|
PR CHEMICAL CAUTERIZATION OF GRANULATION TISSUE
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 17250
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$111.75 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$35.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.32
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$34.25
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.25
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$49.32
|
| Rate for Payer: Cofinity Commercial |
$45.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.25
|
| Rate for Payer: Healthscope Commercial |
$54.80
|
| Rate for Payer: Healthscope Commercial |
$63.36
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.96
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.20
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$34.25
|
| Rate for Payer: PHP Medicare Advantage |
$34.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.50
|
| Rate for Payer: Priority Health Medicare |
$34.25
|
| Rate for Payer: Priority Health SBD |
$51.50
|
| Rate for Payer: Priority Health Tiered Network |
$51.50
|
| Rate for Payer: Railroad Medicare Medicare |
$34.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.62
|
| Rate for Payer: UHC Core |
$64.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.25
|
| Rate for Payer: UHC Exchange |
$64.62
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR CHEMICAL PEEL FACIAL EPIDERMAL
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 15788
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$249.53
|
| Rate for Payer: Aetna Medicare |
$193.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.16
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$186.22
|
| Rate for Payer: BCN Commercial |
$258.79
|
| Rate for Payer: BCN Medicare Advantage |
$186.22
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$268.16
|
| Rate for Payer: Cofinity Commercial |
$249.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.22
|
| Rate for Payer: Healthscope Commercial |
$344.51
|
| Rate for Payer: Healthscope Commercial |
$297.95
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.53
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.16
|
| Rate for Payer: Nomi Health Commercial |
$223.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.50
|
| Rate for Payer: PACE SWMI |
$186.22
|
| Rate for Payer: PHP Medicare Advantage |
$186.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$300.36
|
| Rate for Payer: Priority Health Medicare |
$186.22
|
| Rate for Payer: Priority Health SBD |
$300.36
|
| Rate for Payer: Priority Health Tiered Network |
$300.36
|
| Rate for Payer: Railroad Medicare Medicare |
$186.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$388.92
|
| Rate for Payer: UHC Core |
$388.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.22
|
| Rate for Payer: UHC Exchange |
$388.92
|
| Rate for Payer: UHC Medicaid |
$124.82
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 64644
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$137.43
|
| Rate for Payer: Aetna Medicare |
$106.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.69
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$102.56
|
| Rate for Payer: BCN Commercial |
$174.29
|
| Rate for Payer: BCN Medicare Advantage |
$102.56
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$147.69
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.56
|
| Rate for Payer: Healthscope Commercial |
$189.74
|
| Rate for Payer: Healthscope Commercial |
$164.10
|
| Rate for Payer: Mclaren Medicaid |
$66.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.69
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.72
|
| Rate for Payer: Nomi Health Commercial |
$123.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$102.56
|
| Rate for Payer: PHP Medicare Advantage |
$102.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.43
|
| Rate for Payer: Priority Health Medicare |
$102.56
|
| Rate for Payer: Priority Health SBD |
$202.43
|
| Rate for Payer: Priority Health Tiered Network |
$202.43
|
| Rate for Payer: Railroad Medicare Medicare |
$102.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.30
|
| Rate for Payer: UHC Core |
$205.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$102.56
|
| Rate for Payer: UHC Exchange |
$205.30
|
| Rate for Payer: UHC Medicaid |
$66.03
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 64643
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$80.00
|
| Rate for Payer: Aetna Medicare |
$62.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.97
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.70
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.70
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.70
|
| Rate for Payer: Healthscope Commercial |
$95.52
|
| Rate for Payer: Healthscope Commercial |
$110.44
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.69
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.28
|
| Rate for Payer: Nomi Health Commercial |
$71.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$59.70
|
| Rate for Payer: PHP Medicare Advantage |
$59.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.30
|
| Rate for Payer: Priority Health Medicare |
$59.70
|
| Rate for Payer: Priority Health SBD |
$120.30
|
| Rate for Payer: Priority Health Tiered Network |
$120.30
|
| Rate for Payer: Railroad Medicare Medicare |
$59.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.03
|
| Rate for Payer: UHC Core |
$126.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.70
|
| Rate for Payer: UHC Exchange |
$126.03
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64645
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$94.81
|
| Rate for Payer: Aetna Medicare |
$73.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.81
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$70.75
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$70.75
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$94.81
|
| Rate for Payer: Cofinity Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.75
|
| Rate for Payer: Healthscope Commercial |
$130.89
|
| Rate for Payer: Healthscope Commercial |
$113.20
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.29
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.00
|
| Rate for Payer: Nomi Health Commercial |
$84.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$70.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.14
|
| Rate for Payer: Priority Health Medicare |
$70.75
|
| Rate for Payer: Priority Health SBD |
$141.14
|
| Rate for Payer: Priority Health Tiered Network |
$141.14
|
| Rate for Payer: Railroad Medicare Medicare |
$70.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.06
|
| Rate for Payer: UHC Core |
$145.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.75
|
| Rate for Payer: UHC Exchange |
$145.06
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 64614
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Aetna Medicare |
$241.50
|
| Rate for Payer: BCBS Complete |
$193.20
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
|
|
PR CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 46505
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna Medicare |
$247.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.76
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$238.03
|
| Rate for Payer: BCN Commercial |
$375.48
|
| Rate for Payer: BCN Medicare Advantage |
$238.03
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$342.76
|
| Rate for Payer: Cofinity Commercial |
$318.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.03
|
| Rate for Payer: Healthscope Commercial |
$380.85
|
| Rate for Payer: Healthscope Commercial |
$440.36
|
| Rate for Payer: Mclaren Medicaid |
$157.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.93
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$441.23
|
| Rate for Payer: Nomi Health Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$238.03
|
| Rate for Payer: PHP Medicare Advantage |
$238.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$457.49
|
| Rate for Payer: Priority Health Medicare |
$238.03
|
| Rate for Payer: Priority Health SBD |
$457.49
|
| Rate for Payer: Priority Health Tiered Network |
$457.49
|
| Rate for Payer: Railroad Medicare Medicare |
$238.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.98
|
| Rate for Payer: UHC Core |
$421.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.03
|
| Rate for Payer: UHC Exchange |
$421.98
|
| Rate for Payer: UHC Medicaid |
$157.19
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
|
PR CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 64617
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$122.09
|
| Rate for Payer: Aetna Medicare |
$94.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.20
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$91.11
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$91.11
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$122.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.11
|
| Rate for Payer: Healthscope Commercial |
$168.55
|
| Rate for Payer: Healthscope Commercial |
$145.78
|
| Rate for Payer: Mclaren Medicaid |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.67
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.51
|
| Rate for Payer: Nomi Health Commercial |
$109.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$91.11
|
| Rate for Payer: PHP Medicare Advantage |
$91.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.56
|
| Rate for Payer: Priority Health Medicare |
$91.11
|
| Rate for Payer: Priority Health SBD |
$188.56
|
| Rate for Payer: Priority Health Tiered Network |
$188.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.42
|
| Rate for Payer: UHC Core |
$191.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.11
|
| Rate for Payer: UHC Exchange |
$191.42
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 64616
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$132.41
|
| Rate for Payer: Aetna Medicare |
$102.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.29
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.81
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$98.81
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$142.29
|
| Rate for Payer: Cofinity Commercial |
$132.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.81
|
| Rate for Payer: Healthscope Commercial |
$182.80
|
| Rate for Payer: Healthscope Commercial |
$158.10
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.75
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.04
|
| Rate for Payer: Nomi Health Commercial |
$118.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.00
|
| Rate for Payer: PACE SWMI |
$98.81
|
| Rate for Payer: PHP Medicare Advantage |
$98.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.60
|
| Rate for Payer: Priority Health Medicare |
$98.81
|
| Rate for Payer: Priority Health SBD |
$192.60
|
| Rate for Payer: Priority Health Tiered Network |
$192.60
|
| Rate for Payer: Railroad Medicare Medicare |
$98.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.12
|
| Rate for Payer: UHC Core |
$191.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.81
|
| Rate for Payer: UHC Exchange |
$191.12
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 64646
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: Aetna Medicare |
$107.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.92
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$103.42
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: BCN Medicare Advantage |
$103.42
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$148.92
|
| Rate for Payer: Cofinity Commercial |
$138.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.42
|
| Rate for Payer: Healthscope Commercial |
$191.33
|
| Rate for Payer: Healthscope Commercial |
$165.47
|
| Rate for Payer: Mclaren Medicaid |
$66.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.59
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.41
|
| Rate for Payer: Nomi Health Commercial |
$124.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.50
|
| Rate for Payer: PACE SWMI |
$103.42
|
| Rate for Payer: PHP Medicare Advantage |
$103.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.60
|
| Rate for Payer: Priority Health Medicare |
$103.42
|
| Rate for Payer: Priority Health SBD |
$203.60
|
| Rate for Payer: Priority Health Tiered Network |
$203.60
|
| Rate for Payer: Railroad Medicare Medicare |
$103.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.54
|
| Rate for Payer: UHC Core |
$202.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.42
|
| Rate for Payer: UHC Exchange |
$202.54
|
| Rate for Payer: UHC Medicaid |
$66.24
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
PR CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 64642
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna Medicare |
$99.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.26
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$95.32
|
| Rate for Payer: BCN Commercial |
$160.85
|
| Rate for Payer: BCN Medicare Advantage |
$95.32
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$137.26
|
| Rate for Payer: Cofinity Commercial |
$127.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.32
|
| Rate for Payer: Healthscope Commercial |
$176.34
|
| Rate for Payer: Healthscope Commercial |
$152.51
|
| Rate for Payer: Mclaren Medicaid |
$61.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.09
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$114.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$95.32
|
| Rate for Payer: PHP Medicare Advantage |
$95.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.82
|
| Rate for Payer: Priority Health Medicare |
$95.32
|
| Rate for Payer: Priority Health SBD |
$186.82
|
| Rate for Payer: Priority Health Tiered Network |
$186.82
|
| Rate for Payer: Railroad Medicare Medicare |
$95.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.20
|
| Rate for Payer: UHC Core |
$188.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.32
|
| Rate for Payer: UHC Exchange |
$188.20
|
| Rate for Payer: UHC Medicaid |
$61.34
|
| Rate for Payer: UHCCP Medicaid |
$61.34
|
|
|
PR CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 64611
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$198.39 |
| Rate for Payer: Aetna Commercial |
$140.06
|
| Rate for Payer: Aetna Medicare |
$108.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.51
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.52
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$104.52
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$150.51
|
| Rate for Payer: Cofinity Commercial |
$140.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.52
|
| Rate for Payer: Healthscope Commercial |
$193.36
|
| Rate for Payer: Healthscope Commercial |
$167.23
|
| Rate for Payer: Mclaren Medicaid |
$69.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.75
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.45
|
| Rate for Payer: Nomi Health Commercial |
$125.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.00
|
| Rate for Payer: PACE SWMI |
$104.52
|
| Rate for Payer: PHP Medicare Advantage |
$104.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.39
|
| Rate for Payer: Priority Health Medicare |
$104.52
|
| Rate for Payer: Priority Health SBD |
$198.39
|
| Rate for Payer: Priority Health Tiered Network |
$198.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.87
|
| Rate for Payer: UHC Core |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.52
|
| Rate for Payer: UHC Exchange |
$180.87
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 64615
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$323.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$113.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.56
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$109.42
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$109.42
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$157.56
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.42
|
| Rate for Payer: Healthscope Commercial |
$202.43
|
| Rate for Payer: Healthscope Commercial |
$175.07
|
| Rate for Payer: Mclaren Medicaid |
$69.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.89
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.25
|
| Rate for Payer: PACE SWMI |
$109.42
|
| Rate for Payer: PHP Medicare Advantage |
$109.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.59
|
| Rate for Payer: Priority Health Medicare |
$109.42
|
| Rate for Payer: Priority Health SBD |
$214.59
|
| Rate for Payer: Priority Health Tiered Network |
$214.59
|
| Rate for Payer: Railroad Medicare Medicare |
$109.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.91
|
| Rate for Payer: UHC Core |
$216.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.42
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
|
|
PR CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 64612
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$251.25 |
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Medicare |
$109.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.03
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$141.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.88
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.88
|
| Rate for Payer: Healthscope Commercial |
$194.03
|
| Rate for Payer: Healthscope Commercial |
$167.81
|
| Rate for Payer: Mclaren Medicaid |
$69.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.29
|
| Rate for Payer: Nomi Health Commercial |
$125.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.25
|
| Rate for Payer: PACE SWMI |
$104.88
|
| Rate for Payer: PHP Medicare Advantage |
$104.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.23
|
| Rate for Payer: Priority Health Medicare |
$104.88
|
| Rate for Payer: Priority Health SBD |
$208.23
|
| Rate for Payer: Priority Health Tiered Network |
$208.23
|
| Rate for Payer: Railroad Medicare Medicare |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.44
|
| Rate for Payer: UHC Core |
$201.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.88
|
| Rate for Payer: UHC Exchange |
$201.44
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR CHEMOTHERAPY ADMN IV INFUSION TQ EA HR
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 96415
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$27.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.67
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$42.59
|
| Rate for Payer: Healthscope Commercial |
$49.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.93
|
| Rate for Payer: Nomi Health Commercial |
$31.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.27
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health SBD |
$36.27
|
| Rate for Payer: Priority Health Tiered Network |
$36.27
|
| Rate for Payer: Railroad Medicare Medicare |
$26.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.71
|
| Rate for Payer: UHC Core |
$28.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.62
|
| Rate for Payer: UHC Exchange |
$28.71
|
|
|
PR CHEMOTX ADMN CNS REQ SPINAL PUNCTURE
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 96450
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$88.63
|
| Rate for Payer: Aetna Medicare |
$68.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.24
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$66.14
|
| Rate for Payer: BCN Commercial |
$114.04
|
| Rate for Payer: BCN Medicare Advantage |
$66.14
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$95.24
|
| Rate for Payer: Cofinity Commercial |
$88.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.14
|
| Rate for Payer: Healthscope Commercial |
$122.36
|
| Rate for Payer: Healthscope Commercial |
$105.82
|
| Rate for Payer: Mclaren Medicaid |
$42.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.45
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.21
|
| Rate for Payer: Nomi Health Commercial |
$79.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$66.14
|
| Rate for Payer: PHP Medicare Advantage |
$66.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105.16
|
| Rate for Payer: Priority Health Medicare |
$66.14
|
| Rate for Payer: Priority Health SBD |
$105.16
|
| Rate for Payer: Priority Health Tiered Network |
$105.16
|
| Rate for Payer: Railroad Medicare Medicare |
$66.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.69
|
| Rate for Payer: UHC Core |
$79.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.14
|
| Rate for Payer: UHC Exchange |
$79.69
|
| Rate for Payer: UHC Medicaid |
$42.39
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
|
|
PR CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96417
|
| Min. Negotiated Rate |
$61.51 |
| Max. Negotiated Rate |
$113.79 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare |
$63.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.42
|
| Rate for Payer: BCBS MAPPO |
$61.51
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$61.51
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$88.57
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.51
|
| Rate for Payer: Healthscope Commercial |
$98.42
|
| Rate for Payer: Healthscope Commercial |
$113.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$73.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$61.51
|
| Rate for Payer: PHP Medicare Advantage |
$61.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.58
|
| Rate for Payer: Priority Health Medicare |
$61.51
|
| Rate for Payer: Priority Health SBD |
$83.58
|
| Rate for Payer: Priority Health Tiered Network |
$83.58
|
| Rate for Payer: Railroad Medicare Medicare |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.20
|
| Rate for Payer: UHC Core |
$64.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.51
|
| Rate for Payer: UHC Exchange |
$64.20
|
|
|
PR CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 96413
|
| Min. Negotiated Rate |
$122.99 |
| Max. Negotiated Rate |
$227.53 |
| Rate for Payer: Aetna Commercial |
$164.81
|
| Rate for Payer: Aetna Medicare |
$127.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.11
|
| Rate for Payer: BCBS MAPPO |
$122.99
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$122.99
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$177.11
|
| Rate for Payer: Cofinity Commercial |
$164.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.99
|
| Rate for Payer: Healthscope Commercial |
$227.53
|
| Rate for Payer: Healthscope Commercial |
$196.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.45
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.25
|
| Rate for Payer: PACE SWMI |
$122.99
|
| Rate for Payer: PHP Medicare Advantage |
$122.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.46
|
| Rate for Payer: Priority Health Medicare |
$122.99
|
| Rate for Payer: Priority Health SBD |
$169.46
|
| Rate for Payer: Priority Health Tiered Network |
$169.46
|
| Rate for Payer: Railroad Medicare Medicare |
$122.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.57
|
| Rate for Payer: UHC Core |
$131.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.99
|
| Rate for Payer: UHC Exchange |
$131.57
|
|
|
PR CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 96409
|
| Min. Negotiated Rate |
$96.58 |
| Max. Negotiated Rate |
$178.67 |
| Rate for Payer: Aetna Commercial |
$129.42
|
| Rate for Payer: Aetna Medicare |
$100.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.42
|
| Rate for Payer: BCBS MAPPO |
$96.58
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$96.58
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$139.08
|
| Rate for Payer: Cofinity Commercial |
$129.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.58
|
| Rate for Payer: Healthscope Commercial |
$178.67
|
| Rate for Payer: Healthscope Commercial |
$154.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.97
|
| Rate for Payer: Nomi Health Commercial |
$115.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$96.58
|
| Rate for Payer: PHP Medicare Advantage |
$96.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$96.58
|
| Rate for Payer: Priority Health SBD |
$131.34
|
| Rate for Payer: Priority Health Tiered Network |
$131.34
|
| Rate for Payer: Railroad Medicare Medicare |
$96.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Core |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.58
|
| Rate for Payer: UHC Exchange |
$101.70
|
|
|
PR CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 96411
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$97.94 |
| Rate for Payer: Aetna Commercial |
$70.94
|
| Rate for Payer: Aetna Medicare |
$55.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.23
|
| Rate for Payer: BCBS MAPPO |
$52.94
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.94
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$76.23
|
| Rate for Payer: Cofinity Commercial |
$70.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.94
|
| Rate for Payer: Healthscope Commercial |
$97.94
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.64
|
| Rate for Payer: Nomi Health Commercial |
$63.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$52.94
|
| Rate for Payer: PHP Medicare Advantage |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.10
|
| Rate for Payer: Priority Health Medicare |
$52.94
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: Priority Health Tiered Network |
$72.10
|
| Rate for Payer: Railroad Medicare Medicare |
$52.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.58
|
| Rate for Payer: UHC Core |
$55.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.94
|
| Rate for Payer: UHC Exchange |
$55.58
|
|
|
PR CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 96402
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$66.73 |
| Rate for Payer: Aetna Commercial |
$48.33
|
| Rate for Payer: Aetna Medicare |
$37.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$36.07
|
| Rate for Payer: BCN Commercial |
$53.78
|
| Rate for Payer: BCN Medicare Advantage |
$36.07
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.07
|
| Rate for Payer: Healthscope Commercial |
$66.73
|
| Rate for Payer: Healthscope Commercial |
$57.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.79
|
| Rate for Payer: Nomi Health Commercial |
$43.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
| Rate for Payer: PACE SWMI |
$36.07
|
| Rate for Payer: PHP Medicare Advantage |
$36.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$36.07
|
| Rate for Payer: Priority Health SBD |
$49.59
|
| Rate for Payer: Priority Health Tiered Network |
$49.59
|
| Rate for Payer: Railroad Medicare Medicare |
$36.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.03
|
| Rate for Payer: UHC Core |
$30.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.07
|
| Rate for Payer: UHC Exchange |
$30.03
|
|
|
PR CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 96401
|
| Min. Negotiated Rate |
$66.46 |
| Max. Negotiated Rate |
$122.95 |
| Rate for Payer: Aetna Commercial |
$89.06
|
| Rate for Payer: Aetna Medicare |
$69.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.70
|
| Rate for Payer: BCBS MAPPO |
$66.46
|
| Rate for Payer: BCN Commercial |
$102.08
|
| Rate for Payer: BCN Medicare Advantage |
$66.46
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$95.70
|
| Rate for Payer: Cofinity Commercial |
$89.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.46
|
| Rate for Payer: Healthscope Commercial |
$122.95
|
| Rate for Payer: Healthscope Commercial |
$106.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.78
|
| Rate for Payer: Nomi Health Commercial |
$79.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$66.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.14
|
| Rate for Payer: Priority Health Medicare |
$66.46
|
| Rate for Payer: Priority Health SBD |
$94.14
|
| Rate for Payer: Priority Health Tiered Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$66.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.10
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.46
|
| Rate for Payer: UHC Exchange |
$74.10
|
|
|
PR CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 96542
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Aetna Commercial |
$47.22
|
| Rate for Payer: Aetna Medicare |
$36.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.75
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$35.24
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.24
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$50.75
|
| Rate for Payer: Cofinity Commercial |
$47.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.24
|
| Rate for Payer: Healthscope Commercial |
$65.19
|
| Rate for Payer: Healthscope Commercial |
$56.38
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.00
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.32
|
| Rate for Payer: Nomi Health Commercial |
$42.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.75
|
| Rate for Payer: PACE SWMI |
$35.24
|
| Rate for Payer: PHP Medicare Advantage |
$35.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.49
|
| Rate for Payer: Priority Health Medicare |
$35.24
|
| Rate for Payer: Priority Health SBD |
$56.49
|
| Rate for Payer: Priority Health Tiered Network |
$56.49
|
| Rate for Payer: Railroad Medicare Medicare |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.50
|
| Rate for Payer: UHC Core |
$42.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.24
|
| Rate for Payer: UHC Exchange |
$42.50
|
| Rate for Payer: UHC Medicaid |
$22.79
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 98941
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$51.23 |
| Rate for Payer: Aetna Commercial |
$37.10
|
| Rate for Payer: Aetna Medicare |
$28.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.87
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$27.69
|
| Rate for Payer: BCN Commercial |
$33.72
|
| Rate for Payer: BCN Medicare Advantage |
$27.69
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$39.87
|
| Rate for Payer: Cofinity Commercial |
$37.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.69
|
| Rate for Payer: Healthscope Commercial |
$51.23
|
| Rate for Payer: Healthscope Commercial |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$33.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$27.69
|
| Rate for Payer: PHP Medicare Advantage |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46.38
|
| Rate for Payer: Priority Health Medicare |
$27.69
|
| Rate for Payer: Priority Health SBD |
$46.38
|
| Rate for Payer: Priority Health Tiered Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.11
|
| Rate for Payer: UHC Core |
$31.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.69
|
| Rate for Payer: UHC Exchange |
$31.11
|
|
|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$135.69 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$72.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.78
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.29
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$69.29
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$99.78
|
| Rate for Payer: Cofinity Commercial |
$92.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.29
|
| Rate for Payer: Healthscope Commercial |
$128.19
|
| Rate for Payer: Healthscope Commercial |
$110.86
|
| Rate for Payer: Mclaren Medicaid |
$45.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.75
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$83.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$69.29
|
| Rate for Payer: PHP Medicare Advantage |
$69.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.47
|
| Rate for Payer: Priority Health Medicare |
$69.29
|
| Rate for Payer: Priority Health SBD |
$127.47
|
| Rate for Payer: Priority Health Tiered Network |
$127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$69.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.69
|
| Rate for Payer: UHC Core |
$135.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.29
|
| Rate for Payer: UHC Exchange |
$135.69
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
