|
PR DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 38222
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$83.12
|
| Rate for Payer: Aetna Medicare |
$64.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.32
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$62.03
|
| Rate for Payer: BCN Commercial |
$110.55
|
| Rate for Payer: BCN Medicare Advantage |
$62.03
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Cofinity Commercial |
$89.32
|
| Rate for Payer: Cofinity Commercial |
$83.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.03
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Healthscope Commercial |
$114.76
|
| Rate for Payer: Mclaren Medicaid |
$39.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.13
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.95
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.00
|
| Rate for Payer: PACE SWMI |
$62.03
|
| Rate for Payer: PHP Medicare Advantage |
$62.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$147.10
|
| Rate for Payer: Priority Health Medicare |
$62.03
|
| Rate for Payer: Priority Health SBD |
$147.10
|
| Rate for Payer: Priority Health Tiered Network |
$147.10
|
| Rate for Payer: Railroad Medicare Medicare |
$62.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.97
|
| Rate for Payer: UHC Core |
$136.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.03
|
| Rate for Payer: UHC Exchange |
$136.97
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 62270
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$437.25 |
| Rate for Payer: Aetna Commercial |
$79.35
|
| Rate for Payer: Aetna Medicare |
$61.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.28
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$59.22
|
| Rate for Payer: BCN Commercial |
$96.11
|
| Rate for Payer: BCN Medicare Advantage |
$59.22
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Cofinity Commercial |
$79.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.22
|
| Rate for Payer: Healthscope Commercial |
$94.75
|
| Rate for Payer: Healthscope Commercial |
$109.56
|
| Rate for Payer: Mclaren Medicaid |
$37.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.18
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.30
|
| Rate for Payer: Nomi Health Commercial |
$71.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$437.25
|
| Rate for Payer: PACE SWMI |
$59.22
|
| Rate for Payer: PHP Medicare Advantage |
$59.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.63
|
| Rate for Payer: Priority Health Medicare |
$59.22
|
| Rate for Payer: Priority Health SBD |
$111.63
|
| Rate for Payer: Priority Health Tiered Network |
$111.63
|
| Rate for Payer: Railroad Medicare Medicare |
$59.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.21
|
| Rate for Payer: UHC Core |
$110.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.22
|
| Rate for Payer: UHC Exchange |
$110.21
|
| Rate for Payer: UHC Medicaid |
$37.49
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 62328
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$159.31 |
| Rate for Payer: Aetna Commercial |
$98.22
|
| Rate for Payer: Aetna Medicare |
$76.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.22
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$73.30
|
| Rate for Payer: BCN Commercial |
$125.99
|
| Rate for Payer: BCN Medicare Advantage |
$73.30
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.30
|
| Rate for Payer: Healthscope Commercial |
$135.60
|
| Rate for Payer: Healthscope Commercial |
$117.28
|
| Rate for Payer: Mclaren Medicaid |
$46.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.97
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.00
|
| Rate for Payer: Nomi Health Commercial |
$87.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.50
|
| Rate for Payer: PACE SWMI |
$73.30
|
| Rate for Payer: PHP Medicare Advantage |
$73.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.34
|
| Rate for Payer: Priority Health Medicare |
$73.30
|
| Rate for Payer: Priority Health SBD |
$146.34
|
| Rate for Payer: Priority Health Tiered Network |
$146.34
|
| Rate for Payer: Railroad Medicare Medicare |
$73.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.31
|
| Rate for Payer: UHC Core |
$159.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.30
|
| Rate for Payer: UHC Exchange |
$159.31
|
| Rate for Payer: UHC Medicaid |
$46.86
|
| Rate for Payer: UHCCP Medicaid |
$46.86
|
|
|
PR DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 36909
|
| Min. Negotiated Rate |
$112.04 |
| Max. Negotiated Rate |
$1,191.00 |
| Rate for Payer: Aetna Commercial |
$237.07
|
| Rate for Payer: Aetna Medicare |
$184.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.76
|
| Rate for Payer: BCBS Complete |
$117.64
|
| Rate for Payer: BCBS MAPPO |
$176.92
|
| Rate for Payer: BCN Commercial |
$291.81
|
| Rate for Payer: BCN Medicare Advantage |
$176.92
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$254.76
|
| Rate for Payer: Cofinity Commercial |
$237.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.92
|
| Rate for Payer: Healthscope Commercial |
$327.30
|
| Rate for Payer: Healthscope Commercial |
$283.07
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.77
|
| Rate for Payer: Meridian Medicaid |
$117.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.55
|
| Rate for Payer: Nomi Health Commercial |
$212.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.00
|
| Rate for Payer: PACE SWMI |
$176.92
|
| Rate for Payer: PHP Medicare Advantage |
$176.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$313.81
|
| Rate for Payer: Priority Health Medicare |
$176.92
|
| Rate for Payer: Priority Health SBD |
$313.81
|
| Rate for Payer: Priority Health Tiered Network |
$313.81
|
| Rate for Payer: Railroad Medicare Medicare |
$176.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.15
|
| Rate for Payer: UHC Core |
$360.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.92
|
| Rate for Payer: UHC Exchange |
$360.15
|
| Rate for Payer: UHC Medicaid |
$112.04
|
| Rate for Payer: UHCCP Medicaid |
$112.04
|
|
|
PR DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 90945
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Aetna Commercial |
$101.18
|
| Rate for Payer: Aetna Medicare |
$78.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.73
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$75.51
|
| Rate for Payer: BCN Commercial |
$127.98
|
| Rate for Payer: BCN Medicare Advantage |
$75.51
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$108.73
|
| Rate for Payer: Cofinity Commercial |
$101.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.51
|
| Rate for Payer: Healthscope Commercial |
$139.69
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.29
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.59
|
| Rate for Payer: Nomi Health Commercial |
$90.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: PACE SWMI |
$75.51
|
| Rate for Payer: PHP Medicare Advantage |
$75.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$118.03
|
| Rate for Payer: Priority Health Medicare |
$75.51
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: Priority Health Tiered Network |
$118.03
|
| Rate for Payer: Railroad Medicare Medicare |
$75.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.86
|
| Rate for Payer: UHC Core |
$137.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.51
|
| Rate for Payer: UHC Exchange |
$137.86
|
| Rate for Payer: UHC Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 90947
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$141.17
|
| Rate for Payer: Aetna Medicare |
$109.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.70
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$105.35
|
| Rate for Payer: BCN Commercial |
$180.76
|
| Rate for Payer: BCN Medicare Advantage |
$105.35
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$151.70
|
| Rate for Payer: Cofinity Commercial |
$141.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.35
|
| Rate for Payer: Healthscope Commercial |
$194.90
|
| Rate for Payer: Healthscope Commercial |
$168.56
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.62
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.08
|
| Rate for Payer: Nomi Health Commercial |
$126.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: PACE SWMI |
$105.35
|
| Rate for Payer: PHP Medicare Advantage |
$105.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.71
|
| Rate for Payer: Priority Health Medicare |
$105.35
|
| Rate for Payer: Priority Health SBD |
$166.71
|
| Rate for Payer: Priority Health Tiered Network |
$166.71
|
| Rate for Payer: Railroad Medicare Medicare |
$105.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.38
|
| Rate for Payer: UHC Core |
$201.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.35
|
| Rate for Payer: UHC Exchange |
$201.38
|
| Rate for Payer: UHC Medicaid |
$67.73
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
|
|
PR DIAPHRAGM
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS A4266
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.28
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCN Commercial |
$80.00
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
|
|
PR DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 57170
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$41.55
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.55
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$59.83
|
| Rate for Payer: Cofinity Commercial |
$55.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.55
|
| Rate for Payer: Healthscope Commercial |
$76.87
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.63
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.11
|
| Rate for Payer: Nomi Health Commercial |
$49.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.50
|
| Rate for Payer: PACE SWMI |
$41.55
|
| Rate for Payer: PHP Medicare Advantage |
$41.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.61
|
| Rate for Payer: Priority Health Medicare |
$41.55
|
| Rate for Payer: Priority Health SBD |
$71.61
|
| Rate for Payer: Priority Health Tiered Network |
$71.61
|
| Rate for Payer: Railroad Medicare Medicare |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.84
|
| Rate for Payer: UHC Core |
$84.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.55
|
| Rate for Payer: UHC Exchange |
$84.84
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR DIFFUSING CAPACITY
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 94729
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$108.48 |
| Rate for Payer: Aetna Commercial |
$78.58
|
| Rate for Payer: Aetna Commercial |
$78.58
|
| Rate for Payer: Aetna Medicare |
$60.99
|
| Rate for Payer: Aetna Medicare |
$60.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.58
|
| Rate for Payer: BCBS MAPPO |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$58.64
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Medicare Advantage |
$58.64
|
| Rate for Payer: BCN Medicare Advantage |
$58.64
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$84.44
|
| Rate for Payer: Cofinity Commercial |
$78.58
|
| Rate for Payer: Cofinity Commercial |
$78.58
|
| Rate for Payer: Cofinity Commercial |
$84.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.64
|
| Rate for Payer: Healthscope Commercial |
$93.82
|
| Rate for Payer: Healthscope Commercial |
$93.82
|
| Rate for Payer: Healthscope Commercial |
$108.48
|
| Rate for Payer: Healthscope Commercial |
$108.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.29
|
| Rate for Payer: Nomi Health Commercial |
$70.37
|
| Rate for Payer: Nomi Health Commercial |
$70.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
| Rate for Payer: PACE SWMI |
$58.64
|
| Rate for Payer: PACE SWMI |
$58.64
|
| Rate for Payer: PHP Medicare Advantage |
$58.64
|
| Rate for Payer: PHP Medicare Advantage |
$58.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.15
|
| Rate for Payer: Priority Health Medicare |
$58.64
|
| Rate for Payer: Priority Health Medicare |
$58.64
|
| Rate for Payer: Priority Health SBD |
$77.15
|
| Rate for Payer: Priority Health SBD |
$77.15
|
| Rate for Payer: Priority Health Tiered Network |
$77.15
|
| Rate for Payer: Priority Health Tiered Network |
$77.15
|
| Rate for Payer: Railroad Medicare Medicare |
$58.64
|
| Rate for Payer: Railroad Medicare Medicare |
$58.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.57
|
| Rate for Payer: UHC Core |
$85.57
|
| Rate for Payer: UHC Core |
$85.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.64
|
| Rate for Payer: UHC Exchange |
$85.57
|
| Rate for Payer: UHC Exchange |
$85.57
|
|
|
PR DIGITAL ANALYSIS ELECTROENCEPHALOGRAM
|
Professional
|
Both
|
$801.00
|
|
|
Service Code
|
HCPCS 95957
|
| Min. Negotiated Rate |
$289.40 |
| Max. Negotiated Rate |
$600.75 |
| Rate for Payer: Aetna Commercial |
$387.80
|
| Rate for Payer: Aetna Medicare |
$300.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.80
|
| Rate for Payer: BCBS MAPPO |
$289.40
|
| Rate for Payer: BCN Commercial |
$433.74
|
| Rate for Payer: BCN Medicare Advantage |
$289.40
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cofinity Commercial |
$416.74
|
| Rate for Payer: Cofinity Commercial |
$387.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.40
|
| Rate for Payer: Healthscope Commercial |
$463.04
|
| Rate for Payer: Healthscope Commercial |
$535.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.60
|
| Rate for Payer: Nomi Health Commercial |
$347.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.75
|
| Rate for Payer: PACE SWMI |
$289.40
|
| Rate for Payer: PHP Medicare Advantage |
$289.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$400.00
|
| Rate for Payer: Priority Health Medicare |
$289.40
|
| Rate for Payer: Priority Health SBD |
$400.00
|
| Rate for Payer: Priority Health Tiered Network |
$400.00
|
| Rate for Payer: Railroad Medicare Medicare |
$289.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.29
|
| Rate for Payer: UHC Core |
$395.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.40
|
| Rate for Payer: UHC Exchange |
$395.29
|
|
|
PR DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 45905
|
| Min. Negotiated Rate |
$107.78 |
| Max. Negotiated Rate |
$314.29 |
| Rate for Payer: Aetna Commercial |
$219.75
|
| Rate for Payer: Aetna Medicare |
$170.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.15
|
| Rate for Payer: BCBS Complete |
$113.17
|
| Rate for Payer: BCBS MAPPO |
$163.99
|
| Rate for Payer: BCN Commercial |
$257.96
|
| Rate for Payer: BCN Medicare Advantage |
$163.99
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$236.15
|
| Rate for Payer: Cofinity Commercial |
$219.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.99
|
| Rate for Payer: Healthscope Commercial |
$303.38
|
| Rate for Payer: Healthscope Commercial |
$262.38
|
| Rate for Payer: Mclaren Medicaid |
$107.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.19
|
| Rate for Payer: Meridian Medicaid |
$113.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.38
|
| Rate for Payer: Nomi Health Commercial |
$196.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.50
|
| Rate for Payer: PACE SWMI |
$163.99
|
| Rate for Payer: PHP Medicare Advantage |
$163.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$314.29
|
| Rate for Payer: Priority Health Medicare |
$163.99
|
| Rate for Payer: Priority Health SBD |
$314.29
|
| Rate for Payer: Priority Health Tiered Network |
$314.29
|
| Rate for Payer: Railroad Medicare Medicare |
$163.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.96
|
| Rate for Payer: UHC Core |
$293.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.99
|
| Rate for Payer: UHC Exchange |
$293.96
|
| Rate for Payer: UHC Medicaid |
$107.78
|
| Rate for Payer: UHCCP Medicaid |
$107.78
|
|
|
PR DILAT&CATHJ SALIVARY DUCT W/WO INJECTION
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 42660
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$91.64
|
| Rate for Payer: Aetna Medicare |
$71.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.48
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$68.39
|
| Rate for Payer: BCN Commercial |
$119.02
|
| Rate for Payer: BCN Medicare Advantage |
$68.39
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$98.48
|
| Rate for Payer: Cofinity Commercial |
$91.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.39
|
| Rate for Payer: Healthscope Commercial |
$126.52
|
| Rate for Payer: Healthscope Commercial |
$109.42
|
| Rate for Payer: Mclaren Medicaid |
$44.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.81
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.51
|
| Rate for Payer: Nomi Health Commercial |
$82.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.50
|
| Rate for Payer: PACE SWMI |
$68.39
|
| Rate for Payer: PHP Medicare Advantage |
$68.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$145.02
|
| Rate for Payer: Priority Health Medicare |
$68.39
|
| Rate for Payer: Priority Health SBD |
$145.02
|
| Rate for Payer: Priority Health Tiered Network |
$145.02
|
| Rate for Payer: Railroad Medicare Medicare |
$68.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.41
|
| Rate for Payer: UHC Core |
$152.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.39
|
| Rate for Payer: UHC Exchange |
$152.41
|
| Rate for Payer: UHC Medicaid |
$44.73
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
|
|
PR DILATE ESOPHAGUS,BALLOON RETROGRADE
|
Professional
|
Both
|
$853.00
|
|
|
Service Code
|
HCPCS 43456
|
| Min. Negotiated Rate |
$341.20 |
| Max. Negotiated Rate |
$639.75 |
| Rate for Payer: Aetna Medicare |
$426.50
|
| Rate for Payer: BCBS Complete |
$341.20
|
| Rate for Payer: Cash Price |
$682.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.75
|
|
|
PR DILATE ESOPH,BALLN,>30MM ACHALASIA
|
Professional
|
Both
|
$1,060.00
|
|
|
Service Code
|
HCPCS 43458
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$795.00 |
| Rate for Payer: Aetna Medicare |
$530.00
|
| Rate for Payer: BCBS Complete |
$424.00
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.00
|
|
|
PR DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 53665
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$44.21
|
| Rate for Payer: Aetna Medicare |
$34.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.51
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$32.99
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: BCN Medicare Advantage |
$32.99
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$47.51
|
| Rate for Payer: Cofinity Commercial |
$44.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.99
|
| Rate for Payer: Healthscope Commercial |
$61.03
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.64
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.37
|
| Rate for Payer: Nomi Health Commercial |
$39.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$32.99
|
| Rate for Payer: PHP Medicare Advantage |
$32.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$60.21
|
| Rate for Payer: Priority Health Medicare |
$32.99
|
| Rate for Payer: Priority Health SBD |
$60.21
|
| Rate for Payer: Priority Health Tiered Network |
$60.21
|
| Rate for Payer: Railroad Medicare Medicare |
$32.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.31
|
| Rate for Payer: UHC Core |
$68.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.99
|
| Rate for Payer: UHC Exchange |
$68.31
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
PR DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 53660
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$49.23
|
| Rate for Payer: Aetna Medicare |
$38.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.91
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$36.74
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.74
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$52.91
|
| Rate for Payer: Cofinity Commercial |
$49.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$67.97
|
| Rate for Payer: Healthscope Commercial |
$58.78
|
| Rate for Payer: Mclaren Medicaid |
$23.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.58
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.21
|
| Rate for Payer: Nomi Health Commercial |
$44.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.00
|
| Rate for Payer: PACE SWMI |
$36.74
|
| Rate for Payer: PHP Medicare Advantage |
$36.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.27
|
| Rate for Payer: Priority Health Medicare |
$36.74
|
| Rate for Payer: Priority Health SBD |
$67.27
|
| Rate for Payer: Priority Health Tiered Network |
$67.27
|
| Rate for Payer: Railroad Medicare Medicare |
$36.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.22
|
| Rate for Payer: UHC Core |
$73.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.74
|
| Rate for Payer: UHC Exchange |
$73.22
|
| Rate for Payer: UHC Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 53661
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$111.75 |
| Rate for Payer: Aetna Commercial |
$47.64
|
| Rate for Payer: Aetna Medicare |
$36.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.19
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$35.55
|
| Rate for Payer: BCN Commercial |
$59.76
|
| Rate for Payer: BCN Medicare Advantage |
$35.55
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$51.19
|
| Rate for Payer: Cofinity Commercial |
$47.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.55
|
| Rate for Payer: Healthscope Commercial |
$65.77
|
| Rate for Payer: Healthscope Commercial |
$56.88
|
| Rate for Payer: Mclaren Medicaid |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.33
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.60
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$35.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.10
|
| Rate for Payer: Priority Health Medicare |
$35.55
|
| Rate for Payer: Priority Health SBD |
$65.10
|
| Rate for Payer: Priority Health Tiered Network |
$65.10
|
| Rate for Payer: Railroad Medicare Medicare |
$35.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.55
|
| Rate for Payer: UHC Core |
$71.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.55
|
| Rate for Payer: UHC Exchange |
$71.55
|
| Rate for Payer: UHC Medicaid |
$23.00
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
PR DILATION CERVICAL CANAL INSTRUMENTAL SPX
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 57800
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$158.25 |
| Rate for Payer: Aetna Commercial |
$57.39
|
| Rate for Payer: Aetna Medicare |
$44.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.68
|
| Rate for Payer: BCBS Complete |
$29.07
|
| Rate for Payer: BCBS MAPPO |
$42.83
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$42.83
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$61.68
|
| Rate for Payer: Cofinity Commercial |
$57.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.83
|
| Rate for Payer: Healthscope Commercial |
$79.24
|
| Rate for Payer: Healthscope Commercial |
$68.53
|
| Rate for Payer: Mclaren Medicaid |
$27.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.97
|
| Rate for Payer: Meridian Medicaid |
$29.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.29
|
| Rate for Payer: Nomi Health Commercial |
$51.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.25
|
| Rate for Payer: PACE SWMI |
$42.83
|
| Rate for Payer: PHP Medicare Advantage |
$42.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.13
|
| Rate for Payer: Priority Health Medicare |
$42.83
|
| Rate for Payer: Priority Health SBD |
$73.13
|
| Rate for Payer: Priority Health Tiered Network |
$73.13
|
| Rate for Payer: Railroad Medicare Medicare |
$42.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.62
|
| Rate for Payer: UHC Core |
$84.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.83
|
| Rate for Payer: UHC Exchange |
$84.62
|
| Rate for Payer: UHC Medicaid |
$27.69
|
| Rate for Payer: UHCCP Medicaid |
$27.69
|
|
|
PR DILATION & CURETTAGE CERVICAL STUMP
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 57558
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$148.69
|
| Rate for Payer: Aetna Medicare |
$115.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.78
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: BCBS MAPPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$192.72
|
| Rate for Payer: BCN Medicare Advantage |
$110.96
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$159.78
|
| Rate for Payer: Cofinity Commercial |
$148.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$205.28
|
| Rate for Payer: Healthscope Commercial |
$177.54
|
| Rate for Payer: Mclaren Medicaid |
$72.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.51
|
| Rate for Payer: Meridian Medicaid |
$76.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.66
|
| Rate for Payer: Nomi Health Commercial |
$133.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$110.96
|
| Rate for Payer: PHP Medicare Advantage |
$110.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$195.18
|
| Rate for Payer: Priority Health Medicare |
$110.96
|
| Rate for Payer: Priority Health SBD |
$195.18
|
| Rate for Payer: Priority Health Tiered Network |
$195.18
|
| Rate for Payer: Railroad Medicare Medicare |
$110.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.43
|
| Rate for Payer: UHC Core |
$213.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$110.96
|
| Rate for Payer: UHC Exchange |
$213.43
|
| Rate for Payer: UHC Medicaid |
$72.63
|
| Rate for Payer: UHCCP Medicaid |
$72.63
|
|
|
PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 58120
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$666.00 |
| Rate for Payer: Aetna Commercial |
$276.54
|
| Rate for Payer: Aetna Medicare |
$214.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.17
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$206.37
|
| Rate for Payer: BCN Commercial |
$351.07
|
| Rate for Payer: BCN Medicare Advantage |
$206.37
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$297.17
|
| Rate for Payer: Cofinity Commercial |
$276.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.37
|
| Rate for Payer: Healthscope Commercial |
$381.78
|
| Rate for Payer: Healthscope Commercial |
$330.19
|
| Rate for Payer: Mclaren Medicaid |
$133.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.69
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$227.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.95
|
| Rate for Payer: Nomi Health Commercial |
$247.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.00
|
| Rate for Payer: PACE SWMI |
$206.37
|
| Rate for Payer: PHP Medicare Advantage |
$206.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$355.56
|
| Rate for Payer: Priority Health Medicare |
$206.37
|
| Rate for Payer: Priority Health SBD |
$355.56
|
| Rate for Payer: Priority Health Tiered Network |
$355.56
|
| Rate for Payer: Railroad Medicare Medicare |
$206.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.03
|
| Rate for Payer: UHC Core |
$399.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.37
|
| Rate for Payer: UHC Exchange |
$399.03
|
| Rate for Payer: UHC Medicaid |
$133.76
|
| Rate for Payer: UHCCP Medicaid |
$133.76
|
|
|
PR DILATION ESOPHAGUS GUIDE WIRE
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 43453
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$101.88
|
| Rate for Payer: Aetna Medicare |
$79.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.48
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS MAPPO |
$76.03
|
| Rate for Payer: BCN Commercial |
$128.97
|
| Rate for Payer: BCN Medicare Advantage |
$76.03
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$109.48
|
| Rate for Payer: Cofinity Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.03
|
| Rate for Payer: Healthscope Commercial |
$140.66
|
| Rate for Payer: Healthscope Commercial |
$121.65
|
| Rate for Payer: Mclaren Medicaid |
$49.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.83
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.27
|
| Rate for Payer: Nomi Health Commercial |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$76.03
|
| Rate for Payer: PHP Medicare Advantage |
$76.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.15
|
| Rate for Payer: Priority Health Medicare |
$76.03
|
| Rate for Payer: Priority Health SBD |
$157.15
|
| Rate for Payer: Priority Health Tiered Network |
$157.15
|
| Rate for Payer: Railroad Medicare Medicare |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.28
|
| Rate for Payer: UHC Core |
$150.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.03
|
| Rate for Payer: UHC Exchange |
$150.28
|
| Rate for Payer: UHC Medicaid |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
|
|
PR DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 43450
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$95.81
|
| Rate for Payer: Aetna Medicare |
$74.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.81
|
| Rate for Payer: BCBS Complete |
$48.98
|
| Rate for Payer: BCBS MAPPO |
$71.50
|
| Rate for Payer: BCN Commercial |
$118.52
|
| Rate for Payer: BCN Medicare Advantage |
$71.50
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$95.81
|
| Rate for Payer: Cofinity Commercial |
$102.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.50
|
| Rate for Payer: Healthscope Commercial |
$132.28
|
| Rate for Payer: Healthscope Commercial |
$114.40
|
| Rate for Payer: Mclaren Medicaid |
$46.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.08
|
| Rate for Payer: Meridian Medicaid |
$48.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.81
|
| Rate for Payer: Nomi Health Commercial |
$85.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$71.50
|
| Rate for Payer: PHP Medicare Advantage |
$71.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$144.40
|
| Rate for Payer: Priority Health Medicare |
$71.50
|
| Rate for Payer: Priority Health SBD |
$144.40
|
| Rate for Payer: Priority Health Tiered Network |
$144.40
|
| Rate for Payer: Railroad Medicare Medicare |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.95
|
| Rate for Payer: UHC Core |
$137.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.50
|
| Rate for Payer: UHC Exchange |
$137.95
|
| Rate for Payer: UHC Medicaid |
$46.65
|
| Rate for Payer: UHCCP Medicaid |
$46.65
|
|
|
PR DILATION LACRIMAL PUNCTUM W/WO IRRGATION
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 68801
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$91.45
|
| Rate for Payer: Aetna Medicare |
$70.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$68.25
|
| Rate for Payer: BCN Commercial |
$93.07
|
| Rate for Payer: BCN Medicare Advantage |
$68.25
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$98.28
|
| Rate for Payer: Cofinity Commercial |
$91.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.25
|
| Rate for Payer: Healthscope Commercial |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$109.20
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.66
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.33
|
| Rate for Payer: Nomi Health Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$68.25
|
| Rate for Payer: PHP Medicare Advantage |
$68.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$138.24
|
| Rate for Payer: Priority Health Medicare |
$68.25
|
| Rate for Payer: Priority Health SBD |
$138.24
|
| Rate for Payer: Priority Health Tiered Network |
$138.24
|
| Rate for Payer: Railroad Medicare Medicare |
$68.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.89
|
| Rate for Payer: UHC Core |
$129.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.25
|
| Rate for Payer: UHC Exchange |
$129.89
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR DILATION SALIVARY DUCT
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 42650
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$109.83 |
| Rate for Payer: Aetna Commercial |
$69.37
|
| Rate for Payer: Aetna Medicare |
$53.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.55
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS MAPPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$90.13
|
| Rate for Payer: BCN Medicare Advantage |
$51.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$74.55
|
| Rate for Payer: Cofinity Commercial |
$69.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.77
|
| Rate for Payer: Healthscope Commercial |
$95.77
|
| Rate for Payer: Healthscope Commercial |
$82.83
|
| Rate for Payer: Mclaren Medicaid |
$34.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.36
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.09
|
| Rate for Payer: Nomi Health Commercial |
$62.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$51.77
|
| Rate for Payer: PHP Medicare Advantage |
$51.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$109.83
|
| Rate for Payer: Priority Health Medicare |
$51.77
|
| Rate for Payer: Priority Health SBD |
$109.83
|
| Rate for Payer: Priority Health Tiered Network |
$109.83
|
| Rate for Payer: Railroad Medicare Medicare |
$51.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.49
|
| Rate for Payer: UHC Core |
$99.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.77
|
| Rate for Payer: UHC Exchange |
$99.49
|
| Rate for Payer: UHC Medicaid |
$34.08
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
|
|
PR DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 57400
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$153.76
|
| Rate for Payer: Aetna Medicare |
$119.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.24
|
| Rate for Payer: BCBS Complete |
$77.39
|
| Rate for Payer: BCBS MAPPO |
$114.75
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$114.75
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$165.24
|
| Rate for Payer: Cofinity Commercial |
$153.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.75
|
| Rate for Payer: Healthscope Commercial |
$212.29
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$73.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.49
|
| Rate for Payer: Meridian Medicaid |
$77.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.54
|
| Rate for Payer: Nomi Health Commercial |
$137.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$114.75
|
| Rate for Payer: PHP Medicare Advantage |
$114.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.71
|
| Rate for Payer: Priority Health Medicare |
$114.75
|
| Rate for Payer: Priority Health SBD |
$197.71
|
| Rate for Payer: Priority Health Tiered Network |
$197.71
|
| Rate for Payer: Railroad Medicare Medicare |
$114.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.88
|
| Rate for Payer: UHC Core |
$232.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.75
|
| Rate for Payer: UHC Exchange |
$232.88
|
| Rate for Payer: UHC Medicaid |
$73.70
|
| Rate for Payer: UHCCP Medicaid |
$73.70
|
|
