|
PR CORRECTION INVERTED NIPPLES
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 19355
|
| Min. Negotiated Rate |
$358.48 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$734.88
|
| Rate for Payer: Aetna Medicare |
$570.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.72
|
| Rate for Payer: BCBS Complete |
$376.40
|
| Rate for Payer: BCBS MAPPO |
$548.42
|
| Rate for Payer: BCN Commercial |
$935.21
|
| Rate for Payer: BCN Medicare Advantage |
$548.42
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$789.72
|
| Rate for Payer: Cofinity Commercial |
$734.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.42
|
| Rate for Payer: Healthscope Commercial |
$877.47
|
| Rate for Payer: Healthscope Commercial |
$1,014.58
|
| Rate for Payer: Mclaren Medicaid |
$358.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.84
|
| Rate for Payer: Meridian Medicaid |
$376.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$603.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,089.76
|
| Rate for Payer: Nomi Health Commercial |
$658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$548.42
|
| Rate for Payer: PHP Medicare Advantage |
$548.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$855.96
|
| Rate for Payer: Priority Health Medicare |
$548.42
|
| Rate for Payer: Priority Health SBD |
$855.96
|
| Rate for Payer: Priority Health Tiered Network |
$855.96
|
| Rate for Payer: Railroad Medicare Medicare |
$548.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.32
|
| Rate for Payer: UHC Core |
$1,081.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$548.42
|
| Rate for Payer: UHC Exchange |
$1,081.32
|
| Rate for Payer: UHC Medicaid |
$358.48
|
| Rate for Payer: UHCCP Medicaid |
$358.48
|
|
|
PR CORRECTION TRICHIASIS EPILATION FORCEPS ONLY
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 67820
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$24.70
|
| Rate for Payer: Aetna Medicare |
$19.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.54
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$18.43
|
| Rate for Payer: BCN Commercial |
$25.92
|
| Rate for Payer: BCN Medicare Advantage |
$18.43
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$26.54
|
| Rate for Payer: Cofinity Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.43
|
| Rate for Payer: Healthscope Commercial |
$34.10
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Mclaren Medicaid |
$12.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.35
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.05
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.00
|
| Rate for Payer: PACE SWMI |
$18.43
|
| Rate for Payer: PHP Medicare Advantage |
$18.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.50
|
| Rate for Payer: Priority Health Medicare |
$18.43
|
| Rate for Payer: Priority Health SBD |
$38.50
|
| Rate for Payer: Priority Health Tiered Network |
$38.50
|
| Rate for Payer: Railroad Medicare Medicare |
$18.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.78
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.43
|
| Rate for Payer: UHC Exchange |
$47.78
|
| Rate for Payer: UHC Medicaid |
$12.14
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT
|
Professional
|
Both
|
$2,308.00
|
|
|
Service Code
|
HCPCS 28296
|
| Min. Negotiated Rate |
$308.85 |
| Max. Negotiated Rate |
$1,731.00 |
| Rate for Payer: Aetna Commercial |
$631.76
|
| Rate for Payer: Aetna Medicare |
$490.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.90
|
| Rate for Payer: BCBS Complete |
$324.29
|
| Rate for Payer: BCBS MAPPO |
$471.46
|
| Rate for Payer: BCN Commercial |
$782.32
|
| Rate for Payer: BCN Medicare Advantage |
$471.46
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cofinity Commercial |
$678.90
|
| Rate for Payer: Cofinity Commercial |
$631.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.46
|
| Rate for Payer: Healthscope Commercial |
$872.20
|
| Rate for Payer: Healthscope Commercial |
$754.34
|
| Rate for Payer: Mclaren Medicaid |
$308.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.03
|
| Rate for Payer: Meridian Medicaid |
$324.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.75
|
| Rate for Payer: Nomi Health Commercial |
$565.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,731.00
|
| Rate for Payer: PACE SWMI |
$471.46
|
| Rate for Payer: PHP Medicare Advantage |
$471.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$836.28
|
| Rate for Payer: Priority Health Medicare |
$471.46
|
| Rate for Payer: Priority Health SBD |
$836.28
|
| Rate for Payer: Priority Health Tiered Network |
$836.28
|
| Rate for Payer: Railroad Medicare Medicare |
$471.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$899.01
|
| Rate for Payer: UHC Core |
$899.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.46
|
| Rate for Payer: UHC Exchange |
$899.01
|
| Rate for Payer: UHC Medicaid |
$308.85
|
| Rate for Payer: UHCCP Medicaid |
$308.85
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Professional
|
Both
|
$2,037.00
|
|
|
Service Code
|
HCPCS 28297
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$1,527.75 |
| Rate for Payer: Aetna Commercial |
$733.42
|
| Rate for Payer: Aetna Medicare |
$569.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.16
|
| Rate for Payer: BCBS Complete |
$376.18
|
| Rate for Payer: BCBS MAPPO |
$547.33
|
| Rate for Payer: BCN Commercial |
$907.82
|
| Rate for Payer: BCN Medicare Advantage |
$547.33
|
| Rate for Payer: Cash Price |
$1,629.60
|
| Rate for Payer: Cash Price |
$1,629.60
|
| Rate for Payer: Cofinity Commercial |
$788.16
|
| Rate for Payer: Cofinity Commercial |
$733.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.33
|
| Rate for Payer: Healthscope Commercial |
$875.73
|
| Rate for Payer: Healthscope Commercial |
$1,012.56
|
| Rate for Payer: Mclaren Medicaid |
$358.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.70
|
| Rate for Payer: Meridian Medicaid |
$376.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.72
|
| Rate for Payer: Nomi Health Commercial |
$656.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.75
|
| Rate for Payer: PACE SWMI |
$547.33
|
| Rate for Payer: PHP Medicare Advantage |
$547.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$970.44
|
| Rate for Payer: Priority Health Medicare |
$547.33
|
| Rate for Payer: Priority Health SBD |
$970.44
|
| Rate for Payer: Priority Health Tiered Network |
$970.44
|
| Rate for Payer: Railroad Medicare Medicare |
$547.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.12
|
| Rate for Payer: UHC Core |
$1,055.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.33
|
| Rate for Payer: UHC Exchange |
$1,055.12
|
| Rate for Payer: UHC Medicaid |
$358.27
|
| Rate for Payer: UHCCP Medicaid |
$358.27
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 28295
|
| Min. Negotiated Rate |
$358.91 |
| Max. Negotiated Rate |
$1,269.75 |
| Rate for Payer: Aetna Commercial |
$732.90
|
| Rate for Payer: Aetna Medicare |
$568.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.59
|
| Rate for Payer: BCBS Complete |
$376.86
|
| Rate for Payer: BCBS MAPPO |
$546.94
|
| Rate for Payer: BCN Commercial |
$908.82
|
| Rate for Payer: BCN Medicare Advantage |
$546.94
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$787.59
|
| Rate for Payer: Cofinity Commercial |
$732.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.94
|
| Rate for Payer: Healthscope Commercial |
$875.10
|
| Rate for Payer: Healthscope Commercial |
$1,011.84
|
| Rate for Payer: Mclaren Medicaid |
$358.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.29
|
| Rate for Payer: Meridian Medicaid |
$376.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,072.26
|
| Rate for Payer: Nomi Health Commercial |
$656.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,269.75
|
| Rate for Payer: PACE SWMI |
$546.94
|
| Rate for Payer: PHP Medicare Advantage |
$546.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$971.49
|
| Rate for Payer: Priority Health Medicare |
$546.94
|
| Rate for Payer: Priority Health SBD |
$971.49
|
| Rate for Payer: Priority Health Tiered Network |
$971.49
|
| Rate for Payer: Railroad Medicare Medicare |
$546.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$979.32
|
| Rate for Payer: UHC Core |
$979.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.94
|
| Rate for Payer: UHC Exchange |
$979.32
|
| Rate for Payer: UHC Medicaid |
$358.91
|
| Rate for Payer: UHCCP Medicaid |
$358.91
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT
|
Professional
|
Both
|
$1,968.00
|
|
|
Service Code
|
HCPCS 28298
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$1,476.00 |
| Rate for Payer: Aetna Commercial |
$630.30
|
| Rate for Payer: Aetna Medicare |
$489.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.33
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCBS MAPPO |
$470.37
|
| Rate for Payer: BCN Commercial |
$769.38
|
| Rate for Payer: BCN Medicare Advantage |
$470.37
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cofinity Commercial |
$677.33
|
| Rate for Payer: Cofinity Commercial |
$630.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.37
|
| Rate for Payer: Healthscope Commercial |
$870.18
|
| Rate for Payer: Healthscope Commercial |
$752.59
|
| Rate for Payer: Mclaren Medicaid |
$308.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.89
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.99
|
| Rate for Payer: Nomi Health Commercial |
$564.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.00
|
| Rate for Payer: PACE SWMI |
$470.37
|
| Rate for Payer: PHP Medicare Advantage |
$470.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$822.44
|
| Rate for Payer: Priority Health Medicare |
$470.37
|
| Rate for Payer: Priority Health SBD |
$822.44
|
| Rate for Payer: Priority Health Tiered Network |
$822.44
|
| Rate for Payer: Railroad Medicare Medicare |
$470.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.81
|
| Rate for Payer: UHC Core |
$869.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.37
|
| Rate for Payer: UHC Exchange |
$869.81
|
| Rate for Payer: UHC Medicaid |
$308.21
|
| Rate for Payer: UHCCP Medicaid |
$308.21
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE
|
Professional
|
Both
|
$1,833.00
|
|
|
Service Code
|
HCPCS 28292
|
| Min. Negotiated Rate |
$293.30 |
| Max. Negotiated Rate |
$1,374.75 |
| Rate for Payer: Aetna Commercial |
$598.46
|
| Rate for Payer: Aetna Medicare |
$464.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$598.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.12
|
| Rate for Payer: BCBS Complete |
$307.96
|
| Rate for Payer: BCBS MAPPO |
$446.61
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: BCN Medicare Advantage |
$446.61
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cofinity Commercial |
$643.12
|
| Rate for Payer: Cofinity Commercial |
$598.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.61
|
| Rate for Payer: Healthscope Commercial |
$826.23
|
| Rate for Payer: Healthscope Commercial |
$714.58
|
| Rate for Payer: Mclaren Medicaid |
$293.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$468.94
|
| Rate for Payer: Meridian Medicaid |
$307.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$847.26
|
| Rate for Payer: Nomi Health Commercial |
$535.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.75
|
| Rate for Payer: PACE SWMI |
$446.61
|
| Rate for Payer: PHP Medicare Advantage |
$446.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$791.04
|
| Rate for Payer: Priority Health Medicare |
$446.61
|
| Rate for Payer: Priority Health SBD |
$791.04
|
| Rate for Payer: Priority Health Tiered Network |
$791.04
|
| Rate for Payer: Railroad Medicare Medicare |
$446.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.90
|
| Rate for Payer: UHC Core |
$843.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.61
|
| Rate for Payer: UHC Exchange |
$843.90
|
| Rate for Payer: UHC Medicaid |
$293.30
|
| Rate for Payer: UHCCP Medicaid |
$293.30
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY
|
Professional
|
Both
|
$2,478.00
|
|
|
Service Code
|
HCPCS 28299
|
| Min. Negotiated Rate |
$359.33 |
| Max. Negotiated Rate |
$1,858.50 |
| Rate for Payer: Aetna Commercial |
$735.57
|
| Rate for Payer: Aetna Medicare |
$570.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.46
|
| Rate for Payer: BCBS Complete |
$377.30
|
| Rate for Payer: BCBS MAPPO |
$548.93
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$548.93
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cofinity Commercial |
$790.46
|
| Rate for Payer: Cofinity Commercial |
$735.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.93
|
| Rate for Payer: Healthscope Commercial |
$878.29
|
| Rate for Payer: Healthscope Commercial |
$1,015.52
|
| Rate for Payer: Mclaren Medicaid |
$359.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.38
|
| Rate for Payer: Meridian Medicaid |
$377.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$603.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.36
|
| Rate for Payer: Nomi Health Commercial |
$658.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,858.50
|
| Rate for Payer: PACE SWMI |
$548.93
|
| Rate for Payer: PHP Medicare Advantage |
$548.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$548.93
|
| Rate for Payer: Priority Health SBD |
$967.25
|
| Rate for Payer: Priority Health Tiered Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$548.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.95
|
| Rate for Payer: UHC Core |
$1,019.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$548.93
|
| Rate for Payer: UHC Exchange |
$1,019.95
|
| Rate for Payer: UHC Medicaid |
$359.33
|
| Rate for Payer: UHCCP Medicaid |
$359.33
|
|
|
PR CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 67912
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$2,315.25 |
| Rate for Payer: Aetna Commercial |
$549.27
|
| Rate for Payer: Aetna Medicare |
$426.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.26
|
| Rate for Payer: BCBS Complete |
$283.81
|
| Rate for Payer: BCBS MAPPO |
$409.90
|
| Rate for Payer: BCN Commercial |
$719.59
|
| Rate for Payer: BCN Medicare Advantage |
$409.90
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cofinity Commercial |
$590.26
|
| Rate for Payer: Cofinity Commercial |
$549.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.90
|
| Rate for Payer: Healthscope Commercial |
$758.32
|
| Rate for Payer: Healthscope Commercial |
$655.84
|
| Rate for Payer: Mclaren Medicaid |
$270.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.39
|
| Rate for Payer: Meridian Medicaid |
$283.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.57
|
| Rate for Payer: Nomi Health Commercial |
$491.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,315.25
|
| Rate for Payer: PACE SWMI |
$409.90
|
| Rate for Payer: PHP Medicare Advantage |
$409.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$842.88
|
| Rate for Payer: Priority Health Medicare |
$409.90
|
| Rate for Payer: Priority Health SBD |
$842.88
|
| Rate for Payer: Priority Health Tiered Network |
$842.88
|
| Rate for Payer: Railroad Medicare Medicare |
$409.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.99
|
| Rate for Payer: UHC Core |
$828.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.90
|
| Rate for Payer: UHC Exchange |
$828.99
|
| Rate for Payer: UHC Medicaid |
$270.30
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 44055
|
| Min. Negotiated Rate |
$878.63 |
| Max. Negotiated Rate |
$2,727.38 |
| Rate for Payer: Aetna Commercial |
$1,844.22
|
| Rate for Payer: Aetna Medicare |
$1,431.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,981.84
|
| Rate for Payer: BCBS Complete |
$922.56
|
| Rate for Payer: BCBS MAPPO |
$1,376.28
|
| Rate for Payer: BCN Commercial |
$2,238.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,376.28
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,981.84
|
| Rate for Payer: Cofinity Commercial |
$1,844.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,376.28
|
| Rate for Payer: Healthscope Commercial |
$2,546.12
|
| Rate for Payer: Healthscope Commercial |
$2,202.05
|
| Rate for Payer: Mclaren Medicaid |
$878.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,445.09
|
| Rate for Payer: Meridian Medicaid |
$922.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,513.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,661.50
|
| Rate for Payer: Nomi Health Commercial |
$1,651.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: PACE SWMI |
$1,376.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,376.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,727.38
|
| Rate for Payer: Priority Health Medicare |
$1,376.28
|
| Rate for Payer: Priority Health SBD |
$2,727.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,727.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,376.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,663.49
|
| Rate for Payer: UHC Core |
$2,663.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,376.28
|
| Rate for Payer: UHC Exchange |
$2,663.49
|
| Rate for Payer: UHC Medicaid |
$878.63
|
| Rate for Payer: UHCCP Medicaid |
$878.63
|
|
|
PR COSMETIC CORRECTION OF INVERTED NIPPLES
|
Professional
|
Both
|
$1,803.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$721.20 |
| Max. Negotiated Rate |
$1,352.25 |
| Rate for Payer: Aetna Medicare |
$901.50
|
| Rate for Payer: BCBS Complete |
$721.20
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,171.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,352.25
|
|
|
PR COSMETIC SCLEROTHERAPY
|
Professional
|
Both
|
$300.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
|
|
PR COSMETIC SCLEROTHERAPY/LASER
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR COSMETIC SCLEROTHERAPY/LASER/F/U TREATMENT
|
Professional
|
Both
|
$79.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
PR COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG
|
Professional
|
Both
|
$6,444.00
|
|
|
Service Code
|
HCPCS 63064
|
| Min. Negotiated Rate |
$1,075.01 |
| Max. Negotiated Rate |
$4,833.00 |
| Rate for Payer: Aetna Commercial |
$2,251.32
|
| Rate for Payer: Aetna Medicare |
$1,747.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,251.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.33
|
| Rate for Payer: BCBS Complete |
$1,128.76
|
| Rate for Payer: BCBS MAPPO |
$1,680.09
|
| Rate for Payer: BCN Commercial |
$2,939.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,680.09
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cofinity Commercial |
$2,419.33
|
| Rate for Payer: Cofinity Commercial |
$2,251.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,680.09
|
| Rate for Payer: Healthscope Commercial |
$3,108.17
|
| Rate for Payer: Healthscope Commercial |
$2,688.14
|
| Rate for Payer: Mclaren Medicaid |
$1,075.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,764.09
|
| Rate for Payer: Meridian Medicaid |
$1,128.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,848.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.99
|
| Rate for Payer: Nomi Health Commercial |
$2,016.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,833.00
|
| Rate for Payer: PACE SWMI |
$1,680.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,680.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,108.30
|
| Rate for Payer: Priority Health Medicare |
$1,680.09
|
| Rate for Payer: Priority Health SBD |
$3,108.30
|
| Rate for Payer: Priority Health Tiered Network |
$3,108.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,680.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,145.29
|
| Rate for Payer: UHC Core |
$3,145.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,680.09
|
| Rate for Payer: UHC Exchange |
$3,145.29
|
| Rate for Payer: UHC Medicaid |
$1,075.01
|
| Rate for Payer: UHCCP Medicaid |
$1,075.01
|
|
|
PR COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 63066
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,656.75 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: Aetna Medicare |
$197.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.92
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$190.22
|
| Rate for Payer: BCN Commercial |
$339.18
|
| Rate for Payer: BCN Medicare Advantage |
$190.22
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cofinity Commercial |
$273.92
|
| Rate for Payer: Cofinity Commercial |
$254.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.22
|
| Rate for Payer: Healthscope Commercial |
$351.91
|
| Rate for Payer: Healthscope Commercial |
$304.35
|
| Rate for Payer: Mclaren Medicaid |
$119.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.73
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.73
|
| Rate for Payer: Nomi Health Commercial |
$228.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.75
|
| Rate for Payer: PACE SWMI |
$190.22
|
| Rate for Payer: PHP Medicare Advantage |
$190.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$358.61
|
| Rate for Payer: Priority Health Medicare |
$190.22
|
| Rate for Payer: Priority Health SBD |
$358.61
|
| Rate for Payer: Priority Health Tiered Network |
$358.61
|
| Rate for Payer: Railroad Medicare Medicare |
$190.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.81
|
| Rate for Payer: UHC Core |
$366.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$190.22
|
| Rate for Payer: UHC Exchange |
$366.81
|
| Rate for Payer: UHC Medicaid |
$119.71
|
| Rate for Payer: UHCCP Medicaid |
$119.71
|
|
|
PR COUDE TIP URINARY CATHETER
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4352
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$14.39 |
| Rate for Payer: Aetna Commercial |
$10.43
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$7.78
|
| Rate for Payer: BCN Commercial |
$7.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$10.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$12.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.26
|
| Rate for Payer: Nomi Health Commercial |
$9.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$7.78
|
| Rate for Payer: PHP Medicare Advantage |
$7.78
|
| Rate for Payer: Priority Health Medicare |
$7.78
|
| Rate for Payer: Railroad Medicare Medicare |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.54
|
| Rate for Payer: UHC Core |
$2.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.78
|
| Rate for Payer: UHC Exchange |
$2.54
|
|
|
PR COUNSEL IMMUNE <21 16-30 M
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS G0314
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
|
|
PR COUNSEL IMMUNE <21 5-15 M
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0315
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR CPAP VENTILATION CPAP INITIATION&MGMT
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 94660
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$43.09
|
| Rate for Payer: Aetna Medicare |
$33.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.31
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$32.16
|
| Rate for Payer: BCN Commercial |
$54.28
|
| Rate for Payer: BCN Medicare Advantage |
$32.16
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.16
|
| Rate for Payer: Healthscope Commercial |
$51.46
|
| Rate for Payer: Healthscope Commercial |
$59.50
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.77
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.42
|
| Rate for Payer: Nomi Health Commercial |
$38.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$32.16
|
| Rate for Payer: PHP Medicare Advantage |
$32.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.06
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health SBD |
$50.06
|
| Rate for Payer: Priority Health Tiered Network |
$50.06
|
| Rate for Payer: Railroad Medicare Medicare |
$32.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.00
|
| Rate for Payer: UHC Core |
$62.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.16
|
| Rate for Payer: UHC Exchange |
$62.00
|
| Rate for Payer: UHC Medicaid |
$20.66
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
PR CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99489
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$80.22 |
| Rate for Payer: Aetna Commercial |
$58.10
|
| Rate for Payer: Aetna Medicare |
$45.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.44
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.36
|
| Rate for Payer: BCN Commercial |
$79.19
|
| Rate for Payer: BCN Medicare Advantage |
$43.36
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.36
|
| Rate for Payer: Healthscope Commercial |
$80.22
|
| Rate for Payer: Healthscope Commercial |
$69.38
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.53
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.65
|
| Rate for Payer: Nomi Health Commercial |
$52.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$43.36
|
| Rate for Payer: PHP Medicare Advantage |
$43.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.40
|
| Rate for Payer: Priority Health Medicare |
$43.36
|
| Rate for Payer: Priority Health SBD |
$65.40
|
| Rate for Payer: Priority Health Tiered Network |
$65.40
|
| Rate for Payer: Railroad Medicare Medicare |
$43.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.54
|
| Rate for Payer: UHC Core |
$36.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.36
|
| Rate for Payer: UHC Exchange |
$36.54
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$10,611.00
|
|
|
Service Code
|
HCPCS 61698
|
| Min. Negotiated Rate |
$2,787.96 |
| Max. Negotiated Rate |
$9,661.21 |
| Rate for Payer: Aetna Commercial |
$5,890.02
|
| Rate for Payer: Aetna Medicare |
$4,571.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,890.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,329.58
|
| Rate for Payer: BCBS Complete |
$2,927.36
|
| Rate for Payer: BCBS MAPPO |
$4,395.54
|
| Rate for Payer: BCN Commercial |
$9,661.21
|
| Rate for Payer: BCN Medicare Advantage |
$4,395.54
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cofinity Commercial |
$6,329.58
|
| Rate for Payer: Cofinity Commercial |
$5,890.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,395.54
|
| Rate for Payer: Healthscope Commercial |
$8,131.75
|
| Rate for Payer: Healthscope Commercial |
$7,032.86
|
| Rate for Payer: Mclaren Medicaid |
$2,787.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,615.32
|
| Rate for Payer: Meridian Medicaid |
$2,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,835.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,383.23
|
| Rate for Payer: Nomi Health Commercial |
$5,274.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,958.25
|
| Rate for Payer: PACE SWMI |
$4,395.54
|
| Rate for Payer: PHP Medicare Advantage |
$4,395.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,787.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,122.41
|
| Rate for Payer: Priority Health Medicare |
$4,395.54
|
| Rate for Payer: Priority Health SBD |
$8,122.41
|
| Rate for Payer: Priority Health Tiered Network |
$8,122.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4,395.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,461.50
|
| Rate for Payer: UHC Core |
$8,461.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,395.54
|
| Rate for Payer: UHC Exchange |
$8,461.50
|
| Rate for Payer: UHC Medicaid |
$2,787.96
|
| Rate for Payer: UHCCP Medicaid |
$2,787.96
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 0055T
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: Aetna Medicare |
$262.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.14
|
| Rate for Payer: BCBS Complete |
$154.02
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Mclaren Medicaid |
$146.69
|
| Rate for Payer: Meridian Medicaid |
$154.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.16
|
| Rate for Payer: UHC Core |
$311.16
|
| Rate for Payer: UHC Exchange |
$311.16
|
| Rate for Payer: UHC Medicaid |
$146.69
|
| Rate for Payer: UHCCP Medicaid |
$146.69
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 0054T
|
| Min. Negotiated Rate |
$91.75 |
| Max. Negotiated Rate |
$302.51 |
| Rate for Payer: UHC Core |
$277.22
|
| Rate for Payer: Aetna Commercial |
$179.20
|
| Rate for Payer: Aetna Medicare |
$137.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.20
|
| Rate for Payer: BCBS Complete |
$96.34
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Mclaren Medicaid |
$91.75
|
| Rate for Payer: Meridian Medicaid |
$96.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.22
|
| Rate for Payer: UHC Exchange |
$277.22
|
| Rate for Payer: UHC Medicaid |
$91.75
|
| Rate for Payer: UHCCP Medicaid |
$91.75
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 20985
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$165.93
|
| Rate for Payer: Aetna Medicare |
$128.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.32
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS MAPPO |
$123.83
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$123.83
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$178.32
|
| Rate for Payer: Cofinity Commercial |
$165.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.83
|
| Rate for Payer: Healthscope Commercial |
$229.09
|
| Rate for Payer: Healthscope Commercial |
$198.13
|
| Rate for Payer: Mclaren Medicaid |
$79.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.02
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.65
|
| Rate for Payer: Nomi Health Commercial |
$148.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.25
|
| Rate for Payer: PACE SWMI |
$123.83
|
| Rate for Payer: PHP Medicare Advantage |
$123.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$230.50
|
| Rate for Payer: Priority Health Medicare |
$123.83
|
| Rate for Payer: Priority Health SBD |
$230.50
|
| Rate for Payer: Priority Health Tiered Network |
$230.50
|
| Rate for Payer: Railroad Medicare Medicare |
$123.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.56
|
| Rate for Payer: UHC Core |
$259.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.83
|
| Rate for Payer: UHC Exchange |
$259.56
|
| Rate for Payer: UHC Medicaid |
$79.02
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
|
