|
PR ANNUAL GYNECOLOGICAL EXAMINA
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS S0612
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$65.39 |
| Rate for Payer: Aetna Commercial |
$55.00
|
| Rate for Payer: Aetna Medicare |
$41.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.00
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCN Commercial |
$65.39
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.25
|
|
|
PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 99170
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$95.38
|
| Rate for Payer: Aetna Medicare |
$74.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.38
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.18
|
| Rate for Payer: BCN Commercial |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$71.18
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$102.50
|
| Rate for Payer: Cofinity Commercial |
$95.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.18
|
| Rate for Payer: Healthscope Commercial |
$131.68
|
| Rate for Payer: Healthscope Commercial |
$113.89
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.74
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.16
|
| Rate for Payer: Nomi Health Commercial |
$85.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.00
|
| Rate for Payer: PACE SWMI |
$71.18
|
| Rate for Payer: PHP Medicare Advantage |
$71.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.27
|
| Rate for Payer: Priority Health Medicare |
$71.18
|
| Rate for Payer: Priority Health SBD |
$115.27
|
| Rate for Payer: Priority Health Tiered Network |
$115.27
|
| Rate for Payer: Railroad Medicare Medicare |
$71.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.97
|
| Rate for Payer: UHC Core |
$139.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.18
|
| Rate for Payer: UHC Exchange |
$139.97
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 46700
|
| Min. Negotiated Rate |
$407.90 |
| Max. Negotiated Rate |
$1,205.62 |
| Rate for Payer: Aetna Commercial |
$835.13
|
| Rate for Payer: Aetna Medicare |
$648.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.45
|
| Rate for Payer: BCBS Complete |
$428.30
|
| Rate for Payer: BCBS MAPPO |
$623.23
|
| Rate for Payer: BCN Commercial |
$989.49
|
| Rate for Payer: BCN Medicare Advantage |
$623.23
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cofinity Commercial |
$897.45
|
| Rate for Payer: Cofinity Commercial |
$835.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$997.17
|
| Rate for Payer: Healthscope Commercial |
$1,152.98
|
| Rate for Payer: Mclaren Medicaid |
$407.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.39
|
| Rate for Payer: Meridian Medicaid |
$428.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.20
|
| Rate for Payer: Nomi Health Commercial |
$747.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.75
|
| Rate for Payer: PACE SWMI |
$623.23
|
| Rate for Payer: PHP Medicare Advantage |
$623.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,205.62
|
| Rate for Payer: Priority Health Medicare |
$623.23
|
| Rate for Payer: Priority Health SBD |
$1,205.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,205.62
|
| Rate for Payer: Railroad Medicare Medicare |
$623.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,150.58
|
| Rate for Payer: UHC Core |
$1,150.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$623.23
|
| Rate for Payer: UHC Exchange |
$1,150.58
|
| Rate for Payer: UHC Medicaid |
$407.90
|
| Rate for Payer: UHCCP Medicaid |
$407.90
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 46705
|
| Min. Negotiated Rate |
$367.64 |
| Max. Negotiated Rate |
$1,101.00 |
| Rate for Payer: Aetna Commercial |
$752.16
|
| Rate for Payer: Aetna Medicare |
$583.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.29
|
| Rate for Payer: BCBS Complete |
$386.02
|
| Rate for Payer: BCBS MAPPO |
$561.31
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$561.31
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$808.29
|
| Rate for Payer: Cofinity Commercial |
$752.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.31
|
| Rate for Payer: Healthscope Commercial |
$898.10
|
| Rate for Payer: Healthscope Commercial |
$1,038.42
|
| Rate for Payer: Mclaren Medicaid |
$367.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.38
|
| Rate for Payer: Meridian Medicaid |
$386.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.14
|
| Rate for Payer: Nomi Health Commercial |
$673.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,101.00
|
| Rate for Payer: PACE SWMI |
$561.31
|
| Rate for Payer: PHP Medicare Advantage |
$561.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,061.22
|
| Rate for Payer: Priority Health Medicare |
$561.31
|
| Rate for Payer: Priority Health SBD |
$1,061.22
|
| Rate for Payer: Priority Health Tiered Network |
$1,061.22
|
| Rate for Payer: Railroad Medicare Medicare |
$561.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$988.02
|
| Rate for Payer: UHC Core |
$988.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.31
|
| Rate for Payer: UHC Exchange |
$988.02
|
| Rate for Payer: UHC Medicaid |
$367.64
|
| Rate for Payer: UHCCP Medicaid |
$367.64
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 91122
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$406.85 |
| Rate for Payer: Aetna Commercial |
$290.91
|
| Rate for Payer: Aetna Medicare |
$202.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCN Commercial |
$406.85
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$389.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.75
|
|
|
PR ANORECTAL MYOMECTOMY
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 45108
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$488.32
|
| Rate for Payer: Aetna Medicare |
$379.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.32
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$364.42
|
| Rate for Payer: BCN Commercial |
$570.19
|
| Rate for Payer: BCN Medicare Advantage |
$364.42
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$524.76
|
| Rate for Payer: Cofinity Commercial |
$488.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.42
|
| Rate for Payer: Healthscope Commercial |
$674.18
|
| Rate for Payer: Healthscope Commercial |
$583.07
|
| Rate for Payer: Mclaren Medicaid |
$237.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.64
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.26
|
| Rate for Payer: Nomi Health Commercial |
$437.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$364.42
|
| Rate for Payer: PHP Medicare Advantage |
$364.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$694.74
|
| Rate for Payer: Priority Health Medicare |
$364.42
|
| Rate for Payer: Priority Health SBD |
$694.74
|
| Rate for Payer: Priority Health Tiered Network |
$694.74
|
| Rate for Payer: Railroad Medicare Medicare |
$364.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.74
|
| Rate for Payer: UHC Core |
$652.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.42
|
| Rate for Payer: UHC Exchange |
$652.74
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR ANOSCOPY ABLATION LESION
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 46615
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$110.28
|
| Rate for Payer: Aetna Medicare |
$85.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.51
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$82.30
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$82.30
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$118.51
|
| Rate for Payer: Cofinity Commercial |
$110.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.30
|
| Rate for Payer: Healthscope Commercial |
$152.25
|
| Rate for Payer: Healthscope Commercial |
$131.68
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.42
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.42
|
| Rate for Payer: Nomi Health Commercial |
$98.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$82.30
|
| Rate for Payer: PHP Medicare Advantage |
$82.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$165.03
|
| Rate for Payer: Priority Health Medicare |
$82.30
|
| Rate for Payer: Priority Health SBD |
$165.03
|
| Rate for Payer: Priority Health Tiered Network |
$165.03
|
| Rate for Payer: Railroad Medicare Medicare |
$82.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.81
|
| Rate for Payer: UHC Core |
$160.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.30
|
| Rate for Payer: UHC Exchange |
$160.81
|
| Rate for Payer: UHC Medicaid |
$53.46
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 46614
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$493.50 |
| Rate for Payer: Cofinity Commercial |
$80.55
|
| Rate for Payer: Aetna Commercial |
$80.55
|
| Rate for Payer: Aetna Medicare |
$62.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.56
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.11
|
| Rate for Payer: BCN Commercial |
$97.11
|
| Rate for Payer: BCN Medicare Advantage |
$60.11
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$86.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.11
|
| Rate for Payer: Healthscope Commercial |
$96.18
|
| Rate for Payer: Healthscope Commercial |
$111.20
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.12
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.83
|
| Rate for Payer: Nomi Health Commercial |
$72.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.50
|
| Rate for Payer: PACE SWMI |
$60.11
|
| Rate for Payer: PHP Medicare Advantage |
$60.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$118.33
|
| Rate for Payer: Priority Health Medicare |
$60.11
|
| Rate for Payer: Priority Health SBD |
$118.33
|
| Rate for Payer: Priority Health Tiered Network |
$118.33
|
| Rate for Payer: Railroad Medicare Medicare |
$60.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.42
|
| Rate for Payer: UHC Core |
$112.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.11
|
| Rate for Payer: UHC Exchange |
$112.42
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: Aetna Medicare |
$40.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.23
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$39.05
|
| Rate for Payer: BCN Commercial |
$49.09
|
| Rate for Payer: BCN Medicare Advantage |
$39.05
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Cofinity Commercial |
$52.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.05
|
| Rate for Payer: Healthscope Commercial |
$72.24
|
| Rate for Payer: Healthscope Commercial |
$62.48
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.00
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.34
|
| Rate for Payer: Nomi Health Commercial |
$46.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PACE SWMI |
$39.05
|
| Rate for Payer: PHP Medicare Advantage |
$39.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.84
|
| Rate for Payer: Priority Health Medicare |
$39.05
|
| Rate for Payer: Priority Health SBD |
$75.84
|
| Rate for Payer: Priority Health Tiered Network |
$75.84
|
| Rate for Payer: Railroad Medicare Medicare |
$39.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.64
|
| Rate for Payer: UHC Core |
$70.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.05
|
| Rate for Payer: UHC Exchange |
$70.64
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$112.72
|
| Rate for Payer: Aetna Medicare |
$87.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.13
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$84.12
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$84.12
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$121.13
|
| Rate for Payer: Cofinity Commercial |
$112.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.12
|
| Rate for Payer: Healthscope Commercial |
$155.62
|
| Rate for Payer: Healthscope Commercial |
$134.59
|
| Rate for Payer: Mclaren Medicaid |
$54.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.33
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.27
|
| Rate for Payer: Nomi Health Commercial |
$100.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$84.12
|
| Rate for Payer: PHP Medicare Advantage |
$84.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.49
|
| Rate for Payer: Priority Health Medicare |
$84.12
|
| Rate for Payer: Priority Health SBD |
$170.49
|
| Rate for Payer: Priority Health Tiered Network |
$170.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.25
|
| Rate for Payer: UHC Core |
$165.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.12
|
| Rate for Payer: UHC Exchange |
$165.25
|
| Rate for Payer: UHC Medicaid |
$54.53
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$225.12 |
| Rate for Payer: Aetna Commercial |
$149.80
|
| Rate for Payer: Aetna Medicare |
$116.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.98
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$111.79
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$111.79
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$160.98
|
| Rate for Payer: Cofinity Commercial |
$149.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.79
|
| Rate for Payer: Healthscope Commercial |
$206.81
|
| Rate for Payer: Healthscope Commercial |
$178.86
|
| Rate for Payer: Mclaren Medicaid |
$72.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.38
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.46
|
| Rate for Payer: Nomi Health Commercial |
$134.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: PACE SWMI |
$111.79
|
| Rate for Payer: PHP Medicare Advantage |
$111.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$225.12
|
| Rate for Payer: Priority Health Medicare |
$111.79
|
| Rate for Payer: Priority Health SBD |
$225.12
|
| Rate for Payer: Priority Health Tiered Network |
$225.12
|
| Rate for Payer: Railroad Medicare Medicare |
$111.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.95
|
| Rate for Payer: UHC Core |
$222.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.79
|
| Rate for Payer: UHC Exchange |
$222.95
|
| Rate for Payer: UHC Medicaid |
$72.21
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$93.53
|
| Rate for Payer: Aetna Medicare |
$72.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.53
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.80
|
| Rate for Payer: BCN Commercial |
$113.54
|
| Rate for Payer: BCN Medicare Advantage |
$69.80
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$93.53
|
| Rate for Payer: Cofinity Commercial |
$100.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.80
|
| Rate for Payer: Healthscope Commercial |
$129.13
|
| Rate for Payer: Healthscope Commercial |
$111.68
|
| Rate for Payer: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.29
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.44
|
| Rate for Payer: Nomi Health Commercial |
$83.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.50
|
| Rate for Payer: PACE SWMI |
$69.80
|
| Rate for Payer: PHP Medicare Advantage |
$69.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$138.34
|
| Rate for Payer: Priority Health Medicare |
$69.80
|
| Rate for Payer: Priority Health SBD |
$138.34
|
| Rate for Payer: Priority Health Tiered Network |
$138.34
|
| Rate for Payer: Railroad Medicare Medicare |
$69.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.08
|
| Rate for Payer: UHC Core |
$132.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.80
|
| Rate for Payer: UHC Exchange |
$132.08
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$777.00 |
| Rate for Payer: Aetna Commercial |
$82.05
|
| Rate for Payer: Aetna Medicare |
$63.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.17
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$61.23
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$61.23
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$88.17
|
| Rate for Payer: Cofinity Commercial |
$82.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.23
|
| Rate for Payer: Healthscope Commercial |
$97.97
|
| Rate for Payer: Healthscope Commercial |
$113.28
|
| Rate for Payer: Mclaren Medicaid |
$39.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.29
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.32
|
| Rate for Payer: Nomi Health Commercial |
$73.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.00
|
| Rate for Payer: PACE SWMI |
$61.23
|
| Rate for Payer: PHP Medicare Advantage |
$61.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.15
|
| Rate for Payer: Priority Health Medicare |
$61.23
|
| Rate for Payer: Priority Health SBD |
$120.15
|
| Rate for Payer: Priority Health Tiered Network |
$120.15
|
| Rate for Payer: Railroad Medicare Medicare |
$61.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$114.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.23
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$275.25 |
| Rate for Payer: Aetna Commercial |
$108.03
|
| Rate for Payer: Aetna Medicare |
$83.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.09
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$80.62
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$80.62
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$116.09
|
| Rate for Payer: Cofinity Commercial |
$108.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.62
|
| Rate for Payer: Healthscope Commercial |
$149.15
|
| Rate for Payer: Healthscope Commercial |
$128.99
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.65
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.52
|
| Rate for Payer: Nomi Health Commercial |
$96.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.25
|
| Rate for Payer: PACE SWMI |
$80.62
|
| Rate for Payer: PHP Medicare Advantage |
$80.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$155.34
|
| Rate for Payer: Priority Health Medicare |
$80.62
|
| Rate for Payer: Priority Health SBD |
$155.34
|
| Rate for Payer: Priority Health Tiered Network |
$155.34
|
| Rate for Payer: Railroad Medicare Medicare |
$80.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.82
|
| Rate for Payer: UHC Core |
$148.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.62
|
| Rate for Payer: UHC Exchange |
$148.82
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$443.25 |
| Rate for Payer: Aetna Commercial |
$100.26
|
| Rate for Payer: Aetna Medicare |
$77.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.74
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS MAPPO |
$74.82
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$74.82
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$107.74
|
| Rate for Payer: Cofinity Commercial |
$100.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.82
|
| Rate for Payer: Healthscope Commercial |
$138.42
|
| Rate for Payer: Healthscope Commercial |
$119.71
|
| Rate for Payer: Mclaren Medicaid |
$48.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.56
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.27
|
| Rate for Payer: Nomi Health Commercial |
$89.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$74.82
|
| Rate for Payer: PHP Medicare Advantage |
$74.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.84
|
| Rate for Payer: Priority Health Medicare |
$74.82
|
| Rate for Payer: Priority Health SBD |
$146.84
|
| Rate for Payer: Priority Health Tiered Network |
$146.84
|
| Rate for Payer: Railroad Medicare Medicare |
$74.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.61
|
| Rate for Payer: UHC Core |
$142.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.82
|
| Rate for Payer: UHC Exchange |
$142.61
|
| Rate for Payer: UHC Medicaid |
$48.56
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$443.25 |
| Rate for Payer: Aetna Commercial |
$98.41
|
| Rate for Payer: Aetna Medicare |
$76.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.41
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$73.44
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$73.44
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$98.41
|
| Rate for Payer: Cofinity Commercial |
$105.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Mclaren Medicaid |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.11
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.23
|
| Rate for Payer: Nomi Health Commercial |
$88.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$73.44
|
| Rate for Payer: PHP Medicare Advantage |
$73.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.84
|
| Rate for Payer: Priority Health Medicare |
$73.44
|
| Rate for Payer: Priority Health SBD |
$146.84
|
| Rate for Payer: Priority Health Tiered Network |
$146.84
|
| Rate for Payer: Railroad Medicare Medicare |
$73.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.66
|
| Rate for Payer: UHC Core |
$140.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.44
|
| Rate for Payer: UHC Exchange |
$140.66
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: Aetna Medicare |
$93.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.17
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$89.70
|
| Rate for Payer: BCN Commercial |
$143.92
|
| Rate for Payer: BCN Medicare Advantage |
$89.70
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$129.17
|
| Rate for Payer: Cofinity Commercial |
$120.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.70
|
| Rate for Payer: Healthscope Commercial |
$165.94
|
| Rate for Payer: Healthscope Commercial |
$143.52
|
| Rate for Payer: Mclaren Medicaid |
$57.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.19
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$107.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$89.70
|
| Rate for Payer: PHP Medicare Advantage |
$89.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$175.35
|
| Rate for Payer: Priority Health Medicare |
$89.70
|
| Rate for Payer: Priority Health SBD |
$175.35
|
| Rate for Payer: Priority Health Tiered Network |
$175.35
|
| Rate for Payer: Railroad Medicare Medicare |
$89.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.54
|
| Rate for Payer: UHC Core |
$168.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.70
|
| Rate for Payer: UHC Exchange |
$168.54
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$132.00
|
| Rate for Payer: Aetna Medicare |
$102.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.85
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.51
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$98.51
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$141.85
|
| Rate for Payer: Cofinity Commercial |
$132.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.51
|
| Rate for Payer: Healthscope Commercial |
$182.24
|
| Rate for Payer: Healthscope Commercial |
$157.62
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.44
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.62
|
| Rate for Payer: Nomi Health Commercial |
$118.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$98.51
|
| Rate for Payer: PHP Medicare Advantage |
$98.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$194.16
|
| Rate for Payer: Priority Health Medicare |
$98.51
|
| Rate for Payer: Priority Health SBD |
$194.16
|
| Rate for Payer: Priority Health Tiered Network |
$194.16
|
| Rate for Payer: Railroad Medicare Medicare |
$98.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.64
|
| Rate for Payer: UHC Core |
$187.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.51
|
| Rate for Payer: UHC Exchange |
$187.64
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,191.00
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$376.64 |
| Max. Negotiated Rate |
$893.25 |
| Rate for Payer: Aetna Commercial |
$531.26
|
| Rate for Payer: Aetna Medicare |
$412.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.90
|
| Rate for Payer: BCBS Complete |
$395.47
|
| Rate for Payer: BCBS MAPPO |
$396.46
|
| Rate for Payer: BCN Commercial |
$637.82
|
| Rate for Payer: BCN Medicare Advantage |
$396.46
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cash Price |
$952.80
|
| Rate for Payer: Cofinity Commercial |
$570.90
|
| Rate for Payer: Cofinity Commercial |
$531.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.46
|
| Rate for Payer: Healthscope Commercial |
$733.45
|
| Rate for Payer: Healthscope Commercial |
$634.34
|
| Rate for Payer: Mclaren Medicaid |
$376.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.28
|
| Rate for Payer: Meridian Medicaid |
$395.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$436.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.76
|
| Rate for Payer: Nomi Health Commercial |
$475.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$893.25
|
| Rate for Payer: PACE SWMI |
$396.46
|
| Rate for Payer: PHP Medicare Advantage |
$396.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$612.06
|
| Rate for Payer: Priority Health Medicare |
$396.46
|
| Rate for Payer: Priority Health SBD |
$612.06
|
| Rate for Payer: Priority Health Tiered Network |
$612.06
|
| Rate for Payer: Railroad Medicare Medicare |
$396.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.60
|
| Rate for Payer: UHC Core |
$635.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$396.46
|
| Rate for Payer: UHC Exchange |
$635.60
|
| Rate for Payer: UHC Medicaid |
$376.64
|
| Rate for Payer: UHCCP Medicaid |
$376.64
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$690.73 |
| Max. Negotiated Rate |
$1,441.33 |
| Rate for Payer: Aetna Commercial |
$974.29
|
| Rate for Payer: Aetna Medicare |
$756.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.29
|
| Rate for Payer: BCBS Complete |
$725.27
|
| Rate for Payer: BCBS MAPPO |
$727.08
|
| Rate for Payer: BCN Commercial |
$1,138.94
|
| Rate for Payer: BCN Medicare Advantage |
$727.08
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$974.29
|
| Rate for Payer: Cofinity Commercial |
$1,047.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.08
|
| Rate for Payer: Healthscope Commercial |
$1,345.10
|
| Rate for Payer: Healthscope Commercial |
$1,163.33
|
| Rate for Payer: Mclaren Medicaid |
$690.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.43
|
| Rate for Payer: Meridian Medicaid |
$725.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$799.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.33
|
| Rate for Payer: Nomi Health Commercial |
$872.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.75
|
| Rate for Payer: PACE SWMI |
$727.08
|
| Rate for Payer: PHP Medicare Advantage |
$727.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,123.99
|
| Rate for Payer: Priority Health Medicare |
$727.08
|
| Rate for Payer: Priority Health SBD |
$1,123.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,123.99
|
| Rate for Payer: Railroad Medicare Medicare |
$727.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.33
|
| Rate for Payer: UHC Core |
$1,120.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$727.08
|
| Rate for Payer: UHC Exchange |
$1,120.33
|
| Rate for Payer: UHC Medicaid |
$690.73
|
| Rate for Payer: UHCCP Medicaid |
$690.73
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$347.62 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$720.73
|
| Rate for Payer: Aetna Medicare |
$559.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.52
|
| Rate for Payer: BCBS Complete |
$365.00
|
| Rate for Payer: BCBS MAPPO |
$537.86
|
| Rate for Payer: BCN Commercial |
$921.26
|
| Rate for Payer: BCN Medicare Advantage |
$537.86
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$774.52
|
| Rate for Payer: Cofinity Commercial |
$720.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.86
|
| Rate for Payer: Healthscope Commercial |
$995.04
|
| Rate for Payer: Healthscope Commercial |
$860.58
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.75
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,093.23
|
| Rate for Payer: Nomi Health Commercial |
$645.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.00
|
| Rate for Payer: PACE SWMI |
$537.86
|
| Rate for Payer: PHP Medicare Advantage |
$537.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$933.04
|
| Rate for Payer: Priority Health Medicare |
$537.86
|
| Rate for Payer: Priority Health SBD |
$933.04
|
| Rate for Payer: Priority Health Tiered Network |
$933.04
|
| Rate for Payer: Railroad Medicare Medicare |
$537.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,066.39
|
| Rate for Payer: UHC Core |
$1,066.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.86
|
| Rate for Payer: UHC Exchange |
$1,066.39
|
| Rate for Payer: UHC Medicaid |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$347.62
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,997.00
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$413.01 |
| Max. Negotiated Rate |
$2,997.75 |
| Rate for Payer: Aetna Commercial |
$874.89
|
| Rate for Payer: Aetna Medicare |
$679.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.18
|
| Rate for Payer: BCBS Complete |
$433.66
|
| Rate for Payer: BCBS MAPPO |
$652.90
|
| Rate for Payer: BCN Commercial |
$1,192.61
|
| Rate for Payer: BCN Medicare Advantage |
$652.90
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cofinity Commercial |
$940.18
|
| Rate for Payer: Cofinity Commercial |
$874.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.90
|
| Rate for Payer: Healthscope Commercial |
$1,207.87
|
| Rate for Payer: Healthscope Commercial |
$1,044.64
|
| Rate for Payer: Mclaren Medicaid |
$413.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.54
|
| Rate for Payer: Meridian Medicaid |
$433.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$718.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,305.36
|
| Rate for Payer: Nomi Health Commercial |
$783.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,997.75
|
| Rate for Payer: PACE SWMI |
$652.90
|
| Rate for Payer: PHP Medicare Advantage |
$652.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,160.47
|
| Rate for Payer: Priority Health Medicare |
$652.90
|
| Rate for Payer: Priority Health SBD |
$1,160.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,160.47
|
| Rate for Payer: Railroad Medicare Medicare |
$652.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.89
|
| Rate for Payer: UHC Core |
$1,298.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.90
|
| Rate for Payer: UHC Exchange |
$1,298.89
|
| Rate for Payer: UHC Medicaid |
$413.01
|
| Rate for Payer: UHCCP Medicaid |
$413.01
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$4,398.00
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$3,298.50 |
| Rate for Payer: Aetna Commercial |
$909.65
|
| Rate for Payer: Aetna Medicare |
$705.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.53
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS MAPPO |
$678.84
|
| Rate for Payer: BCN Commercial |
$1,242.39
|
| Rate for Payer: BCN Medicare Advantage |
$678.84
|
| Rate for Payer: Cash Price |
$3,518.40
|
| Rate for Payer: Cash Price |
$3,518.40
|
| Rate for Payer: Cofinity Commercial |
$977.53
|
| Rate for Payer: Cofinity Commercial |
$909.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.84
|
| Rate for Payer: Healthscope Commercial |
$1,255.85
|
| Rate for Payer: Healthscope Commercial |
$1,086.14
|
| Rate for Payer: Mclaren Medicaid |
$429.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.78
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.57
|
| Rate for Payer: Nomi Health Commercial |
$814.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,298.50
|
| Rate for Payer: PACE SWMI |
$678.84
|
| Rate for Payer: PHP Medicare Advantage |
$678.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,208.92
|
| Rate for Payer: Priority Health Medicare |
$678.84
|
| Rate for Payer: Priority Health SBD |
$1,208.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,208.92
|
| Rate for Payer: Railroad Medicare Medicare |
$678.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,350.41
|
| Rate for Payer: UHC Core |
$1,350.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$678.84
|
| Rate for Payer: UHC Exchange |
$1,350.41
|
| Rate for Payer: UHC Medicaid |
$429.41
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,892.00
|
|
|
Service Code
|
HCPCS 22847
|
| Min. Negotiated Rate |
$438.35 |
| Max. Negotiated Rate |
$2,919.00 |
| Rate for Payer: Aetna Commercial |
$920.96
|
| Rate for Payer: Aetna Medicare |
$714.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.68
|
| Rate for Payer: BCBS Complete |
$460.27
|
| Rate for Payer: BCBS MAPPO |
$687.28
|
| Rate for Payer: BCN Commercial |
$1,188.68
|
| Rate for Payer: BCN Medicare Advantage |
$687.28
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cofinity Commercial |
$989.68
|
| Rate for Payer: Cofinity Commercial |
$920.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.28
|
| Rate for Payer: Healthscope Commercial |
$1,271.47
|
| Rate for Payer: Healthscope Commercial |
$1,099.65
|
| Rate for Payer: Mclaren Medicaid |
$438.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.64
|
| Rate for Payer: Meridian Medicaid |
$460.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$756.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,419.66
|
| Rate for Payer: Nomi Health Commercial |
$824.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,919.00
|
| Rate for Payer: PACE SWMI |
$687.28
|
| Rate for Payer: PHP Medicare Advantage |
$687.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,270.66
|
| Rate for Payer: Priority Health Medicare |
$687.28
|
| Rate for Payer: Priority Health SBD |
$1,270.66
|
| Rate for Payer: Priority Health Tiered Network |
$1,270.66
|
| Rate for Payer: Railroad Medicare Medicare |
$687.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,434.25
|
| Rate for Payer: UHC Core |
$1,434.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.28
|
| Rate for Payer: UHC Exchange |
$1,434.25
|
| Rate for Payer: UHC Medicaid |
$438.35
|
| Rate for Payer: UHCCP Medicaid |
$438.35
|
|
|
PR ANTERIOR TIBIAL TUBERCLEPLASTY
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 27418
|
| Min. Negotiated Rate |
$486.71 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$999.61
|
| Rate for Payer: Aetna Medicare |
$775.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.61
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$745.98
|
| Rate for Payer: BCN Commercial |
$1,366.58
|
| Rate for Payer: BCN Medicare Advantage |
$745.98
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cofinity Commercial |
$999.61
|
| Rate for Payer: Cofinity Commercial |
$1,074.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.98
|
| Rate for Payer: Healthscope Commercial |
$1,380.06
|
| Rate for Payer: Healthscope Commercial |
$1,193.57
|
| Rate for Payer: Mclaren Medicaid |
$486.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.28
|
| Rate for Payer: Meridian Medicaid |
$511.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.16
|
| Rate for Payer: Nomi Health Commercial |
$895.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: PACE SWMI |
$745.98
|
| Rate for Payer: PHP Medicare Advantage |
$745.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,329.76
|
| Rate for Payer: Priority Health Medicare |
$745.98
|
| Rate for Payer: Priority Health SBD |
$1,329.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,329.76
|
| Rate for Payer: Railroad Medicare Medicare |
$745.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,447.87
|
| Rate for Payer: UHC Core |
$1,447.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$745.98
|
| Rate for Payer: UHC Exchange |
$1,447.87
|
| Rate for Payer: UHC Medicaid |
$486.71
|
| Rate for Payer: UHCCP Medicaid |
$486.71
|
|
