|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 95929
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$33,855.00 |
| Rate for Payer: Aetna Commercial |
$286.55
|
| Rate for Payer: Aetna Medicare |
$222.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.93
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$213.84
|
| Rate for Payer: BCBS Trust/PPO |
$111.47
|
| Rate for Payer: BCN Commercial |
$349.40
|
| Rate for Payer: BCN Medicare Advantage |
$213.84
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$307.93
|
| Rate for Payer: Cofinity Commercial |
$286.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.84
|
| Rate for Payer: Healthscope Commercial |
$395.60
|
| Rate for Payer: Healthscope Commercial |
$342.14
|
| Rate for Payer: Mclaren Medicaid |
$48.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.53
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,855.00
|
| Rate for Payer: Nomi Health Commercial |
$256.61
|
| Rate for Payer: PACE SWMI |
$213.84
|
| Rate for Payer: PHP Medicare Advantage |
$213.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.19
|
| Rate for Payer: Priority Health Medicare |
$213.84
|
| Rate for Payer: Priority Health Narrow Network |
$330.19
|
| Rate for Payer: Priority Health SBD |
$104.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.84
|
| Rate for Payer: UHC Exchange |
$201.30
|
| Rate for Payer: UHC Medicare Advantage |
$213.84
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 95928
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$33,354.00 |
| Rate for Payer: Aetna Commercial |
$286.26
|
| Rate for Payer: Aetna Commercial |
$286.26
|
| Rate for Payer: Aetna Medicare |
$222.18
|
| Rate for Payer: Aetna Medicare |
$222.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.26
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$213.63
|
| Rate for Payer: BCBS MAPPO |
$213.63
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: BCN Medicare Advantage |
$213.63
|
| Rate for Payer: BCN Medicare Advantage |
$213.63
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$286.26
|
| Rate for Payer: Cofinity Commercial |
$286.26
|
| Rate for Payer: Cofinity Commercial |
$307.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.63
|
| Rate for Payer: Healthscope Commercial |
$341.81
|
| Rate for Payer: Healthscope Commercial |
$395.22
|
| Rate for Payer: Healthscope Commercial |
$341.81
|
| Rate for Payer: Healthscope Commercial |
$395.22
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.31
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,354.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,354.00
|
| Rate for Payer: Nomi Health Commercial |
$256.36
|
| Rate for Payer: Nomi Health Commercial |
$256.36
|
| Rate for Payer: PACE SWMI |
$213.63
|
| Rate for Payer: PACE SWMI |
$213.63
|
| Rate for Payer: PHP Medicare Advantage |
$213.63
|
| Rate for Payer: PHP Medicare Advantage |
$213.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.58
|
| Rate for Payer: Priority Health Medicare |
$213.63
|
| Rate for Payer: Priority Health Medicare |
$213.63
|
| Rate for Payer: Priority Health Narrow Network |
$326.58
|
| Rate for Payer: Priority Health Narrow Network |
$326.58
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: Priority Health SBD |
$104.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.63
|
| Rate for Payer: UHC Exchange |
$193.60
|
| Rate for Payer: UHC Exchange |
$193.60
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 95939
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$76,662.00 |
| Rate for Payer: Aetna Commercial |
$663.49
|
| Rate for Payer: Aetna Medicare |
$514.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.00
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$495.14
|
| Rate for Payer: BCBS Trust/PPO |
$596.45
|
| Rate for Payer: BCN Commercial |
$797.04
|
| Rate for Payer: BCN Medicare Advantage |
$495.14
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$713.00
|
| Rate for Payer: Cofinity Commercial |
$663.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.14
|
| Rate for Payer: Healthscope Commercial |
$792.22
|
| Rate for Payer: Healthscope Commercial |
$916.01
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.90
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,662.00
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PACE SWMI |
$495.14
|
| Rate for Payer: PHP Medicare Advantage |
$495.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.17
|
| Rate for Payer: Priority Health Medicare |
$495.14
|
| Rate for Payer: Priority Health Narrow Network |
$757.17
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$495.14
|
| Rate for Payer: UHC Medicare Advantage |
$495.14
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
|
|
PR CURETTAGE POSTPARTUM
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 59160
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$33,998.00 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$189.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.17
|
| Rate for Payer: BCBS Complete |
$126.81
|
| Rate for Payer: BCBS MAPPO |
$182.06
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$405.60
|
| Rate for Payer: BCN Medicare Advantage |
$182.06
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$262.17
|
| Rate for Payer: Cofinity Commercial |
$243.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.06
|
| Rate for Payer: Healthscope Commercial |
$336.81
|
| Rate for Payer: Healthscope Commercial |
$291.30
|
| Rate for Payer: Mclaren Medicaid |
$120.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.16
|
| Rate for Payer: Meridian Medicaid |
$126.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,998.00
|
| Rate for Payer: Nomi Health Commercial |
$218.47
|
| Rate for Payer: PACE SWMI |
$182.06
|
| Rate for Payer: PHP Medicare Advantage |
$182.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.41
|
| Rate for Payer: Priority Health Medicare |
$182.06
|
| Rate for Payer: Priority Health Narrow Network |
$266.41
|
| Rate for Payer: Priority Health SBD |
$266.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.06
|
| Rate for Payer: UHC Exchange |
$363.63
|
| Rate for Payer: UHC Medicare Advantage |
$182.06
|
| Rate for Payer: UHCCP Medicaid |
$120.77
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 46940
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$25,745.00 |
| Rate for Payer: Aetna Commercial |
$185.88
|
| Rate for Payer: Aetna Medicare |
$144.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.76
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$138.72
|
| Rate for Payer: BCN Commercial |
$392.89
|
| Rate for Payer: BCN Medicare Advantage |
$138.72
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$199.76
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$256.63
|
| Rate for Payer: Healthscope Commercial |
$221.95
|
| Rate for Payer: Mclaren Medicaid |
$93.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.66
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,745.00
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: PACE SWMI |
$138.72
|
| Rate for Payer: PHP Medicare Advantage |
$138.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.11
|
| Rate for Payer: Priority Health Medicare |
$138.72
|
| Rate for Payer: Priority Health Narrow Network |
$260.11
|
| Rate for Payer: Priority Health SBD |
$260.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.72
|
| Rate for Payer: UHC Exchange |
$227.65
|
| Rate for Payer: UHC Medicare Advantage |
$138.72
|
| Rate for Payer: UHCCP Medicaid |
$93.29
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 46942
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$23,031.00 |
| Rate for Payer: Aetna Commercial |
$166.35
|
| Rate for Payer: Aetna Medicare |
$129.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.76
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$124.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.83
|
| Rate for Payer: BCN Commercial |
$373.84
|
| Rate for Payer: BCN Medicare Advantage |
$124.14
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$178.76
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.14
|
| Rate for Payer: Healthscope Commercial |
$229.66
|
| Rate for Payer: Healthscope Commercial |
$198.62
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.35
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,031.00
|
| Rate for Payer: Nomi Health Commercial |
$148.97
|
| Rate for Payer: PACE SWMI |
$124.14
|
| Rate for Payer: PHP Medicare Advantage |
$124.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.87
|
| Rate for Payer: Priority Health Medicare |
$124.14
|
| Rate for Payer: Priority Health Narrow Network |
$233.87
|
| Rate for Payer: Priority Health SBD |
$233.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.14
|
| Rate for Payer: UHC Exchange |
$203.38
|
| Rate for Payer: UHC Medicare Advantage |
$124.14
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR CUSTOM EAR PLUGS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00592
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
PR CUTANANEOUS APPENDICO-VESICOSTOMY
|
Professional
|
Both
|
$2,587.00
|
|
|
Service Code
|
HCPCS 50845
|
| Min. Negotiated Rate |
$801.73 |
| Max. Negotiated Rate |
$220,037.00 |
| Rate for Payer: Aetna Commercial |
$1,603.93
|
| Rate for Payer: Aetna Medicare |
$1,244.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,603.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,723.62
|
| Rate for Payer: BCBS Complete |
$841.82
|
| Rate for Payer: BCBS MAPPO |
$1,196.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,554.33
|
| Rate for Payer: BCN Commercial |
$1,804.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,196.96
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cash Price |
$2,069.60
|
| Rate for Payer: Cofinity Commercial |
$1,723.62
|
| Rate for Payer: Cofinity Commercial |
$1,603.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,196.96
|
| Rate for Payer: Healthscope Commercial |
$2,214.38
|
| Rate for Payer: Healthscope Commercial |
$1,915.14
|
| Rate for Payer: Mclaren Medicaid |
$801.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,256.81
|
| Rate for Payer: Meridian Medicaid |
$841.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220,037.00
|
| Rate for Payer: Nomi Health Commercial |
$1,436.35
|
| Rate for Payer: PACE SWMI |
$1,196.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,196.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,990.32
|
| Rate for Payer: Priority Health Medicare |
$1,196.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,990.32
|
| Rate for Payer: Priority Health SBD |
$1,990.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,522.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,196.96
|
| Rate for Payer: UHC Exchange |
$1,522.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,196.96
|
| Rate for Payer: UHCCP Medicaid |
$801.73
|
|
|
PR CUTANEOUS VESICOSTOMY
|
Professional
|
Both
|
$1,460.00
|
|
|
Service Code
|
HCPCS 51980
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$125,482.00 |
| Rate for Payer: Aetna Commercial |
$913.92
|
| Rate for Payer: Aetna Medicare |
$709.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.12
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS MAPPO |
$682.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,370.48
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: BCN Medicare Advantage |
$682.03
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cash Price |
$1,168.00
|
| Rate for Payer: Cofinity Commercial |
$982.12
|
| Rate for Payer: Cofinity Commercial |
$913.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.03
|
| Rate for Payer: Healthscope Commercial |
$1,261.76
|
| Rate for Payer: Healthscope Commercial |
$1,091.25
|
| Rate for Payer: Mclaren Medicaid |
$457.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.13
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125,482.00
|
| Rate for Payer: Nomi Health Commercial |
$818.44
|
| Rate for Payer: PACE SWMI |
$682.03
|
| Rate for Payer: PHP Medicare Advantage |
$682.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.58
|
| Rate for Payer: Priority Health Medicare |
$682.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.58
|
| Rate for Payer: Priority Health SBD |
$1,136.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.03
|
| Rate for Payer: UHC Exchange |
$850.00
|
| Rate for Payer: UHC Medicare Advantage |
$682.03
|
| Rate for Payer: UHCCP Medicaid |
$457.52
|
|
|
PR CV STRS TST XERS&/OR RX CONT ECG I&R ONLY
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 93018
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$2,043.00 |
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.18
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.71
|
| Rate for Payer: BCN Commercial |
$20.04
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$24.64
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.00
|
| Rate for Payer: Nomi Health Commercial |
$15.98
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$13.32
|
| Rate for Payer: Priority Health Narrow Network |
$19.31
|
| Rate for Payer: Priority Health SBD |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.32
|
| Rate for Payer: UHC Exchange |
$35.33
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
PR CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 93017
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$4,971.00 |
| Rate for Payer: Aetna Commercial |
$45.64
|
| Rate for Payer: Aetna Medicare |
$35.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.05
|
| Rate for Payer: BCBS Complete |
$45.20
|
| Rate for Payer: BCBS MAPPO |
$34.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.94
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$34.06
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$49.05
|
| Rate for Payer: Cofinity Commercial |
$45.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.06
|
| Rate for Payer: Healthscope Commercial |
$54.50
|
| Rate for Payer: Healthscope Commercial |
$63.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,971.00
|
| Rate for Payer: Nomi Health Commercial |
$40.87
|
| Rate for Payer: PACE SWMI |
$34.06
|
| Rate for Payer: PHP Medicare Advantage |
$34.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.20
|
| Rate for Payer: Priority Health Medicare |
$34.06
|
| Rate for Payer: Priority Health Narrow Network |
$53.20
|
| Rate for Payer: Priority Health SBD |
$53.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.06
|
| Rate for Payer: UHC Exchange |
$84.63
|
| Rate for Payer: UHC Medicare Advantage |
$34.06
|
|
|
PR CV STRS TST XERS&/OR RX CONT ECG W/O I&R
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 93016
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$3,083.00 |
| Rate for Payer: Aetna Commercial |
$26.33
|
| Rate for Payer: Aetna Medicare |
$20.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.30
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$19.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.90
|
| Rate for Payer: BCN Commercial |
$30.29
|
| Rate for Payer: BCN Medicare Advantage |
$19.65
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$36.35
|
| Rate for Payer: Healthscope Commercial |
$31.44
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.63
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,083.00
|
| Rate for Payer: Nomi Health Commercial |
$23.58
|
| Rate for Payer: PACE SWMI |
$19.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.19
|
| Rate for Payer: Priority Health Medicare |
$19.65
|
| Rate for Payer: Priority Health Narrow Network |
$29.19
|
| Rate for Payer: Priority Health SBD |
$29.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.65
|
| Rate for Payer: UHC Exchange |
$51.74
|
| Rate for Payer: UHC Medicare Advantage |
$19.65
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
|
PR CV STRS TST XERS&/OR RX CONT ECG W/SI&R
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 93015
|
| Min. Negotiated Rate |
$67.03 |
| Max. Negotiated Rate |
$10,098.00 |
| Rate for Payer: Aetna Commercial |
$89.82
|
| Rate for Payer: Aetna Medicare |
$69.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.52
|
| Rate for Payer: BCBS Complete |
$180.80
|
| Rate for Payer: BCBS MAPPO |
$67.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,485.65
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: BCN Medicare Advantage |
$67.03
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cofinity Commercial |
$96.52
|
| Rate for Payer: Cofinity Commercial |
$89.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.03
|
| Rate for Payer: Healthscope Commercial |
$107.25
|
| Rate for Payer: Healthscope Commercial |
$124.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,098.00
|
| Rate for Payer: Nomi Health Commercial |
$80.44
|
| Rate for Payer: PACE SWMI |
$67.03
|
| Rate for Payer: PHP Medicare Advantage |
$67.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.70
|
| Rate for Payer: Priority Health Medicare |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$101.70
|
| Rate for Payer: Priority Health SBD |
$101.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.03
|
| Rate for Payer: UHC Exchange |
$200.27
|
| Rate for Payer: UHC Medicare Advantage |
$67.03
|
|
|
PR CYSTECTOMY COMPLETE SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,811.00
|
|
|
Service Code
|
HCPCS 51570
|
| Min. Negotiated Rate |
$935.71 |
| Max. Negotiated Rate |
$258,950.00 |
| Rate for Payer: Aetna Commercial |
$1,879.64
|
| Rate for Payer: Aetna Medicare |
$1,458.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,879.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,019.92
|
| Rate for Payer: BCBS Complete |
$982.50
|
| Rate for Payer: BCBS MAPPO |
$1,402.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,145.50
|
| Rate for Payer: BCN Commercial |
$2,115.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,402.72
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cash Price |
$2,248.80
|
| Rate for Payer: Cofinity Commercial |
$2,019.92
|
| Rate for Payer: Cofinity Commercial |
$1,879.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,402.72
|
| Rate for Payer: Healthscope Commercial |
$2,595.03
|
| Rate for Payer: Healthscope Commercial |
$2,244.35
|
| Rate for Payer: Mclaren Medicaid |
$935.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,472.86
|
| Rate for Payer: Meridian Medicaid |
$982.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258,950.00
|
| Rate for Payer: Nomi Health Commercial |
$1,683.26
|
| Rate for Payer: PACE SWMI |
$1,402.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,402.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,827.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,328.53
|
| Rate for Payer: Priority Health Medicare |
$1,402.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,328.53
|
| Rate for Payer: Priority Health SBD |
$2,328.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,772.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,402.72
|
| Rate for Payer: UHC Exchange |
$1,772.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,402.72
|
| Rate for Payer: UHCCP Medicaid |
$935.71
|
|
|
PR CYSTECTOMY PARTIAL COMPLICATED
|
Professional
|
Both
|
$7,752.00
|
|
|
Service Code
|
HCPCS 51555
|
| Min. Negotiated Rate |
$803.65 |
| Max. Negotiated Rate |
$221,429.00 |
| Rate for Payer: Aetna Commercial |
$1,613.09
|
| Rate for Payer: Aetna Medicare |
$1,251.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,613.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,733.47
|
| Rate for Payer: BCBS Complete |
$843.83
|
| Rate for Payer: BCBS MAPPO |
$1,203.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,383.69
|
| Rate for Payer: BCN Commercial |
$1,811.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,203.80
|
| Rate for Payer: Cash Price |
$6,201.60
|
| Rate for Payer: Cash Price |
$6,201.60
|
| Rate for Payer: Cofinity Commercial |
$1,733.47
|
| Rate for Payer: Cofinity Commercial |
$1,613.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,203.80
|
| Rate for Payer: Healthscope Commercial |
$2,227.03
|
| Rate for Payer: Healthscope Commercial |
$1,926.08
|
| Rate for Payer: Mclaren Medicaid |
$803.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,263.99
|
| Rate for Payer: Meridian Medicaid |
$843.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221,429.00
|
| Rate for Payer: Nomi Health Commercial |
$1,444.56
|
| Rate for Payer: PACE SWMI |
$1,203.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,203.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,038.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,997.78
|
| Rate for Payer: Priority Health Medicare |
$1,203.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,997.78
|
| Rate for Payer: Priority Health SBD |
$1,997.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,390.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,203.80
|
| Rate for Payer: UHC Exchange |
$1,390.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,203.80
|
| Rate for Payer: UHCCP Medicaid |
$803.65
|
|
|
PR CYSTECTOMY PARTIAL SIMPLE
|
Professional
|
Both
|
$1,545.00
|
|
|
Service Code
|
HCPCS 51550
|
| Min. Negotiated Rate |
$615.36 |
| Max. Negotiated Rate |
$169,513.00 |
| Rate for Payer: Aetna Commercial |
$1,234.15
|
| Rate for Payer: Aetna Medicare |
$957.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.25
|
| Rate for Payer: BCBS Complete |
$646.13
|
| Rate for Payer: BCBS MAPPO |
$921.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,405.35
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$921.01
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cash Price |
$1,236.00
|
| Rate for Payer: Cofinity Commercial |
$1,326.25
|
| Rate for Payer: Cofinity Commercial |
$1,234.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.01
|
| Rate for Payer: Healthscope Commercial |
$1,703.87
|
| Rate for Payer: Healthscope Commercial |
$1,473.62
|
| Rate for Payer: Mclaren Medicaid |
$615.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.06
|
| Rate for Payer: Meridian Medicaid |
$646.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169,513.00
|
| Rate for Payer: Nomi Health Commercial |
$1,105.21
|
| Rate for Payer: PACE SWMI |
$921.01
|
| Rate for Payer: PHP Medicare Advantage |
$921.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,531.23
|
| Rate for Payer: Priority Health Medicare |
$921.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,531.23
|
| Rate for Payer: Priority Health SBD |
$1,531.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,183.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.01
|
| Rate for Payer: UHC Exchange |
$1,183.03
|
| Rate for Payer: UHC Medicare Advantage |
$921.01
|
| Rate for Payer: UHCCP Medicaid |
$615.36
|
|
|
PR CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY
|
Professional
|
Both
|
$3,796.00
|
|
|
Service Code
|
HCPCS 51575
|
| Min. Negotiated Rate |
$1,152.97 |
| Max. Negotiated Rate |
$319,502.00 |
| Rate for Payer: Aetna Commercial |
$2,316.16
|
| Rate for Payer: Aetna Medicare |
$1,797.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,316.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,489.01
|
| Rate for Payer: BCBS Complete |
$1,210.62
|
| Rate for Payer: BCBS MAPPO |
$1,728.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,111.16
|
| Rate for Payer: BCN Commercial |
$2,610.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,728.48
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cofinity Commercial |
$2,489.01
|
| Rate for Payer: Cofinity Commercial |
$2,316.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,728.48
|
| Rate for Payer: Healthscope Commercial |
$3,197.69
|
| Rate for Payer: Healthscope Commercial |
$2,765.57
|
| Rate for Payer: Mclaren Medicaid |
$1,152.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,814.90
|
| Rate for Payer: Meridian Medicaid |
$1,210.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319,502.00
|
| Rate for Payer: Nomi Health Commercial |
$2,074.18
|
| Rate for Payer: PACE SWMI |
$1,728.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,728.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,152.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,467.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,866.45
|
| Rate for Payer: Priority Health Medicare |
$1,728.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,866.45
|
| Rate for Payer: Priority Health SBD |
$2,866.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,235.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,728.48
|
| Rate for Payer: UHC Exchange |
$2,235.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,728.48
|
| Rate for Payer: UHCCP Medicaid |
$1,152.97
|
|
|
PR CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS
|
Professional
|
Both
|
$773.00
|
|
|
Service Code
|
HCPCS 52281
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$26,563.00 |
| Rate for Payer: Aetna Commercial |
$193.74
|
| Rate for Payer: Aetna Medicare |
$150.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.20
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$144.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,364.67
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: BCN Medicare Advantage |
$144.58
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$208.20
|
| Rate for Payer: Cofinity Commercial |
$193.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.58
|
| Rate for Payer: Healthscope Commercial |
$267.47
|
| Rate for Payer: Healthscope Commercial |
$231.33
|
| Rate for Payer: Mclaren Medicaid |
$96.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.81
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,563.00
|
| Rate for Payer: Nomi Health Commercial |
$173.50
|
| Rate for Payer: PACE SWMI |
$144.58
|
| Rate for Payer: PHP Medicare Advantage |
$144.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.66
|
| Rate for Payer: Priority Health Medicare |
$144.58
|
| Rate for Payer: Priority Health Narrow Network |
$239.66
|
| Rate for Payer: Priority Health SBD |
$239.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.58
|
| Rate for Payer: UHC Exchange |
$437.11
|
| Rate for Payer: UHC Medicare Advantage |
$144.58
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
|
|
PR CYSTO FRAGMENTATION URETERAL STONE
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 52325
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$55,975.00 |
| Rate for Payer: Aetna Commercial |
$406.46
|
| Rate for Payer: Aetna Medicare |
$315.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.80
|
| Rate for Payer: BCBS Complete |
$212.02
|
| Rate for Payer: BCBS MAPPO |
$303.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,083.76
|
| Rate for Payer: BCN Commercial |
$456.42
|
| Rate for Payer: BCN Medicare Advantage |
$303.33
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$406.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.33
|
| Rate for Payer: Healthscope Commercial |
$561.16
|
| Rate for Payer: Healthscope Commercial |
$485.33
|
| Rate for Payer: Mclaren Medicaid |
$201.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.50
|
| Rate for Payer: Meridian Medicaid |
$212.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,975.00
|
| Rate for Payer: Nomi Health Commercial |
$364.00
|
| Rate for Payer: PACE SWMI |
$303.33
|
| Rate for Payer: PHP Medicare Advantage |
$303.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$501.71
|
| Rate for Payer: Priority Health Medicare |
$303.33
|
| Rate for Payer: Priority Health Narrow Network |
$501.71
|
| Rate for Payer: Priority Health SBD |
$501.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.33
|
| Rate for Payer: UHC Exchange |
$418.83
|
| Rate for Payer: UHC Medicare Advantage |
$303.33
|
| Rate for Payer: UHCCP Medicaid |
$201.92
|
|
|
PR CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 52305
|
| Min. Negotiated Rate |
$175.51 |
| Max. Negotiated Rate |
$48,764.00 |
| Rate for Payer: Aetna Commercial |
$352.97
|
| Rate for Payer: Aetna Medicare |
$273.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.31
|
| Rate for Payer: BCBS Complete |
$184.29
|
| Rate for Payer: BCBS MAPPO |
$263.41
|
| Rate for Payer: BCBS Trust/PPO |
$894.94
|
| Rate for Payer: BCN Commercial |
$397.79
|
| Rate for Payer: BCN Medicare Advantage |
$263.41
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$379.31
|
| Rate for Payer: Cofinity Commercial |
$352.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.41
|
| Rate for Payer: Healthscope Commercial |
$487.31
|
| Rate for Payer: Healthscope Commercial |
$421.46
|
| Rate for Payer: Mclaren Medicaid |
$175.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.58
|
| Rate for Payer: Meridian Medicaid |
$184.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,764.00
|
| Rate for Payer: Nomi Health Commercial |
$316.09
|
| Rate for Payer: PACE SWMI |
$263.41
|
| Rate for Payer: PHP Medicare Advantage |
$263.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.19
|
| Rate for Payer: Priority Health Medicare |
$263.41
|
| Rate for Payer: Priority Health Narrow Network |
$436.19
|
| Rate for Payer: Priority Health SBD |
$436.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.41
|
| Rate for Payer: UHC Exchange |
$361.69
|
| Rate for Payer: UHC Medicare Advantage |
$263.41
|
| Rate for Payer: UHCCP Medicaid |
$175.51
|
|
|
PR CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL
|
Professional
|
Both
|
$1,720.00
|
|
|
Service Code
|
HCPCS 52442
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$8,894.00 |
| Rate for Payer: Aetna Commercial |
$65.00
|
| Rate for Payer: Aetna Medicare |
$50.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.85
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$48.51
|
| Rate for Payer: BCBS Trust/PPO |
$367.70
|
| Rate for Payer: BCN Commercial |
$1,276.43
|
| Rate for Payer: BCN Medicare Advantage |
$48.51
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cofinity Commercial |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$65.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.51
|
| Rate for Payer: Healthscope Commercial |
$77.62
|
| Rate for Payer: Healthscope Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.94
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,894.00
|
| Rate for Payer: Nomi Health Commercial |
$58.21
|
| Rate for Payer: PACE SWMI |
$48.51
|
| Rate for Payer: PHP Medicare Advantage |
$48.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.36
|
| Rate for Payer: Priority Health Medicare |
$48.51
|
| Rate for Payer: Priority Health Narrow Network |
$79.36
|
| Rate for Payer: Priority Health SBD |
$79.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.51
|
| Rate for Payer: UHC Medicare Advantage |
$48.51
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE
|
Professional
|
Both
|
$2,248.00
|
|
|
Service Code
|
HCPCS 52441
|
| Min. Negotiated Rate |
$132.91 |
| Max. Negotiated Rate |
$36,652.00 |
| Rate for Payer: Aetna Commercial |
$267.50
|
| Rate for Payer: Aetna Medicare |
$207.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.47
|
| Rate for Payer: BCBS Complete |
$139.56
|
| Rate for Payer: BCBS MAPPO |
$199.63
|
| Rate for Payer: BCBS Trust/PPO |
$528.83
|
| Rate for Payer: BCN Commercial |
$1,866.75
|
| Rate for Payer: BCN Medicare Advantage |
$199.63
|
| Rate for Payer: Cash Price |
$1,798.40
|
| Rate for Payer: Cash Price |
$1,798.40
|
| Rate for Payer: Cofinity Commercial |
$287.47
|
| Rate for Payer: Cofinity Commercial |
$267.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.63
|
| Rate for Payer: Healthscope Commercial |
$319.41
|
| Rate for Payer: Healthscope Commercial |
$369.32
|
| Rate for Payer: Mclaren Medicaid |
$132.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.61
|
| Rate for Payer: Meridian Medicaid |
$139.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,652.00
|
| Rate for Payer: Nomi Health Commercial |
$239.56
|
| Rate for Payer: PACE SWMI |
$199.63
|
| Rate for Payer: PHP Medicare Advantage |
$199.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,461.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.15
|
| Rate for Payer: Priority Health Medicare |
$199.63
|
| Rate for Payer: Priority Health Narrow Network |
$329.15
|
| Rate for Payer: Priority Health SBD |
$329.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.63
|
| Rate for Payer: UHC Medicare Advantage |
$199.63
|
| Rate for Payer: UHCCP Medicaid |
$132.91
|
|
|
PR CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 52334
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$31,972.00 |
| Rate for Payer: Aetna Commercial |
$233.36
|
| Rate for Payer: Aetna Medicare |
$181.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.78
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$174.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.39
|
| Rate for Payer: BCN Commercial |
$261.44
|
| Rate for Payer: BCN Medicare Advantage |
$174.15
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$250.78
|
| Rate for Payer: Cofinity Commercial |
$233.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.15
|
| Rate for Payer: Healthscope Commercial |
$322.18
|
| Rate for Payer: Healthscope Commercial |
$278.64
|
| Rate for Payer: Mclaren Medicaid |
$116.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.86
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,972.00
|
| Rate for Payer: Nomi Health Commercial |
$208.98
|
| Rate for Payer: PACE SWMI |
$174.15
|
| Rate for Payer: PHP Medicare Advantage |
$174.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.07
|
| Rate for Payer: Priority Health Medicare |
$174.15
|
| Rate for Payer: Priority Health Narrow Network |
$287.07
|
| Rate for Payer: Priority Health SBD |
$287.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.15
|
| Rate for Payer: UHC Exchange |
$332.06
|
| Rate for Payer: UHC Medicare Advantage |
$174.15
|
| Rate for Payer: UHCCP Medicaid |
$116.30
|
|
|
PR CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 51050
|
| Min. Negotiated Rate |
$304.59 |
| Max. Negotiated Rate |
$82,856.00 |
| Rate for Payer: Aetna Commercial |
$606.54
|
| Rate for Payer: Aetna Medicare |
$470.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.80
|
| Rate for Payer: BCBS Complete |
$319.82
|
| Rate for Payer: BCBS MAPPO |
$452.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.27
|
| Rate for Payer: BCN Commercial |
$682.20
|
| Rate for Payer: BCN Medicare Advantage |
$452.64
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$651.80
|
| Rate for Payer: Cofinity Commercial |
$606.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.64
|
| Rate for Payer: Healthscope Commercial |
$837.38
|
| Rate for Payer: Healthscope Commercial |
$724.22
|
| Rate for Payer: Mclaren Medicaid |
$304.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.27
|
| Rate for Payer: Meridian Medicaid |
$319.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,856.00
|
| Rate for Payer: Nomi Health Commercial |
$543.17
|
| Rate for Payer: PACE SWMI |
$452.64
|
| Rate for Payer: PHP Medicare Advantage |
$452.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.23
|
| Rate for Payer: Priority Health Medicare |
$452.64
|
| Rate for Payer: Priority Health Narrow Network |
$755.23
|
| Rate for Payer: Priority Health SBD |
$755.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.64
|
| Rate for Payer: UHC Exchange |
$564.68
|
| Rate for Payer: UHC Medicare Advantage |
$452.64
|
| Rate for Payer: UHCCP Medicaid |
$304.59
|
|
|
PR CYSTO MANJ W/O RMVL URETERAL STONE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 52330
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$46,001.00 |
| Rate for Payer: Aetna Commercial |
$334.72
|
| Rate for Payer: Aetna Medicare |
$259.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.70
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$249.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,449.49
|
| Rate for Payer: BCN Commercial |
$884.01
|
| Rate for Payer: BCN Medicare Advantage |
$249.79
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$359.70
|
| Rate for Payer: Cofinity Commercial |
$334.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.79
|
| Rate for Payer: Healthscope Commercial |
$462.11
|
| Rate for Payer: Healthscope Commercial |
$399.66
|
| Rate for Payer: Mclaren Medicaid |
$166.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.28
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,001.00
|
| Rate for Payer: Nomi Health Commercial |
$299.75
|
| Rate for Payer: PACE SWMI |
$249.79
|
| Rate for Payer: PHP Medicare Advantage |
$249.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.30
|
| Rate for Payer: Priority Health Medicare |
$249.79
|
| Rate for Payer: Priority Health Narrow Network |
$413.30
|
| Rate for Payer: Priority Health SBD |
$413.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.79
|
| Rate for Payer: UHC Exchange |
$587.31
|
| Rate for Payer: UHC Medicare Advantage |
$249.79
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
|
