|
PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 93293
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$6,455.00 |
| Rate for Payer: Aetna Commercial |
$50.38
|
| Rate for Payer: Aetna Medicare |
$39.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.14
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$37.60
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: BCN Medicare Advantage |
$37.60
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$50.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$60.16
|
| Rate for Payer: Healthscope Commercial |
$69.56
|
| Rate for Payer: Mclaren Medicaid |
$8.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.48
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,455.00
|
| Rate for Payer: Nomi Health Commercial |
$45.12
|
| Rate for Payer: PACE SWMI |
$37.60
|
| Rate for Payer: PHP Medicare Advantage |
$37.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.15
|
| Rate for Payer: Priority Health Medicare |
$37.60
|
| Rate for Payer: Priority Health Narrow Network |
$62.15
|
| Rate for Payer: Priority Health SBD |
$19.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.60
|
| Rate for Payer: UHC Medicare Advantage |
$37.60
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
|
|
PR TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV
|
Professional
|
Both
|
$6,249.00
|
|
|
Service Code
|
HCPCS 61595
|
| Min. Negotiated Rate |
$1,535.52 |
| Max. Negotiated Rate |
$425,171.00 |
| Rate for Payer: Aetna Commercial |
$3,075.43
|
| Rate for Payer: Aetna Medicare |
$2,386.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,075.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.94
|
| Rate for Payer: BCBS Complete |
$1,612.30
|
| Rate for Payer: BCBS MAPPO |
$2,295.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.52
|
| Rate for Payer: BCN Commercial |
$3,505.29
|
| Rate for Payer: BCN Medicare Advantage |
$2,295.10
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Cofinity Commercial |
$3,304.94
|
| Rate for Payer: Cofinity Commercial |
$3,075.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,295.10
|
| Rate for Payer: Healthscope Commercial |
$4,245.94
|
| Rate for Payer: Healthscope Commercial |
$3,672.16
|
| Rate for Payer: Mclaren Medicaid |
$1,535.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,409.86
|
| Rate for Payer: Meridian Medicaid |
$1,612.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425,171.00
|
| Rate for Payer: Nomi Health Commercial |
$2,754.12
|
| Rate for Payer: PACE SWMI |
$2,295.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,295.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,535.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,061.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,103.86
|
| Rate for Payer: Priority Health Medicare |
$2,295.10
|
| Rate for Payer: Priority Health Narrow Network |
$4,103.86
|
| Rate for Payer: Priority Health SBD |
$4,103.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,546.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,295.10
|
| Rate for Payer: UHC Exchange |
$2,546.31
|
| Rate for Payer: UHC Medicare Advantage |
$2,295.10
|
| Rate for Payer: UHCCP Medicaid |
$1,535.52
|
|
|
PR TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 50770
|
| Min. Negotiated Rate |
$734.64 |
| Max. Negotiated Rate |
$202,311.00 |
| Rate for Payer: Aetna Commercial |
$1,472.82
|
| Rate for Payer: Aetna Medicare |
$1,143.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,472.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.73
|
| Rate for Payer: BCBS Complete |
$771.37
|
| Rate for Payer: BCBS MAPPO |
$1,099.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,761.42
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.12
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,582.73
|
| Rate for Payer: Cofinity Commercial |
$1,472.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.12
|
| Rate for Payer: Healthscope Commercial |
$2,033.37
|
| Rate for Payer: Healthscope Commercial |
$1,758.59
|
| Rate for Payer: Mclaren Medicaid |
$734.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.08
|
| Rate for Payer: Meridian Medicaid |
$771.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202,311.00
|
| Rate for Payer: Nomi Health Commercial |
$1,318.94
|
| Rate for Payer: PACE SWMI |
$1,099.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,404.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,825.76
|
| Rate for Payer: Priority Health Medicare |
$1,099.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,825.76
|
| Rate for Payer: Priority Health SBD |
$1,825.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.12
|
| Rate for Payer: UHC Exchange |
$1,452.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.12
|
| Rate for Payer: UHCCP Medicaid |
$734.64
|
|
|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$356.60 |
| Max. Negotiated Rate |
$83,102.00 |
| Rate for Payer: Aetna Commercial |
$608.90
|
| Rate for Payer: Aetna Medicare |
$472.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.34
|
| Rate for Payer: BCBS Complete |
$586.00
|
| Rate for Payer: BCBS MAPPO |
$454.40
|
| Rate for Payer: BCBS Trust/PPO |
$356.60
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$454.40
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$654.34
|
| Rate for Payer: Cofinity Commercial |
$608.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.40
|
| Rate for Payer: Healthscope Commercial |
$727.04
|
| Rate for Payer: Healthscope Commercial |
$840.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,102.00
|
| Rate for Payer: Nomi Health Commercial |
$545.28
|
| Rate for Payer: PACE SWMI |
$454.40
|
| Rate for Payer: PHP Medicare Advantage |
$454.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.56
|
| Rate for Payer: Priority Health Medicare |
$454.40
|
| Rate for Payer: Priority Health Narrow Network |
$760.56
|
| Rate for Payer: Priority Health SBD |
$760.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.40
|
| Rate for Payer: UHC Exchange |
$595.42
|
| Rate for Payer: UHC Medicare Advantage |
$454.40
|
|
|
PR TRANSURETHRAL RESECTION BLADDER NECK
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 52500
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$86,359.00 |
| Rate for Payer: Aetna Commercial |
$632.19
|
| Rate for Payer: Aetna Medicare |
$490.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.36
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS MAPPO |
$471.78
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: BCN Medicare Advantage |
$471.78
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$679.36
|
| Rate for Payer: Cofinity Commercial |
$632.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.78
|
| Rate for Payer: Healthscope Commercial |
$872.79
|
| Rate for Payer: Healthscope Commercial |
$754.85
|
| Rate for Payer: Mclaren Medicaid |
$318.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.37
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,359.00
|
| Rate for Payer: Nomi Health Commercial |
$566.14
|
| Rate for Payer: PACE SWMI |
$471.78
|
| Rate for Payer: PHP Medicare Advantage |
$471.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$789.31
|
| Rate for Payer: Priority Health Medicare |
$471.78
|
| Rate for Payer: Priority Health Narrow Network |
$789.31
|
| Rate for Payer: Priority Health SBD |
$789.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.78
|
| Rate for Payer: UHC Exchange |
$616.79
|
| Rate for Payer: UHC Medicare Advantage |
$471.78
|
| Rate for Payer: UHCCP Medicaid |
$318.01
|
|
|
PR TRANSV AORTIC ARCH GRAFT W BYPASS
|
Professional
|
Both
|
$10,285.00
|
|
|
Service Code
|
HCPCS 33870
|
| Min. Negotiated Rate |
$4,114.00 |
| Max. Negotiated Rate |
$6,685.25 |
| Rate for Payer: Aetna Medicare |
$5,142.50
|
| Rate for Payer: BCBS Complete |
$4,114.00
|
| Rate for Payer: Cash Price |
$8,228.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,685.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,685.25
|
|
|
PR TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA
|
Professional
|
Both
|
$5,629.00
|
|
|
Service Code
|
HCPCS 33871
|
| Min. Negotiated Rate |
$972.07 |
| Max. Negotiated Rate |
$576,376.00 |
| Rate for Payer: Aetna Commercial |
$4,175.45
|
| Rate for Payer: Aetna Medicare |
$3,240.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,175.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,487.05
|
| Rate for Payer: BCBS Complete |
$2,138.99
|
| Rate for Payer: BCBS MAPPO |
$3,116.01
|
| Rate for Payer: BCBS Trust/PPO |
$972.07
|
| Rate for Payer: BCN Commercial |
$4,652.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,116.01
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cofinity Commercial |
$4,487.05
|
| Rate for Payer: Cofinity Commercial |
$4,175.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,116.01
|
| Rate for Payer: Healthscope Commercial |
$4,985.62
|
| Rate for Payer: Healthscope Commercial |
$5,764.62
|
| Rate for Payer: Mclaren Medicaid |
$2,037.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.81
|
| Rate for Payer: Meridian Medicaid |
$2,138.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$576,376.00
|
| Rate for Payer: Nomi Health Commercial |
$3,739.21
|
| Rate for Payer: PACE SWMI |
$3,116.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,116.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,037.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,658.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,074.67
|
| Rate for Payer: Priority Health Medicare |
$3,116.01
|
| Rate for Payer: Priority Health Narrow Network |
$5,074.67
|
| Rate for Payer: Priority Health SBD |
$5,074.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,116.01
|
| Rate for Payer: UHC Medicare Advantage |
$3,116.01
|
| Rate for Payer: UHCCP Medicaid |
$2,037.13
|
|
|
PR TRAY FEE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 00521
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$85,097.00 |
| Rate for Payer: Aetna Commercial |
$619.62
|
| Rate for Payer: Aetna Medicare |
$480.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.86
|
| Rate for Payer: BCBS Complete |
$331.22
|
| Rate for Payer: BCBS MAPPO |
$462.40
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$711.51
|
| Rate for Payer: BCN Medicare Advantage |
$462.40
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$665.86
|
| Rate for Payer: Cofinity Commercial |
$619.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.40
|
| Rate for Payer: Healthscope Commercial |
$855.44
|
| Rate for Payer: Healthscope Commercial |
$739.84
|
| Rate for Payer: Mclaren Medicaid |
$315.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.52
|
| Rate for Payer: Meridian Medicaid |
$331.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,097.00
|
| Rate for Payer: Nomi Health Commercial |
$554.88
|
| Rate for Payer: PACE SWMI |
$462.40
|
| Rate for Payer: PHP Medicare Advantage |
$462.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.06
|
| Rate for Payer: Priority Health Medicare |
$462.40
|
| Rate for Payer: Priority Health Narrow Network |
$750.06
|
| Rate for Payer: Priority Health SBD |
$750.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.40
|
| Rate for Payer: UHC Exchange |
$456.33
|
| Rate for Payer: UHC Medicare Advantage |
$462.40
|
| Rate for Payer: UHCCP Medicaid |
$315.45
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$229.61 |
| Max. Negotiated Rate |
$61,670.00 |
| Rate for Payer: Aetna Commercial |
$452.63
|
| Rate for Payer: Aetna Medicare |
$351.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.40
|
| Rate for Payer: BCBS Complete |
$241.09
|
| Rate for Payer: BCBS MAPPO |
$337.78
|
| Rate for Payer: BCBS Trust/PPO |
$525.13
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: BCN Medicare Advantage |
$337.78
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$486.40
|
| Rate for Payer: Cofinity Commercial |
$452.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.78
|
| Rate for Payer: Healthscope Commercial |
$624.89
|
| Rate for Payer: Healthscope Commercial |
$540.45
|
| Rate for Payer: Mclaren Medicaid |
$229.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.67
|
| Rate for Payer: Meridian Medicaid |
$241.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,670.00
|
| Rate for Payer: Nomi Health Commercial |
$405.34
|
| Rate for Payer: PACE SWMI |
$337.78
|
| Rate for Payer: PHP Medicare Advantage |
$337.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Medicare |
$337.78
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: Priority Health SBD |
$542.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.78
|
| Rate for Payer: UHC Exchange |
$454.88
|
| Rate for Payer: UHC Medicare Advantage |
$337.78
|
| Rate for Payer: UHCCP Medicaid |
$229.61
|
|
|
PR TRIAMCINOLONE ACET INJ NOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$116.00 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: Aetna Medicare |
$0.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.24
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.55
|
| Rate for Payer: BCN Commercial |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.86
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$1.16
|
| Rate for Payer: Cofinity Commercial |
$1.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.86
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Healthscope Commercial |
$1.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.00
|
| Rate for Payer: Nomi Health Commercial |
$1.03
|
| Rate for Payer: PACE SWMI |
$0.86
|
| Rate for Payer: PHP Medicare Advantage |
$0.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$0.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.86
|
| Rate for Payer: UHC Exchange |
$0.95
|
| Rate for Payer: UHC Medicare Advantage |
$0.86
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$4,495.00 |
| Rate for Payer: Aetna Commercial |
$71.56
|
| Rate for Payer: Aetna Medicare |
$55.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.90
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$48.74
|
| Rate for Payer: BCN Commercial |
$45.78
|
| Rate for Payer: BCN Medicare Advantage |
$53.40
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$76.90
|
| Rate for Payer: Cofinity Commercial |
$71.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.40
|
| Rate for Payer: Healthscope Commercial |
$85.44
|
| Rate for Payer: Healthscope Commercial |
$98.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,495.00
|
| Rate for Payer: Nomi Health Commercial |
$64.08
|
| Rate for Payer: PACE SWMI |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$53.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.40
|
| Rate for Payer: UHC Exchange |
$54.01
|
| Rate for Payer: UHC Medicare Advantage |
$53.40
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$1,325.00 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$12.00
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$10.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$13.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,325.00
|
| Rate for Payer: Nomi Health Commercial |
$8.47
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: Priority Health SBD |
$9.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Exchange |
$17.02
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$1,929.35 |
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.46
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.35
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$10.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$11.30
|
| Rate for Payer: Healthscope Commercial |
$13.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.00
|
| Rate for Payer: Nomi Health Commercial |
$8.47
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Medicare |
$7.06
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: Priority Health SBD |
$9.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.06
|
| Rate for Payer: UHC Exchange |
$16.62
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37246
|
| Min. Negotiated Rate |
$217.26 |
| Max. Negotiated Rate |
$61,303.00 |
| Rate for Payer: Aetna Commercial |
$444.99
|
| Rate for Payer: Aetna Medicare |
$345.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.20
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$332.08
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$2,674.54
|
| Rate for Payer: BCN Medicare Advantage |
$332.08
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$478.20
|
| Rate for Payer: Cofinity Commercial |
$444.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.08
|
| Rate for Payer: Healthscope Commercial |
$531.33
|
| Rate for Payer: Healthscope Commercial |
$614.35
|
| Rate for Payer: Mclaren Medicaid |
$217.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.68
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,303.00
|
| Rate for Payer: Nomi Health Commercial |
$398.50
|
| Rate for Payer: PACE SWMI |
$332.08
|
| Rate for Payer: PHP Medicare Advantage |
$332.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.28
|
| Rate for Payer: Priority Health Medicare |
$332.08
|
| Rate for Payer: Priority Health Narrow Network |
$539.28
|
| Rate for Payer: Priority Health SBD |
$539.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.08
|
| Rate for Payer: UHC Medicare Advantage |
$332.08
|
| Rate for Payer: UHCCP Medicaid |
$217.26
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$30,454.00 |
| Rate for Payer: Aetna Commercial |
$221.65
|
| Rate for Payer: Aetna Medicare |
$172.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.19
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS MAPPO |
$165.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,142.18
|
| Rate for Payer: BCN Commercial |
$828.80
|
| Rate for Payer: BCN Medicare Advantage |
$165.41
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cofinity Commercial |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$221.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.41
|
| Rate for Payer: Healthscope Commercial |
$264.66
|
| Rate for Payer: Healthscope Commercial |
$306.01
|
| Rate for Payer: Mclaren Medicaid |
$108.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.68
|
| Rate for Payer: Meridian Medicaid |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,454.00
|
| Rate for Payer: Nomi Health Commercial |
$198.49
|
| Rate for Payer: PACE SWMI |
$165.41
|
| Rate for Payer: PHP Medicare Advantage |
$165.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.57
|
| Rate for Payer: Priority Health Medicare |
$165.41
|
| Rate for Payer: Priority Health Narrow Network |
$268.57
|
| Rate for Payer: Priority Health SBD |
$268.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.41
|
| Rate for Payer: UHC Medicare Advantage |
$165.41
|
| Rate for Payer: UHCCP Medicaid |
$108.42
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$184.88 |
| Max. Negotiated Rate |
$52,069.00 |
| Rate for Payer: Aetna Commercial |
$376.11
|
| Rate for Payer: Aetna Medicare |
$291.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.18
|
| Rate for Payer: BCBS Complete |
$194.12
|
| Rate for Payer: BCBS MAPPO |
$280.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.73
|
| Rate for Payer: BCN Commercial |
$1,997.22
|
| Rate for Payer: BCN Medicare Advantage |
$280.68
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$404.18
|
| Rate for Payer: Cofinity Commercial |
$376.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.68
|
| Rate for Payer: Healthscope Commercial |
$449.09
|
| Rate for Payer: Healthscope Commercial |
$519.26
|
| Rate for Payer: Mclaren Medicaid |
$184.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Meridian Medicaid |
$194.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,069.00
|
| Rate for Payer: Nomi Health Commercial |
$336.82
|
| Rate for Payer: PACE SWMI |
$280.68
|
| Rate for Payer: PHP Medicare Advantage |
$280.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.03
|
| Rate for Payer: Priority Health Medicare |
$280.68
|
| Rate for Payer: Priority Health Narrow Network |
$460.03
|
| Rate for Payer: Priority Health SBD |
$460.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.68
|
| Rate for Payer: UHC Medicare Advantage |
$280.68
|
| Rate for Payer: UHCCP Medicaid |
$184.88
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN
|
Professional
|
Both
|
$463.00
|
|
|
Service Code
|
HCPCS 37249
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$25,630.00 |
| Rate for Payer: Aetna Commercial |
$186.98
|
| Rate for Payer: Aetna Medicare |
$145.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$139.54
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$647.99
|
| Rate for Payer: BCN Medicare Advantage |
$139.54
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cofinity Commercial |
$200.94
|
| Rate for Payer: Cofinity Commercial |
$186.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.54
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Healthscope Commercial |
$258.15
|
| Rate for Payer: Mclaren Medicaid |
$91.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.52
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,630.00
|
| Rate for Payer: Nomi Health Commercial |
$167.45
|
| Rate for Payer: PACE SWMI |
$139.54
|
| Rate for Payer: PHP Medicare Advantage |
$139.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.50
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: Priority Health Narrow Network |
$225.50
|
| Rate for Payer: Priority Health SBD |
$225.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.54
|
| Rate for Payer: UHC Medicare Advantage |
$139.54
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
|
|
PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 36907
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$25,744.00 |
| Rate for Payer: Aetna Commercial |
$186.82
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.76
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$139.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.24
|
| Rate for Payer: BCN Commercial |
$867.89
|
| Rate for Payer: BCN Medicare Advantage |
$139.42
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$200.76
|
| Rate for Payer: Cofinity Commercial |
$186.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.42
|
| Rate for Payer: Healthscope Commercial |
$223.07
|
| Rate for Payer: Healthscope Commercial |
$257.93
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.39
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,744.00
|
| Rate for Payer: Nomi Health Commercial |
$167.30
|
| Rate for Payer: PACE SWMI |
$139.42
|
| Rate for Payer: PHP Medicare Advantage |
$139.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.02
|
| Rate for Payer: Priority Health Medicare |
$139.42
|
| Rate for Payer: Priority Health Narrow Network |
$226.02
|
| Rate for Payer: Priority Health SBD |
$226.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.42
|
| Rate for Payer: UHC Medicare Advantage |
$139.42
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL
|
Professional
|
Both
|
$9,821.00
|
|
|
Service Code
|
HCPCS 0237T
|
| Min. Negotiated Rate |
$100.60 |
| Max. Negotiated Rate |
$1,183,711.00 |
| Rate for Payer: Aetna Commercial |
$4,395.81
|
| Rate for Payer: Aetna Medicare |
$4,910.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,395.81
|
| Rate for Payer: BCBS Complete |
$260.96
|
| Rate for Payer: BCBS Trust/PPO |
$100.60
|
| Rate for Payer: BCN Commercial |
$9,819.16
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Cash Price |
$7,856.80
|
| Rate for Payer: Mclaren Medicaid |
$248.53
|
| Rate for Payer: Meridian Medicaid |
$260.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183,711.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,383.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,548.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.58
|
| Rate for Payer: Priority Health SBD |
$1,548.58
|
| Rate for Payer: UHCCP Medicaid |
$248.53
|
|
|
PR TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL
|
Professional
|
Both
|
$8,756.00
|
|
|
Service Code
|
HCPCS 61597
|
| Min. Negotiated Rate |
$1,813.13 |
| Max. Negotiated Rate |
$533,453.00 |
| Rate for Payer: Aetna Commercial |
$3,829.51
|
| Rate for Payer: Aetna Medicare |
$2,972.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,829.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,115.29
|
| Rate for Payer: BCBS Complete |
$1,981.99
|
| Rate for Payer: BCBS MAPPO |
$2,857.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.13
|
| Rate for Payer: BCN Commercial |
$6,047.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,857.84
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cash Price |
$7,004.80
|
| Rate for Payer: Cofinity Commercial |
$4,115.29
|
| Rate for Payer: Cofinity Commercial |
$3,829.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,857.84
|
| Rate for Payer: Healthscope Commercial |
$5,287.00
|
| Rate for Payer: Healthscope Commercial |
$4,572.54
|
| Rate for Payer: Mclaren Medicaid |
$1,887.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,000.73
|
| Rate for Payer: Meridian Medicaid |
$1,981.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$533,453.00
|
| Rate for Payer: Nomi Health Commercial |
$3,429.41
|
| Rate for Payer: PACE SWMI |
$2,857.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,857.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,887.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,691.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,112.76
|
| Rate for Payer: Priority Health Medicare |
$2,857.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,112.76
|
| Rate for Payer: Priority Health SBD |
$5,112.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,270.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,857.84
|
| Rate for Payer: UHC Exchange |
$3,270.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,857.84
|
| Rate for Payer: UHCCP Medicaid |
$1,887.61
|
|
|
PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 38207
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$7,974.00 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.89
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.41
|
| Rate for Payer: BCN Commercial |
$64.99
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Mclaren Medicaid |
$28.12
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,974.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.54
|
| Rate for Payer: Priority Health Narrow Network |
$88.54
|
| Rate for Payer: Priority Health SBD |
$88.54
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
|
|
PR TR PARASPI MUSC HIP FASC/TDN XTN GRF
|
Professional
|
Both
|
$6,317.00
|
|
|
Service Code
|
HCPCS 27105
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$154,561.00 |
| Rate for Payer: Aetna Commercial |
$1,125.68
|
| Rate for Payer: Aetna Medicare |
$873.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.69
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$840.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.41
|
| Rate for Payer: BCN Commercial |
$1,280.34
|
| Rate for Payer: BCN Medicare Advantage |
$840.06
|
| Rate for Payer: Cash Price |
$5,053.60
|
| Rate for Payer: Cash Price |
$5,053.60
|
| Rate for Payer: Cofinity Commercial |
$1,209.69
|
| Rate for Payer: Cofinity Commercial |
$1,125.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.06
|
| Rate for Payer: Healthscope Commercial |
$1,554.11
|
| Rate for Payer: Healthscope Commercial |
$1,344.10
|
| Rate for Payer: Mclaren Medicaid |
$567.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$882.06
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,561.00
|
| Rate for Payer: Nomi Health Commercial |
$1,008.07
|
| Rate for Payer: PACE SWMI |
$840.06
|
| Rate for Payer: PHP Medicare Advantage |
$840.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,106.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,344.42
|
| Rate for Payer: Priority Health Medicare |
$840.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,344.42
|
| Rate for Payer: Priority Health SBD |
$1,344.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$840.06
|
| Rate for Payer: UHC Exchange |
$1,024.49
|
| Rate for Payer: UHC Medicare Advantage |
$840.06
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
|
|
PR TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART
|
Professional
|
Both
|
$2,076.00
|
|
|
Service Code
|
HCPCS 35695
|
| Min. Negotiated Rate |
$642.62 |
| Max. Negotiated Rate |
$182,218.00 |
| Rate for Payer: Aetna Commercial |
$1,324.79
|
| Rate for Payer: Aetna Medicare |
$1,028.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,324.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.66
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$988.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.09
|
| Rate for Payer: BCN Commercial |
$1,463.59
|
| Rate for Payer: BCN Medicare Advantage |
$988.65
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cash Price |
$1,660.80
|
| Rate for Payer: Cofinity Commercial |
$1,423.66
|
| Rate for Payer: Cofinity Commercial |
$1,324.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.65
|
| Rate for Payer: Healthscope Commercial |
$1,829.00
|
| Rate for Payer: Healthscope Commercial |
$1,581.84
|
| Rate for Payer: Mclaren Medicaid |
$642.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,038.08
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,218.00
|
| Rate for Payer: Nomi Health Commercial |
$1,186.38
|
| Rate for Payer: PACE SWMI |
$988.65
|
| Rate for Payer: PHP Medicare Advantage |
$988.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,349.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,599.73
|
| Rate for Payer: Priority Health Medicare |
$988.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,599.73
|
| Rate for Payer: Priority Health SBD |
$1,599.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,438.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$988.65
|
| Rate for Payer: UHC Exchange |
$1,438.00
|
| Rate for Payer: UHC Medicare Advantage |
$988.65
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
|
|
PR TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART
|
Professional
|
Both
|
$2,142.00
|
|
|
Service Code
|
HCPCS 35694
|
| Min. Negotiated Rate |
$619.40 |
| Max. Negotiated Rate |
$175,480.00 |
| Rate for Payer: Aetna Commercial |
$1,276.59
|
| Rate for Payer: Aetna Medicare |
$990.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,276.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.86
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS MAPPO |
$952.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$1,409.84
|
| Rate for Payer: BCN Medicare Advantage |
$952.68
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cash Price |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$1,371.86
|
| Rate for Payer: Cofinity Commercial |
$1,276.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.68
|
| Rate for Payer: Healthscope Commercial |
$1,762.46
|
| Rate for Payer: Healthscope Commercial |
$1,524.29
|
| Rate for Payer: Mclaren Medicaid |
$619.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.31
|
| Rate for Payer: Meridian Medicaid |
$650.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,480.00
|
| Rate for Payer: Nomi Health Commercial |
$1,143.22
|
| Rate for Payer: PACE SWMI |
$952.68
|
| Rate for Payer: PHP Medicare Advantage |
$952.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.75
|
| Rate for Payer: Priority Health Medicare |
$952.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,541.75
|
| Rate for Payer: Priority Health SBD |
$1,541.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,423.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$952.68
|
| Rate for Payer: UHC Exchange |
$1,423.46
|
| Rate for Payer: UHC Medicare Advantage |
$952.68
|
| Rate for Payer: UHCCP Medicaid |
$619.40
|
|
