|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$87.65
|
| Rate for Payer: Aetna Medicare |
$68.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.19
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$112.55
|
| Rate for Payer: BCN Medicare Advantage |
$65.41
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.41
|
| Rate for Payer: Healthscope Commercial |
$121.01
|
| Rate for Payer: Healthscope Commercial |
$104.66
|
| Rate for Payer: Mclaren Medicaid |
$41.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.68
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.98
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$65.41
|
| Rate for Payer: PHP Medicare Advantage |
$65.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.03
|
| Rate for Payer: Priority Health Medicare |
$65.41
|
| Rate for Payer: Priority Health SBD |
$122.03
|
| Rate for Payer: Priority Health Tiered Network |
$122.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.30
|
| Rate for Payer: UHC Core |
$138.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.41
|
| Rate for Payer: UHC Exchange |
$138.30
|
| Rate for Payer: UHC Medicaid |
$41.75
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$126.54
|
| Rate for Payer: Aetna Medicare |
$98.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.98
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCBS MAPPO |
$94.43
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$94.43
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Cofinity Commercial |
$126.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.43
|
| Rate for Payer: Healthscope Commercial |
$174.70
|
| Rate for Payer: Healthscope Commercial |
$151.09
|
| Rate for Payer: Mclaren Medicaid |
$62.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.15
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.55
|
| Rate for Payer: Nomi Health Commercial |
$113.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$94.43
|
| Rate for Payer: PHP Medicare Advantage |
$94.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.80
|
| Rate for Payer: Priority Health Medicare |
$94.43
|
| Rate for Payer: Priority Health SBD |
$197.80
|
| Rate for Payer: Priority Health Tiered Network |
$197.80
|
| Rate for Payer: Railroad Medicare Medicare |
$94.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.06
|
| Rate for Payer: UHC Core |
$182.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.43
|
| Rate for Payer: UHC Exchange |
$182.06
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Medicare |
$101.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.24
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS MAPPO |
$97.39
|
| Rate for Payer: BCN Commercial |
$166.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.39
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$140.24
|
| Rate for Payer: Cofinity Commercial |
$130.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$180.17
|
| Rate for Payer: Healthscope Commercial |
$155.82
|
| Rate for Payer: Mclaren Medicaid |
$64.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.26
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.27
|
| Rate for Payer: Nomi Health Commercial |
$116.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.75
|
| Rate for Payer: PACE SWMI |
$97.39
|
| Rate for Payer: PHP Medicare Advantage |
$97.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.26
|
| Rate for Payer: Priority Health Medicare |
$97.39
|
| Rate for Payer: Priority Health SBD |
$203.26
|
| Rate for Payer: Priority Health Tiered Network |
$203.26
|
| Rate for Payer: Railroad Medicare Medicare |
$97.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.49
|
| Rate for Payer: UHC Core |
$187.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.39
|
| Rate for Payer: UHC Exchange |
$187.49
|
| Rate for Payer: UHC Medicaid |
$64.11
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$298.50 |
| Rate for Payer: Aetna Commercial |
$170.03
|
| Rate for Payer: Aetna Medicare |
$131.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.72
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$126.89
|
| Rate for Payer: BCN Commercial |
$212.14
|
| Rate for Payer: BCN Medicare Advantage |
$126.89
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$182.72
|
| Rate for Payer: Cofinity Commercial |
$170.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.89
|
| Rate for Payer: Healthscope Commercial |
$234.75
|
| Rate for Payer: Healthscope Commercial |
$203.02
|
| Rate for Payer: Mclaren Medicaid |
$81.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.23
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.21
|
| Rate for Payer: Nomi Health Commercial |
$152.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: PACE SWMI |
$126.89
|
| Rate for Payer: PHP Medicare Advantage |
$126.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$231.10
|
| Rate for Payer: Priority Health Medicare |
$126.89
|
| Rate for Payer: Priority Health SBD |
$231.10
|
| Rate for Payer: Priority Health Tiered Network |
$231.10
|
| Rate for Payer: Railroad Medicare Medicare |
$126.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.53
|
| Rate for Payer: UHC Core |
$250.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.89
|
| Rate for Payer: UHC Exchange |
$250.53
|
| Rate for Payer: UHC Medicaid |
$81.58
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$257.22 |
| Rate for Payer: Priority Health SBD |
$222.92
|
| Rate for Payer: Aetna Commercial |
$175.71
|
| Rate for Payer: Aetna Medicare |
$136.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.83
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$131.13
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$131.13
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$188.83
|
| Rate for Payer: Cofinity Commercial |
$175.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.13
|
| Rate for Payer: Healthscope Commercial |
$242.59
|
| Rate for Payer: Healthscope Commercial |
$209.81
|
| Rate for Payer: Mclaren Medicaid |
$86.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.69
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.22
|
| Rate for Payer: Nomi Health Commercial |
$157.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$131.13
|
| Rate for Payer: PHP Medicare Advantage |
$131.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$222.92
|
| Rate for Payer: Priority Health Medicare |
$131.13
|
| Rate for Payer: Priority Health Tiered Network |
$222.92
|
| Rate for Payer: Railroad Medicare Medicare |
$131.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.52
|
| Rate for Payer: UHC Core |
$236.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.13
|
| Rate for Payer: UHC Exchange |
$236.52
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$78.19
|
| Rate for Payer: Aetna Medicare |
$60.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.02
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCBS MAPPO |
$58.35
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Medicare Advantage |
$58.35
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$84.02
|
| Rate for Payer: Cofinity Commercial |
$78.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.35
|
| Rate for Payer: Healthscope Commercial |
$93.36
|
| Rate for Payer: Healthscope Commercial |
$107.95
|
| Rate for Payer: Mclaren Medicaid |
$37.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.27
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.23
|
| Rate for Payer: Nomi Health Commercial |
$70.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: PACE SWMI |
$58.35
|
| Rate for Payer: PHP Medicare Advantage |
$58.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.35
|
| Rate for Payer: Priority Health Medicare |
$58.35
|
| Rate for Payer: Priority Health SBD |
$99.35
|
| Rate for Payer: Priority Health Tiered Network |
$99.35
|
| Rate for Payer: Railroad Medicare Medicare |
$58.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.53
|
| Rate for Payer: UHC Core |
$116.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.35
|
| Rate for Payer: UHC Exchange |
$116.53
|
| Rate for Payer: UHC Medicaid |
$37.28
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 20251
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,025.25 |
| Rate for Payer: Aetna Commercial |
$553.06
|
| Rate for Payer: Aetna Medicare |
$429.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.33
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$412.73
|
| Rate for Payer: BCN Commercial |
$654.35
|
| Rate for Payer: BCN Medicare Advantage |
$412.73
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Cofinity Commercial |
$553.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.73
|
| Rate for Payer: Healthscope Commercial |
$763.55
|
| Rate for Payer: Healthscope Commercial |
$660.37
|
| Rate for Payer: Mclaren Medicaid |
$268.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.37
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$454.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.15
|
| Rate for Payer: Nomi Health Commercial |
$495.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$412.73
|
| Rate for Payer: PHP Medicare Advantage |
$412.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$699.47
|
| Rate for Payer: Priority Health Medicare |
$412.73
|
| Rate for Payer: Priority Health SBD |
$699.47
|
| Rate for Payer: Priority Health Tiered Network |
$699.47
|
| Rate for Payer: Railroad Medicare Medicare |
$412.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.05
|
| Rate for Payer: UHC Core |
$749.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.73
|
| Rate for Payer: UHC Exchange |
$749.05
|
| Rate for Payer: UHC Medicaid |
$268.59
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN THORACIC
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 20250
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$701.11 |
| Rate for Payer: Aetna Commercial |
$507.83
|
| Rate for Payer: Aetna Medicare |
$394.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.73
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCBS MAPPO |
$378.98
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: BCN Medicare Advantage |
$378.98
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$545.73
|
| Rate for Payer: Cofinity Commercial |
$507.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.98
|
| Rate for Payer: Healthscope Commercial |
$701.11
|
| Rate for Payer: Healthscope Commercial |
$606.37
|
| Rate for Payer: Mclaren Medicaid |
$247.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.93
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.58
|
| Rate for Payer: Nomi Health Commercial |
$454.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PACE SWMI |
$378.98
|
| Rate for Payer: PHP Medicare Advantage |
$378.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$636.13
|
| Rate for Payer: Priority Health Medicare |
$378.98
|
| Rate for Payer: Priority Health SBD |
$636.13
|
| Rate for Payer: Priority Health Tiered Network |
$636.13
|
| Rate for Payer: Railroad Medicare Medicare |
$378.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.07
|
| Rate for Payer: UHC Core |
$689.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.98
|
| Rate for Payer: UHC Exchange |
$689.07
|
| Rate for Payer: UHC Medicaid |
$247.08
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$106.26
|
| Rate for Payer: Aetna Medicare |
$82.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.19
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$135.95
|
| Rate for Payer: BCN Medicare Advantage |
$79.30
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$114.19
|
| Rate for Payer: Cofinity Commercial |
$106.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.30
|
| Rate for Payer: Healthscope Commercial |
$146.71
|
| Rate for Payer: Healthscope Commercial |
$126.88
|
| Rate for Payer: Mclaren Medicaid |
$52.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.27
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.17
|
| Rate for Payer: Nomi Health Commercial |
$95.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$79.30
|
| Rate for Payer: PHP Medicare Advantage |
$79.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$165.65
|
| Rate for Payer: Priority Health Medicare |
$79.30
|
| Rate for Payer: Priority Health SBD |
$165.65
|
| Rate for Payer: Priority Health Tiered Network |
$165.65
|
| Rate for Payer: Railroad Medicare Medicare |
$79.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.11
|
| Rate for Payer: UHC Core |
$148.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.30
|
| Rate for Payer: UHC Exchange |
$148.11
|
| Rate for Payer: UHC Medicaid |
$52.61
|
| Rate for Payer: UHCCP Medicaid |
$52.61
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$69.34
|
| Rate for Payer: Aetna Medicare |
$53.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.52
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$51.75
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$51.75
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$74.52
|
| Rate for Payer: Cofinity Commercial |
$69.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.75
|
| Rate for Payer: Healthscope Commercial |
$95.74
|
| Rate for Payer: Healthscope Commercial |
$82.80
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.34
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.15
|
| Rate for Payer: Nomi Health Commercial |
$62.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$51.75
|
| Rate for Payer: PHP Medicare Advantage |
$51.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.26
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health SBD |
$89.26
|
| Rate for Payer: Priority Health Tiered Network |
$89.26
|
| Rate for Payer: Railroad Medicare Medicare |
$51.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.38
|
| Rate for Payer: UHC Core |
$107.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.75
|
| Rate for Payer: UHC Exchange |
$107.38
|
| Rate for Payer: UHC Medicaid |
$33.02
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$34.02
|
| Rate for Payer: Aetna Medicare |
$26.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.56
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.39
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$25.39
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$36.56
|
| Rate for Payer: Cofinity Commercial |
$34.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.39
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Healthscope Commercial |
$40.62
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.66
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.88
|
| Rate for Payer: Nomi Health Commercial |
$30.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: PACE SWMI |
$25.39
|
| Rate for Payer: PHP Medicare Advantage |
$25.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.38
|
| Rate for Payer: Priority Health Medicare |
$25.39
|
| Rate for Payer: Priority Health SBD |
$43.38
|
| Rate for Payer: Priority Health Tiered Network |
$43.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.83
|
| Rate for Payer: UHC Core |
$52.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.39
|
| Rate for Payer: UHC Exchange |
$52.83
|
| Rate for Payer: UHC Medicaid |
$16.19
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 33933
|
| Min. Negotiated Rate |
$251.71 |
| Max. Negotiated Rate |
$712.11 |
| Rate for Payer: Aetna Commercial |
$536.72
|
| Rate for Payer: Aetna Medicare |
$347.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.72
|
| Rate for Payer: BCBS Complete |
$264.30
|
| Rate for Payer: BCN Commercial |
$633.90
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Mclaren Medicaid |
$251.71
|
| Rate for Payer: Meridian Medicaid |
$264.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$684.39
|
| Rate for Payer: Priority Health SBD |
$684.39
|
| Rate for Payer: Priority Health Tiered Network |
$684.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.11
|
| Rate for Payer: UHC Core |
$712.11
|
| Rate for Payer: UHC Exchange |
$712.11
|
| Rate for Payer: UHC Medicaid |
$251.71
|
| Rate for Payer: UHCCP Medicaid |
$251.71
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Aetna Commercial |
$50.96
|
| Rate for Payer: Aetna Medicare |
$39.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.96
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$38.03
|
| Rate for Payer: BCN Commercial |
$51.44
|
| Rate for Payer: BCN Medicare Advantage |
$38.03
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Cofinity Commercial |
$50.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.03
|
| Rate for Payer: Healthscope Commercial |
$70.36
|
| Rate for Payer: Healthscope Commercial |
$60.85
|
| Rate for Payer: Mclaren Medicaid |
$24.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.93
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.51
|
| Rate for Payer: Nomi Health Commercial |
$45.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$38.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.06
|
| Rate for Payer: Priority Health Medicare |
$38.03
|
| Rate for Payer: Priority Health SBD |
$71.06
|
| Rate for Payer: Priority Health Tiered Network |
$71.06
|
| Rate for Payer: Railroad Medicare Medicare |
$38.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.52
|
| Rate for Payer: UHC Core |
$77.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.03
|
| Rate for Payer: UHC Exchange |
$77.52
|
| Rate for Payer: UHC Medicaid |
$24.28
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$253.39 |
| Max. Negotiated Rate |
$540.75 |
| Rate for Payer: Aetna Commercial |
$339.54
|
| Rate for Payer: Aetna Medicare |
$263.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.54
|
| Rate for Payer: BCBS MAPPO |
$253.39
|
| Rate for Payer: BCN Commercial |
$414.32
|
| Rate for Payer: BCN Medicare Advantage |
$253.39
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$364.88
|
| Rate for Payer: Cofinity Commercial |
$339.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.39
|
| Rate for Payer: Healthscope Commercial |
$405.42
|
| Rate for Payer: Healthscope Commercial |
$468.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$278.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.54
|
| Rate for Payer: Nomi Health Commercial |
$304.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$540.75
|
| Rate for Payer: PACE SWMI |
$253.39
|
| Rate for Payer: PHP Medicare Advantage |
$253.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$451.32
|
| Rate for Payer: Priority Health Medicare |
$253.39
|
| Rate for Payer: Priority Health SBD |
$451.32
|
| Rate for Payer: Priority Health Tiered Network |
$451.32
|
| Rate for Payer: Railroad Medicare Medicare |
$253.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.80
|
| Rate for Payer: UHC Core |
$482.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$253.39
|
| Rate for Payer: UHC Exchange |
$482.80
|
|
|
PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 38206
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$89.10
|
| Rate for Payer: Aetna Medicare |
$69.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.75
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$66.49
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$66.49
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$95.75
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.49
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Healthscope Commercial |
$106.38
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.81
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.85
|
| Rate for Payer: Nomi Health Commercial |
$79.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$356.25
|
| Rate for Payer: PACE SWMI |
$66.49
|
| Rate for Payer: PHP Medicare Advantage |
$66.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.68
|
| Rate for Payer: Priority Health Medicare |
$66.49
|
| Rate for Payer: Priority Health SBD |
$161.68
|
| Rate for Payer: Priority Health Tiered Network |
$161.68
|
| Rate for Payer: Railroad Medicare Medicare |
$66.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.11
|
| Rate for Payer: UHC Core |
$148.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.49
|
| Rate for Payer: UHC Exchange |
$148.11
|
| Rate for Payer: UHC Medicaid |
$43.03
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 51700
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$34.85
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.45
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCN Commercial |
$34.95
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$37.45
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$48.12
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.51
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48.28
|
| Rate for Payer: Priority Health Medicare |
$26.01
|
| Rate for Payer: Priority Health SBD |
$48.28
|
| Rate for Payer: Priority Health Tiered Network |
$48.28
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC Core |
$55.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.01
|
| Rate for Payer: UHC Exchange |
$55.38
|
| Rate for Payer: UHC Medicaid |
$16.61
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
PR BLEPHAROPLASTY LOWER EYELID W/HERNIATED FAT PAD
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15821
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$951.77 |
| Rate for Payer: Aetna Commercial |
$623.96
|
| Rate for Payer: Aetna Medicare |
$484.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.52
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$465.64
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: BCN Medicare Advantage |
$465.64
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$670.52
|
| Rate for Payer: Cofinity Commercial |
$623.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.64
|
| Rate for Payer: Healthscope Commercial |
$861.43
|
| Rate for Payer: Healthscope Commercial |
$745.02
|
| Rate for Payer: Mclaren Medicaid |
$308.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.92
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.77
|
| Rate for Payer: Nomi Health Commercial |
$558.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$465.64
|
| Rate for Payer: PHP Medicare Advantage |
$465.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.13
|
| Rate for Payer: Priority Health Medicare |
$465.64
|
| Rate for Payer: Priority Health SBD |
$751.13
|
| Rate for Payer: Priority Health Tiered Network |
$751.13
|
| Rate for Payer: Railroad Medicare Medicare |
$465.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$932.10
|
| Rate for Payer: UHC Core |
$932.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.64
|
| Rate for Payer: UHC Exchange |
$932.10
|
| Rate for Payer: UHC Medicaid |
$308.42
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
|
|
PR BLEPHAROPLASTY UPPER EYELID
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 15822
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$457.45
|
| Rate for Payer: Aetna Medicare |
$355.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.59
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS MAPPO |
$341.38
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: BCN Medicare Advantage |
$341.38
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cofinity Commercial |
$491.59
|
| Rate for Payer: Cofinity Commercial |
$457.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.38
|
| Rate for Payer: Healthscope Commercial |
$631.55
|
| Rate for Payer: Healthscope Commercial |
$546.21
|
| Rate for Payer: Mclaren Medicaid |
$226.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.45
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.91
|
| Rate for Payer: Nomi Health Commercial |
$409.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: PACE SWMI |
$341.38
|
| Rate for Payer: PHP Medicare Advantage |
$341.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$544.66
|
| Rate for Payer: Priority Health Medicare |
$341.38
|
| Rate for Payer: Priority Health SBD |
$544.66
|
| Rate for Payer: Priority Health Tiered Network |
$544.66
|
| Rate for Payer: Railroad Medicare Medicare |
$341.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.04
|
| Rate for Payer: UHC Core |
$672.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$341.38
|
| Rate for Payer: UHC Exchange |
$672.04
|
| Rate for Payer: UHC Medicaid |
$226.85
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15823
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$951.91 |
| Rate for Payer: Aetna Commercial |
$620.71
|
| Rate for Payer: Aetna Medicare |
$481.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.04
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$463.22
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: BCN Medicare Advantage |
$463.22
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$667.04
|
| Rate for Payer: Cofinity Commercial |
$620.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.22
|
| Rate for Payer: Healthscope Commercial |
$856.96
|
| Rate for Payer: Healthscope Commercial |
$741.15
|
| Rate for Payer: Mclaren Medicaid |
$307.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.38
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$509.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.91
|
| Rate for Payer: Nomi Health Commercial |
$555.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$463.22
|
| Rate for Payer: PHP Medicare Advantage |
$463.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.13
|
| Rate for Payer: Priority Health Medicare |
$463.22
|
| Rate for Payer: Priority Health SBD |
$751.13
|
| Rate for Payer: Priority Health Tiered Network |
$751.13
|
| Rate for Payer: Railroad Medicare Medicare |
$463.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$932.26
|
| Rate for Payer: UHC Core |
$932.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$463.22
|
| Rate for Payer: UHC Exchange |
$932.26
|
| Rate for Payer: UHC Medicaid |
$307.15
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
|
|
PR BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 67700
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Aetna Commercial |
$131.84
|
| Rate for Payer: Aetna Medicare |
$102.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.68
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$98.39
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$98.39
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$141.68
|
| Rate for Payer: Cofinity Commercial |
$131.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.39
|
| Rate for Payer: Healthscope Commercial |
$182.02
|
| Rate for Payer: Healthscope Commercial |
$157.42
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.31
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.31
|
| Rate for Payer: Nomi Health Commercial |
$118.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: PACE SWMI |
$98.39
|
| Rate for Payer: PHP Medicare Advantage |
$98.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.58
|
| Rate for Payer: Priority Health Medicare |
$98.39
|
| Rate for Payer: Priority Health SBD |
$203.58
|
| Rate for Payer: Priority Health Tiered Network |
$203.58
|
| Rate for Payer: Railroad Medicare Medicare |
$98.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.52
|
| Rate for Payer: UHC Core |
$196.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.39
|
| Rate for Payer: UHC Exchange |
$196.52
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR BLUE TIDAL
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR BONE GRAFT ANY DONOR AREA MAJOR/LARGE
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 20902
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$321.28
|
| Rate for Payer: Aetna Medicare |
$249.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.25
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$239.76
|
| Rate for Payer: BCN Commercial |
$409.84
|
| Rate for Payer: BCN Medicare Advantage |
$239.76
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cofinity Commercial |
$345.25
|
| Rate for Payer: Cofinity Commercial |
$321.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.76
|
| Rate for Payer: Healthscope Commercial |
$383.62
|
| Rate for Payer: Healthscope Commercial |
$443.56
|
| Rate for Payer: Mclaren Medicaid |
$154.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.75
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.88
|
| Rate for Payer: Nomi Health Commercial |
$287.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: PACE SWMI |
$239.76
|
| Rate for Payer: PHP Medicare Advantage |
$239.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$438.10
|
| Rate for Payer: Priority Health Medicare |
$239.76
|
| Rate for Payer: Priority Health SBD |
$438.10
|
| Rate for Payer: Priority Health Tiered Network |
$438.10
|
| Rate for Payer: Railroad Medicare Medicare |
$239.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.85
|
| Rate for Payer: UHC Core |
$497.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.76
|
| Rate for Payer: UHC Exchange |
$497.85
|
| Rate for Payer: UHC Medicaid |
$154.21
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
|
|
PR BONE GRAFT ANY DONOR AREA MINOR/SMALL
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 20900
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$212.60
|
| Rate for Payer: Aetna Medicare |
$165.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.47
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$158.66
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$158.66
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cofinity Commercial |
$228.47
|
| Rate for Payer: Cofinity Commercial |
$212.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$293.52
|
| Rate for Payer: Healthscope Commercial |
$253.86
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.59
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.48
|
| Rate for Payer: Nomi Health Commercial |
$190.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.00
|
| Rate for Payer: PACE SWMI |
$158.66
|
| Rate for Payer: PHP Medicare Advantage |
$158.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$288.52
|
| Rate for Payer: Priority Health Medicare |
$158.66
|
| Rate for Payer: Priority Health SBD |
$288.52
|
| Rate for Payer: Priority Health Tiered Network |
$288.52
|
| Rate for Payer: Railroad Medicare Medicare |
$158.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.96
|
| Rate for Payer: UHC Core |
$324.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.66
|
| Rate for Payer: UHC Exchange |
$324.96
|
| Rate for Payer: UHC Medicaid |
$102.45
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR
|
Professional
|
Both
|
$4,726.00
|
|
|
Service Code
|
HCPCS 20962
|
| Min. Negotiated Rate |
$1,548.51 |
| Max. Negotiated Rate |
$4,711.72 |
| Rate for Payer: Aetna Commercial |
$3,198.42
|
| Rate for Payer: Aetna Medicare |
$2,482.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,198.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,437.11
|
| Rate for Payer: BCBS Complete |
$1,625.94
|
| Rate for Payer: BCBS MAPPO |
$2,386.88
|
| Rate for Payer: BCN Commercial |
$4,024.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,386.88
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Cofinity Commercial |
$3,437.11
|
| Rate for Payer: Cofinity Commercial |
$3,198.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,386.88
|
| Rate for Payer: Healthscope Commercial |
$4,415.73
|
| Rate for Payer: Healthscope Commercial |
$3,819.01
|
| Rate for Payer: Mclaren Medicaid |
$1,548.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,506.22
|
| Rate for Payer: Meridian Medicaid |
$1,625.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,625.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,711.72
|
| Rate for Payer: Nomi Health Commercial |
$2,864.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,544.50
|
| Rate for Payer: PACE SWMI |
$2,386.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,386.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,548.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,301.74
|
| Rate for Payer: Priority Health Medicare |
$2,386.88
|
| Rate for Payer: Priority Health SBD |
$4,301.74
|
| Rate for Payer: Priority Health Tiered Network |
$4,301.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,386.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,668.92
|
| Rate for Payer: UHC Core |
$4,668.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,386.88
|
| Rate for Payer: UHC Exchange |
$4,668.92
|
| Rate for Payer: UHC Medicaid |
$1,548.51
|
| Rate for Payer: UHCCP Medicaid |
$1,548.51
|
|
|
PR BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 20939
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$125.86 |
| Rate for Payer: Aetna Commercial |
$82.88
|
| Rate for Payer: Aetna Medicare |
$64.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.06
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$61.85
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$61.85
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$82.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.85
|
| Rate for Payer: Healthscope Commercial |
$98.96
|
| Rate for Payer: Healthscope Commercial |
$114.42
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.94
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.86
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$61.85
|
| Rate for Payer: PHP Medicare Advantage |
$61.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.79
|
| Rate for Payer: Priority Health Medicare |
$61.85
|
| Rate for Payer: Priority Health SBD |
$111.79
|
| Rate for Payer: Priority Health Tiered Network |
$111.79
|
| Rate for Payer: Railroad Medicare Medicare |
$61.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.46
|
| Rate for Payer: UHC Core |
$124.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.85
|
| Rate for Payer: UHC Exchange |
$124.46
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
