|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna Commercial |
$170.89
|
| Rate for Payer: Aetna Medicare |
$132.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.64
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$127.53
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$127.53
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$183.64
|
| Rate for Payer: Cofinity Commercial |
$170.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.53
|
| Rate for Payer: Healthscope Commercial |
$235.93
|
| Rate for Payer: Healthscope Commercial |
$204.05
|
| Rate for Payer: Mclaren Medicaid |
$82.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.91
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.21
|
| Rate for Payer: Nomi Health Commercial |
$153.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.00
|
| Rate for Payer: PACE SWMI |
$127.53
|
| Rate for Payer: PHP Medicare Advantage |
$127.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$196.97
|
| Rate for Payer: Priority Health Medicare |
$127.53
|
| Rate for Payer: Priority Health SBD |
$196.97
|
| Rate for Payer: Priority Health Tiered Network |
$196.97
|
| Rate for Payer: Railroad Medicare Medicare |
$127.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.54
|
| Rate for Payer: UHC Core |
$250.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.53
|
| Rate for Payer: UHC Exchange |
$250.54
|
| Rate for Payer: UHC Medicaid |
$82.22
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$587.25 |
| Rate for Payer: Aetna Commercial |
$210.77
|
| Rate for Payer: Aetna Medicare |
$163.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.50
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$157.29
|
| Rate for Payer: BCN Commercial |
$281.74
|
| Rate for Payer: BCN Medicare Advantage |
$157.29
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$226.50
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.29
|
| Rate for Payer: Healthscope Commercial |
$290.99
|
| Rate for Payer: Healthscope Commercial |
$251.66
|
| Rate for Payer: Mclaren Medicaid |
$101.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.15
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.79
|
| Rate for Payer: Nomi Health Commercial |
$188.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$587.25
|
| Rate for Payer: PACE SWMI |
$157.29
|
| Rate for Payer: PHP Medicare Advantage |
$157.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$241.50
|
| Rate for Payer: Priority Health Medicare |
$157.29
|
| Rate for Payer: Priority Health SBD |
$241.50
|
| Rate for Payer: Priority Health Tiered Network |
$241.50
|
| Rate for Payer: Railroad Medicare Medicare |
$157.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.11
|
| Rate for Payer: UHC Core |
$311.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.29
|
| Rate for Payer: UHC Exchange |
$311.11
|
| Rate for Payer: UHC Medicaid |
$101.18
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$57.38
|
| Rate for Payer: Aetna Medicare |
$44.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.66
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$42.82
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.82
|
| Rate for Payer: Healthscope Commercial |
$79.22
|
| Rate for Payer: Healthscope Commercial |
$68.51
|
| Rate for Payer: Mclaren Medicaid |
$27.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.96
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.62
|
| Rate for Payer: Nomi Health Commercial |
$51.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: PACE SWMI |
$42.82
|
| Rate for Payer: PHP Medicare Advantage |
$42.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$42.82
|
| Rate for Payer: Priority Health SBD |
$66.59
|
| Rate for Payer: Priority Health Tiered Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$42.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.13
|
| Rate for Payer: UHC Core |
$88.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.82
|
| Rate for Payer: UHC Exchange |
$88.13
|
| Rate for Payer: UHC Medicaid |
$27.48
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Aetna Commercial |
$74.84
|
| Rate for Payer: Aetna Medicare |
$58.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.42
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCN Commercial |
$92.13
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$80.42
|
| Rate for Payer: Cofinity Commercial |
$74.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$89.36
|
| Rate for Payer: Healthscope Commercial |
$103.32
|
| Rate for Payer: Mclaren Medicaid |
$35.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.07
|
| Rate for Payer: Nomi Health Commercial |
$67.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.50
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$86.75
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health SBD |
$86.75
|
| Rate for Payer: Priority Health Tiered Network |
$86.75
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.09
|
| Rate for Payer: UHC Core |
$112.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.85
|
| Rate for Payer: UHC Exchange |
$112.09
|
| Rate for Payer: UHC Medicaid |
$35.78
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$6,173.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$1,272.04 |
| Max. Negotiated Rate |
$4,629.75 |
| Rate for Payer: Aetna Commercial |
$2,657.11
|
| Rate for Payer: Aetna Medicare |
$2,062.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,657.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,855.40
|
| Rate for Payer: BCBS Complete |
$1,335.64
|
| Rate for Payer: BCBS MAPPO |
$1,982.92
|
| Rate for Payer: BCN Commercial |
$3,250.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,982.92
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cofinity Commercial |
$2,855.40
|
| Rate for Payer: Cofinity Commercial |
$2,657.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,982.92
|
| Rate for Payer: Healthscope Commercial |
$3,172.67
|
| Rate for Payer: Healthscope Commercial |
$3,668.40
|
| Rate for Payer: Mclaren Medicaid |
$1,272.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,082.07
|
| Rate for Payer: Meridian Medicaid |
$1,335.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,181.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,855.60
|
| Rate for Payer: Nomi Health Commercial |
$2,379.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,629.75
|
| Rate for Payer: PACE SWMI |
$1,982.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,982.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,272.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,292.38
|
| Rate for Payer: Priority Health Medicare |
$1,982.92
|
| Rate for Payer: Priority Health SBD |
$3,292.38
|
| Rate for Payer: Priority Health Tiered Network |
$3,292.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,982.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,816.27
|
| Rate for Payer: UHC Core |
$3,816.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,982.92
|
| Rate for Payer: UHC Exchange |
$3,816.27
|
| Rate for Payer: UHC Medicaid |
$1,272.04
|
| Rate for Payer: UHCCP Medicaid |
$1,272.04
|
|
|
PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION
|
Professional
|
Both
|
$5,397.00
|
|
|
Service Code
|
HCPCS 58953
|
| Min. Negotiated Rate |
$1,176.83 |
| Max. Negotiated Rate |
$4,047.75 |
| Rate for Payer: Aetna Commercial |
$2,457.28
|
| Rate for Payer: Aetna Medicare |
$1,907.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,457.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,640.66
|
| Rate for Payer: BCBS Complete |
$1,235.67
|
| Rate for Payer: BCBS MAPPO |
$1,833.79
|
| Rate for Payer: BCN Commercial |
$3,003.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,833.79
|
| Rate for Payer: Cash Price |
$4,317.60
|
| Rate for Payer: Cash Price |
$4,317.60
|
| Rate for Payer: Cofinity Commercial |
$2,640.66
|
| Rate for Payer: Cofinity Commercial |
$2,457.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,833.79
|
| Rate for Payer: Healthscope Commercial |
$3,392.51
|
| Rate for Payer: Healthscope Commercial |
$2,934.06
|
| Rate for Payer: Mclaren Medicaid |
$1,176.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,925.48
|
| Rate for Payer: Meridian Medicaid |
$1,235.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,017.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,564.77
|
| Rate for Payer: Nomi Health Commercial |
$2,200.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,047.75
|
| Rate for Payer: PACE SWMI |
$1,833.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,833.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,176.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,042.22
|
| Rate for Payer: Priority Health Medicare |
$1,833.79
|
| Rate for Payer: Priority Health SBD |
$3,042.22
|
| Rate for Payer: Priority Health Tiered Network |
$3,042.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,833.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,520.77
|
| Rate for Payer: UHC Core |
$3,520.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,833.79
|
| Rate for Payer: UHC Exchange |
$3,520.77
|
| Rate for Payer: UHC Medicaid |
$1,176.83
|
| Rate for Payer: UHCCP Medicaid |
$1,176.83
|
|
|
PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC
|
Professional
|
Both
|
$2,503.00
|
|
|
Service Code
|
HCPCS 58956
|
| Min. Negotiated Rate |
$803.86 |
| Max. Negotiated Rate |
$2,420.68 |
| Rate for Payer: Aetna Commercial |
$1,674.76
|
| Rate for Payer: Aetna Medicare |
$1,299.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,674.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,799.74
|
| Rate for Payer: BCBS Complete |
$844.05
|
| Rate for Payer: BCBS MAPPO |
$1,249.82
|
| Rate for Payer: BCN Commercial |
$2,044.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,249.82
|
| Rate for Payer: Cash Price |
$2,002.40
|
| Rate for Payer: Cash Price |
$2,002.40
|
| Rate for Payer: Cofinity Commercial |
$1,799.74
|
| Rate for Payer: Cofinity Commercial |
$1,674.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,249.82
|
| Rate for Payer: Healthscope Commercial |
$2,312.17
|
| Rate for Payer: Healthscope Commercial |
$1,999.71
|
| Rate for Payer: Mclaren Medicaid |
$803.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,312.31
|
| Rate for Payer: Meridian Medicaid |
$844.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,374.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,420.68
|
| Rate for Payer: Nomi Health Commercial |
$1,499.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.25
|
| Rate for Payer: PACE SWMI |
$1,249.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,249.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,070.85
|
| Rate for Payer: Priority Health Medicare |
$1,249.82
|
| Rate for Payer: Priority Health SBD |
$2,070.85
|
| Rate for Payer: Priority Health Tiered Network |
$2,070.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,249.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,390.34
|
| Rate for Payer: UHC Core |
$2,390.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,249.82
|
| Rate for Payer: UHC Exchange |
$2,390.34
|
| Rate for Payer: UHC Medicaid |
$803.86
|
| Rate for Payer: UHCCP Medicaid |
$803.86
|
|
|
PR BUDESONIDE NON-COMP UNIT
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS J7626
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna Commercial |
$1.47
|
| Rate for Payer: Aetna Medicare |
$1.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.58
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$1.10
|
| Rate for Payer: BCN Commercial |
$0.08
|
| Rate for Payer: BCN Medicare Advantage |
$1.10
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$1.58
|
| Rate for Payer: Cofinity Commercial |
$1.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$2.04
|
| Rate for Payer: Healthscope Commercial |
$1.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.14
|
| Rate for Payer: Nomi Health Commercial |
$1.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.75
|
| Rate for Payer: PACE SWMI |
$1.10
|
| Rate for Payer: PHP Medicare Advantage |
$1.10
|
| Rate for Payer: Priority Health Medicare |
$1.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.05
|
| Rate for Payer: UHC Core |
$1.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.10
|
| Rate for Payer: UHC Exchange |
$1.05
|
|
|
PR BURR HOLE FOR VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$1,927.00
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$493.31 |
| Max. Negotiated Rate |
$1,445.25 |
| Rate for Payer: Aetna Commercial |
$1,020.84
|
| Rate for Payer: Aetna Medicare |
$792.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.02
|
| Rate for Payer: BCBS Complete |
$517.98
|
| Rate for Payer: BCBS MAPPO |
$761.82
|
| Rate for Payer: BCN Commercial |
$1,154.32
|
| Rate for Payer: BCN Medicare Advantage |
$761.82
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cofinity Commercial |
$1,097.02
|
| Rate for Payer: Cofinity Commercial |
$1,020.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.82
|
| Rate for Payer: Healthscope Commercial |
$1,409.37
|
| Rate for Payer: Healthscope Commercial |
$1,218.91
|
| Rate for Payer: Mclaren Medicaid |
$493.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.91
|
| Rate for Payer: Meridian Medicaid |
$517.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$838.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,355.90
|
| Rate for Payer: Nomi Health Commercial |
$914.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.25
|
| Rate for Payer: PACE SWMI |
$761.82
|
| Rate for Payer: PHP Medicare Advantage |
$761.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,340.72
|
| Rate for Payer: Priority Health Medicare |
$761.82
|
| Rate for Payer: Priority Health SBD |
$1,340.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,340.72
|
| Rate for Payer: Railroad Medicare Medicare |
$761.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,306.36
|
| Rate for Payer: UHC Core |
$1,306.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.82
|
| Rate for Payer: UHC Exchange |
$1,306.36
|
| Rate for Payer: UHC Medicaid |
$493.31
|
| Rate for Payer: UHCCP Medicaid |
$493.31
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$2,631.00
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$1,973.25 |
| Rate for Payer: Aetna Commercial |
$455.80
|
| Rate for Payer: Aetna Medicare |
$353.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.82
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$340.15
|
| Rate for Payer: BCN Commercial |
$761.59
|
| Rate for Payer: BCN Medicare Advantage |
$340.15
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cofinity Commercial |
$489.82
|
| Rate for Payer: Cofinity Commercial |
$455.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.15
|
| Rate for Payer: Healthscope Commercial |
$629.28
|
| Rate for Payer: Healthscope Commercial |
$544.24
|
| Rate for Payer: Mclaren Medicaid |
$214.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.16
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.00
|
| Rate for Payer: Nomi Health Commercial |
$408.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.25
|
| Rate for Payer: PACE SWMI |
$340.15
|
| Rate for Payer: PHP Medicare Advantage |
$340.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.29
|
| Rate for Payer: Priority Health Medicare |
$340.15
|
| Rate for Payer: Priority Health SBD |
$640.29
|
| Rate for Payer: Priority Health Tiered Network |
$640.29
|
| Rate for Payer: Railroad Medicare Medicare |
$340.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.29
|
| Rate for Payer: UHC Core |
$654.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.15
|
| Rate for Payer: UHC Exchange |
$654.29
|
| Rate for Payer: UHC Medicaid |
$214.07
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
|
|
PR BURR HOLE/TREPHINE STTL EXPL N/FLWD OTH SURG
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$563.17 |
| Max. Negotiated Rate |
$2,105.25 |
| Rate for Payer: Aetna Commercial |
$1,169.77
|
| Rate for Payer: Aetna Medicare |
$907.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,257.06
|
| Rate for Payer: BCBS Complete |
$591.33
|
| Rate for Payer: BCBS MAPPO |
$872.96
|
| Rate for Payer: BCN Commercial |
$1,333.59
|
| Rate for Payer: BCN Medicare Advantage |
$872.96
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,257.06
|
| Rate for Payer: Cofinity Commercial |
$1,169.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.96
|
| Rate for Payer: Healthscope Commercial |
$1,614.98
|
| Rate for Payer: Healthscope Commercial |
$1,396.74
|
| Rate for Payer: Mclaren Medicaid |
$563.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$916.61
|
| Rate for Payer: Meridian Medicaid |
$591.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$960.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,574.15
|
| Rate for Payer: Nomi Health Commercial |
$1,047.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$872.96
|
| Rate for Payer: PHP Medicare Advantage |
$872.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,548.94
|
| Rate for Payer: Priority Health Medicare |
$872.96
|
| Rate for Payer: Priority Health SBD |
$1,548.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,548.94
|
| Rate for Payer: Railroad Medicare Medicare |
$872.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,519.58
|
| Rate for Payer: UHC Core |
$1,519.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$872.96
|
| Rate for Payer: UHC Exchange |
$1,519.58
|
| Rate for Payer: UHC Medicaid |
$563.17
|
| Rate for Payer: UHCCP Medicaid |
$563.17
|
|
|
PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION
|
Professional
|
Both
|
$4,751.00
|
|
|
Service Code
|
HCPCS 61140
|
| Min. Negotiated Rate |
$808.55 |
| Max. Negotiated Rate |
$3,563.25 |
| Rate for Payer: Aetna Commercial |
$1,684.46
|
| Rate for Payer: Aetna Medicare |
$1,307.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,684.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,810.17
|
| Rate for Payer: BCBS Complete |
$848.98
|
| Rate for Payer: BCBS MAPPO |
$1,257.06
|
| Rate for Payer: BCN Commercial |
$2,689.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.06
|
| Rate for Payer: Cash Price |
$3,800.80
|
| Rate for Payer: Cash Price |
$3,800.80
|
| Rate for Payer: Cofinity Commercial |
$1,810.17
|
| Rate for Payer: Cofinity Commercial |
$1,684.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.06
|
| Rate for Payer: Healthscope Commercial |
$2,325.56
|
| Rate for Payer: Healthscope Commercial |
$2,011.30
|
| Rate for Payer: Mclaren Medicaid |
$808.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.91
|
| Rate for Payer: Meridian Medicaid |
$848.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,382.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,298.11
|
| Rate for Payer: Nomi Health Commercial |
$1,508.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,563.25
|
| Rate for Payer: PACE SWMI |
$1,257.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,261.53
|
| Rate for Payer: Priority Health Medicare |
$1,257.06
|
| Rate for Payer: Priority Health SBD |
$2,261.53
|
| Rate for Payer: Priority Health Tiered Network |
$2,261.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,224.89
|
| Rate for Payer: UHC Core |
$2,224.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,257.06
|
| Rate for Payer: UHC Exchange |
$2,224.89
|
| Rate for Payer: UHC Medicaid |
$808.55
|
| Rate for Payer: UHCCP Medicaid |
$808.55
|
|
|
PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST
|
Professional
|
Both
|
$4,245.00
|
|
|
Service Code
|
HCPCS 61150
|
| Min. Negotiated Rate |
$852.21 |
| Max. Negotiated Rate |
$3,183.75 |
| Rate for Payer: Aetna Commercial |
$1,781.73
|
| Rate for Payer: Aetna Medicare |
$1,382.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,914.70
|
| Rate for Payer: BCBS Complete |
$894.82
|
| Rate for Payer: BCBS MAPPO |
$1,329.65
|
| Rate for Payer: BCN Commercial |
$2,852.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,329.65
|
| Rate for Payer: Cash Price |
$3,396.00
|
| Rate for Payer: Cash Price |
$3,396.00
|
| Rate for Payer: Cofinity Commercial |
$1,914.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,329.65
|
| Rate for Payer: Healthscope Commercial |
$2,459.85
|
| Rate for Payer: Healthscope Commercial |
$2,127.44
|
| Rate for Payer: Mclaren Medicaid |
$852.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,396.13
|
| Rate for Payer: Meridian Medicaid |
$894.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,462.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,449.01
|
| Rate for Payer: Nomi Health Commercial |
$1,595.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,183.75
|
| Rate for Payer: PACE SWMI |
$1,329.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,329.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,398.04
|
| Rate for Payer: Priority Health Medicare |
$1,329.65
|
| Rate for Payer: Priority Health SBD |
$2,398.04
|
| Rate for Payer: Priority Health Tiered Network |
$2,398.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,329.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,379.10
|
| Rate for Payer: UHC Core |
$2,379.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,329.65
|
| Rate for Payer: UHC Exchange |
$2,379.10
|
| Rate for Payer: UHC Medicaid |
$852.21
|
| Rate for Payer: UHCCP Medicaid |
$852.21
|
|
|
PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL
|
Professional
|
Both
|
$3,796.00
|
|
|
Service Code
|
HCPCS 61156
|
| Min. Negotiated Rate |
$780.65 |
| Max. Negotiated Rate |
$2,847.00 |
| Rate for Payer: Aetna Commercial |
$1,632.71
|
| Rate for Payer: Aetna Medicare |
$1,267.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.55
|
| Rate for Payer: BCBS Complete |
$819.68
|
| Rate for Payer: BCBS MAPPO |
$1,218.44
|
| Rate for Payer: BCN Commercial |
$2,620.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.44
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cofinity Commercial |
$1,754.55
|
| Rate for Payer: Cofinity Commercial |
$1,632.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.44
|
| Rate for Payer: Healthscope Commercial |
$2,254.11
|
| Rate for Payer: Healthscope Commercial |
$1,949.50
|
| Rate for Payer: Mclaren Medicaid |
$780.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.36
|
| Rate for Payer: Meridian Medicaid |
$819.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,340.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,233.89
|
| Rate for Payer: Nomi Health Commercial |
$1,462.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.00
|
| Rate for Payer: PACE SWMI |
$1,218.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,203.11
|
| Rate for Payer: Priority Health Medicare |
$1,218.44
|
| Rate for Payer: Priority Health SBD |
$2,203.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,203.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,218.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,186.26
|
| Rate for Payer: UHC Core |
$2,186.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,218.44
|
| Rate for Payer: UHC Exchange |
$2,186.26
|
| Rate for Payer: UHC Medicaid |
$780.65
|
| Rate for Payer: UHCCP Medicaid |
$780.65
|
|
|
PR BURR HOLE W/EVAC&/DRG HEMATOMA EXTRADURAL/SDRL
|
Professional
|
Both
|
$4,314.00
|
|
|
Service Code
|
HCPCS 61154
|
| Min. Negotiated Rate |
$820.48 |
| Max. Negotiated Rate |
$3,235.50 |
| Rate for Payer: Aetna Commercial |
$1,706.42
|
| Rate for Payer: Aetna Medicare |
$1,324.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,706.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,833.77
|
| Rate for Payer: BCBS Complete |
$861.50
|
| Rate for Payer: BCBS MAPPO |
$1,273.45
|
| Rate for Payer: BCN Commercial |
$2,704.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,273.45
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,833.77
|
| Rate for Payer: Cofinity Commercial |
$1,706.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,273.45
|
| Rate for Payer: Healthscope Commercial |
$2,355.88
|
| Rate for Payer: Healthscope Commercial |
$2,037.52
|
| Rate for Payer: Mclaren Medicaid |
$820.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,337.12
|
| Rate for Payer: Meridian Medicaid |
$861.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,400.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.64
|
| Rate for Payer: Nomi Health Commercial |
$1,528.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,235.50
|
| Rate for Payer: PACE SWMI |
$1,273.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,273.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,273.67
|
| Rate for Payer: Priority Health Medicare |
$1,273.45
|
| Rate for Payer: Priority Health SBD |
$2,273.67
|
| Rate for Payer: Priority Health Tiered Network |
$2,273.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,273.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,231.60
|
| Rate for Payer: UHC Core |
$2,231.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,273.45
|
| Rate for Payer: UHC Exchange |
$2,231.60
|
| Rate for Payer: UHC Medicaid |
$820.48
|
| Rate for Payer: UHCCP Medicaid |
$820.48
|
|
|
PR BUTORPHANOL TARTRATE 1 MG
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0595
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$11.38 |
| Rate for Payer: Aetna Commercial |
$8.24
|
| Rate for Payer: Aetna Medicare |
$6.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.86
|
| Rate for Payer: BCBS MAPPO |
$6.15
|
| Rate for Payer: BCBS Trust/PPO |
$3.57
|
| Rate for Payer: BCN Commercial |
$3.02
|
| Rate for Payer: BCN Medicare Advantage |
$6.15
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$8.86
|
| Rate for Payer: Cofinity Commercial |
$8.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.15
|
| Rate for Payer: Healthscope Commercial |
$9.84
|
| Rate for Payer: Healthscope Commercial |
$11.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.54
|
| Rate for Payer: Nomi Health Commercial |
$7.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: PACE SWMI |
$6.15
|
| Rate for Payer: PHP Medicare Advantage |
$6.15
|
| Rate for Payer: Priority Health Medicare |
$6.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.54
|
| Rate for Payer: UHC Core |
$5.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.15
|
| Rate for Payer: UHC Exchange |
$5.54
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$95.35
|
| Rate for Payer: Aetna Medicare |
$74.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.35
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$71.16
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$71.16
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$95.35
|
| Rate for Payer: Cofinity Commercial |
$102.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.16
|
| Rate for Payer: Healthscope Commercial |
$131.65
|
| Rate for Payer: Healthscope Commercial |
$113.86
|
| Rate for Payer: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.72
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.35
|
| Rate for Payer: Nomi Health Commercial |
$85.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.50
|
| Rate for Payer: PACE SWMI |
$71.16
|
| Rate for Payer: PHP Medicare Advantage |
$71.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$148.06
|
| Rate for Payer: Priority Health Medicare |
$71.16
|
| Rate for Payer: Priority Health SBD |
$148.06
|
| Rate for Payer: Priority Health Tiered Network |
$148.06
|
| Rate for Payer: Railroad Medicare Medicare |
$71.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.54
|
| Rate for Payer: UHC Core |
$149.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.16
|
| Rate for Payer: UHC Exchange |
$149.54
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$392.70
|
| Rate for Payer: Aetna Medicare |
$304.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.01
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$460.13
|
| Rate for Payer: BCN Medicare Advantage |
$293.06
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$422.01
|
| Rate for Payer: Cofinity Commercial |
$392.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.06
|
| Rate for Payer: Healthscope Commercial |
$542.16
|
| Rate for Payer: Healthscope Commercial |
$468.90
|
| Rate for Payer: Mclaren Medicaid |
$192.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.71
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$533.93
|
| Rate for Payer: Nomi Health Commercial |
$351.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: PACE SWMI |
$293.06
|
| Rate for Payer: PHP Medicare Advantage |
$293.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$560.64
|
| Rate for Payer: Priority Health Medicare |
$293.06
|
| Rate for Payer: Priority Health SBD |
$560.64
|
| Rate for Payer: Priority Health Tiered Network |
$560.64
|
| Rate for Payer: Railroad Medicare Medicare |
$293.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.44
|
| Rate for Payer: UHC Core |
$522.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.06
|
| Rate for Payer: UHC Exchange |
$522.44
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 19100
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$83.32
|
| Rate for Payer: Aetna Medicare |
$64.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.54
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS MAPPO |
$62.18
|
| Rate for Payer: BCN Commercial |
$102.08
|
| Rate for Payer: BCN Medicare Advantage |
$62.18
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Cofinity Commercial |
$83.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.18
|
| Rate for Payer: Healthscope Commercial |
$99.49
|
| Rate for Payer: Healthscope Commercial |
$115.03
|
| Rate for Payer: Mclaren Medicaid |
$39.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.29
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.82
|
| Rate for Payer: Nomi Health Commercial |
$74.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.00
|
| Rate for Payer: PACE SWMI |
$62.18
|
| Rate for Payer: PHP Medicare Advantage |
$62.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.43
|
| Rate for Payer: Priority Health Medicare |
$62.18
|
| Rate for Payer: Priority Health SBD |
$93.43
|
| Rate for Payer: Priority Health Tiered Network |
$93.43
|
| Rate for Payer: Railroad Medicare Medicare |
$62.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.58
|
| Rate for Payer: UHC Core |
$125.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.18
|
| Rate for Payer: UHC Exchange |
$125.58
|
| Rate for Payer: UHC Medicaid |
$39.41
|
| Rate for Payer: UHCCP Medicaid |
$39.41
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$597.00 |
| Rate for Payer: Aetna Commercial |
$185.05
|
| Rate for Payer: Aetna Medicare |
$143.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.86
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$138.10
|
| Rate for Payer: BCN Commercial |
$240.02
|
| Rate for Payer: BCN Medicare Advantage |
$138.10
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$198.86
|
| Rate for Payer: Cofinity Commercial |
$185.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.10
|
| Rate for Payer: Healthscope Commercial |
$255.49
|
| Rate for Payer: Healthscope Commercial |
$220.96
|
| Rate for Payer: Mclaren Medicaid |
$88.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.00
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.12
|
| Rate for Payer: Nomi Health Commercial |
$165.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$597.00
|
| Rate for Payer: PACE SWMI |
$138.10
|
| Rate for Payer: PHP Medicare Advantage |
$138.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$219.69
|
| Rate for Payer: Priority Health Medicare |
$138.10
|
| Rate for Payer: Priority Health SBD |
$219.69
|
| Rate for Payer: Priority Health Tiered Network |
$219.69
|
| Rate for Payer: Railroad Medicare Medicare |
$138.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.20
|
| Rate for Payer: UHC Core |
$296.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.10
|
| Rate for Payer: UHC Exchange |
$296.20
|
| Rate for Payer: UHC Medicaid |
$88.18
|
| Rate for Payer: UHCCP Medicaid |
$88.18
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$340.50 |
| Rate for Payer: Aetna Commercial |
$174.82
|
| Rate for Payer: Aetna Medicare |
$135.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.86
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$130.46
|
| Rate for Payer: BCN Commercial |
$225.59
|
| Rate for Payer: BCN Medicare Advantage |
$130.46
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$187.86
|
| Rate for Payer: Cofinity Commercial |
$174.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.46
|
| Rate for Payer: Healthscope Commercial |
$241.35
|
| Rate for Payer: Healthscope Commercial |
$208.74
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.98
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.67
|
| Rate for Payer: Nomi Health Commercial |
$156.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$340.50
|
| Rate for Payer: PACE SWMI |
$130.46
|
| Rate for Payer: PHP Medicare Advantage |
$130.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$206.47
|
| Rate for Payer: Priority Health Medicare |
$130.46
|
| Rate for Payer: Priority Health SBD |
$206.47
|
| Rate for Payer: Priority Health Tiered Network |
$206.47
|
| Rate for Payer: Railroad Medicare Medicare |
$130.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.24
|
| Rate for Payer: UHC Core |
$280.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.46
|
| Rate for Payer: UHC Exchange |
$280.24
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$612.75 |
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: Aetna Medicare |
$67.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.61
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$65.01
|
| Rate for Payer: BCN Commercial |
$113.54
|
| Rate for Payer: BCN Medicare Advantage |
$65.01
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$93.61
|
| Rate for Payer: Cofinity Commercial |
$87.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.01
|
| Rate for Payer: Healthscope Commercial |
$120.27
|
| Rate for Payer: Healthscope Commercial |
$104.02
|
| Rate for Payer: Mclaren Medicaid |
$41.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.26
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.38
|
| Rate for Payer: Nomi Health Commercial |
$78.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.75
|
| Rate for Payer: PACE SWMI |
$65.01
|
| Rate for Payer: PHP Medicare Advantage |
$65.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.92
|
| Rate for Payer: Priority Health Medicare |
$65.01
|
| Rate for Payer: Priority Health SBD |
$103.92
|
| Rate for Payer: Priority Health Tiered Network |
$103.92
|
| Rate for Payer: Railroad Medicare Medicare |
$65.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.24
|
| Rate for Payer: UHC Core |
$138.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.01
|
| Rate for Payer: UHC Exchange |
$138.24
|
| Rate for Payer: UHC Medicaid |
$41.54
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$99.21
|
| Rate for Payer: Aetna Medicare |
$77.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.21
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$74.04
|
| Rate for Payer: BCN Commercial |
$126.98
|
| Rate for Payer: BCN Medicare Advantage |
$74.04
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.04
|
| Rate for Payer: Healthscope Commercial |
$136.97
|
| Rate for Payer: Healthscope Commercial |
$118.46
|
| Rate for Payer: Mclaren Medicaid |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.74
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.49
|
| Rate for Payer: Nomi Health Commercial |
$88.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$74.04
|
| Rate for Payer: PHP Medicare Advantage |
$74.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$168.96
|
| Rate for Payer: Priority Health Medicare |
$74.04
|
| Rate for Payer: Priority Health SBD |
$168.96
|
| Rate for Payer: Priority Health Tiered Network |
$168.96
|
| Rate for Payer: Railroad Medicare Medicare |
$74.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.72
|
| Rate for Payer: UHC Core |
$122.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.04
|
| Rate for Payer: UHC Exchange |
$122.72
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$274.56 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$566.71
|
| Rate for Payer: Aetna Medicare |
$439.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.00
|
| Rate for Payer: BCBS Complete |
$288.29
|
| Rate for Payer: BCBS MAPPO |
$422.92
|
| Rate for Payer: BCN Commercial |
$668.79
|
| Rate for Payer: BCN Medicare Advantage |
$422.92
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$609.00
|
| Rate for Payer: Cofinity Commercial |
$566.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.92
|
| Rate for Payer: Healthscope Commercial |
$782.40
|
| Rate for Payer: Healthscope Commercial |
$676.67
|
| Rate for Payer: Mclaren Medicaid |
$274.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.07
|
| Rate for Payer: Meridian Medicaid |
$288.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$465.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.32
|
| Rate for Payer: Nomi Health Commercial |
$507.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$422.92
|
| Rate for Payer: PHP Medicare Advantage |
$422.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$889.87
|
| Rate for Payer: Priority Health Medicare |
$422.92
|
| Rate for Payer: Priority Health SBD |
$889.87
|
| Rate for Payer: Priority Health Tiered Network |
$889.87
|
| Rate for Payer: Railroad Medicare Medicare |
$422.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.06
|
| Rate for Payer: UHC Core |
$772.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.92
|
| Rate for Payer: UHC Exchange |
$772.06
|
| Rate for Payer: UHC Medicaid |
$274.56
|
| Rate for Payer: UHCCP Medicaid |
$274.56
|
|
