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Healthscope Commercial |
$351.57
|
| Rate for Payer: Healthscope Commercial |
$304.06
|
| Rate for Payer: Mclaren Medicaid |
$129.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,424.00
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$356.21
|
| Rate for Payer: Priority Health Medicare |
$190.04
|
| Rate for Payer: Priority Health Narrow Network |
$356.21
|
| Rate for Payer: Priority Health SBD |
$356.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Exchange |
$421.06
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
| Rate for Payer: UHCCP Medicaid |
$129.72
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$8,723.00 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.13
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.75
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Healthscope Commercial |
$86.25
|
| Rate for Payer: Healthscope Commercial |
$74.59
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,723.00
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$46.62
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Priority Health SBD |
$66.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Exchange |
$104.66
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
