|
PR BALLN ANGIOPLASTY PERC,BRACHIOCEPH
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 35475
|
| Min. Negotiated Rate |
$815.60 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,325.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
|
|
PR BALLN ANGIOPLASTY,PERC VENOUS
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 35476
|
| Min. Negotiated Rate |
$1,376.40 |
| Max. Negotiated Rate |
$2,236.65 |
| Rate for Payer: Aetna Medicare |
$1,720.50
|
| Rate for Payer: BCBS Complete |
$1,376.40
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,236.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
|
|
PR BALLN ANGIOPLASTY PERC,VISCERAL
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 35471
|
| Min. Negotiated Rate |
$1,142.80 |
| Max. Negotiated Rate |
$1,857.05 |
| Rate for Payer: Aetna Medicare |
$1,428.50
|
| Rate for Payer: BCBS Complete |
$1,142.80
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.05
|
|
|
PR BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS
|
Professional
|
Both
|
$4,922.00
|
|
|
Service Code
|
HCPCS 61630
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$245,473.00 |
| Rate for Payer: Aetna Commercial |
$1,784.40
|
| Rate for Payer: Aetna Medicare |
$1,384.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,784.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,917.56
|
| Rate for Payer: BCBS Complete |
$1,968.80
|
| Rate for Payer: BCBS MAPPO |
$1,331.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCN Commercial |
$1,995.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.64
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,917.56
|
| Rate for Payer: Cofinity Commercial |
$1,784.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.64
|
| Rate for Payer: Healthscope Commercial |
$2,463.53
|
| Rate for Payer: Healthscope Commercial |
$2,130.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,398.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245,473.00
|
| Rate for Payer: Nomi Health Commercial |
$1,597.97
|
| Rate for Payer: PACE SWMI |
$1,331.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,327.76
|
| Rate for Payer: Priority Health Medicare |
$1,331.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,327.76
|
| Rate for Payer: Priority Health SBD |
$2,327.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,432.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.64
|
| Rate for Payer: UHC Exchange |
$1,432.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.64
|
|
|
PR BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 47542
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$23,845.00 |
| Rate for Payer: Aetna Commercial |
$170.65
|
| Rate for Payer: Aetna Medicare |
$132.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.38
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$127.35
|
| Rate for Payer: BCN Commercial |
$736.44
|
| Rate for Payer: BCN Medicare Advantage |
$127.35
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$170.65
|
| Rate for Payer: Cofinity Commercial |
$183.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.35
|
| Rate for Payer: Healthscope Commercial |
$203.76
|
| Rate for Payer: Healthscope Commercial |
$235.60
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.72
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,845.00
|
| Rate for Payer: Nomi Health Commercial |
$152.82
|
| Rate for Payer: PACE SWMI |
$127.35
|
| Rate for Payer: PHP Medicare Advantage |
$127.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.46
|
| Rate for Payer: Priority Health Medicare |
$127.35
|
| Rate for Payer: Priority Health Narrow Network |
$234.46
|
| Rate for Payer: Priority Health SBD |
$234.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.35
|
| Rate for Payer: UHC Medicare Advantage |
$127.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 61640
|
| Min. Negotiated Rate |
$73.96 |
| Max. Negotiated Rate |
$86,240.00 |
| Rate for Payer: Aetna Commercial |
$633.90
|
| Rate for Payer: Aetna Medicare |
$493.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.90
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS Trust/PPO |
$73.96
|
| Rate for Payer: BCN Commercial |
$684.64
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.77
|
| Rate for Payer: Priority Health Narrow Network |
$796.77
|
| Rate for Payer: Priority Health SBD |
$796.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.50
|
| Rate for Payer: UHC Exchange |
$1,320.50
|
|
|
PR BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 50706
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$31,675.00 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.99
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,073.19
|
| Rate for Payer: BCN Commercial |
$1,238.31
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Healthscope Commercial |
$272.21
|
| Rate for Payer: Healthscope Commercial |
$314.74
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,675.00
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,248.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.62
|
| Rate for Payer: Priority Health Medicare |
$170.13
|
| Rate for Payer: Priority Health Narrow Network |
$279.62
|
| Rate for Payer: Priority Health SBD |
$279.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR BCG LIVE INTRAVESICAL VAC
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS J9031
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
|
|
PR BCN APNEALINK PLUS
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 00119
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$489.45 |
| Rate for Payer: Aetna Medicare |
$376.50
|
| Rate for Payer: BCBS Complete |
$301.20
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
|
|
PR BCN WATCHPAT
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 00120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$223.60 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: BCBS Complete |
$223.60
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
|
|
PR BEDSIDE DRAINAGE BAG
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS A4357
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$1,291.00 |
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCN Commercial |
$10.69
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,291.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
|
|
PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 96127
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$986.86 |
| Rate for Payer: Aetna Commercial |
$5.64
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.64
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.21
|
| Rate for Payer: BCBS Trust/PPO |
$986.86
|
| Rate for Payer: BCN Commercial |
$6.85
|
| Rate for Payer: BCN Medicare Advantage |
$4.21
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.06
|
| Rate for Payer: Cofinity Commercial |
$5.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.21
|
| Rate for Payer: Healthscope Commercial |
$6.74
|
| Rate for Payer: Healthscope Commercial |
$7.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.00
|
| Rate for Payer: Nomi Health Commercial |
$5.05
|
| Rate for Payer: PACE SWMI |
$4.21
|
| Rate for Payer: PHP Medicare Advantage |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.89
|
| Rate for Payer: Priority Health Medicare |
$4.21
|
| Rate for Payer: Priority Health Narrow Network |
$8.89
|
| Rate for Payer: Priority Health SBD |
$8.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.21
|
| Rate for Payer: UHC Medicare Advantage |
$4.21
|
|
|
PR BEHAV HLTH DAY TREAT, PER HR
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS H2012
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$357.50 |
| Rate for Payer: Aetna Commercial |
$39.28
|
| Rate for Payer: Aetna Medicare |
$275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.28
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
|
|
PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 92524
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$16,070.00 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.59
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,450.71
|
| Rate for Payer: BCN Commercial |
$159.79
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Healthscope Commercial |
$165.10
|
| Rate for Payer: Healthscope Commercial |
$190.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,070.00
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.82
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: Priority Health Narrow Network |
$148.82
|
| Rate for Payer: Priority Health SBD |
$148.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
|
|
PR BEHAVIOR COUNSEL OBESITY 15M
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0447
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$3,386.00 |
| Rate for Payer: Aetna Commercial |
$38.31
|
| Rate for Payer: Aetna Medicare |
$29.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.17
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$28.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: BCN Medicare Advantage |
$28.59
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.59
|
| Rate for Payer: Healthscope Commercial |
$45.74
|
| Rate for Payer: Healthscope Commercial |
$52.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,386.00
|
| Rate for Payer: Nomi Health Commercial |
$34.31
|
| Rate for Payer: PACE SWMI |
$28.59
|
| Rate for Payer: PHP Medicare Advantage |
$28.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.23
|
| Rate for Payer: Priority Health Medicare |
$28.59
|
| Rate for Payer: Priority Health Narrow Network |
$27.23
|
| Rate for Payer: Priority Health SBD |
$27.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
|
|
PR BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 97151
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$1,118.41 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.79
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.41
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.59
|
| Rate for Payer: Priority Health Narrow Network |
$65.59
|
| Rate for Payer: Priority Health SBD |
$65.59
|
|
|
PR BETAMETHASONE ACET&SOD PHOSP
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0702
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$641.00 |
| Rate for Payer: Aetna Commercial |
$9.23
|
| Rate for Payer: Aetna Medicare |
$7.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.92
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$3.84
|
| Rate for Payer: BCN Commercial |
$4.80
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.23
|
| Rate for Payer: Cofinity Commercial |
$9.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.00
|
| Rate for Payer: Nomi Health Commercial |
$8.27
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.89
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicare Advantage |
$6.89
|
|
|
PR BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 90912
|
| Min. Negotiated Rate |
$40.06 |
| Max. Negotiated Rate |
$6,276.00 |
| Rate for Payer: Aetna Commercial |
$53.68
|
| Rate for Payer: Aetna Medicare |
$41.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.69
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$40.06
|
| Rate for Payer: BCBS Trust/PPO |
$184.91
|
| Rate for Payer: BCN Commercial |
$117.28
|
| Rate for Payer: BCN Medicare Advantage |
$40.06
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$57.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.06
|
| Rate for Payer: Healthscope Commercial |
$64.10
|
| Rate for Payer: Healthscope Commercial |
$74.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,276.00
|
| Rate for Payer: Nomi Health Commercial |
$48.07
|
| Rate for Payer: PACE SWMI |
$40.06
|
| Rate for Payer: PHP Medicare Advantage |
$40.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.04
|
| Rate for Payer: Priority Health Medicare |
$40.06
|
| Rate for Payer: Priority Health Narrow Network |
$65.04
|
| Rate for Payer: Priority Health SBD |
$65.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.06
|
| Rate for Payer: UHC Medicare Advantage |
$40.06
|
|
|
PR BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 0358T
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$4,955.00 |
| Rate for Payer: Aetna Commercial |
$29.66
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.66
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$23.09
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,955.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
|
|
PR BILATERAL GYNECOMASTIA
|
Professional
|
Both
|
$3,264.00
|
|
|
Service Code
|
HCPCS 00524
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,305.60 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Medicare |
$1,632.00
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.60
|
|
|
PR BILATERAL MASTOPEXY
|
Professional
|
Both
|
$3,876.00
|
|
|
Service Code
|
HCPCS 00525
|
|
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 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 |
$282.23 |
| Max. Negotiated Rate |
$79,193.00 |
| 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 |
$296.34
|
| Rate for Payer: BCBS MAPPO |
$427.01
|
| Rate for Payer: BCBS Trust/PPO |
$7,499.75
|
| Rate for Payer: BCN Commercial |
$642.61
|
| 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 |
$789.97
|
| Rate for Payer: Healthscope Commercial |
$683.22
|
| Rate for Payer: Mclaren Medicaid |
$282.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.36
|
| Rate for Payer: Meridian Medicaid |
$296.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,193.00
|
| 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 Choice Medicaid |
$282.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.93
|
| Rate for Payer: Priority Health Medicare |
$427.01
|
| Rate for Payer: Priority Health Narrow Network |
$783.93
|
| Rate for Payer: Priority Health SBD |
$783.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.01
|
| Rate for Payer: UHC Exchange |
$527.17
|
| Rate for Payer: UHC Medicare Advantage |
$427.01
|
| Rate for Payer: UHCCP Medicaid |
$282.23
|
|
