|
PR ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 93050
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$29.95 |
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Medicare |
$16.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.31
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$24.40
|
| Rate for Payer: BCN Medicare Advantage |
$16.19
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$23.31
|
| Rate for Payer: Cofinity Commercial |
$21.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.19
|
| Rate for Payer: Healthscope Commercial |
$29.95
|
| Rate for Payer: Healthscope Commercial |
$25.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.70
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$16.19
|
| Rate for Payer: PHP Medicare Advantage |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.19
|
| Rate for Payer: Priority Health Medicare |
$16.19
|
| Rate for Payer: Priority Health SBD |
$23.19
|
| Rate for Payer: Priority Health Tiered Network |
$23.19
|
| Rate for Payer: Railroad Medicare Medicare |
$16.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.39
|
| Rate for Payer: UHC Core |
$25.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.19
|
| Rate for Payer: UHC Exchange |
$25.39
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,304.18 |
| Rate for Payer: Aetna Commercial |
$892.88
|
| Rate for Payer: Aetna Medicare |
$692.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$892.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.52
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS MAPPO |
$666.33
|
| Rate for Payer: BCN Commercial |
$1,069.16
|
| Rate for Payer: BCN Medicare Advantage |
$666.33
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$959.52
|
| Rate for Payer: Cofinity Commercial |
$892.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.33
|
| Rate for Payer: Healthscope Commercial |
$1,232.71
|
| Rate for Payer: Healthscope Commercial |
$1,066.13
|
| Rate for Payer: Mclaren Medicaid |
$423.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.65
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$732.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,279.19
|
| Rate for Payer: Nomi Health Commercial |
$799.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.50
|
| Rate for Payer: PACE SWMI |
$666.33
|
| Rate for Payer: PHP Medicare Advantage |
$666.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,149.75
|
| Rate for Payer: Priority Health Medicare |
$666.33
|
| Rate for Payer: Priority Health SBD |
$1,149.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,149.75
|
| Rate for Payer: Railroad Medicare Medicare |
$666.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.18
|
| Rate for Payer: UHC Core |
$1,304.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.33
|
| Rate for Payer: UHC Exchange |
$1,304.18
|
| Rate for Payer: UHC Medicaid |
$423.23
|
| Rate for Payer: UHCCP Medicaid |
$423.23
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,508.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,881.00 |
| Rate for Payer: Aetna Commercial |
$894.42
|
| Rate for Payer: Aetna Medicare |
$694.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.17
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS MAPPO |
$667.48
|
| Rate for Payer: BCN Commercial |
$1,067.17
|
| Rate for Payer: BCN Medicare Advantage |
$667.48
|
| Rate for Payer: Cash Price |
$2,006.40
|
| Rate for Payer: Cash Price |
$2,006.40
|
| Rate for Payer: Cofinity Commercial |
$961.17
|
| Rate for Payer: Cofinity Commercial |
$894.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.48
|
| Rate for Payer: Healthscope Commercial |
$1,234.84
|
| Rate for Payer: Healthscope Commercial |
$1,067.97
|
| Rate for Payer: Mclaren Medicaid |
$423.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.85
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$734.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,292.04
|
| Rate for Payer: Nomi Health Commercial |
$800.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,881.00
|
| Rate for Payer: PACE SWMI |
$667.48
|
| Rate for Payer: PHP Medicare Advantage |
$667.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,147.62
|
| Rate for Payer: Priority Health Medicare |
$667.48
|
| Rate for Payer: Priority Health SBD |
$1,147.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,147.62
|
| Rate for Payer: Railroad Medicare Medicare |
$667.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,309.70
|
| Rate for Payer: UHC Core |
$1,309.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$667.48
|
| Rate for Payer: UHC Exchange |
$1,309.70
|
| Rate for Payer: UHC Medicaid |
$423.23
|
| Rate for Payer: UHCCP Medicaid |
$423.23
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$2,069.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$1,551.75 |
| Rate for Payer: Aetna Commercial |
$845.57
|
| Rate for Payer: Aetna Medicare |
$656.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$908.67
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$631.02
|
| Rate for Payer: BCN Commercial |
$1,009.41
|
| Rate for Payer: BCN Medicare Advantage |
$631.02
|
| Rate for Payer: Cash Price |
$1,655.20
|
| Rate for Payer: Cash Price |
$1,655.20
|
| Rate for Payer: Cofinity Commercial |
$908.67
|
| Rate for Payer: Cofinity Commercial |
$845.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.02
|
| Rate for Payer: Healthscope Commercial |
$1,167.39
|
| Rate for Payer: Healthscope Commercial |
$1,009.63
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.57
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,219.28
|
| Rate for Payer: Nomi Health Commercial |
$757.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,551.75
|
| Rate for Payer: PACE SWMI |
$631.02
|
| Rate for Payer: PHP Medicare Advantage |
$631.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.48
|
| Rate for Payer: Priority Health Medicare |
$631.02
|
| Rate for Payer: Priority Health SBD |
$1,085.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.48
|
| Rate for Payer: Railroad Medicare Medicare |
$631.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.12
|
| Rate for Payer: UHC Core |
$1,237.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.02
|
| Rate for Payer: UHC Exchange |
$1,237.12
|
| Rate for Payer: UHC Medicaid |
$400.87
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,680.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$1,595.16 |
| Max. Negotiated Rate |
$6,510.00 |
| Rate for Payer: Aetna Commercial |
$3,356.41
|
| Rate for Payer: Aetna Medicare |
$2,604.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,356.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,606.88
|
| Rate for Payer: BCBS Complete |
$1,674.92
|
| Rate for Payer: BCBS MAPPO |
$2,504.78
|
| Rate for Payer: BCN Commercial |
$3,952.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,504.78
|
| Rate for Payer: Cash Price |
$6,944.00
|
| Rate for Payer: Cash Price |
$6,944.00
|
| Rate for Payer: Cofinity Commercial |
$3,606.88
|
| Rate for Payer: Cofinity Commercial |
$3,356.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,504.78
|
| Rate for Payer: Healthscope Commercial |
$4,633.84
|
| Rate for Payer: Healthscope Commercial |
$4,007.65
|
| Rate for Payer: Mclaren Medicaid |
$1,595.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,630.02
|
| Rate for Payer: Meridian Medicaid |
$1,674.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,755.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,719.69
|
| Rate for Payer: Nomi Health Commercial |
$3,005.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,510.00
|
| Rate for Payer: PACE SWMI |
$2,504.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,504.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,595.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,591.31
|
| Rate for Payer: Priority Health Medicare |
$2,504.78
|
| Rate for Payer: Priority Health SBD |
$4,591.31
|
| Rate for Payer: Priority Health Tiered Network |
$4,591.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,504.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,604.25
|
| Rate for Payer: UHC Core |
$4,604.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,504.78
|
| Rate for Payer: UHC Exchange |
$4,604.25
|
| Rate for Payer: UHC Medicaid |
$1,595.16
|
| Rate for Payer: UHCCP Medicaid |
$1,595.16
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$595.55 |
| Max. Negotiated Rate |
$1,776.19 |
| Rate for Payer: Aetna Commercial |
$1,202.53
|
| Rate for Payer: Aetna Medicare |
$933.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.27
|
| Rate for Payer: BCBS Complete |
$625.33
|
| Rate for Payer: BCBS MAPPO |
$897.41
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: BCN Medicare Advantage |
$897.41
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,292.27
|
| Rate for Payer: Cofinity Commercial |
$1,202.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.41
|
| Rate for Payer: Healthscope Commercial |
$1,660.21
|
| Rate for Payer: Healthscope Commercial |
$1,435.86
|
| Rate for Payer: Mclaren Medicaid |
$595.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.28
|
| Rate for Payer: Meridian Medicaid |
$625.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,776.19
|
| Rate for Payer: Nomi Health Commercial |
$1,076.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: PACE SWMI |
$897.41
|
| Rate for Payer: PHP Medicare Advantage |
$897.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,435.93
|
| Rate for Payer: Priority Health Medicare |
$897.41
|
| Rate for Payer: Priority Health SBD |
$1,435.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,435.93
|
| Rate for Payer: Railroad Medicare Medicare |
$897.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.28
|
| Rate for Payer: UHC Core |
$1,680.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.41
|
| Rate for Payer: UHC Exchange |
$1,680.28
|
| Rate for Payer: UHC Medicaid |
$595.55
|
| Rate for Payer: UHCCP Medicaid |
$595.55
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,821.00
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$1,853.10 |
| Max. Negotiated Rate |
$5,636.85 |
| Rate for Payer: Aetna Commercial |
$3,915.01
|
| Rate for Payer: Aetna Medicare |
$3,038.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,915.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,207.18
|
| Rate for Payer: BCBS Complete |
$1,945.76
|
| Rate for Payer: BCBS MAPPO |
$2,921.65
|
| Rate for Payer: BCN Commercial |
$4,604.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,921.65
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cofinity Commercial |
$4,207.18
|
| Rate for Payer: Cofinity Commercial |
$3,915.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,921.65
|
| Rate for Payer: Healthscope Commercial |
$5,405.05
|
| Rate for Payer: Healthscope Commercial |
$4,674.64
|
| Rate for Payer: Mclaren Medicaid |
$1,853.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,067.73
|
| Rate for Payer: Meridian Medicaid |
$1,945.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,213.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,567.45
|
| Rate for Payer: Nomi Health Commercial |
$3,505.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,115.75
|
| Rate for Payer: PACE SWMI |
$2,921.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,921.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,951.91
|
| Rate for Payer: Priority Health Medicare |
$2,921.65
|
| Rate for Payer: Priority Health SBD |
$4,951.91
|
| Rate for Payer: Priority Health Tiered Network |
$4,951.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,921.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,636.85
|
| Rate for Payer: UHC Core |
$5,636.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,921.65
|
| Rate for Payer: UHC Exchange |
$5,636.85
|
| Rate for Payer: UHC Medicaid |
$1,853.10
|
| Rate for Payer: UHCCP Medicaid |
$1,853.10
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$7,339.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$1,998.37 |
| Max. Negotiated Rate |
$6,076.72 |
| Rate for Payer: Aetna Commercial |
$4,222.53
|
| Rate for Payer: Aetna Medicare |
$3,277.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,222.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,537.64
|
| Rate for Payer: BCBS Complete |
$2,098.29
|
| Rate for Payer: BCBS MAPPO |
$3,151.14
|
| Rate for Payer: BCN Commercial |
$4,969.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.14
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cofinity Commercial |
$4,537.64
|
| Rate for Payer: Cofinity Commercial |
$4,222.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.14
|
| Rate for Payer: Healthscope Commercial |
$5,829.61
|
| Rate for Payer: Healthscope Commercial |
$5,041.82
|
| Rate for Payer: Mclaren Medicaid |
$1,998.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.70
|
| Rate for Payer: Meridian Medicaid |
$2,098.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,466.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,009.64
|
| Rate for Payer: Nomi Health Commercial |
$3,781.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,504.25
|
| Rate for Payer: PACE SWMI |
$3,151.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,998.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,343.91
|
| Rate for Payer: Priority Health Medicare |
$3,151.14
|
| Rate for Payer: Priority Health SBD |
$5,343.91
|
| Rate for Payer: Priority Health Tiered Network |
$5,343.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,076.72
|
| Rate for Payer: UHC Core |
$6,076.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,151.14
|
| Rate for Payer: UHC Exchange |
$6,076.72
|
| Rate for Payer: UHC Medicaid |
$1,998.37
|
| Rate for Payer: UHCCP Medicaid |
$1,998.37
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,264.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,442.44 |
| Max. Negotiated Rate |
$4,359.60 |
| Rate for Payer: Aetna Commercial |
$3,043.58
|
| Rate for Payer: Aetna Medicare |
$2,362.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,043.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,270.72
|
| Rate for Payer: BCBS Complete |
$1,514.56
|
| Rate for Payer: BCBS MAPPO |
$2,271.33
|
| Rate for Payer: BCN Commercial |
$3,573.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,271.33
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cofinity Commercial |
$3,270.72
|
| Rate for Payer: Cofinity Commercial |
$3,043.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,271.33
|
| Rate for Payer: Healthscope Commercial |
$4,201.96
|
| Rate for Payer: Healthscope Commercial |
$3,634.13
|
| Rate for Payer: Mclaren Medicaid |
$1,442.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,384.90
|
| Rate for Payer: Meridian Medicaid |
$1,514.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,498.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,312.94
|
| Rate for Payer: Nomi Health Commercial |
$2,725.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,948.00
|
| Rate for Payer: PACE SWMI |
$2,271.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,271.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,442.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,842.32
|
| Rate for Payer: Priority Health Medicare |
$2,271.33
|
| Rate for Payer: Priority Health SBD |
$3,842.32
|
| Rate for Payer: Priority Health Tiered Network |
$3,842.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,271.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,359.60
|
| Rate for Payer: UHC Core |
$4,359.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,271.33
|
| Rate for Payer: UHC Exchange |
$4,359.60
|
| Rate for Payer: UHC Medicaid |
$1,442.44
|
| Rate for Payer: UHCCP Medicaid |
$1,442.44
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$10,357.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$4,142.80 |
| Max. Negotiated Rate |
$7,767.75 |
| Rate for Payer: Aetna Medicare |
$5,178.50
|
| Rate for Payer: BCBS Complete |
$4,142.80
|
| Rate for Payer: Cash Price |
$8,285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,732.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,767.75
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,385.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,891.65 |
| Max. Negotiated Rate |
$5,759.09 |
| Rate for Payer: Aetna Commercial |
$3,996.58
|
| Rate for Payer: Aetna Medicare |
$3,101.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,996.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,294.83
|
| Rate for Payer: BCBS Complete |
$1,986.23
|
| Rate for Payer: BCBS MAPPO |
$2,982.52
|
| Rate for Payer: BCN Commercial |
$4,706.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,982.52
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cofinity Commercial |
$4,294.83
|
| Rate for Payer: Cofinity Commercial |
$3,996.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,982.52
|
| Rate for Payer: Healthscope Commercial |
$4,772.03
|
| Rate for Payer: Healthscope Commercial |
$5,517.66
|
| Rate for Payer: Mclaren Medicaid |
$1,891.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,131.65
|
| Rate for Payer: Meridian Medicaid |
$1,986.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,280.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,691.44
|
| Rate for Payer: Nomi Health Commercial |
$3,579.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,038.75
|
| Rate for Payer: PACE SWMI |
$2,982.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,982.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,891.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,061.69
|
| Rate for Payer: Priority Health Medicare |
$2,982.52
|
| Rate for Payer: Priority Health SBD |
$5,061.69
|
| Rate for Payer: Priority Health Tiered Network |
$5,061.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,982.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,759.09
|
| Rate for Payer: UHC Core |
$5,759.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,982.52
|
| Rate for Payer: UHC Exchange |
$5,759.09
|
| Rate for Payer: UHC Medicaid |
$1,891.65
|
| Rate for Payer: UHCCP Medicaid |
$1,891.65
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Aetna Commercial |
$55.84
|
| Rate for Payer: Aetna Medicare |
$43.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.00
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.67
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.67
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$55.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.67
|
| Rate for Payer: Healthscope Commercial |
$77.09
|
| Rate for Payer: Healthscope Commercial |
$66.67
|
| Rate for Payer: Mclaren Medicaid |
$26.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.75
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.73
|
| Rate for Payer: Nomi Health Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$41.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.76
|
| Rate for Payer: Priority Health Medicare |
$41.67
|
| Rate for Payer: Priority Health SBD |
$77.76
|
| Rate for Payer: Priority Health Tiered Network |
$77.76
|
| Rate for Payer: Railroad Medicare Medicare |
$41.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.24
|
| Rate for Payer: UHC Core |
$87.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.67
|
| Rate for Payer: UHC Exchange |
$87.24
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$257.31 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: BCBS Complete |
$84.31
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Healthscope Commercial |
$231.23
|
| Rate for Payer: Healthscope Commercial |
$199.98
|
| Rate for Payer: Mclaren Medicaid |
$80.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$84.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.18
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$228.38
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health SBD |
$228.38
|
| Rate for Payer: Priority Health Tiered Network |
$228.38
|
| Rate for Payer: Railroad Medicare Medicare |
$124.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.31
|
| Rate for Payer: UHC Core |
$257.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Exchange |
$257.31
|
| Rate for Payer: UHC Medicaid |
$80.30
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCN Commercial |
$57.76
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$62.27
|
| Rate for Payer: Healthscope Commercial |
$53.86
|
| Rate for Payer: Mclaren Medicaid |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.14
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.92
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: Priority Health Tiered Network |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$33.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.99
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Exchange |
$68.99
|
| Rate for Payer: UHC Medicaid |
$21.51
|
| Rate for Payer: UHCCP Medicaid |
$21.51
|
|
|
PR ASPIRATION BLADDER TROCAR/INTRACATHETER
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS 51101
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna Commercial |
$59.46
|
| Rate for Payer: Aetna Medicare |
$46.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.89
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$44.37
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Cofinity Commercial |
$59.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.37
|
| Rate for Payer: Healthscope Commercial |
$82.08
|
| Rate for Payer: Healthscope Commercial |
$70.99
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.59
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.55
|
| Rate for Payer: Nomi Health Commercial |
$53.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.25
|
| Rate for Payer: PACE SWMI |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$44.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.46
|
| Rate for Payer: Priority Health Medicare |
$44.37
|
| Rate for Payer: Priority Health SBD |
$82.46
|
| Rate for Payer: Priority Health Tiered Network |
$82.46
|
| Rate for Payer: Railroad Medicare Medicare |
$44.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.70
|
| Rate for Payer: UHC Core |
$91.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.37
|
| Rate for Payer: UHC Exchange |
$91.70
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 20612
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Aetna Medicare |
$37.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.08
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$36.17
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.17
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.17
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Healthscope Commercial |
$57.87
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.98
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.59
|
| Rate for Payer: Nomi Health Commercial |
$43.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.25
|
| Rate for Payer: PACE SWMI |
$36.17
|
| Rate for Payer: PHP Medicare Advantage |
$36.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.01
|
| Rate for Payer: Priority Health Medicare |
$36.17
|
| Rate for Payer: Priority Health SBD |
$66.01
|
| Rate for Payer: Priority Health Tiered Network |
$66.01
|
| Rate for Payer: Railroad Medicare Medicare |
$36.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.59
|
| Rate for Payer: UHC Core |
$72.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.17
|
| Rate for Payer: UHC Exchange |
$72.59
|
| Rate for Payer: UHC Medicaid |
$23.43
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
|
|
PR ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 96105
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$174.25 |
| Rate for Payer: Aetna Commercial |
$126.21
|
| Rate for Payer: Aetna Medicare |
$97.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.63
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS MAPPO |
$94.19
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$94.19
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$135.63
|
| Rate for Payer: Cofinity Commercial |
$126.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.19
|
| Rate for Payer: Healthscope Commercial |
$174.25
|
| Rate for Payer: Healthscope Commercial |
$150.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.04
|
| Rate for Payer: Nomi Health Commercial |
$113.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.75
|
| Rate for Payer: PACE SWMI |
$94.19
|
| Rate for Payer: PHP Medicare Advantage |
$94.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$133.17
|
| Rate for Payer: Priority Health Medicare |
$94.19
|
| Rate for Payer: Priority Health SBD |
$133.17
|
| Rate for Payer: Priority Health Tiered Network |
$133.17
|
| Rate for Payer: Railroad Medicare Medicare |
$94.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.86
|
| Rate for Payer: UHC Core |
$164.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.19
|
| Rate for Payer: UHC Exchange |
$164.86
|
|
|
PR ASSESSMENT FOR HEARING AID
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS V5010
|
| Min. Negotiated Rate |
$47.05 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$47.05
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.05
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
|
|
PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 99483
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$310.84 |
| Rate for Payer: Aetna Commercial |
$225.15
|
| Rate for Payer: Aetna Medicare |
$174.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.95
|
| Rate for Payer: BCBS Complete |
$113.61
|
| Rate for Payer: BCBS MAPPO |
$168.02
|
| Rate for Payer: BCN Commercial |
$208.87
|
| Rate for Payer: BCN Medicare Advantage |
$168.02
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$241.95
|
| Rate for Payer: Cofinity Commercial |
$225.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.02
|
| Rate for Payer: Healthscope Commercial |
$310.84
|
| Rate for Payer: Healthscope Commercial |
$268.83
|
| Rate for Payer: Mclaren Medicaid |
$108.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.42
|
| Rate for Payer: Meridian Medicaid |
$113.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.90
|
| Rate for Payer: Nomi Health Commercial |
$201.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: PACE SWMI |
$168.02
|
| Rate for Payer: PHP Medicare Advantage |
$168.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.55
|
| Rate for Payer: Priority Health Medicare |
$168.02
|
| Rate for Payer: Priority Health SBD |
$257.55
|
| Rate for Payer: Priority Health Tiered Network |
$257.55
|
| Rate for Payer: Railroad Medicare Medicare |
$168.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.10
|
| Rate for Payer: UHC Core |
$256.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.02
|
| Rate for Payer: UHC Exchange |
$256.10
|
| Rate for Payer: UHC Medicaid |
$108.20
|
| Rate for Payer: UHCCP Medicaid |
$108.20
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
OP
|
$110.30
|
|
|
Service Code
|
NDC 60505464303
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.35 |
| Max. Negotiated Rate |
$99.27 |
| Rate for Payer: Aetna Commercial |
$93.75
|
| Rate for Payer: Aetna Medicare |
$55.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.69
|
| Rate for Payer: BCBS Complete |
$44.12
|
| Rate for Payer: Cash Price |
$88.24
|
| Rate for Payer: Cofinity Advantage |
$77.21
|
| Rate for Payer: Cofinity Commercial |
$94.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.24
|
| Rate for Payer: Healthscope Commercial |
$99.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.72
|
| Rate for Payer: PHP Commercial |
$93.75
|
| Rate for Payer: Priority Health SBD |
$69.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.69
|
| Rate for Payer: UHC Core |
$57.47
|
| Rate for Payer: UHC Exchange |
$43.35
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
OP
|
$110.30
|
|
|
Service Code
|
NDC 60505485603
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.35 |
| Max. Negotiated Rate |
$99.27 |
| Rate for Payer: Aetna Commercial |
$93.75
|
| Rate for Payer: Aetna Medicare |
$55.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.69
|
| Rate for Payer: BCBS Complete |
$44.12
|
| Rate for Payer: Cash Price |
$88.24
|
| Rate for Payer: Cofinity Advantage |
$77.21
|
| Rate for Payer: Cofinity Commercial |
$94.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.24
|
| Rate for Payer: Healthscope Commercial |
$99.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.72
|
| Rate for Payer: PHP Commercial |
$93.75
|
| Rate for Payer: Priority Health SBD |
$69.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.69
|
| Rate for Payer: UHC Core |
$57.47
|
| Rate for Payer: UHC Exchange |
$43.35
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
IP
|
$110.30
|
|
|
Service Code
|
NDC 60505464303
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.49 |
| Max. Negotiated Rate |
$99.27 |
| Rate for Payer: Aetna Commercial |
$93.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.69
|
| Rate for Payer: Cash Price |
$88.24
|
| Rate for Payer: Cofinity Advantage |
$77.21
|
| Rate for Payer: Cofinity Commercial |
$94.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.24
|
| Rate for Payer: Healthscope Commercial |
$99.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.72
|
| Rate for Payer: PHP Commercial |
$93.75
|
| Rate for Payer: Priority Health SBD |
$69.49
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
IP
|
$110.30
|
|
|
Service Code
|
NDC 60505485603
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.49 |
| Max. Negotiated Rate |
$99.27 |
| Rate for Payer: Aetna Commercial |
$93.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.69
|
| Rate for Payer: Cash Price |
$88.24
|
| Rate for Payer: Cofinity Advantage |
$77.21
|
| Rate for Payer: Cofinity Commercial |
$94.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.24
|
| Rate for Payer: Healthscope Commercial |
$99.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.72
|
| Rate for Payer: PHP Commercial |
$93.75
|
| Rate for Payer: Priority Health SBD |
$69.49
|
|
|
PR ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 33257
|
| Min. Negotiated Rate |
$362.95 |
| Max. Negotiated Rate |
$1,178.25 |
| Rate for Payer: Aetna Commercial |
$755.40
|
| Rate for Payer: Aetna Medicare |
$586.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.77
|
| Rate for Payer: BCBS Complete |
$381.10
|
| Rate for Payer: BCBS MAPPO |
$563.73
|
| Rate for Payer: BCN Commercial |
$864.49
|
| Rate for Payer: BCN Medicare Advantage |
$563.73
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cofinity Commercial |
$811.77
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.73
|
| Rate for Payer: Healthscope Commercial |
$901.97
|
| Rate for Payer: Healthscope Commercial |
$1,042.90
|
| Rate for Payer: Mclaren Medicaid |
$362.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.92
|
| Rate for Payer: Meridian Medicaid |
$381.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$620.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.57
|
| Rate for Payer: Nomi Health Commercial |
$676.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,178.25
|
| Rate for Payer: PACE SWMI |
$563.73
|
| Rate for Payer: PHP Medicare Advantage |
$563.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$929.66
|
| Rate for Payer: Priority Health Medicare |
$563.73
|
| Rate for Payer: Priority Health SBD |
$929.66
|
| Rate for Payer: Priority Health Tiered Network |
$929.66
|
| Rate for Payer: Railroad Medicare Medicare |
$563.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.15
|
| Rate for Payer: UHC Core |
$1,028.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$563.73
|
| Rate for Payer: UHC Exchange |
$1,028.15
|
| Rate for Payer: UHC Medicaid |
$362.95
|
| Rate for Payer: UHCCP Medicaid |
$362.95
|
|
|
PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS
|
Professional
|
Both
|
$2,372.00
|
|
|
Service Code
|
HCPCS 33259
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,779.00 |
| Rate for Payer: Aetna Commercial |
$1,090.60
|
| Rate for Payer: Aetna Medicare |
$846.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.99
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS MAPPO |
$813.88
|
| Rate for Payer: BCN Commercial |
$1,254.91
|
| Rate for Payer: BCN Medicare Advantage |
$813.88
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cofinity Commercial |
$1,171.99
|
| Rate for Payer: Cofinity Commercial |
$1,090.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.88
|
| Rate for Payer: Healthscope Commercial |
$1,505.68
|
| Rate for Payer: Healthscope Commercial |
$1,302.21
|
| Rate for Payer: Mclaren Medicaid |
$523.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.57
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$895.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,492.56
|
| Rate for Payer: Nomi Health Commercial |
$976.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,779.00
|
| Rate for Payer: PACE SWMI |
$813.88
|
| Rate for Payer: PHP Medicare Advantage |
$813.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,349.50
|
| Rate for Payer: Priority Health Medicare |
$813.88
|
| Rate for Payer: Priority Health SBD |
$1,349.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,349.50
|
| Rate for Payer: Railroad Medicare Medicare |
$813.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.97
|
| Rate for Payer: UHC Core |
$1,492.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$813.88
|
| Rate for Payer: UHC Exchange |
$1,492.97
|
| Rate for Payer: UHC Medicaid |
$523.55
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
|
