|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 51729
|
| Min. Negotiated Rate |
$332.60 |
| Max. Negotiated Rate |
$659.92 |
| Rate for Payer: Aetna Commercial |
$445.68
|
| Rate for Payer: Aetna Medicare |
$345.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.68
|
| Rate for Payer: BCBS MAPPO |
$332.60
|
| Rate for Payer: BCN Commercial |
$535.83
|
| Rate for Payer: BCN Medicare Advantage |
$332.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$478.94
|
| Rate for Payer: Cofinity Commercial |
$445.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.60
|
| Rate for Payer: Healthscope Commercial |
$532.16
|
| Rate for Payer: Healthscope Commercial |
$615.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.92
|
| Rate for Payer: Nomi Health Commercial |
$399.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$332.60
|
| Rate for Payer: PHP Medicare Advantage |
$332.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$583.69
|
| Rate for Payer: Priority Health Medicare |
$332.60
|
| Rate for Payer: Priority Health SBD |
$583.69
|
| Rate for Payer: Priority Health Tiered Network |
$583.69
|
| Rate for Payer: Railroad Medicare Medicare |
$332.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.90
|
| Rate for Payer: UHC Core |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.60
|
| Rate for Payer: UHC Exchange |
$627.90
|
|
|
PR COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$10,611.00
|
|
|
Service Code
|
HCPCS 61697
|
| Min. Negotiated Rate |
$2,553.66 |
| Max. Negotiated Rate |
$8,817.75 |
| Rate for Payer: Aetna Commercial |
$5,391.37
|
| Rate for Payer: Aetna Medicare |
$4,184.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,391.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,793.71
|
| Rate for Payer: BCBS Complete |
$2,681.34
|
| Rate for Payer: BCBS MAPPO |
$4,023.41
|
| Rate for Payer: BCN Commercial |
$8,817.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,023.41
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cofinity Commercial |
$5,793.71
|
| Rate for Payer: Cofinity Commercial |
$5,391.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,023.41
|
| Rate for Payer: Healthscope Commercial |
$7,443.31
|
| Rate for Payer: Healthscope Commercial |
$6,437.46
|
| Rate for Payer: Mclaren Medicaid |
$2,553.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,224.58
|
| Rate for Payer: Meridian Medicaid |
$2,681.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,425.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,658.50
|
| Rate for Payer: Nomi Health Commercial |
$4,828.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,958.25
|
| Rate for Payer: PACE SWMI |
$4,023.41
|
| Rate for Payer: PHP Medicare Advantage |
$4,023.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,553.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,413.29
|
| Rate for Payer: Priority Health Medicare |
$4,023.41
|
| Rate for Payer: Priority Health SBD |
$7,413.29
|
| Rate for Payer: Priority Health Tiered Network |
$7,413.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4,023.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,514.26
|
| Rate for Payer: UHC Core |
$7,514.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,023.41
|
| Rate for Payer: UHC Exchange |
$7,514.26
|
| Rate for Payer: UHC Medicaid |
$2,553.66
|
| Rate for Payer: UHCCP Medicaid |
$2,553.66
|
|
|
PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92557
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Commercial |
$33.90
|
| Rate for Payer: Aetna Medicare |
$26.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.30
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Cofinity Commercial |
$33.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Healthscope Commercial |
$40.48
|
| Rate for Payer: Mclaren Medicaid |
$16.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.57
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.41
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$25.30
|
| Rate for Payer: PHP Medicare Advantage |
$25.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.63
|
| Rate for Payer: Priority Health Medicare |
$25.30
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health Tiered Network |
$43.63
|
| Rate for Payer: Railroad Medicare Medicare |
$25.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.55
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.30
|
| Rate for Payer: UHC Exchange |
$52.55
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
PR COMPRE EP EVAL ABLTJ 3D MAPG TX SVT
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 93653
|
| Min. Negotiated Rate |
$453.69 |
| Max. Negotiated Rate |
$1,491.58 |
| Rate for Payer: Aetna Commercial |
$960.71
|
| Rate for Payer: Aetna Medicare |
$745.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.71
|
| Rate for Payer: BCBS Complete |
$476.37
|
| Rate for Payer: BCBS MAPPO |
$716.95
|
| Rate for Payer: BCN Commercial |
$1,218.06
|
| Rate for Payer: BCN Medicare Advantage |
$716.95
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cofinity Commercial |
$960.71
|
| Rate for Payer: Cofinity Commercial |
$1,032.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.95
|
| Rate for Payer: Healthscope Commercial |
$1,326.36
|
| Rate for Payer: Healthscope Commercial |
$1,147.12
|
| Rate for Payer: Mclaren Medicaid |
$453.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.80
|
| Rate for Payer: Meridian Medicaid |
$476.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$788.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.57
|
| Rate for Payer: Nomi Health Commercial |
$860.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,355.25
|
| Rate for Payer: PACE SWMI |
$716.95
|
| Rate for Payer: PHP Medicare Advantage |
$716.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,157.71
|
| Rate for Payer: Priority Health Medicare |
$716.95
|
| Rate for Payer: Priority Health SBD |
$1,157.71
|
| Rate for Payer: Priority Health Tiered Network |
$1,157.71
|
| Rate for Payer: Railroad Medicare Medicare |
$716.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,491.58
|
| Rate for Payer: UHC Core |
$1,491.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$716.95
|
| Rate for Payer: UHC Exchange |
$1,491.58
|
| Rate for Payer: UHC Medicaid |
$453.69
|
| Rate for Payer: UHCCP Medicaid |
$453.69
|
|
|
PR COMPRE EP EVAL ABLTJ 3D MAPG TX VT
|
Professional
|
Both
|
$2,421.00
|
|
|
Service Code
|
HCPCS 93654
|
| Min. Negotiated Rate |
$546.77 |
| Max. Negotiated Rate |
$1,997.64 |
| Rate for Payer: Aetna Commercial |
$1,157.81
|
| Rate for Payer: Aetna Medicare |
$898.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,244.22
|
| Rate for Payer: BCBS Complete |
$574.11
|
| Rate for Payer: BCBS MAPPO |
$864.04
|
| Rate for Payer: BCN Commercial |
$1,468.04
|
| Rate for Payer: BCN Medicare Advantage |
$864.04
|
| Rate for Payer: Cash Price |
$1,936.80
|
| Rate for Payer: Cash Price |
$1,936.80
|
| Rate for Payer: Cofinity Commercial |
$1,244.22
|
| Rate for Payer: Cofinity Commercial |
$1,157.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.04
|
| Rate for Payer: Healthscope Commercial |
$1,598.47
|
| Rate for Payer: Healthscope Commercial |
$1,382.46
|
| Rate for Payer: Mclaren Medicaid |
$546.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.24
|
| Rate for Payer: Meridian Medicaid |
$574.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$950.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,494.15
|
| Rate for Payer: Nomi Health Commercial |
$1,036.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,815.75
|
| Rate for Payer: PACE SWMI |
$864.04
|
| Rate for Payer: PHP Medicare Advantage |
$864.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,395.30
|
| Rate for Payer: Priority Health Medicare |
$864.04
|
| Rate for Payer: Priority Health SBD |
$1,395.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,395.30
|
| Rate for Payer: Railroad Medicare Medicare |
$864.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,997.64
|
| Rate for Payer: UHC Core |
$1,997.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$864.04
|
| Rate for Payer: UHC Exchange |
$1,997.64
|
| Rate for Payer: UHC Medicaid |
$546.77
|
| Rate for Payer: UHCCP Medicaid |
$546.77
|
|
|
PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION
|
Professional
|
Both
|
$1,897.00
|
|
|
Service Code
|
HCPCS 93656
|
| Min. Negotiated Rate |
$514.40 |
| Max. Negotiated Rate |
$2,002.91 |
| Rate for Payer: Aetna Commercial |
$1,089.21
|
| Rate for Payer: Aetna Medicare |
$845.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.49
|
| Rate for Payer: BCBS Complete |
$540.12
|
| Rate for Payer: BCBS MAPPO |
$812.84
|
| Rate for Payer: BCN Commercial |
$1,380.41
|
| Rate for Payer: BCN Medicare Advantage |
$812.84
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cash Price |
$1,517.60
|
| Rate for Payer: Cofinity Commercial |
$1,170.49
|
| Rate for Payer: Cofinity Commercial |
$1,089.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.84
|
| Rate for Payer: Healthscope Commercial |
$1,503.75
|
| Rate for Payer: Healthscope Commercial |
$1,300.54
|
| Rate for Payer: Mclaren Medicaid |
$514.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.48
|
| Rate for Payer: Meridian Medicaid |
$540.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$894.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,405.67
|
| Rate for Payer: Nomi Health Commercial |
$975.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.75
|
| Rate for Payer: PACE SWMI |
$812.84
|
| Rate for Payer: PHP Medicare Advantage |
$812.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,312.00
|
| Rate for Payer: Priority Health Medicare |
$812.84
|
| Rate for Payer: Priority Health SBD |
$1,312.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,312.00
|
| Rate for Payer: Railroad Medicare Medicare |
$812.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,002.91
|
| Rate for Payer: UHC Core |
$2,002.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.84
|
| Rate for Payer: UHC Exchange |
$2,002.91
|
| Rate for Payer: UHC Medicaid |
$514.40
|
| Rate for Payer: UHCCP Medicaid |
$514.40
|
|
|
PR COMPRE EP EVAL R ATR VNTRC PACG&REC HIS BNDL REC
|
Professional
|
Both
|
$1,359.00
|
|
|
Service Code
|
HCPCS 93620
|
| Min. Negotiated Rate |
$679.50 |
| Max. Negotiated Rate |
$1,349.99 |
| Rate for Payer: Aetna Commercial |
$1,103.18
|
| Rate for Payer: Aetna Medicare |
$679.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.18
|
| Rate for Payer: BCN Commercial |
$896.87
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,019.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,136.41
|
| Rate for Payer: Priority Health SBD |
$1,136.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,136.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.99
|
| Rate for Payer: UHC Core |
$1,349.99
|
| Rate for Payer: UHC Exchange |
$1,349.99
|
|
|
PR COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 93621
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$1,658.64 |
| Rate for Payer: Aetna Commercial |
$205.99
|
| Rate for Payer: Aetna Medicare |
$126.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.99
|
| Rate for Payer: BCN Commercial |
$1,658.64
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$150.99
|
| Rate for Payer: Priority Health SBD |
$150.99
|
| Rate for Payer: Priority Health Tiered Network |
$150.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.33
|
| Rate for Payer: UHC Core |
$586.33
|
| Rate for Payer: UHC Exchange |
$586.33
|
|
|
PR CONDITIONING PLAY AUDIOMETRY
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 92582
|
| Min. Negotiated Rate |
$79.36 |
| Max. Negotiated Rate |
$146.82 |
| Rate for Payer: Aetna Commercial |
$106.34
|
| Rate for Payer: Aetna Medicare |
$82.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.34
|
| Rate for Payer: BCBS MAPPO |
$79.36
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$79.36
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$114.28
|
| Rate for Payer: Cofinity Commercial |
$106.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.36
|
| Rate for Payer: Healthscope Commercial |
$126.98
|
| Rate for Payer: Healthscope Commercial |
$146.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.54
|
| Rate for Payer: Nomi Health Commercial |
$95.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$79.36
|
| Rate for Payer: PHP Medicare Advantage |
$79.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$123.08
|
| Rate for Payer: Priority Health Medicare |
$79.36
|
| Rate for Payer: Priority Health SBD |
$123.08
|
| Rate for Payer: Priority Health Tiered Network |
$123.08
|
| Rate for Payer: Railroad Medicare Medicare |
$79.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.16
|
| Rate for Payer: UHC Core |
$110.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.36
|
| Rate for Payer: UHC Exchange |
$110.16
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57522
|
| Hospital Charge Code |
57522
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$714.00 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$235.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.94
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$384.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Healthscope Commercial |
$418.75
|
| Rate for Payer: Healthscope Commercial |
$362.16
|
| Rate for Payer: Mclaren Medicaid |
$147.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.07
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: Priority Health Tiered Network |
$389.86
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.86
|
| Rate for Payer: UHC Core |
$436.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$436.86
|
| Rate for Payer: UHC Medicaid |
$147.61
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$599.76 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Aetna Commercial |
$809.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.80
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Advantage |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$818.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Healthscope Commercial |
$856.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PHP Commercial |
$809.20
|
| Rate for Payer: Priority Health SBD |
$599.76
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57522
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$714.00 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$235.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.94
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$384.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Healthscope Commercial |
$418.75
|
| Rate for Payer: Healthscope Commercial |
$362.16
|
| Rate for Payer: Mclaren Medicaid |
$147.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.07
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: Priority Health Tiered Network |
$389.86
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.86
|
| Rate for Payer: UHC Core |
$436.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$436.86
|
| Rate for Payer: UHC Medicaid |
$147.61
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$293.81 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Commercial |
$809.20
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.01
|
| Rate for Payer: BCCCP Commercial |
$293.81
|
| Rate for Payer: BCN Commercial |
$1,697.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Advantage |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$818.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$856.80
|
| Rate for Payer: Mclaren Medicaid |
$1,686.93
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$809.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$599.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 57520
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$802.50 |
| Rate for Payer: Aetna Commercial |
$357.93
|
| Rate for Payer: Aetna Medicare |
$277.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.64
|
| Rate for Payer: BCBS Complete |
$183.17
|
| Rate for Payer: BCBS MAPPO |
$267.11
|
| Rate for Payer: BCN Commercial |
$447.69
|
| Rate for Payer: BCN Medicare Advantage |
$267.11
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cofinity Commercial |
$384.64
|
| Rate for Payer: Cofinity Commercial |
$357.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.11
|
| Rate for Payer: Healthscope Commercial |
$494.15
|
| Rate for Payer: Healthscope Commercial |
$427.38
|
| Rate for Payer: Mclaren Medicaid |
$174.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.47
|
| Rate for Payer: Meridian Medicaid |
$183.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$524.72
|
| Rate for Payer: Nomi Health Commercial |
$320.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$802.50
|
| Rate for Payer: PACE SWMI |
$267.11
|
| Rate for Payer: PHP Medicare Advantage |
$267.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$453.42
|
| Rate for Payer: Priority Health Medicare |
$267.11
|
| Rate for Payer: Priority Health SBD |
$453.42
|
| Rate for Payer: Priority Health Tiered Network |
$453.42
|
| Rate for Payer: Railroad Medicare Medicare |
$267.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.14
|
| Rate for Payer: UHC Core |
$498.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$267.11
|
| Rate for Payer: UHC Exchange |
$498.14
|
| Rate for Payer: UHC Medicaid |
$174.45
|
| Rate for Payer: UHCCP Medicaid |
$174.45
|
|
|
PR CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT
|
Professional
|
Both
|
$1,752.00
|
|
|
Service Code
|
HCPCS 57291
|
| Min. Negotiated Rate |
$311.41 |
| Max. Negotiated Rate |
$1,314.00 |
| Rate for Payer: Aetna Commercial |
$644.42
|
| Rate for Payer: Aetna Medicare |
$500.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.51
|
| Rate for Payer: BCBS Complete |
$326.98
|
| Rate for Payer: BCBS MAPPO |
$480.91
|
| Rate for Payer: BCN Commercial |
$826.15
|
| Rate for Payer: BCN Medicare Advantage |
$480.91
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cofinity Commercial |
$692.51
|
| Rate for Payer: Cofinity Commercial |
$644.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.91
|
| Rate for Payer: Healthscope Commercial |
$889.68
|
| Rate for Payer: Healthscope Commercial |
$769.46
|
| Rate for Payer: Mclaren Medicaid |
$311.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$504.96
|
| Rate for Payer: Meridian Medicaid |
$326.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$529.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$979.54
|
| Rate for Payer: Nomi Health Commercial |
$577.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,314.00
|
| Rate for Payer: PACE SWMI |
$480.91
|
| Rate for Payer: PHP Medicare Advantage |
$480.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$836.71
|
| Rate for Payer: Priority Health Medicare |
$480.91
|
| Rate for Payer: Priority Health SBD |
$836.71
|
| Rate for Payer: Priority Health Tiered Network |
$836.71
|
| Rate for Payer: Railroad Medicare Medicare |
$480.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.13
|
| Rate for Payer: UHC Core |
$954.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.91
|
| Rate for Payer: UHC Exchange |
$954.13
|
| Rate for Payer: UHC Medicaid |
$311.41
|
| Rate for Payer: UHCCP Medicaid |
$311.41
|
|
|
PR CONSULTS
|
Professional
|
Both
|
$525.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Medicare |
$262.50
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
|
|
PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95250
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$258.48 |
| Rate for Payer: Aetna Commercial |
$187.22
|
| Rate for Payer: Aetna Medicare |
$145.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.20
|
| Rate for Payer: BCBS MAPPO |
$139.72
|
| Rate for Payer: BCN Commercial |
$214.63
|
| Rate for Payer: BCN Medicare Advantage |
$139.72
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$187.22
|
| Rate for Payer: Cofinity Commercial |
$201.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.72
|
| Rate for Payer: Healthscope Commercial |
$258.48
|
| Rate for Payer: Healthscope Commercial |
$223.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.30
|
| Rate for Payer: Nomi Health Commercial |
$167.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE SWMI |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$139.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.93
|
| Rate for Payer: Priority Health Medicare |
$139.72
|
| Rate for Payer: Priority Health SBD |
$197.93
|
| Rate for Payer: Priority Health Tiered Network |
$197.93
|
| Rate for Payer: Railroad Medicare Medicare |
$139.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.13
|
| Rate for Payer: UHC Core |
$225.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.72
|
| Rate for Payer: UHC Exchange |
$225.13
|
|
|
PR CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 95249
|
| Min. Negotiated Rate |
$64.02 |
| Max. Negotiated Rate |
$118.44 |
| Rate for Payer: Aetna Commercial |
$85.79
|
| Rate for Payer: Aetna Medicare |
$66.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.79
|
| Rate for Payer: BCBS MAPPO |
$64.02
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$64.02
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$92.19
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.02
|
| Rate for Payer: Healthscope Commercial |
$102.43
|
| Rate for Payer: Healthscope Commercial |
$118.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.62
|
| Rate for Payer: Nomi Health Commercial |
$76.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE SWMI |
$64.02
|
| Rate for Payer: PHP Medicare Advantage |
$64.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$64.02
|
| Rate for Payer: Priority Health SBD |
$90.94
|
| Rate for Payer: Priority Health Tiered Network |
$90.94
|
| Rate for Payer: Railroad Medicare Medicare |
$64.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.01
|
| Rate for Payer: UHC Core |
$82.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64.02
|
| Rate for Payer: UHC Exchange |
$82.01
|
|
|
PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN
|
Professional
|
Both
|
$3,537.00
|
|
|
Service Code
|
HCPCS 50825
|
| Min. Negotiated Rate |
$933.79 |
| Max. Negotiated Rate |
$2,933.27 |
| Rate for Payer: Aetna Commercial |
$1,945.13
|
| Rate for Payer: Aetna Medicare |
$1,509.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,090.29
|
| Rate for Payer: BCBS Complete |
$980.48
|
| Rate for Payer: BCBS MAPPO |
$1,451.59
|
| Rate for Payer: BCN Commercial |
$2,448.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.59
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cofinity Commercial |
$2,090.29
|
| Rate for Payer: Cofinity Commercial |
$1,945.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.59
|
| Rate for Payer: Healthscope Commercial |
$2,685.44
|
| Rate for Payer: Healthscope Commercial |
$2,322.54
|
| Rate for Payer: Mclaren Medicaid |
$933.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,524.17
|
| Rate for Payer: Meridian Medicaid |
$980.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,596.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,889.45
|
| Rate for Payer: Nomi Health Commercial |
$1,741.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.75
|
| Rate for Payer: PACE SWMI |
$1,451.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,666.74
|
| Rate for Payer: Priority Health Medicare |
$1,451.59
|
| Rate for Payer: Priority Health SBD |
$2,666.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,666.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,933.27
|
| Rate for Payer: UHC Core |
$2,933.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,451.59
|
| Rate for Payer: UHC Exchange |
$2,933.27
|
| Rate for Payer: UHC Medicaid |
$933.79
|
| Rate for Payer: UHCCP Medicaid |
$933.79
|
|
|
PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX
|
Professional
|
Both
|
$4,162.00
|
|
|
Service Code
|
HCPCS 44316
|
| Min. Negotiated Rate |
$844.55 |
| Max. Negotiated Rate |
$3,121.50 |
| Rate for Payer: Aetna Commercial |
$1,769.34
|
| Rate for Payer: Aetna Medicare |
$1,373.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,769.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,901.38
|
| Rate for Payer: BCBS Complete |
$886.78
|
| Rate for Payer: BCBS MAPPO |
$1,320.40
|
| Rate for Payer: BCN Commercial |
$2,125.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,320.40
|
| Rate for Payer: Cash Price |
$3,329.60
|
| Rate for Payer: Cash Price |
$3,329.60
|
| Rate for Payer: Cofinity Commercial |
$1,901.38
|
| Rate for Payer: Cofinity Commercial |
$1,769.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,320.40
|
| Rate for Payer: Healthscope Commercial |
$2,442.74
|
| Rate for Payer: Healthscope Commercial |
$2,112.64
|
| Rate for Payer: Mclaren Medicaid |
$844.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,386.42
|
| Rate for Payer: Meridian Medicaid |
$886.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,452.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,535.41
|
| Rate for Payer: Nomi Health Commercial |
$1,584.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.50
|
| Rate for Payer: PACE SWMI |
$1,320.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,320.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,589.64
|
| Rate for Payer: Priority Health Medicare |
$1,320.40
|
| Rate for Payer: Priority Health SBD |
$2,589.64
|
| Rate for Payer: Priority Health Tiered Network |
$2,589.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,320.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,526.81
|
| Rate for Payer: UHC Core |
$2,526.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,320.40
|
| Rate for Payer: UHC Exchange |
$2,526.81
|
| Rate for Payer: UHC Medicaid |
$844.55
|
| Rate for Payer: UHCCP Medicaid |
$844.55
|
|
|
PR CONT INTRAOP NEURO MONITOR
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS G0453
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$36.33
|
| Rate for Payer: Aetna Medicare |
$28.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.04
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$50.15
|
| Rate for Payer: Healthscope Commercial |
$43.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.58
|
| Rate for Payer: Nomi Health Commercial |
$32.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.18
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health SBD |
$43.18
|
| Rate for Payer: Priority Health Tiered Network |
$43.18
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.18
|
| Rate for Payer: UHC Core |
$53.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.11
|
| Rate for Payer: UHC Exchange |
$53.18
|
|
|
PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 95251
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$63.57 |
| Rate for Payer: Aetna Commercial |
$46.04
|
| Rate for Payer: Aetna Medicare |
$35.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.48
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$34.36
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$34.36
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$46.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.36
|
| Rate for Payer: Healthscope Commercial |
$63.57
|
| Rate for Payer: Healthscope Commercial |
$54.98
|
| Rate for Payer: Mclaren Medicaid |
$22.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.08
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.73
|
| Rate for Payer: Nomi Health Commercial |
$41.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.00
|
| Rate for Payer: PACE SWMI |
$34.36
|
| Rate for Payer: PHP Medicare Advantage |
$34.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.31
|
| Rate for Payer: Priority Health Medicare |
$34.36
|
| Rate for Payer: Priority Health SBD |
$47.31
|
| Rate for Payer: Priority Health Tiered Network |
$47.31
|
| Rate for Payer: Railroad Medicare Medicare |
$34.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.93
|
| Rate for Payer: UHC Core |
$57.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.36
|
| Rate for Payer: UHC Exchange |
$57.93
|
| Rate for Payer: UHC Medicaid |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR CONTINUOUS INHALATION TREATMENT 1ST HR
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 94644
|
| Min. Negotiated Rate |
$57.17 |
| Max. Negotiated Rate |
$105.76 |
| Rate for Payer: Aetna Commercial |
$76.61
|
| Rate for Payer: Aetna Medicare |
$59.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.61
|
| Rate for Payer: BCBS MAPPO |
$57.17
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: BCN Medicare Advantage |
$57.17
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$76.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.17
|
| Rate for Payer: Healthscope Commercial |
$105.76
|
| Rate for Payer: Healthscope Commercial |
$91.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.52
|
| Rate for Payer: Nomi Health Commercial |
$68.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$57.17
|
| Rate for Payer: PHP Medicare Advantage |
$57.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79.45
|
| Rate for Payer: Priority Health Medicare |
$57.17
|
| Rate for Payer: Priority Health SBD |
$79.45
|
| Rate for Payer: Priority Health Tiered Network |
$79.45
|
| Rate for Payer: Railroad Medicare Medicare |
$57.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.32
|
| Rate for Payer: UHC Core |
$80.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.17
|
| Rate for Payer: UHC Exchange |
$80.32
|
|
|
PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 49465
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$54.71 |
| Rate for Payer: Aetna Commercial |
$34.38
|
| Rate for Payer: Aetna Medicare |
$26.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.95
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$25.66
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$34.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.66
|
| Rate for Payer: Healthscope Commercial |
$47.47
|
| Rate for Payer: Healthscope Commercial |
$41.06
|
| Rate for Payer: Mclaren Medicaid |
$16.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.94
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.98
|
| Rate for Payer: Nomi Health Commercial |
$30.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$25.66
|
| Rate for Payer: PHP Medicare Advantage |
$25.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$54.00
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health SBD |
$54.00
|
| Rate for Payer: Priority Health Tiered Network |
$54.00
|
| Rate for Payer: Railroad Medicare Medicare |
$25.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.71
|
| Rate for Payer: UHC Core |
$54.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.66
|
| Rate for Payer: UHC Exchange |
$54.71
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 30903
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$306.00 |
| Rate for Payer: Aetna Commercial |
$93.95
|
| Rate for Payer: Aetna Medicare |
$72.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.95
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$70.11
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: BCN Medicare Advantage |
$70.11
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Commercial |
$100.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.11
|
| Rate for Payer: Healthscope Commercial |
$129.70
|
| Rate for Payer: Healthscope Commercial |
$112.18
|
| Rate for Payer: Mclaren Medicaid |
$44.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.62
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.34
|
| Rate for Payer: Nomi Health Commercial |
$84.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.00
|
| Rate for Payer: PACE SWMI |
$70.11
|
| Rate for Payer: PHP Medicare Advantage |
$70.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$108.79
|
| Rate for Payer: Priority Health Medicare |
$70.11
|
| Rate for Payer: Priority Health SBD |
$108.79
|
| Rate for Payer: Priority Health Tiered Network |
$108.79
|
| Rate for Payer: Railroad Medicare Medicare |
$70.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.64
|
| Rate for Payer: UHC Core |
$140.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.11
|
| Rate for Payer: UHC Exchange |
$140.64
|
| Rate for Payer: UHC Medicaid |
$44.52
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
|
