|
PR BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP
|
Professional
|
Both
|
$3,123.00
|
|
|
Service Code
|
HCPCS 19367
|
| Min. Negotiated Rate |
$994.28 |
| Max. Negotiated Rate |
$3,131.33 |
| Rate for Payer: Aetna Commercial |
$2,056.14
|
| Rate for Payer: Aetna Medicare |
$1,595.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,056.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,209.58
|
| Rate for Payer: BCBS Complete |
$1,043.99
|
| Rate for Payer: BCBS MAPPO |
$1,534.43
|
| Rate for Payer: BCN Commercial |
$2,663.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,534.43
|
| Rate for Payer: Cash Price |
$2,498.40
|
| Rate for Payer: Cash Price |
$2,498.40
|
| Rate for Payer: Cofinity Commercial |
$2,209.58
|
| Rate for Payer: Cofinity Commercial |
$2,056.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,534.43
|
| Rate for Payer: Healthscope Commercial |
$2,838.70
|
| Rate for Payer: Healthscope Commercial |
$2,455.09
|
| Rate for Payer: Mclaren Medicaid |
$994.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,611.15
|
| Rate for Payer: Meridian Medicaid |
$1,043.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,687.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,131.33
|
| Rate for Payer: Nomi Health Commercial |
$1,841.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,342.25
|
| Rate for Payer: PACE SWMI |
$1,534.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,534.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$994.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,437.52
|
| Rate for Payer: Priority Health Medicare |
$1,534.43
|
| Rate for Payer: Priority Health SBD |
$2,437.52
|
| Rate for Payer: Priority Health Tiered Network |
$2,437.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,534.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,127.42
|
| Rate for Payer: UHC Core |
$3,127.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,534.43
|
| Rate for Payer: UHC Exchange |
$3,127.42
|
| Rate for Payer: UHC Medicaid |
$994.28
|
| Rate for Payer: UHCCP Medicaid |
$994.28
|
|
|
PR BREAST RECONSTRUCTION W/LATISSIMUS DORSI FLAP
|
Professional
|
Both
|
$3,008.00
|
|
|
Service Code
|
HCPCS 19361
|
| Min. Negotiated Rate |
$881.39 |
| Max. Negotiated Rate |
$2,758.68 |
| Rate for Payer: Aetna Commercial |
$1,821.10
|
| Rate for Payer: Aetna Medicare |
$1,413.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,821.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,957.00
|
| Rate for Payer: BCBS Complete |
$925.46
|
| Rate for Payer: BCBS MAPPO |
$1,359.03
|
| Rate for Payer: BCN Commercial |
$2,345.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,359.03
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cash Price |
$2,406.40
|
| Rate for Payer: Cofinity Commercial |
$1,957.00
|
| Rate for Payer: Cofinity Commercial |
$1,821.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,359.03
|
| Rate for Payer: Healthscope Commercial |
$2,514.21
|
| Rate for Payer: Healthscope Commercial |
$2,174.45
|
| Rate for Payer: Mclaren Medicaid |
$881.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,426.98
|
| Rate for Payer: Meridian Medicaid |
$925.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,494.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.73
|
| Rate for Payer: Nomi Health Commercial |
$1,630.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,256.00
|
| Rate for Payer: PACE SWMI |
$1,359.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,359.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,147.18
|
| Rate for Payer: Priority Health Medicare |
$1,359.03
|
| Rate for Payer: Priority Health SBD |
$2,147.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,147.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,359.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,758.68
|
| Rate for Payer: UHC Core |
$2,758.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,359.03
|
| Rate for Payer: UHC Exchange |
$2,758.68
|
| Rate for Payer: UHC Medicaid |
$881.39
|
| Rate for Payer: UHCCP Medicaid |
$881.39
|
|
|
PR BREAST RECONSTRUC W OTHR TECHNIQ
|
Professional
|
Both
|
$2,990.00
|
|
|
Service Code
|
HCPCS 19366
|
| Min. Negotiated Rate |
$1,196.00 |
| Max. Negotiated Rate |
$2,242.50 |
| Rate for Payer: Aetna Medicare |
$1,495.00
|
| Rate for Payer: BCBS Complete |
$1,196.00
|
| Rate for Payer: Cash Price |
$2,392.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,943.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,242.50
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 19318
|
| Min. Negotiated Rate |
$625.16 |
| Max. Negotiated Rate |
$1,933.69 |
| Rate for Payer: Aetna Commercial |
$1,288.81
|
| Rate for Payer: Aetna Medicare |
$1,000.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.99
|
| Rate for Payer: BCBS Complete |
$656.42
|
| Rate for Payer: BCBS MAPPO |
$961.80
|
| Rate for Payer: BCN Commercial |
$1,650.81
|
| Rate for Payer: BCN Medicare Advantage |
$961.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$1,384.99
|
| Rate for Payer: Cofinity Commercial |
$1,288.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$961.80
|
| Rate for Payer: Healthscope Commercial |
$1,538.88
|
| Rate for Payer: Healthscope Commercial |
$1,779.33
|
| Rate for Payer: Mclaren Medicaid |
$625.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.89
|
| Rate for Payer: Meridian Medicaid |
$656.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,057.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,933.69
|
| Rate for Payer: Nomi Health Commercial |
$1,154.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$961.80
|
| Rate for Payer: PHP Medicare Advantage |
$961.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$625.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,510.92
|
| Rate for Payer: Priority Health Medicare |
$961.80
|
| Rate for Payer: Priority Health SBD |
$1,510.92
|
| Rate for Payer: Priority Health Tiered Network |
$1,510.92
|
| Rate for Payer: Railroad Medicare Medicare |
$961.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,923.27
|
| Rate for Payer: UHC Core |
$1,923.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$961.80
|
| Rate for Payer: UHC Exchange |
$1,923.27
|
| Rate for Payer: UHC Medicaid |
$625.16
|
| Rate for Payer: UHCCP Medicaid |
$625.16
|
|
|
PR BREATH HYDROGEN/METHANE TEST
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 91065
|
| Min. Negotiated Rate |
$59.58 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Aetna Commercial |
$79.84
|
| Rate for Payer: Aetna Medicare |
$61.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$59.58
|
| Rate for Payer: BCN Commercial |
$97.60
|
| Rate for Payer: BCN Medicare Advantage |
$59.58
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$85.80
|
| Rate for Payer: Cofinity Commercial |
$79.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.58
|
| Rate for Payer: Healthscope Commercial |
$95.33
|
| Rate for Payer: Healthscope Commercial |
$110.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.77
|
| Rate for Payer: Nomi Health Commercial |
$71.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.00
|
| Rate for Payer: PACE SWMI |
$59.58
|
| Rate for Payer: PHP Medicare Advantage |
$59.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$90.01
|
| Rate for Payer: Priority Health Medicare |
$59.58
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: Priority Health Tiered Network |
$90.01
|
| Rate for Payer: Railroad Medicare Medicare |
$59.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.23
|
| Rate for Payer: UHC Core |
$121.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.58
|
| Rate for Payer: UHC Exchange |
$121.23
|
|
|
PR BREATHING RESPONSE TO HYPOXIA
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 94450
|
| Min. Negotiated Rate |
$102.12 |
| Max. Negotiated Rate |
$194.44 |
| Rate for Payer: Aetna Commercial |
$140.83
|
| Rate for Payer: Aetna Medicare |
$109.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.34
|
| Rate for Payer: BCBS MAPPO |
$105.10
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: BCN Medicare Advantage |
$105.10
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$151.34
|
| Rate for Payer: Cofinity Commercial |
$140.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.10
|
| Rate for Payer: Healthscope Commercial |
$194.44
|
| Rate for Payer: Healthscope Commercial |
$168.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.59
|
| Rate for Payer: Nomi Health Commercial |
$126.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.75
|
| Rate for Payer: PACE SWMI |
$105.10
|
| Rate for Payer: PHP Medicare Advantage |
$105.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.78
|
| Rate for Payer: Priority Health Medicare |
$105.10
|
| Rate for Payer: Priority Health SBD |
$120.78
|
| Rate for Payer: Priority Health Tiered Network |
$120.78
|
| Rate for Payer: Railroad Medicare Medicare |
$105.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.12
|
| Rate for Payer: UHC Core |
$102.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.10
|
| Rate for Payer: UHC Exchange |
$102.12
|
|
|
PR BRIEF CHECK IN BY MD/QHP
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G2012
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Aetna Commercial |
$13.03
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.03
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCN Commercial |
$18.72
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
|
|
PR BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 98016
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$17.30
|
| Rate for Payer: Aetna Medicare |
$13.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.30
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$16.34
|
| Rate for Payer: BCN Medicare Advantage |
$12.91
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$17.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.91
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$20.66
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.56
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Nomi Health Commercial |
$15.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.16
|
| Rate for Payer: Priority Health Medicare |
$12.91
|
| Rate for Payer: Priority Health SBD |
$20.16
|
| Rate for Payer: Priority Health Tiered Network |
$20.16
|
| Rate for Payer: Railroad Medicare Medicare |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.49
|
| Rate for Payer: UHC Core |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.91
|
| Rate for Payer: UHC Exchange |
$22.49
|
| Rate for Payer: UHC Medicaid |
$8.31
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 94060
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$90.27 |
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Medicare |
$42.02
|
| Rate for Payer: Aetna Medicare |
$42.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.14
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Healthscope Commercial |
$64.64
|
| Rate for Payer: Healthscope Commercial |
$64.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.42
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.70
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health SBD |
$85.70
|
| Rate for Payer: Priority Health SBD |
$85.70
|
| Rate for Payer: Priority Health Tiered Network |
$85.70
|
| Rate for Payer: Priority Health Tiered Network |
$85.70
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.27
|
| Rate for Payer: UHC Core |
$90.27
|
| Rate for Payer: UHC Core |
$90.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Exchange |
$90.27
|
| Rate for Payer: UHC Exchange |
$90.27
|
|
|
PR BRNCHSC BRUSHING/PROTECTED BRUSHINGS
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
HCPCS 31623
|
| Min. Negotiated Rate |
$76.04 |
| Max. Negotiated Rate |
$501.00 |
| Rate for Payer: Aetna Commercial |
$158.17
|
| Rate for Payer: Aetna Medicare |
$122.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.98
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$118.04
|
| Rate for Payer: BCN Commercial |
$193.22
|
| Rate for Payer: BCN Medicare Advantage |
$118.04
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cofinity Commercial |
$169.98
|
| Rate for Payer: Cofinity Commercial |
$158.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.04
|
| Rate for Payer: Healthscope Commercial |
$218.37
|
| Rate for Payer: Healthscope Commercial |
$188.86
|
| Rate for Payer: Mclaren Medicaid |
$76.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.94
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.88
|
| Rate for Payer: Nomi Health Commercial |
$141.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$501.00
|
| Rate for Payer: PACE SWMI |
$118.04
|
| Rate for Payer: PHP Medicare Advantage |
$118.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$181.95
|
| Rate for Payer: Priority Health Medicare |
$118.04
|
| Rate for Payer: Priority Health SBD |
$181.95
|
| Rate for Payer: Priority Health Tiered Network |
$181.95
|
| Rate for Payer: Railroad Medicare Medicare |
$118.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.69
|
| Rate for Payer: UHC Core |
$234.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.04
|
| Rate for Payer: UHC Exchange |
$234.69
|
| Rate for Payer: UHC Medicaid |
$76.04
|
| Rate for Payer: UHCCP Medicaid |
$76.04
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 31652
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$392.44 |
| Rate for Payer: Aetna Commercial |
$263.42
|
| Rate for Payer: Aetna Medicare |
$204.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.08
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$196.58
|
| Rate for Payer: BCN Commercial |
$322.69
|
| Rate for Payer: BCN Medicare Advantage |
$196.58
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cofinity Commercial |
$283.08
|
| Rate for Payer: Cofinity Commercial |
$263.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.58
|
| Rate for Payer: Healthscope Commercial |
$363.67
|
| Rate for Payer: Healthscope Commercial |
$314.53
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.41
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.74
|
| Rate for Payer: Nomi Health Commercial |
$235.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: PACE SWMI |
$196.58
|
| Rate for Payer: PHP Medicare Advantage |
$196.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$303.89
|
| Rate for Payer: Priority Health Medicare |
$196.58
|
| Rate for Payer: Priority Health SBD |
$303.89
|
| Rate for Payer: Priority Health Tiered Network |
$303.89
|
| Rate for Payer: Railroad Medicare Medicare |
$196.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.44
|
| Rate for Payer: UHC Core |
$392.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$196.58
|
| Rate for Payer: UHC Exchange |
$392.44
|
| Rate for Payer: UHC Medicaid |
$126.31
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 31653
|
| Min. Negotiated Rate |
$139.73 |
| Max. Negotiated Rate |
$435.59 |
| Rate for Payer: Aetna Commercial |
$291.45
|
| Rate for Payer: Aetna Medicare |
$226.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.20
|
| Rate for Payer: BCBS Complete |
$146.72
|
| Rate for Payer: BCBS MAPPO |
$217.50
|
| Rate for Payer: BCN Commercial |
$357.55
|
| Rate for Payer: BCN Medicare Advantage |
$217.50
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cofinity Commercial |
$313.20
|
| Rate for Payer: Cofinity Commercial |
$291.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.50
|
| Rate for Payer: Healthscope Commercial |
$402.38
|
| Rate for Payer: Healthscope Commercial |
$348.00
|
| Rate for Payer: Mclaren Medicaid |
$139.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.38
|
| Rate for Payer: Meridian Medicaid |
$146.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.86
|
| Rate for Payer: Nomi Health Commercial |
$261.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: PACE SWMI |
$217.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.71
|
| Rate for Payer: Priority Health Medicare |
$217.50
|
| Rate for Payer: Priority Health SBD |
$336.71
|
| Rate for Payer: Priority Health Tiered Network |
$336.71
|
| Rate for Payer: Railroad Medicare Medicare |
$217.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.59
|
| Rate for Payer: UHC Core |
$435.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.50
|
| Rate for Payer: UHC Exchange |
$435.59
|
| Rate for Payer: UHC Medicaid |
$139.73
|
| Rate for Payer: UHCCP Medicaid |
$139.73
|
|
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$159.62
|
| Rate for Payer: Aetna Medicare |
$123.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.53
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$119.12
|
| Rate for Payer: BCN Commercial |
$213.36
|
| Rate for Payer: BCN Medicare Advantage |
$119.12
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$171.53
|
| Rate for Payer: Cofinity Commercial |
$159.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.12
|
| Rate for Payer: Healthscope Commercial |
$220.37
|
| Rate for Payer: Healthscope Commercial |
$190.59
|
| Rate for Payer: Mclaren Medicaid |
$76.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.08
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.60
|
| Rate for Payer: Nomi Health Commercial |
$142.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$119.12
|
| Rate for Payer: PHP Medicare Advantage |
$119.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.89
|
| Rate for Payer: Priority Health Medicare |
$119.12
|
| Rate for Payer: Priority Health SBD |
$182.89
|
| Rate for Payer: Priority Health Tiered Network |
$182.89
|
| Rate for Payer: Railroad Medicare Medicare |
$119.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.69
|
| Rate for Payer: UHC Core |
$232.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.12
|
| Rate for Payer: UHC Exchange |
$232.69
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$467.25 |
| Rate for Payer: Aetna Commercial |
$160.21
|
| Rate for Payer: Aetna Medicare |
$124.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.17
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$119.56
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$119.56
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$172.17
|
| Rate for Payer: Cofinity Commercial |
$160.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.56
|
| Rate for Payer: Healthscope Commercial |
$221.19
|
| Rate for Payer: Healthscope Commercial |
$191.30
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.54
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.07
|
| Rate for Payer: Nomi Health Commercial |
$143.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$467.25
|
| Rate for Payer: PACE SWMI |
$119.56
|
| Rate for Payer: PHP Medicare Advantage |
$119.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$184.77
|
| Rate for Payer: Priority Health Medicare |
$119.56
|
| Rate for Payer: Priority Health SBD |
$184.77
|
| Rate for Payer: Priority Health Tiered Network |
$184.77
|
| Rate for Payer: Railroad Medicare Medicare |
$119.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.61
|
| Rate for Payer: UHC Core |
$237.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.56
|
| Rate for Payer: UHC Exchange |
$237.61
|
| Rate for Payer: UHC Medicaid |
$77.11
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 31630
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$351.27 |
| Rate for Payer: Aetna Commercial |
$234.86
|
| Rate for Payer: Aetna Medicare |
$182.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.39
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$175.27
|
| Rate for Payer: BCN Commercial |
$291.32
|
| Rate for Payer: BCN Medicare Advantage |
$175.27
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$252.39
|
| Rate for Payer: Cofinity Commercial |
$234.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.27
|
| Rate for Payer: Healthscope Commercial |
$324.25
|
| Rate for Payer: Healthscope Commercial |
$280.43
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.03
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.62
|
| Rate for Payer: Nomi Health Commercial |
$210.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$175.27
|
| Rate for Payer: PHP Medicare Advantage |
$175.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$274.34
|
| Rate for Payer: Priority Health Medicare |
$175.27
|
| Rate for Payer: Priority Health SBD |
$274.34
|
| Rate for Payer: Priority Health Tiered Network |
$274.34
|
| Rate for Payer: Railroad Medicare Medicare |
$175.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.27
|
| Rate for Payer: UHC Core |
$351.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.27
|
| Rate for Payer: UHC Exchange |
$351.27
|
| Rate for Payer: UHC Medicaid |
$112.68
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$121.75 |
| Rate for Payer: Aetna Commercial |
$88.19
|
| Rate for Payer: Aetna Commercial |
$88.19
|
| Rate for Payer: Aetna Medicare |
$68.44
|
| Rate for Payer: Aetna Medicare |
$68.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$65.81
|
| Rate for Payer: BCBS MAPPO |
$65.81
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: BCN Medicare Advantage |
$65.81
|
| Rate for Payer: BCN Medicare Advantage |
$65.81
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Cofinity Commercial |
$88.19
|
| Rate for Payer: Cofinity Commercial |
$88.19
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.81
|
| Rate for Payer: Healthscope Commercial |
$121.75
|
| Rate for Payer: Healthscope Commercial |
$121.75
|
| Rate for Payer: Healthscope Commercial |
$105.30
|
| Rate for Payer: Healthscope Commercial |
$105.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.24
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$65.81
|
| Rate for Payer: PACE SWMI |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.26
|
| Rate for Payer: Priority Health Medicare |
$65.81
|
| Rate for Payer: Priority Health Medicare |
$65.81
|
| Rate for Payer: Priority Health SBD |
$87.26
|
| Rate for Payer: Priority Health SBD |
$87.26
|
| Rate for Payer: Priority Health Tiered Network |
$87.26
|
| Rate for Payer: Priority Health Tiered Network |
$87.26
|
| Rate for Payer: Railroad Medicare Medicare |
$65.81
|
| Rate for Payer: Railroad Medicare Medicare |
$65.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.90
|
| Rate for Payer: UHC Core |
$91.90
|
| Rate for Payer: UHC Core |
$91.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.81
|
| Rate for Payer: UHC Exchange |
$91.90
|
| Rate for Payer: UHC Exchange |
$91.90
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$79.74
|
| Rate for Payer: Aetna Medicare |
$61.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.69
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.51
|
| Rate for Payer: BCN Commercial |
$97.60
|
| Rate for Payer: BCN Medicare Advantage |
$59.51
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$85.69
|
| Rate for Payer: Cofinity Commercial |
$79.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.51
|
| Rate for Payer: Healthscope Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$110.09
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.49
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.60
|
| Rate for Payer: Nomi Health Commercial |
$71.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$59.51
|
| Rate for Payer: PHP Medicare Advantage |
$59.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$91.92
|
| Rate for Payer: Priority Health Medicare |
$59.51
|
| Rate for Payer: Priority Health SBD |
$91.92
|
| Rate for Payer: Priority Health Tiered Network |
$91.92
|
| Rate for Payer: Railroad Medicare Medicare |
$59.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.52
|
| Rate for Payer: UHC Core |
$119.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.51
|
| Rate for Payer: UHC Exchange |
$119.52
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$3,042.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$799.18 |
| Max. Negotiated Rate |
$2,362.68 |
| Rate for Payer: Aetna Commercial |
$1,678.34
|
| Rate for Payer: Aetna Medicare |
$1,302.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,678.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,803.59
|
| Rate for Payer: BCBS Complete |
$839.14
|
| Rate for Payer: BCBS MAPPO |
$1,252.49
|
| Rate for Payer: BCN Commercial |
$1,960.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.49
|
| Rate for Payer: Cash Price |
$2,433.60
|
| Rate for Payer: Cash Price |
$2,433.60
|
| Rate for Payer: Cofinity Commercial |
$1,803.59
|
| Rate for Payer: Cofinity Commercial |
$1,678.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.49
|
| Rate for Payer: Healthscope Commercial |
$2,317.11
|
| Rate for Payer: Healthscope Commercial |
$2,003.98
|
| Rate for Payer: Mclaren Medicaid |
$799.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,315.11
|
| Rate for Payer: Meridian Medicaid |
$839.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,377.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.47
|
| Rate for Payer: Nomi Health Commercial |
$1,502.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,281.50
|
| Rate for Payer: PACE SWMI |
$1,252.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$799.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,846.26
|
| Rate for Payer: Priority Health Medicare |
$1,252.49
|
| Rate for Payer: Priority Health SBD |
$1,846.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,846.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,252.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,362.68
|
| Rate for Payer: UHC Core |
$2,362.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,252.49
|
| Rate for Payer: UHC Exchange |
$2,362.68
|
| Rate for Payer: UHC Medicaid |
$799.18
|
| Rate for Payer: UHCCP Medicaid |
$799.18
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$500.25 |
| Rate for Payer: Aetna Commercial |
$186.73
|
| Rate for Payer: Aetna Medicare |
$144.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.66
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$139.35
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$139.35
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$200.66
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.35
|
| Rate for Payer: Healthscope Commercial |
$257.80
|
| Rate for Payer: Healthscope Commercial |
$222.96
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.32
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.09
|
| Rate for Payer: Nomi Health Commercial |
$167.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.25
|
| Rate for Payer: PACE SWMI |
$139.35
|
| Rate for Payer: PHP Medicare Advantage |
$139.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.78
|
| Rate for Payer: Priority Health Medicare |
$139.35
|
| Rate for Payer: Priority Health SBD |
$214.78
|
| Rate for Payer: Priority Health Tiered Network |
$214.78
|
| Rate for Payer: Railroad Medicare Medicare |
$139.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.59
|
| Rate for Payer: UHC Core |
$276.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.35
|
| Rate for Payer: UHC Exchange |
$276.59
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Aetna Commercial |
$223.69
|
| Rate for Payer: Aetna Medicare |
$173.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.38
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$166.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$166.93
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$240.38
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.93
|
| Rate for Payer: Healthscope Commercial |
$308.82
|
| Rate for Payer: Healthscope Commercial |
$267.09
|
| Rate for Payer: Mclaren Medicaid |
$107.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.28
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.62
|
| Rate for Payer: Nomi Health Commercial |
$200.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PACE SWMI |
$166.93
|
| Rate for Payer: PHP Medicare Advantage |
$166.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.45
|
| Rate for Payer: Priority Health Medicare |
$166.93
|
| Rate for Payer: Priority Health SBD |
$257.45
|
| Rate for Payer: Priority Health Tiered Network |
$257.45
|
| Rate for Payer: Railroad Medicare Medicare |
$166.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.20
|
| Rate for Payer: UHC Core |
$330.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.93
|
| Rate for Payer: UHC Exchange |
$330.20
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$113.73
|
| Rate for Payer: Aetna Medicare |
$88.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.21
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$84.87
|
| Rate for Payer: BCN Commercial |
$140.43
|
| Rate for Payer: BCN Medicare Advantage |
$84.87
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$122.21
|
| Rate for Payer: Cofinity Commercial |
$113.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.87
|
| Rate for Payer: Healthscope Commercial |
$157.01
|
| Rate for Payer: Healthscope Commercial |
$135.79
|
| Rate for Payer: Mclaren Medicaid |
$54.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.11
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.46
|
| Rate for Payer: Nomi Health Commercial |
$101.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: PACE SWMI |
$84.87
|
| Rate for Payer: PHP Medicare Advantage |
$84.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.25
|
| Rate for Payer: Priority Health Medicare |
$84.87
|
| Rate for Payer: Priority Health SBD |
$132.25
|
| Rate for Payer: Priority Health Tiered Network |
$132.25
|
| Rate for Payer: Railroad Medicare Medicare |
$84.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.36
|
| Rate for Payer: UHC Core |
$171.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.87
|
| Rate for Payer: UHC Exchange |
$171.36
|
| Rate for Payer: UHC Medicaid |
$54.32
|
| Rate for Payer: UHCCP Medicaid |
$54.32
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$139.09 |
| Max. Negotiated Rate |
$443.18 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$224.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.44
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCN Commercial |
$360.54
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Healthscope Commercial |
$400.12
|
| Rate for Payer: Healthscope Commercial |
$346.05
|
| Rate for Payer: Mclaren Medicaid |
$139.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.77
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$339.52
|
| Rate for Payer: Priority Health Medicare |
$216.28
|
| Rate for Payer: Priority Health SBD |
$339.52
|
| Rate for Payer: Priority Health Tiered Network |
$339.52
|
| Rate for Payer: Railroad Medicare Medicare |
$216.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.18
|
| Rate for Payer: UHC Core |
$443.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.28
|
| Rate for Payer: UHC Exchange |
$443.18
|
| Rate for Payer: UHC Medicaid |
$139.09
|
| Rate for Payer: UHCCP Medicaid |
$139.09
|
|
|
PR BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 31631
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$265.55
|
| Rate for Payer: Aetna Medicare |
$206.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.36
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS MAPPO |
$198.17
|
| Rate for Payer: BCN Commercial |
$332.15
|
| Rate for Payer: BCN Medicare Advantage |
$198.17
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$285.36
|
| Rate for Payer: Cofinity Commercial |
$265.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.17
|
| Rate for Payer: Healthscope Commercial |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$317.07
|
| Rate for Payer: Mclaren Medicaid |
$127.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.08
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.97
|
| Rate for Payer: Nomi Health Commercial |
$237.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$198.17
|
| Rate for Payer: PHP Medicare Advantage |
$198.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$312.79
|
| Rate for Payer: Priority Health Medicare |
$198.17
|
| Rate for Payer: Priority Health SBD |
$312.79
|
| Rate for Payer: Priority Health Tiered Network |
$312.79
|
| Rate for Payer: Railroad Medicare Medicare |
$198.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.00
|
| Rate for Payer: UHC Core |
$403.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.17
|
| Rate for Payer: UHC Exchange |
$403.00
|
| Rate for Payer: UHC Medicaid |
$127.37
|
| Rate for Payer: UHCCP Medicaid |
$127.37
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,171.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: Aetna Medicare |
$163.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.82
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$156.82
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$156.82
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cofinity Commercial |
$225.82
|
| Rate for Payer: Cofinity Commercial |
$210.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.82
|
| Rate for Payer: Healthscope Commercial |
$290.12
|
| Rate for Payer: Healthscope Commercial |
$250.91
|
| Rate for Payer: Mclaren Medicaid |
$100.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.66
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.59
|
| Rate for Payer: Nomi Health Commercial |
$188.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$878.25
|
| Rate for Payer: PACE SWMI |
$156.82
|
| Rate for Payer: PHP Medicare Advantage |
$156.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$241.98
|
| Rate for Payer: Priority Health Medicare |
$156.82
|
| Rate for Payer: Priority Health SBD |
$241.98
|
| Rate for Payer: Priority Health Tiered Network |
$241.98
|
| Rate for Payer: Railroad Medicare Medicare |
$156.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.78
|
| Rate for Payer: UHC Core |
$310.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$156.82
|
| Rate for Payer: UHC Exchange |
$310.78
|
| Rate for Payer: UHC Medicaid |
$100.96
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$176.79
|
| Rate for Payer: Aetna Medicare |
$137.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.98
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$131.93
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$131.93
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$189.98
|
| Rate for Payer: Cofinity Commercial |
$176.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.93
|
| Rate for Payer: Healthscope Commercial |
$244.07
|
| Rate for Payer: Healthscope Commercial |
$211.09
|
| Rate for Payer: Mclaren Medicaid |
$84.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.53
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.18
|
| Rate for Payer: Nomi Health Commercial |
$158.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.50
|
| Rate for Payer: PACE SWMI |
$131.93
|
| Rate for Payer: PHP Medicare Advantage |
$131.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.06
|
| Rate for Payer: Priority Health Medicare |
$131.93
|
| Rate for Payer: Priority Health SBD |
$203.06
|
| Rate for Payer: Priority Health Tiered Network |
$203.06
|
| Rate for Payer: Railroad Medicare Medicare |
$131.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.80
|
| Rate for Payer: UHC Core |
$259.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.93
|
| Rate for Payer: UHC Exchange |
$259.80
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
