|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
IP
|
$446.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$280.98 |
| Max. Negotiated Rate |
$401.40 |
| Rate for Payer: Aetna Commercial |
$379.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.90
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$312.20
|
| Rate for Payer: Cofinity Commercial |
$383.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$312.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.80
|
| Rate for Payer: Healthscope Commercial |
$401.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.10
|
| Rate for Payer: PHP Commercial |
$379.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: Priority Health SBD |
$280.98
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$147.41 |
| Max. Negotiated Rate |
$297.05 |
| Rate for Payer: Aetna Commercial |
$197.53
|
| Rate for Payer: Aetna Medicare |
$153.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.53
|
| Rate for Payer: BCBS Complete |
$182.80
|
| Rate for Payer: BCBS MAPPO |
$147.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.41
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cofinity Commercial |
$212.27
|
| Rate for Payer: Cofinity Commercial |
$197.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.41
|
| Rate for Payer: Healthscope Commercial |
$272.71
|
| Rate for Payer: Healthscope Commercial |
$235.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.05
|
| Rate for Payer: Nomi Health Commercial |
$176.89
|
| Rate for Payer: PACE SWMI |
$147.41
|
| Rate for Payer: PHP Medicare Advantage |
$147.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.05
|
| Rate for Payer: Priority Health Medicare |
$147.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.41
|
| Rate for Payer: UHC Medicare Advantage |
$147.41
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL
|
Professional
|
Both
|
$597.00
|
|
|
Service Code
|
HCPCS 27040
|
| Min. Negotiated Rate |
$191.05 |
| Max. Negotiated Rate |
$388.05 |
| Rate for Payer: Aetna Commercial |
$256.01
|
| Rate for Payer: Aetna Medicare |
$198.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.01
|
| Rate for Payer: BCBS Complete |
$238.80
|
| Rate for Payer: BCBS MAPPO |
$191.05
|
| Rate for Payer: BCN Medicare Advantage |
$191.05
|
| Rate for Payer: Cash Price |
$477.60
|
| Rate for Payer: Cash Price |
$477.60
|
| Rate for Payer: Cofinity Commercial |
$275.11
|
| Rate for Payer: Cofinity Commercial |
$256.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.05
|
| Rate for Payer: Healthscope Commercial |
$305.68
|
| Rate for Payer: Healthscope Commercial |
$353.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.05
|
| Rate for Payer: Nomi Health Commercial |
$229.26
|
| Rate for Payer: PACE SWMI |
$191.05
|
| Rate for Payer: PHP Medicare Advantage |
$191.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.05
|
| Rate for Payer: Priority Health Medicare |
$191.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.05
|
| Rate for Payer: UHC Medicare Advantage |
$191.05
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 27041
|
| Min. Negotiated Rate |
$569.60 |
| Max. Negotiated Rate |
$1,261.39 |
| Rate for Payer: Aetna Commercial |
$913.65
|
| Rate for Payer: Aetna Medicare |
$709.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$981.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.65
|
| Rate for Payer: BCBS Complete |
$569.60
|
| Rate for Payer: BCBS MAPPO |
$681.83
|
| Rate for Payer: BCN Medicare Advantage |
$681.83
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$981.84
|
| Rate for Payer: Cofinity Commercial |
$913.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.83
|
| Rate for Payer: Healthscope Commercial |
$1,261.39
|
| Rate for Payer: Healthscope Commercial |
$1,090.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.60
|
| Rate for Payer: Nomi Health Commercial |
$818.20
|
| Rate for Payer: PACE SWMI |
$681.83
|
| Rate for Payer: PHP Medicare Advantage |
$681.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health Medicare |
$681.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.83
|
| Rate for Payer: UHC Medicare Advantage |
$681.83
|
|
|
PR BIOPSY SOFT TISSUE SHOULDER DEEP
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 23066
|
| Min. Negotiated Rate |
$339.20 |
| Max. Negotiated Rate |
$661.76 |
| Rate for Payer: Aetna Commercial |
$479.33
|
| Rate for Payer: Aetna Medicare |
$372.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.33
|
| Rate for Payer: BCBS Complete |
$339.20
|
| Rate for Payer: BCBS MAPPO |
$357.71
|
| Rate for Payer: BCN Medicare Advantage |
$357.71
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$515.10
|
| Rate for Payer: Cofinity Commercial |
$479.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.71
|
| Rate for Payer: Healthscope Commercial |
$572.34
|
| Rate for Payer: Healthscope Commercial |
$661.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$551.20
|
| Rate for Payer: Nomi Health Commercial |
$429.25
|
| Rate for Payer: PACE SWMI |
$357.71
|
| Rate for Payer: PHP Medicare Advantage |
$357.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.20
|
| Rate for Payer: Priority Health Medicare |
$357.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.71
|
| Rate for Payer: UHC Medicare Advantage |
$357.71
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$278.40 |
| Max. Negotiated Rate |
$735.12 |
| Rate for Payer: Aetna Commercial |
$532.46
|
| Rate for Payer: Aetna Medicare |
$413.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.46
|
| Rate for Payer: BCBS Complete |
$278.40
|
| Rate for Payer: BCBS MAPPO |
$397.36
|
| Rate for Payer: BCN Medicare Advantage |
$397.36
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$572.20
|
| Rate for Payer: Cofinity Commercial |
$532.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.36
|
| Rate for Payer: Healthscope Commercial |
$735.12
|
| Rate for Payer: Healthscope Commercial |
$635.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.40
|
| Rate for Payer: Nomi Health Commercial |
$476.83
|
| Rate for Payer: PACE SWMI |
$397.36
|
| Rate for Payer: PHP Medicare Advantage |
$397.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.40
|
| Rate for Payer: Priority Health Medicare |
$397.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.36
|
| Rate for Payer: UHC Medicare Advantage |
$397.36
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 27323
|
| Min. Negotiated Rate |
$166.95 |
| Max. Negotiated Rate |
$312.65 |
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna Medicare |
$173.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.71
|
| Rate for Payer: BCBS Complete |
$192.40
|
| Rate for Payer: BCBS MAPPO |
$166.95
|
| Rate for Payer: BCN Medicare Advantage |
$166.95
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$240.41
|
| Rate for Payer: Cofinity Commercial |
$223.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.95
|
| Rate for Payer: Healthscope Commercial |
$267.12
|
| Rate for Payer: Healthscope Commercial |
$308.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.65
|
| Rate for Payer: Nomi Health Commercial |
$200.34
|
| Rate for Payer: PACE SWMI |
$166.95
|
| Rate for Payer: PHP Medicare Advantage |
$166.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.65
|
| Rate for Payer: Priority Health Medicare |
$166.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.95
|
| Rate for Payer: UHC Medicare Advantage |
$166.95
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP
|
Professional
|
Both
|
$1,073.00
|
|
|
Service Code
|
HCPCS 24066
|
| Min. Negotiated Rate |
$411.26 |
| Max. Negotiated Rate |
$760.83 |
| Rate for Payer: Aetna Commercial |
$551.09
|
| Rate for Payer: Aetna Medicare |
$427.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.09
|
| Rate for Payer: BCBS Complete |
$429.20
|
| Rate for Payer: BCBS MAPPO |
$411.26
|
| Rate for Payer: BCN Medicare Advantage |
$411.26
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Commercial |
$592.21
|
| Rate for Payer: Cofinity Commercial |
$551.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.26
|
| Rate for Payer: Healthscope Commercial |
$760.83
|
| Rate for Payer: Healthscope Commercial |
$658.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$697.45
|
| Rate for Payer: Nomi Health Commercial |
$493.51
|
| Rate for Payer: PACE SWMI |
$411.26
|
| Rate for Payer: PHP Medicare Advantage |
$411.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.45
|
| Rate for Payer: Priority Health Medicare |
$411.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.26
|
| Rate for Payer: UHC Medicare Advantage |
$411.26
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 24065
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$303.55 |
| Rate for Payer: Aetna Commercial |
$206.57
|
| Rate for Payer: Aetna Medicare |
$160.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.57
|
| Rate for Payer: BCBS Complete |
$186.80
|
| Rate for Payer: BCBS MAPPO |
$154.16
|
| Rate for Payer: BCN Medicare Advantage |
$154.16
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$221.99
|
| Rate for Payer: Cofinity Commercial |
$206.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.16
|
| Rate for Payer: Healthscope Commercial |
$246.66
|
| Rate for Payer: Healthscope Commercial |
$285.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.55
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: PACE SWMI |
$154.16
|
| Rate for Payer: PHP Medicare Advantage |
$154.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health Medicare |
$154.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.16
|
| Rate for Payer: UHC Medicare Advantage |
$154.16
|
|
|
PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 62269
|
| Min. Negotiated Rate |
$246.78 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$330.69
|
| Rate for Payer: Aetna Medicare |
$256.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.69
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$246.78
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$355.36
|
| Rate for Payer: Cofinity Commercial |
$330.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.78
|
| Rate for Payer: Healthscope Commercial |
$456.54
|
| Rate for Payer: Healthscope Commercial |
$394.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,654.25
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: PACE SWMI |
$246.78
|
| Rate for Payer: PHP Medicare Advantage |
$246.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$246.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.78
|
| Rate for Payer: UHC Medicare Advantage |
$246.78
|
|
|
PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$681.00
|
|
|
Service Code
|
HCPCS 54505
|
| Min. Negotiated Rate |
$200.55 |
| Max. Negotiated Rate |
$442.65 |
| Rate for Payer: Aetna Commercial |
$268.74
|
| Rate for Payer: Aetna Medicare |
$208.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.74
|
| Rate for Payer: BCBS Complete |
$272.40
|
| Rate for Payer: BCBS MAPPO |
$200.55
|
| Rate for Payer: BCN Medicare Advantage |
$200.55
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cofinity Commercial |
$288.79
|
| Rate for Payer: Cofinity Commercial |
$268.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.55
|
| Rate for Payer: Healthscope Commercial |
$320.88
|
| Rate for Payer: Healthscope Commercial |
$371.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.65
|
| Rate for Payer: Nomi Health Commercial |
$240.66
|
| Rate for Payer: PACE SWMI |
$200.55
|
| Rate for Payer: PHP Medicare Advantage |
$200.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.65
|
| Rate for Payer: Priority Health Medicare |
$200.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.55
|
| Rate for Payer: UHC Medicare Advantage |
$200.55
|
|
|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$72.44 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$97.07
|
| Rate for Payer: Aetna Medicare |
$75.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.31
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$72.44
|
| Rate for Payer: BCN Medicare Advantage |
$72.44
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$97.07
|
| Rate for Payer: Cofinity Commercial |
$104.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.44
|
| Rate for Payer: Healthscope Commercial |
$134.01
|
| Rate for Payer: Healthscope Commercial |
$115.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.40
|
| Rate for Payer: Nomi Health Commercial |
$86.93
|
| Rate for Payer: PACE SWMI |
$72.44
|
| Rate for Payer: PHP Medicare Advantage |
$72.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.44
|
| Rate for Payer: UHC Medicare Advantage |
$72.44
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$101.68 |
| Max. Negotiated Rate |
$213.20 |
| Rate for Payer: Aetna Commercial |
$136.25
|
| Rate for Payer: Aetna Medicare |
$105.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.25
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS MAPPO |
$101.68
|
| Rate for Payer: BCN Medicare Advantage |
$101.68
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Cofinity Commercial |
$136.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.68
|
| Rate for Payer: Healthscope Commercial |
$162.69
|
| Rate for Payer: Healthscope Commercial |
$188.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.20
|
| Rate for Payer: Nomi Health Commercial |
$122.02
|
| Rate for Payer: PACE SWMI |
$101.68
|
| Rate for Payer: PHP Medicare Advantage |
$101.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health Medicare |
$101.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.68
|
| Rate for Payer: UHC Medicare Advantage |
$101.68
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$104.47 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna Commercial |
$139.99
|
| Rate for Payer: Aetna Medicare |
$108.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.99
|
| Rate for Payer: BCBS Complete |
$121.60
|
| Rate for Payer: BCBS MAPPO |
$104.47
|
| Rate for Payer: BCN Medicare Advantage |
$104.47
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$150.44
|
| Rate for Payer: Cofinity Commercial |
$139.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.47
|
| Rate for Payer: Healthscope Commercial |
$193.27
|
| Rate for Payer: Healthscope Commercial |
$167.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.60
|
| Rate for Payer: Nomi Health Commercial |
$125.36
|
| Rate for Payer: PACE SWMI |
$104.47
|
| Rate for Payer: PHP Medicare Advantage |
$104.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.60
|
| Rate for Payer: Priority Health Medicare |
$104.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.47
|
| Rate for Payer: UHC Medicare Advantage |
$104.47
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$135.95 |
| Max. Negotiated Rate |
$251.51 |
| Rate for Payer: Aetna Commercial |
$182.17
|
| Rate for Payer: Aetna Medicare |
$141.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.17
|
| Rate for Payer: BCBS Complete |
$154.40
|
| Rate for Payer: BCBS MAPPO |
$135.95
|
| Rate for Payer: BCN Medicare Advantage |
$135.95
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$195.77
|
| Rate for Payer: Cofinity Commercial |
$182.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.95
|
| Rate for Payer: Healthscope Commercial |
$217.52
|
| Rate for Payer: Healthscope Commercial |
$251.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.90
|
| Rate for Payer: Nomi Health Commercial |
$163.14
|
| Rate for Payer: PACE SWMI |
$135.95
|
| Rate for Payer: PHP Medicare Advantage |
$135.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.90
|
| Rate for Payer: Priority Health Medicare |
$135.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.95
|
| Rate for Payer: UHC Medicare Advantage |
$135.95
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$126.40 |
| Max. Negotiated Rate |
$254.62 |
| Rate for Payer: Aetna Commercial |
$184.42
|
| Rate for Payer: Aetna Medicare |
$143.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.42
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$137.63
|
| Rate for Payer: BCN Medicare Advantage |
$137.63
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$198.19
|
| Rate for Payer: Cofinity Commercial |
$184.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.63
|
| Rate for Payer: Healthscope Commercial |
$254.62
|
| Rate for Payer: Healthscope Commercial |
$220.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.40
|
| Rate for Payer: Nomi Health Commercial |
$165.16
|
| Rate for Payer: PACE SWMI |
$137.63
|
| Rate for Payer: PHP Medicare Advantage |
$137.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$137.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.63
|
| Rate for Payer: UHC Medicare Advantage |
$137.63
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$116.92 |
| Rate for Payer: Aetna Commercial |
$84.69
|
| Rate for Payer: Aetna Medicare |
$65.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.69
|
| Rate for Payer: BCBS Complete |
$67.60
|
| Rate for Payer: BCBS MAPPO |
$63.20
|
| Rate for Payer: BCN Medicare Advantage |
$63.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$91.01
|
| Rate for Payer: Cofinity Commercial |
$84.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$101.12
|
| Rate for Payer: Healthscope Commercial |
$116.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Nomi Health Commercial |
$75.84
|
| Rate for Payer: PACE SWMI |
$63.20
|
| Rate for Payer: PHP Medicare Advantage |
$63.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.85
|
| Rate for Payer: Priority Health Medicare |
$63.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$63.20
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 20251
|
| Min. Negotiated Rate |
$417.82 |
| Max. Negotiated Rate |
$862.55 |
| Rate for Payer: Aetna Commercial |
$559.88
|
| Rate for Payer: Aetna Medicare |
$434.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.88
|
| Rate for Payer: BCBS Complete |
$530.80
|
| Rate for Payer: BCBS MAPPO |
$417.82
|
| Rate for Payer: BCN Medicare Advantage |
$417.82
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$601.66
|
| Rate for Payer: Cofinity Commercial |
$559.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.82
|
| Rate for Payer: Healthscope Commercial |
$772.97
|
| Rate for Payer: Healthscope Commercial |
$668.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$862.55
|
| Rate for Payer: Nomi Health Commercial |
$501.38
|
| Rate for Payer: PACE SWMI |
$417.82
|
| Rate for Payer: PHP Medicare Advantage |
$417.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health Medicare |
$417.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$417.82
|
| Rate for Payer: UHC Medicare Advantage |
$417.82
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN THORACIC
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 20250
|
| Min. Negotiated Rate |
$321.20 |
| Max. Negotiated Rate |
$701.83 |
| Rate for Payer: Aetna Commercial |
$508.36
|
| Rate for Payer: Aetna Medicare |
$394.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.36
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS MAPPO |
$379.37
|
| Rate for Payer: BCN Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$546.29
|
| Rate for Payer: Cofinity Commercial |
$508.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.37
|
| Rate for Payer: Healthscope Commercial |
$606.99
|
| Rate for Payer: Healthscope Commercial |
$701.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.95
|
| Rate for Payer: Nomi Health Commercial |
$455.24
|
| Rate for Payer: PACE SWMI |
$379.37
|
| Rate for Payer: PHP Medicare Advantage |
$379.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$379.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.37
|
| Rate for Payer: UHC Medicare Advantage |
$379.37
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$198.25 |
| Rate for Payer: Aetna Commercial |
$113.32
|
| Rate for Payer: Aetna Medicare |
$87.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.32
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: BCBS MAPPO |
$84.57
|
| Rate for Payer: BCN Medicare Advantage |
$84.57
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$113.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.57
|
| Rate for Payer: Healthscope Commercial |
$156.45
|
| Rate for Payer: Healthscope Commercial |
$135.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.25
|
| Rate for Payer: Nomi Health Commercial |
$101.48
|
| Rate for Payer: PACE SWMI |
$84.57
|
| Rate for Payer: PHP Medicare Advantage |
$84.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health Medicare |
$84.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.57
|
| Rate for Payer: UHC Medicare Advantage |
$84.57
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$56.77 |
| Max. Negotiated Rate |
$198.25 |
| Rate for Payer: Aetna Commercial |
$76.07
|
| Rate for Payer: Aetna Medicare |
$59.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.07
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: BCBS MAPPO |
$56.77
|
| Rate for Payer: BCN Medicare Advantage |
$56.77
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$81.75
|
| Rate for Payer: Cofinity Commercial |
$76.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.77
|
| Rate for Payer: Healthscope Commercial |
$105.02
|
| Rate for Payer: Healthscope Commercial |
$90.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.25
|
| Rate for Payer: Nomi Health Commercial |
$68.12
|
| Rate for Payer: PACE SWMI |
$56.77
|
| Rate for Payer: PHP Medicare Advantage |
$56.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health Medicare |
$56.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.77
|
| Rate for Payer: UHC Medicare Advantage |
$56.77
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$124.80 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$28.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: BCBS Complete |
$76.80
|
| Rate for Payer: BCBS MAPPO |
$27.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$39.74
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.60
|
| Rate for Payer: Healthscope Commercial |
$44.16
|
| Rate for Payer: Healthscope Commercial |
$51.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.80
|
| Rate for Payer: Nomi Health Commercial |
$33.12
|
| Rate for Payer: PACE SWMI |
$27.60
|
| Rate for Payer: PHP Medicare Advantage |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.80
|
| Rate for Payer: Priority Health Medicare |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.60
|
| Rate for Payer: UHC Medicare Advantage |
$27.60
|
|
|
PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 33933
|
| Min. Negotiated Rate |
$269.60 |
| Max. Negotiated Rate |
$438.10 |
| Rate for Payer: Aetna Medicare |
$337.00
|
| Rate for Payer: BCBS Complete |
$269.60
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.10
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$42.12 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$43.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.65
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$42.12
|
| Rate for Payer: BCN Medicare Advantage |
$42.12
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$56.44
|
| Rate for Payer: Cofinity Commercial |
$60.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.12
|
| Rate for Payer: Healthscope Commercial |
$67.39
|
| Rate for Payer: Healthscope Commercial |
$77.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.80
|
| Rate for Payer: Nomi Health Commercial |
$50.54
|
| Rate for Payer: PACE SWMI |
$42.12
|
| Rate for Payer: PHP Medicare Advantage |
$42.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Medicare |
$42.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.12
|
| Rate for Payer: UHC Medicare Advantage |
$42.12
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$251.62 |
| Max. Negotiated Rate |
$465.50 |
| Rate for Payer: Aetna Commercial |
$337.17
|
| Rate for Payer: Aetna Medicare |
$261.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.17
|
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: BCBS MAPPO |
$251.62
|
| Rate for Payer: BCN Medicare Advantage |
$251.62
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$362.33
|
| Rate for Payer: Cofinity Commercial |
$337.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.62
|
| Rate for Payer: Healthscope Commercial |
$465.50
|
| Rate for Payer: Healthscope Commercial |
$402.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.00
|
| Rate for Payer: Nomi Health Commercial |
$301.94
|
| Rate for Payer: PACE SWMI |
$251.62
|
| Rate for Payer: PHP Medicare Advantage |
$251.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health Medicare |
$251.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.62
|
| Rate for Payer: UHC Medicare Advantage |
$251.62
|
|
