|
PR BILATERAL OTOPLASTY
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 00533
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,264.80 |
| Max. Negotiated Rate |
$2,055.30 |
| Rate for Payer: Aetna Medicare |
$1,581.00
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,055.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
|
|
PR BILATERAL REDUCTION MAMMOPLASTY
|
Professional
|
Both
|
$3,876.00
|
|
|
Service Code
|
HCPCS 00526
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,550.40 |
| Max. Negotiated Rate |
$2,519.40 |
| Rate for Payer: Aetna Medicare |
$1,938.00
|
| Rate for Payer: BCBS Complete |
$1,550.40
|
| Rate for Payer: Cash Price |
$3,100.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,519.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,519.40
|
|
|
PR BILATERAL THORACIC ROLL EXCISION
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 00543
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,101.60 |
| Max. Negotiated Rate |
$1,790.10 |
| Rate for Payer: Aetna Medicare |
$1,377.00
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
|
|
PR BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 47554
|
| Min. Negotiated Rate |
$366.40 |
| Max. Negotiated Rate |
$789.97 |
| Rate for Payer: Aetna Commercial |
$572.19
|
| Rate for Payer: Aetna Medicare |
$444.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$614.89
|
| Rate for Payer: BCBS Complete |
$366.40
|
| Rate for Payer: BCBS MAPPO |
$427.01
|
| Rate for Payer: BCN Medicare Advantage |
$427.01
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$614.89
|
| Rate for Payer: Cofinity Commercial |
$572.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.01
|
| Rate for Payer: Healthscope Commercial |
$683.22
|
| Rate for Payer: Healthscope Commercial |
$789.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.40
|
| Rate for Payer: Nomi Health Commercial |
$512.41
|
| Rate for Payer: PACE SWMI |
$427.01
|
| Rate for Payer: PHP Medicare Advantage |
$427.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.40
|
| Rate for Payer: Priority Health Medicare |
$427.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.01
|
| Rate for Payer: UHC Medicare Advantage |
$427.01
|
|
|
PR BILIARY NDSC INTRAOPERATIVE
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 47550
|
| Min. Negotiated Rate |
$157.63 |
| Max. Negotiated Rate |
$344.50 |
| Rate for Payer: Aetna Commercial |
$211.22
|
| Rate for Payer: Aetna Medicare |
$163.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.22
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: BCBS MAPPO |
$157.63
|
| Rate for Payer: BCN Medicare Advantage |
$157.63
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cofinity Commercial |
$226.99
|
| Rate for Payer: Cofinity Commercial |
$211.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.63
|
| Rate for Payer: Healthscope Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$252.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.50
|
| Rate for Payer: Nomi Health Commercial |
$189.16
|
| Rate for Payer: PACE SWMI |
$157.63
|
| Rate for Payer: PHP Medicare Advantage |
$157.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
| Rate for Payer: Priority Health Medicare |
$157.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.63
|
| Rate for Payer: UHC Medicare Advantage |
$157.63
|
|
|
PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 92504
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.86
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$8.85
|
| Rate for Payer: BCN Medicare Advantage |
$8.85
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$11.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.85
|
| Rate for Payer: Healthscope Commercial |
$14.16
|
| Rate for Payer: Healthscope Commercial |
$16.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Nomi Health Commercial |
$10.62
|
| Rate for Payer: PACE SWMI |
$8.85
|
| Rate for Payer: PHP Medicare Advantage |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$8.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.85
|
| Rate for Payer: UHC Medicare Advantage |
$8.85
|
|
|
PR BIOFEEDBACK PERI/URO/RECTAL
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 90911
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
|
|
PR BIOFEEDBACK TRAINING ANY MODALITY
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 90901
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$24.32
|
| Rate for Payer: Aetna Medicare |
$18.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.14
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$18.15
|
| Rate for Payer: BCN Medicare Advantage |
$18.15
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$26.14
|
| Rate for Payer: Cofinity Commercial |
$24.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.15
|
| Rate for Payer: Healthscope Commercial |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$29.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: PACE SWMI |
$18.15
|
| Rate for Payer: PHP Medicare Advantage |
$18.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$18.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.15
|
|
|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$1,264.00
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$328.68 |
| Max. Negotiated Rate |
$821.60 |
| Rate for Payer: Aetna Commercial |
$440.43
|
| Rate for Payer: Aetna Medicare |
$341.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.30
|
| Rate for Payer: BCBS Complete |
$505.60
|
| Rate for Payer: BCBS MAPPO |
$328.68
|
| Rate for Payer: BCN Medicare Advantage |
$328.68
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Cofinity Commercial |
$440.43
|
| Rate for Payer: Cofinity Commercial |
$473.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.68
|
| Rate for Payer: Healthscope Commercial |
$525.89
|
| Rate for Payer: Healthscope Commercial |
$608.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.60
|
| Rate for Payer: Nomi Health Commercial |
$394.42
|
| Rate for Payer: PACE SWMI |
$328.68
|
| Rate for Payer: PHP Medicare Advantage |
$328.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.60
|
| Rate for Payer: Priority Health Medicare |
$328.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.68
|
| Rate for Payer: UHC Medicare Advantage |
$328.68
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$133.74 |
| Max. Negotiated Rate |
$354.90 |
| Rate for Payer: Aetna Commercial |
$179.21
|
| Rate for Payer: Aetna Medicare |
$139.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.21
|
| Rate for Payer: BCBS Complete |
$218.40
|
| Rate for Payer: BCBS MAPPO |
$133.74
|
| Rate for Payer: BCN Medicare Advantage |
$133.74
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$192.59
|
| Rate for Payer: Cofinity Commercial |
$179.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.74
|
| Rate for Payer: Healthscope Commercial |
$247.42
|
| Rate for Payer: Healthscope Commercial |
$213.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.90
|
| Rate for Payer: Nomi Health Commercial |
$160.49
|
| Rate for Payer: PACE SWMI |
$133.74
|
| Rate for Payer: PHP Medicare Advantage |
$133.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health Medicare |
$133.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.74
|
| Rate for Payer: UHC Medicare Advantage |
$133.74
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$1,918.00
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$122.62 |
| Max. Negotiated Rate |
$1,246.70 |
| Rate for Payer: Aetna Commercial |
$164.31
|
| Rate for Payer: Aetna Medicare |
$127.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.31
|
| Rate for Payer: BCBS Complete |
$767.20
|
| Rate for Payer: BCBS MAPPO |
$122.62
|
| Rate for Payer: BCN Medicare Advantage |
$122.62
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Cofinity Commercial |
$176.57
|
| Rate for Payer: Cofinity Commercial |
$164.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.62
|
| Rate for Payer: Healthscope Commercial |
$196.19
|
| Rate for Payer: Healthscope Commercial |
$226.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,246.70
|
| Rate for Payer: Nomi Health Commercial |
$147.14
|
| Rate for Payer: PACE SWMI |
$122.62
|
| Rate for Payer: PHP Medicare Advantage |
$122.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.70
|
| Rate for Payer: Priority Health Medicare |
$122.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.62
|
| Rate for Payer: UHC Medicare Advantage |
$122.62
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$226.20 |
| Rate for Payer: Aetna Commercial |
$110.46
|
| Rate for Payer: Aetna Medicare |
$85.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.46
|
| Rate for Payer: BCBS Complete |
$139.20
|
| Rate for Payer: BCBS MAPPO |
$82.43
|
| Rate for Payer: BCN Medicare Advantage |
$82.43
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Cofinity Commercial |
$110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.43
|
| Rate for Payer: Healthscope Commercial |
$152.50
|
| Rate for Payer: Healthscope Commercial |
$131.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.20
|
| Rate for Payer: Nomi Health Commercial |
$98.92
|
| Rate for Payer: PACE SWMI |
$82.43
|
| Rate for Payer: PHP Medicare Advantage |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health Medicare |
$82.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.43
|
| Rate for Payer: UHC Medicare Advantage |
$82.43
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$216.16 |
| Max. Negotiated Rate |
$399.90 |
| Rate for Payer: Aetna Commercial |
$289.65
|
| Rate for Payer: Aetna Medicare |
$224.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.65
|
| Rate for Payer: BCBS Complete |
$228.00
|
| Rate for Payer: BCBS MAPPO |
$216.16
|
| Rate for Payer: BCN Medicare Advantage |
$216.16
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$311.27
|
| Rate for Payer: Cofinity Commercial |
$289.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.16
|
| Rate for Payer: Healthscope Commercial |
$345.86
|
| Rate for Payer: Healthscope Commercial |
$399.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.50
|
| Rate for Payer: Nomi Health Commercial |
$259.39
|
| Rate for Payer: PACE SWMI |
$216.16
|
| Rate for Payer: PHP Medicare Advantage |
$216.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$370.50
|
| Rate for Payer: Priority Health Medicare |
$216.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.16
|
| Rate for Payer: UHC Medicare Advantage |
$216.16
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$72.04 |
| Max. Negotiated Rate |
$167.70 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.74
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Healthscope Commercial |
$115.26
|
| Rate for Payer: Healthscope Commercial |
$133.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.70
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Medicare |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
|
|
PR BIOPSY, EACH ADDED LESION
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 11101
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$44.20 |
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$61.31 |
| Max. Negotiated Rate |
$155.35 |
| Rate for Payer: Aetna Commercial |
$82.16
|
| Rate for Payer: Aetna Medicare |
$63.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.29
|
| Rate for Payer: BCBS Complete |
$95.60
|
| Rate for Payer: BCBS MAPPO |
$61.31
|
| Rate for Payer: BCN Medicare Advantage |
$61.31
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$82.16
|
| Rate for Payer: Cofinity Commercial |
$88.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.31
|
| Rate for Payer: Healthscope Commercial |
$113.42
|
| Rate for Payer: Healthscope Commercial |
$98.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.35
|
| Rate for Payer: Nomi Health Commercial |
$73.57
|
| Rate for Payer: PACE SWMI |
$61.31
|
| Rate for Payer: PHP Medicare Advantage |
$61.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health Medicare |
$61.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.31
|
| Rate for Payer: UHC Medicare Advantage |
$61.31
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$43.68 |
| Max. Negotiated Rate |
$113.10 |
| Rate for Payer: Aetna Commercial |
$58.53
|
| Rate for Payer: Aetna Medicare |
$45.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.53
|
| Rate for Payer: BCBS Complete |
$69.60
|
| Rate for Payer: BCBS MAPPO |
$43.68
|
| Rate for Payer: BCN Medicare Advantage |
$43.68
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$62.90
|
| Rate for Payer: Cofinity Commercial |
$58.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.68
|
| Rate for Payer: Healthscope Commercial |
$80.81
|
| Rate for Payer: Healthscope Commercial |
$69.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.10
|
| Rate for Payer: Nomi Health Commercial |
$52.42
|
| Rate for Payer: PACE SWMI |
$43.68
|
| Rate for Payer: PHP Medicare Advantage |
$43.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.10
|
| Rate for Payer: Priority Health Medicare |
$43.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.68
|
| Rate for Payer: UHC Medicare Advantage |
$43.68
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$86.74 |
| Max. Negotiated Rate |
$160.47 |
| Rate for Payer: Aetna Commercial |
$116.23
|
| Rate for Payer: Aetna Medicare |
$90.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.23
|
| Rate for Payer: BCBS Complete |
$96.00
|
| Rate for Payer: BCBS MAPPO |
$86.74
|
| Rate for Payer: BCN Medicare Advantage |
$86.74
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$124.91
|
| Rate for Payer: Cofinity Commercial |
$116.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.74
|
| Rate for Payer: Healthscope Commercial |
$138.78
|
| Rate for Payer: Healthscope Commercial |
$160.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.00
|
| Rate for Payer: Nomi Health Commercial |
$104.09
|
| Rate for Payer: PACE SWMI |
$86.74
|
| Rate for Payer: PHP Medicare Advantage |
$86.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health Medicare |
$86.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.74
|
| Rate for Payer: UHC Medicare Advantage |
$86.74
|
|
|
PR BIOPSY HYPOPHARYNX
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 42802
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$286.65 |
| Rate for Payer: Aetna Medicare |
$220.50
|
| Rate for Payer: BCBS Complete |
$176.40
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.65
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$65.10 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$87.23
|
| Rate for Payer: Aetna Medicare |
$67.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.74
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$65.10
|
| Rate for Payer: BCN Medicare Advantage |
$65.10
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$93.74
|
| Rate for Payer: Cofinity Commercial |
$87.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.10
|
| Rate for Payer: Healthscope Commercial |
$120.44
|
| Rate for Payer: Healthscope Commercial |
$104.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.20
|
| Rate for Payer: Nomi Health Commercial |
$78.12
|
| Rate for Payer: PACE SWMI |
$65.10
|
| Rate for Payer: PHP Medicare Advantage |
$65.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$65.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.10
|
| Rate for Payer: UHC Medicare Advantage |
$65.10
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$110.46
|
| Rate for Payer: Aetna Medicare |
$85.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.70
|
| Rate for Payer: BCBS Complete |
$237.20
|
| Rate for Payer: BCBS MAPPO |
$82.43
|
| Rate for Payer: BCN Medicare Advantage |
$82.43
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cofinity Commercial |
$110.46
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.43
|
| Rate for Payer: Healthscope Commercial |
$131.89
|
| Rate for Payer: Healthscope Commercial |
$152.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.45
|
| Rate for Payer: Nomi Health Commercial |
$98.92
|
| Rate for Payer: PACE SWMI |
$82.43
|
| Rate for Payer: PHP Medicare Advantage |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.45
|
| Rate for Payer: Priority Health Medicare |
$82.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.43
|
| Rate for Payer: UHC Medicare Advantage |
$82.43
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$715.60 |
| Max. Negotiated Rate |
$1,518.65 |
| Rate for Payer: Aetna Commercial |
$1,099.99
|
| Rate for Payer: Aetna Medicare |
$853.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.99
|
| Rate for Payer: BCBS Complete |
$715.60
|
| Rate for Payer: BCBS MAPPO |
$820.89
|
| Rate for Payer: BCN Medicare Advantage |
$820.89
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.08
|
| Rate for Payer: Cofinity Commercial |
$1,099.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.89
|
| Rate for Payer: Healthscope Commercial |
$1,313.42
|
| Rate for Payer: Healthscope Commercial |
$1,518.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.85
|
| Rate for Payer: Nomi Health Commercial |
$985.07
|
| Rate for Payer: PACE SWMI |
$820.89
|
| Rate for Payer: PHP Medicare Advantage |
$820.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.85
|
| Rate for Payer: Priority Health Medicare |
$820.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$820.89
|
| Rate for Payer: UHC Medicare Advantage |
$820.89
|
|
|
PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 32405
|
| Min. Negotiated Rate |
$304.80 |
| Max. Negotiated Rate |
$495.30 |
| Rate for Payer: Aetna Medicare |
$381.00
|
| Rate for Payer: BCBS Complete |
$304.80
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$150.10 |
| Max. Negotiated Rate |
$384.15 |
| Rate for Payer: Aetna Commercial |
$201.13
|
| Rate for Payer: Aetna Medicare |
$156.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.14
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$150.10
|
| Rate for Payer: BCN Medicare Advantage |
$150.10
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$201.13
|
| Rate for Payer: Cofinity Commercial |
$216.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.10
|
| Rate for Payer: Healthscope Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$277.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.15
|
| Rate for Payer: Nomi Health Commercial |
$180.12
|
| Rate for Payer: PACE SWMI |
$150.10
|
| Rate for Payer: PHP Medicare Advantage |
$150.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health Medicare |
$150.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.10
|
| Rate for Payer: UHC Medicare Advantage |
$150.10
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$54.09 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: Aetna Medicare |
$56.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.48
|
| Rate for Payer: BCBS Complete |
$165.60
|
| Rate for Payer: BCBS MAPPO |
$54.09
|
| Rate for Payer: BCN Medicare Advantage |
$54.09
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$77.89
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.09
|
| Rate for Payer: Healthscope Commercial |
$86.54
|
| Rate for Payer: Healthscope Commercial |
$100.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.10
|
| Rate for Payer: Nomi Health Commercial |
$64.91
|
| Rate for Payer: PACE SWMI |
$54.09
|
| Rate for Payer: PHP Medicare Advantage |
$54.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.10
|
| Rate for Payer: Priority Health Medicare |
$54.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.09
|
| Rate for Payer: UHC Medicare Advantage |
$54.09
|
|
