|
PR CAST SUP SHOULDER CAST FBRGL
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS Q4004
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$14,467.00 |
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCN Commercial |
$119.78
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,467.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
|
|
PR CAST SUP SHRT LEG FIBERGLASS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS Q4038
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$4,897.00 |
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCN Commercial |
$40.55
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,897.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR CAST SUP SHRT LEG PED FBRGLS
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q4040
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$2,448.00 |
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCN Commercial |
$20.27
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,448.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
|
|
PR CAST SUP SHT ARM ADULT FBRGL
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS Q4010
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$2,314.00 |
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCN Commercial |
$19.16
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,314.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
|
|
PR CAST SUP SHT ARM PED FBRGLAS
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS Q4012
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$1,160.00 |
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCN Commercial |
$9.60
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,160.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
|
|
PR CAST SUP SHT ARM SPLINT FBRG
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS Q4022
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$1,446.00 |
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCN Commercial |
$11.97
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,446.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
|
|
PR CAST SUP SHT ARM SPLNT PED F
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS Q4024
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$724.00 |
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCN Commercial |
$5.99
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
|
|
PR CAST SUP SHT LEG SPLNT FBRGL
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS Q4046
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$2,219.00 |
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCN Commercial |
$18.37
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,219.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
PR CAST SUP SHT LEG SPLNT PED F
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS Q4048
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$1,111.00 |
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCN Commercial |
$9.20
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,111.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
|
|
PR CAST SUP SHT LEG SPLNT PED P
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS Q4047
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$687.00 |
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCN Commercial |
$5.69
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
|
|
PR CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 36660
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$12,029.00 |
| Rate for Payer: Aetna Commercial |
$85.91
|
| Rate for Payer: Aetna Medicare |
$66.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.32
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$64.11
|
| Rate for Payer: BCBS Trust/PPO |
$738.56
|
| Rate for Payer: BCN Commercial |
$98.23
|
| Rate for Payer: BCN Medicare Advantage |
$64.11
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$92.32
|
| Rate for Payer: Cofinity Commercial |
$85.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.11
|
| Rate for Payer: Healthscope Commercial |
$118.60
|
| Rate for Payer: Healthscope Commercial |
$102.58
|
| Rate for Payer: Mclaren Medicaid |
$42.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.32
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,029.00
|
| Rate for Payer: Nomi Health Commercial |
$76.93
|
| Rate for Payer: PACE SWMI |
$64.11
|
| Rate for Payer: PHP Medicare Advantage |
$64.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.90
|
| Rate for Payer: Priority Health Medicare |
$64.11
|
| Rate for Payer: Priority Health Narrow Network |
$106.90
|
| Rate for Payer: Priority Health SBD |
$106.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.11
|
| Rate for Payer: UHC Exchange |
$82.23
|
| Rate for Payer: UHC Medicare Advantage |
$64.11
|
| Rate for Payer: UHCCP Medicaid |
$42.81
|
|
|
PR CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 31717
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$18,614.00 |
| Rate for Payer: Aetna Commercial |
$132.79
|
| Rate for Payer: Aetna Medicare |
$103.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.70
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$99.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.81
|
| Rate for Payer: BCN Commercial |
$420.26
|
| Rate for Payer: BCN Medicare Advantage |
$99.10
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cofinity Commercial |
$142.70
|
| Rate for Payer: Cofinity Commercial |
$132.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.10
|
| Rate for Payer: Healthscope Commercial |
$183.34
|
| Rate for Payer: Healthscope Commercial |
$158.56
|
| Rate for Payer: Mclaren Medicaid |
$66.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.06
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,614.00
|
| Rate for Payer: Nomi Health Commercial |
$118.92
|
| Rate for Payer: PACE SWMI |
$99.10
|
| Rate for Payer: PHP Medicare Advantage |
$99.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.61
|
| Rate for Payer: Priority Health Medicare |
$99.10
|
| Rate for Payer: Priority Health Narrow Network |
$144.61
|
| Rate for Payer: Priority Health SBD |
$144.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.10
|
| Rate for Payer: UHC Exchange |
$230.31
|
| Rate for Payer: UHC Medicare Advantage |
$99.10
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
PR CATHETERIZE FOR URINE SPEC
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS P9612
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$1,574.33 |
| Rate for Payer: Aetna Commercial |
$12.18
|
| Rate for Payer: Aetna Medicare |
$9.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.09
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,574.33
|
| Rate for Payer: BCN Commercial |
$5.95
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$13.09
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$16.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.00
|
| Rate for Payer: Nomi Health Commercial |
$10.91
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Exchange |
$3.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
|
|
PR CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 36510
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$9,396.00 |
| Rate for Payer: Aetna Commercial |
$66.21
|
| Rate for Payer: Aetna Medicare |
$51.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.21
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$49.41
|
| Rate for Payer: BCBS Trust/PPO |
$947.77
|
| Rate for Payer: BCN Commercial |
$124.62
|
| Rate for Payer: BCN Medicare Advantage |
$49.41
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.41
|
| Rate for Payer: Healthscope Commercial |
$91.41
|
| Rate for Payer: Healthscope Commercial |
$79.06
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.88
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,396.00
|
| Rate for Payer: Nomi Health Commercial |
$59.29
|
| Rate for Payer: PACE SWMI |
$49.41
|
| Rate for Payer: PHP Medicare Advantage |
$49.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.49
|
| Rate for Payer: Priority Health Medicare |
$49.41
|
| Rate for Payer: Priority Health Narrow Network |
$83.49
|
| Rate for Payer: Priority Health SBD |
$83.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.41
|
| Rate for Payer: UHC Exchange |
$193.93
|
| Rate for Payer: UHC Medicare Advantage |
$49.41
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 93454
|
| Min. Negotiated Rate |
$148.25 |
| Max. Negotiated Rate |
$128,322.00 |
| Rate for Payer: Aetna Commercial |
$1,047.84
|
| Rate for Payer: Aetna Commercial |
$1,047.84
|
| Rate for Payer: Aetna Medicare |
$813.25
|
| Rate for Payer: Aetna Medicare |
$813.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,047.84
|
| Rate for Payer: BCBS Complete |
$155.66
|
| Rate for Payer: BCBS Complete |
$155.66
|
| Rate for Payer: BCBS MAPPO |
$781.97
|
| Rate for Payer: BCBS MAPPO |
$781.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,147.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,147.01
|
| Rate for Payer: BCN Commercial |
$1,324.80
|
| Rate for Payer: BCN Commercial |
$1,324.80
|
| Rate for Payer: BCN Medicare Advantage |
$781.97
|
| Rate for Payer: BCN Medicare Advantage |
$781.97
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$1,047.84
|
| Rate for Payer: Cofinity Commercial |
$1,126.04
|
| Rate for Payer: Cofinity Commercial |
$1,047.84
|
| Rate for Payer: Cofinity Commercial |
$1,126.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.97
|
| Rate for Payer: Healthscope Commercial |
$1,251.15
|
| Rate for Payer: Healthscope Commercial |
$1,446.64
|
| Rate for Payer: Healthscope Commercial |
$1,446.64
|
| Rate for Payer: Healthscope Commercial |
$1,251.15
|
| Rate for Payer: Mclaren Medicaid |
$148.25
|
| Rate for Payer: Mclaren Medicaid |
$148.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.07
|
| Rate for Payer: Meridian Medicaid |
$155.66
|
| Rate for Payer: Meridian Medicaid |
$155.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,322.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,322.00
|
| Rate for Payer: Nomi Health Commercial |
$938.36
|
| Rate for Payer: Nomi Health Commercial |
$938.36
|
| Rate for Payer: PACE SWMI |
$781.97
|
| Rate for Payer: PACE SWMI |
$781.97
|
| Rate for Payer: PHP Medicare Advantage |
$781.97
|
| Rate for Payer: PHP Medicare Advantage |
$781.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,259.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,259.02
|
| Rate for Payer: Priority Health Medicare |
$781.97
|
| Rate for Payer: Priority Health Medicare |
$781.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,259.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,259.02
|
| Rate for Payer: Priority Health SBD |
$327.70
|
| Rate for Payer: Priority Health SBD |
$327.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.97
|
| Rate for Payer: UHC Medicare Advantage |
$781.97
|
| Rate for Payer: UHC Medicare Advantage |
$781.97
|
| Rate for Payer: UHCCP Medicaid |
$148.25
|
| Rate for Payer: UHCCP Medicaid |
$148.25
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 93459
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$159,062.00 |
| Rate for Payer: Aetna Commercial |
$1,304.01
|
| Rate for Payer: Aetna Commercial |
$1,304.01
|
| Rate for Payer: Aetna Medicare |
$1,012.07
|
| Rate for Payer: Aetna Medicare |
$1,012.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.01
|
| Rate for Payer: BCBS Complete |
$217.61
|
| Rate for Payer: BCBS Complete |
$217.61
|
| Rate for Payer: BCBS MAPPO |
$973.14
|
| Rate for Payer: BCBS MAPPO |
$973.14
|
| Rate for Payer: BCBS Trust/PPO |
$570.56
|
| Rate for Payer: BCBS Trust/PPO |
$570.56
|
| Rate for Payer: BCN Commercial |
$1,637.56
|
| Rate for Payer: BCN Commercial |
$1,637.56
|
| Rate for Payer: BCN Medicare Advantage |
$973.14
|
| Rate for Payer: BCN Medicare Advantage |
$973.14
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cofinity Commercial |
$1,304.01
|
| Rate for Payer: Cofinity Commercial |
$1,401.32
|
| Rate for Payer: Cofinity Commercial |
$1,304.01
|
| Rate for Payer: Cofinity Commercial |
$1,401.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.14
|
| Rate for Payer: Healthscope Commercial |
$1,557.02
|
| Rate for Payer: Healthscope Commercial |
$1,800.31
|
| Rate for Payer: Healthscope Commercial |
$1,800.31
|
| Rate for Payer: Healthscope Commercial |
$1,557.02
|
| Rate for Payer: Mclaren Medicaid |
$207.25
|
| Rate for Payer: Mclaren Medicaid |
$207.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.80
|
| Rate for Payer: Meridian Medicaid |
$217.61
|
| Rate for Payer: Meridian Medicaid |
$217.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159,062.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159,062.00
|
| Rate for Payer: Nomi Health Commercial |
$1,167.77
|
| Rate for Payer: Nomi Health Commercial |
$1,167.77
|
| Rate for Payer: PACE SWMI |
$973.14
|
| Rate for Payer: PACE SWMI |
$973.14
|
| Rate for Payer: PHP Medicare Advantage |
$973.14
|
| Rate for Payer: PHP Medicare Advantage |
$973.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,430.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,557.99
|
| Rate for Payer: Priority Health Medicare |
$973.14
|
| Rate for Payer: Priority Health Medicare |
$973.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,557.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,557.99
|
| Rate for Payer: Priority Health SBD |
$458.13
|
| Rate for Payer: Priority Health SBD |
$458.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.14
|
| Rate for Payer: UHC Medicare Advantage |
$973.14
|
| Rate for Payer: UHC Medicare Advantage |
$973.14
|
| Rate for Payer: UHCCP Medicaid |
$207.25
|
| Rate for Payer: UHCCP Medicaid |
$207.25
|
|
|
PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 93458
|
| Min. Negotiated Rate |
$182.75 |
| Max. Negotiated Rate |
$147,677.00 |
| Rate for Payer: Aetna Commercial |
$1,209.50
|
| Rate for Payer: Aetna Commercial |
$1,209.50
|
| Rate for Payer: Aetna Medicare |
$938.71
|
| Rate for Payer: Aetna Medicare |
$938.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.50
|
| Rate for Payer: BCBS Complete |
$191.89
|
| Rate for Payer: BCBS Complete |
$191.89
|
| Rate for Payer: BCBS MAPPO |
$902.61
|
| Rate for Payer: BCBS MAPPO |
$902.61
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCN Commercial |
$1,522.23
|
| Rate for Payer: BCN Commercial |
$1,522.23
|
| Rate for Payer: BCN Medicare Advantage |
$902.61
|
| Rate for Payer: BCN Medicare Advantage |
$902.61
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$1,587.20
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$1,209.50
|
| Rate for Payer: Cofinity Commercial |
$1,299.76
|
| Rate for Payer: Cofinity Commercial |
$1,209.50
|
| Rate for Payer: Cofinity Commercial |
$1,299.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.61
|
| Rate for Payer: Healthscope Commercial |
$1,444.18
|
| Rate for Payer: Healthscope Commercial |
$1,669.83
|
| Rate for Payer: Healthscope Commercial |
$1,669.83
|
| Rate for Payer: Healthscope Commercial |
$1,444.18
|
| Rate for Payer: Mclaren Medicaid |
$182.75
|
| Rate for Payer: Mclaren Medicaid |
$182.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.74
|
| Rate for Payer: Meridian Medicaid |
$191.89
|
| Rate for Payer: Meridian Medicaid |
$191.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,677.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,677.00
|
| Rate for Payer: Nomi Health Commercial |
$1,083.13
|
| Rate for Payer: Nomi Health Commercial |
$1,083.13
|
| Rate for Payer: PACE SWMI |
$902.61
|
| Rate for Payer: PACE SWMI |
$902.61
|
| Rate for Payer: PHP Medicare Advantage |
$902.61
|
| Rate for Payer: PHP Medicare Advantage |
$902.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,289.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,448.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,448.29
|
| Rate for Payer: Priority Health Medicare |
$902.61
|
| Rate for Payer: Priority Health Medicare |
$902.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,448.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,448.29
|
| Rate for Payer: Priority Health SBD |
$404.45
|
| Rate for Payer: Priority Health SBD |
$404.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.61
|
| Rate for Payer: UHC Medicare Advantage |
$902.61
|
| Rate for Payer: UHC Medicare Advantage |
$902.61
|
| Rate for Payer: UHCCP Medicaid |
$182.75
|
| Rate for Payer: UHCCP Medicaid |
$182.75
|
|
|
PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I
|
Professional
|
Both
|
$582.00
|
|
|
Service Code
|
HCPCS 93455
|
| Min. Negotiated Rate |
$173.17 |
| Max. Negotiated Rate |
$143,087.00 |
| Rate for Payer: Aetna Commercial |
$1,171.40
|
| Rate for Payer: Aetna Medicare |
$909.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.82
|
| Rate for Payer: BCBS Complete |
$181.83
|
| Rate for Payer: BCBS MAPPO |
$874.18
|
| Rate for Payer: BCBS Trust/PPO |
$472.30
|
| Rate for Payer: BCN Commercial |
$1,475.81
|
| Rate for Payer: BCN Medicare Advantage |
$874.18
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cofinity Commercial |
$1,258.82
|
| Rate for Payer: Cofinity Commercial |
$1,171.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.18
|
| Rate for Payer: Healthscope Commercial |
$1,398.69
|
| Rate for Payer: Healthscope Commercial |
$1,617.23
|
| Rate for Payer: Mclaren Medicaid |
$173.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$917.89
|
| Rate for Payer: Meridian Medicaid |
$181.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143,087.00
|
| Rate for Payer: Nomi Health Commercial |
$1,049.02
|
| Rate for Payer: PACE SWMI |
$874.18
|
| Rate for Payer: PHP Medicare Advantage |
$874.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.61
|
| Rate for Payer: Priority Health Medicare |
$874.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.61
|
| Rate for Payer: Priority Health SBD |
$381.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$874.18
|
| Rate for Payer: UHC Medicare Advantage |
$874.18
|
| Rate for Payer: UHCCP Medicaid |
$173.17
|
|
|
PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I
|
Professional
|
Both
|
$2,427.00
|
|
|
Service Code
|
HCPCS 93457
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$174,230.00 |
| Rate for Payer: Aetna Commercial |
$1,426.75
|
| Rate for Payer: Aetna Medicare |
$1,107.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,426.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.23
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS MAPPO |
$1,064.74
|
| Rate for Payer: BCBS Trust/PPO |
$542.56
|
| Rate for Payer: BCN Commercial |
$1,795.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.74
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Cash Price |
$1,941.60
|
| Rate for Payer: Cofinity Commercial |
$1,533.23
|
| Rate for Payer: Cofinity Commercial |
$1,426.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.74
|
| Rate for Payer: Healthscope Commercial |
$1,703.58
|
| Rate for Payer: Healthscope Commercial |
$1,969.77
|
| Rate for Payer: Mclaren Medicaid |
$217.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.98
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174,230.00
|
| Rate for Payer: Nomi Health Commercial |
$1,277.69
|
| Rate for Payer: PACE SWMI |
$1,064.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,577.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,707.25
|
| Rate for Payer: Priority Health Medicare |
$1,064.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,707.25
|
| Rate for Payer: Priority Health SBD |
$479.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,064.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,064.74
|
| Rate for Payer: UHCCP Medicaid |
$217.47
|
|
|
PR CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$2,171.00
|
|
|
Service Code
|
HCPCS 93456
|
| Min. Negotiated Rate |
$193.40 |
| Max. Negotiated Rate |
$159,801.00 |
| Rate for Payer: Aetna Commercial |
$1,306.11
|
| Rate for Payer: Aetna Medicare |
$1,013.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.58
|
| Rate for Payer: BCBS Complete |
$203.07
|
| Rate for Payer: BCBS MAPPO |
$974.71
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$1,648.31
|
| Rate for Payer: BCN Medicare Advantage |
$974.71
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cofinity Commercial |
$1,403.58
|
| Rate for Payer: Cofinity Commercial |
$1,306.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.71
|
| Rate for Payer: Healthscope Commercial |
$1,559.54
|
| Rate for Payer: Healthscope Commercial |
$1,803.21
|
| Rate for Payer: Mclaren Medicaid |
$193.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,023.45
|
| Rate for Payer: Meridian Medicaid |
$203.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159,801.00
|
| Rate for Payer: Nomi Health Commercial |
$1,169.65
|
| Rate for Payer: PACE SWMI |
$974.71
|
| Rate for Payer: PHP Medicare Advantage |
$974.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,411.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,566.48
|
| Rate for Payer: Priority Health Medicare |
$974.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,566.48
|
| Rate for Payer: Priority Health SBD |
$427.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.71
|
| Rate for Payer: UHC Medicare Advantage |
$974.71
|
| Rate for Payer: UHCCP Medicaid |
$193.40
|
|
|
PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
HCPCS 58340
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$10,121.00 |
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$57.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.73
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCBS MAPPO |
$55.37
|
| Rate for Payer: BCBS Trust/PPO |
$441.13
|
| Rate for Payer: BCN Commercial |
$362.60
|
| Rate for Payer: BCN Medicare Advantage |
$55.37
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$79.73
|
| Rate for Payer: Cofinity Commercial |
$74.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.37
|
| Rate for Payer: Healthscope Commercial |
$88.59
|
| Rate for Payer: Healthscope Commercial |
$102.43
|
| Rate for Payer: Mclaren Medicaid |
$37.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.14
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,121.00
|
| Rate for Payer: Nomi Health Commercial |
$66.44
|
| Rate for Payer: PACE SWMI |
$55.37
|
| Rate for Payer: PHP Medicare Advantage |
$55.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.82
|
| Rate for Payer: Priority Health Medicare |
$55.37
|
| Rate for Payer: Priority Health Narrow Network |
$85.82
|
| Rate for Payer: Priority Health SBD |
$85.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.37
|
| Rate for Payer: UHC Exchange |
$547.96
|
| Rate for Payer: UHC Medicare Advantage |
$55.37
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
|
|
PR CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 57511
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$25,987.00 |
| Rate for Payer: Aetna Commercial |
$186.98
|
| Rate for Payer: Aetna Medicare |
$145.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$139.54
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$236.77
|
| Rate for Payer: BCN Medicare Advantage |
$139.54
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cofinity Commercial |
$200.94
|
| Rate for Payer: Cofinity Commercial |
$186.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.54
|
| Rate for Payer: Healthscope Commercial |
$258.15
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.52
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,987.00
|
| Rate for Payer: Nomi Health Commercial |
$167.45
|
| Rate for Payer: PACE SWMI |
$139.54
|
| Rate for Payer: PHP Medicare Advantage |
$139.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.74
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: Priority Health Narrow Network |
$221.74
|
| Rate for Payer: Priority Health SBD |
$221.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.54
|
| Rate for Payer: UHC Exchange |
$185.75
|
| Rate for Payer: UHC Medicare Advantage |
$139.54
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
|
|
PR CAUTERY CERVIX ELECTRO/THERMAL
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
HCPCS 57510
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$20,005.00 |
| Rate for Payer: Aetna Commercial |
$144.99
|
| Rate for Payer: Aetna Medicare |
$112.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.81
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS MAPPO |
$108.20
|
| Rate for Payer: BCBS Trust/PPO |
$689.96
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$108.20
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$155.81
|
| Rate for Payer: Cofinity Commercial |
$144.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$200.17
|
| Rate for Payer: Healthscope Commercial |
$173.12
|
| Rate for Payer: Mclaren Medicaid |
$72.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.61
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,005.00
|
| Rate for Payer: Nomi Health Commercial |
$129.84
|
| Rate for Payer: PACE SWMI |
$108.20
|
| Rate for Payer: PHP Medicare Advantage |
$108.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.15
|
| Rate for Payer: Priority Health Medicare |
$108.20
|
| Rate for Payer: Priority Health Narrow Network |
$169.15
|
| Rate for Payer: Priority Health SBD |
$169.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.20
|
| Rate for Payer: UHC Exchange |
$211.53
|
| Rate for Payer: UHC Medicare Advantage |
$108.20
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
|
|
PR CAUTERY CERVIX LASER ABLATION
|
Professional
|
Both
|
$554.00
|
|
|
Service Code
|
HCPCS 57513
|
| Min. Negotiated Rate |
$94.36 |
| Max. Negotiated Rate |
$25,933.00 |
| Rate for Payer: Aetna Commercial |
$186.19
|
| Rate for Payer: Aetna Medicare |
$144.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.09
|
| Rate for Payer: BCBS Complete |
$99.08
|
| Rate for Payer: BCBS MAPPO |
$138.95
|
| Rate for Payer: BCBS Trust/PPO |
$646.64
|
| Rate for Payer: BCN Commercial |
$304.45
|
| Rate for Payer: BCN Medicare Advantage |
$138.95
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cash Price |
$443.20
|
| Rate for Payer: Cofinity Commercial |
$200.09
|
| Rate for Payer: Cofinity Commercial |
$186.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.95
|
| Rate for Payer: Healthscope Commercial |
$257.06
|
| Rate for Payer: Healthscope Commercial |
$222.32
|
| Rate for Payer: Mclaren Medicaid |
$94.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.90
|
| Rate for Payer: Meridian Medicaid |
$99.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,933.00
|
| Rate for Payer: Nomi Health Commercial |
$166.74
|
| Rate for Payer: PACE SWMI |
$138.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.74
|
| Rate for Payer: Priority Health Medicare |
$138.95
|
| Rate for Payer: Priority Health Narrow Network |
$220.74
|
| Rate for Payer: Priority Health SBD |
$220.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.95
|
| Rate for Payer: UHC Exchange |
$254.01
|
| Rate for Payer: UHC Medicare Advantage |
$138.95
|
| Rate for Payer: UHCCP Medicaid |
$94.36
|
|
|
PR CBHC CONSULT FEE $150
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 00678
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
