|
PR DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR
|
Professional
|
Both
|
$2,510.00
|
|
|
Service Code
|
HCPCS 43130
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$1,882.50 |
| Rate for Payer: Aetna Commercial |
$943.11
|
| Rate for Payer: Aetna Medicare |
$731.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.11
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$703.81
|
| Rate for Payer: BCN Commercial |
$1,192.67
|
| Rate for Payer: BCN Medicare Advantage |
$703.81
|
| Rate for Payer: Cash Price |
$2,008.00
|
| Rate for Payer: Cash Price |
$2,008.00
|
| Rate for Payer: Cofinity Commercial |
$943.11
|
| Rate for Payer: Cofinity Commercial |
$1,013.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.81
|
| Rate for Payer: Healthscope Commercial |
$1,302.05
|
| Rate for Payer: Healthscope Commercial |
$1,126.10
|
| Rate for Payer: Mclaren Medicaid |
$455.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.00
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.51
|
| Rate for Payer: Nomi Health Commercial |
$844.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,882.50
|
| Rate for Payer: PACE SWMI |
$703.81
|
| Rate for Payer: PHP Medicare Advantage |
$703.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,453.19
|
| Rate for Payer: Priority Health Medicare |
$703.81
|
| Rate for Payer: Priority Health SBD |
$1,453.19
|
| Rate for Payer: Priority Health Tiered Network |
$1,453.19
|
| Rate for Payer: Railroad Medicare Medicare |
$703.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.32
|
| Rate for Payer: UHC Core |
$1,380.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.81
|
| Rate for Payer: UHC Exchange |
$1,380.32
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR
|
Professional
|
Both
|
$3,262.00
|
|
|
Service Code
|
HCPCS 43135
|
| Min. Negotiated Rate |
$885.44 |
| Max. Negotiated Rate |
$2,647.89 |
| Rate for Payer: Aetna Commercial |
$1,860.23
|
| Rate for Payer: Aetna Medicare |
$1,443.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,860.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,999.05
|
| Rate for Payer: BCBS Complete |
$929.71
|
| Rate for Payer: BCBS MAPPO |
$1,388.23
|
| Rate for Payer: BCN Commercial |
$2,173.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,388.23
|
| Rate for Payer: Cash Price |
$2,609.60
|
| Rate for Payer: Cash Price |
$2,609.60
|
| Rate for Payer: Cofinity Commercial |
$1,999.05
|
| Rate for Payer: Cofinity Commercial |
$1,860.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,388.23
|
| Rate for Payer: Healthscope Commercial |
$2,568.23
|
| Rate for Payer: Healthscope Commercial |
$2,221.17
|
| Rate for Payer: Mclaren Medicaid |
$885.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,457.64
|
| Rate for Payer: Meridian Medicaid |
$929.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,527.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,612.23
|
| Rate for Payer: Nomi Health Commercial |
$1,665.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,446.50
|
| Rate for Payer: PACE SWMI |
$1,388.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,388.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$885.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,647.89
|
| Rate for Payer: Priority Health Medicare |
$1,388.23
|
| Rate for Payer: Priority Health SBD |
$2,647.89
|
| Rate for Payer: Priority Health Tiered Network |
$2,647.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,388.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,619.36
|
| Rate for Payer: UHC Core |
$2,619.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,388.23
|
| Rate for Payer: UHC Exchange |
$2,619.36
|
| Rate for Payer: UHC Medicaid |
$885.44
|
| Rate for Payer: UHCCP Medicaid |
$885.44
|
|
|
PR DIVISION ABERRANT VESSEL VASCULAR RING
|
Professional
|
Both
|
$4,360.00
|
|
|
Service Code
|
HCPCS 33802
|
| Min. Negotiated Rate |
$666.69 |
| Max. Negotiated Rate |
$3,270.00 |
| Rate for Payer: Aetna Commercial |
$1,392.37
|
| Rate for Payer: Aetna Medicare |
$1,080.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,496.28
|
| Rate for Payer: BCBS Complete |
$700.02
|
| Rate for Payer: BCBS MAPPO |
$1,039.08
|
| Rate for Payer: BCN Commercial |
$1,612.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.08
|
| Rate for Payer: Cash Price |
$3,488.00
|
| Rate for Payer: Cash Price |
$3,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,496.28
|
| Rate for Payer: Cofinity Commercial |
$1,392.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.08
|
| Rate for Payer: Healthscope Commercial |
$1,922.30
|
| Rate for Payer: Healthscope Commercial |
$1,662.53
|
| Rate for Payer: Mclaren Medicaid |
$666.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,091.03
|
| Rate for Payer: Meridian Medicaid |
$700.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,142.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,922.85
|
| Rate for Payer: Nomi Health Commercial |
$1,246.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,270.00
|
| Rate for Payer: PACE SWMI |
$1,039.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,734.00
|
| Rate for Payer: Priority Health Medicare |
$1,039.08
|
| Rate for Payer: Priority Health SBD |
$1,734.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,734.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,039.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,920.84
|
| Rate for Payer: UHC Core |
$1,920.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,039.08
|
| Rate for Payer: UHC Exchange |
$1,920.84
|
| Rate for Payer: UHC Medicaid |
$666.69
|
| Rate for Payer: UHCCP Medicaid |
$666.69
|
|
|
PR DIVISION PLANTAR FASCIA & MUSCLE SPX
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 28250
|
| Min. Negotiated Rate |
$246.65 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$504.23
|
| Rate for Payer: Aetna Medicare |
$391.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.86
|
| Rate for Payer: BCBS Complete |
$258.98
|
| Rate for Payer: BCBS MAPPO |
$376.29
|
| Rate for Payer: BCN Commercial |
$629.95
|
| Rate for Payer: BCN Medicare Advantage |
$376.29
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$541.86
|
| Rate for Payer: Cofinity Commercial |
$504.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.29
|
| Rate for Payer: Healthscope Commercial |
$696.14
|
| Rate for Payer: Healthscope Commercial |
$602.06
|
| Rate for Payer: Mclaren Medicaid |
$246.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.10
|
| Rate for Payer: Meridian Medicaid |
$258.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.09
|
| Rate for Payer: Nomi Health Commercial |
$451.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,012.50
|
| Rate for Payer: PACE SWMI |
$376.29
|
| Rate for Payer: PHP Medicare Advantage |
$376.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$673.39
|
| Rate for Payer: Priority Health Medicare |
$376.29
|
| Rate for Payer: Priority Health SBD |
$673.39
|
| Rate for Payer: Priority Health Tiered Network |
$673.39
|
| Rate for Payer: Railroad Medicare Medicare |
$376.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.37
|
| Rate for Payer: UHC Core |
$706.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$376.29
|
| Rate for Payer: UHC Exchange |
$706.37
|
| Rate for Payer: UHC Medicaid |
$246.65
|
| Rate for Payer: UHCCP Medicaid |
$246.65
|
|
|
PR DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 21705
|
| Min. Negotiated Rate |
$315.24 |
| Max. Negotiated Rate |
$958.36 |
| Rate for Payer: Aetna Commercial |
$666.41
|
| Rate for Payer: Aetna Medicare |
$517.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$716.14
|
| Rate for Payer: BCBS Complete |
$331.00
|
| Rate for Payer: BCBS MAPPO |
$497.32
|
| Rate for Payer: BCN Commercial |
$792.29
|
| Rate for Payer: BCN Medicare Advantage |
$497.32
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$716.14
|
| Rate for Payer: Cofinity Commercial |
$666.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.32
|
| Rate for Payer: Healthscope Commercial |
$920.04
|
| Rate for Payer: Healthscope Commercial |
$795.71
|
| Rate for Payer: Mclaren Medicaid |
$315.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.19
|
| Rate for Payer: Meridian Medicaid |
$331.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$547.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.86
|
| Rate for Payer: Nomi Health Commercial |
$596.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$864.75
|
| Rate for Payer: PACE SWMI |
$497.32
|
| Rate for Payer: PHP Medicare Advantage |
$497.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$846.93
|
| Rate for Payer: Priority Health Medicare |
$497.32
|
| Rate for Payer: Priority Health SBD |
$846.93
|
| Rate for Payer: Priority Health Tiered Network |
$846.93
|
| Rate for Payer: Railroad Medicare Medicare |
$497.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.36
|
| Rate for Payer: UHC Core |
$958.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$497.32
|
| Rate for Payer: UHC Exchange |
$958.36
|
| Rate for Payer: UHC Medicaid |
$315.24
|
| Rate for Payer: UHCCP Medicaid |
$315.24
|
|
|
PR DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 21700
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$1,196.25 |
| Rate for Payer: Aetna Commercial |
$445.71
|
| Rate for Payer: Aetna Medicare |
$345.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.97
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS MAPPO |
$332.62
|
| Rate for Payer: BCN Commercial |
$531.34
|
| Rate for Payer: BCN Medicare Advantage |
$332.62
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$478.97
|
| Rate for Payer: Cofinity Commercial |
$445.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.62
|
| Rate for Payer: Healthscope Commercial |
$615.35
|
| Rate for Payer: Healthscope Commercial |
$532.19
|
| Rate for Payer: Mclaren Medicaid |
$211.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.25
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$636.55
|
| Rate for Payer: Nomi Health Commercial |
$399.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,196.25
|
| Rate for Payer: PACE SWMI |
$332.62
|
| Rate for Payer: PHP Medicare Advantage |
$332.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$568.00
|
| Rate for Payer: Priority Health Medicare |
$332.62
|
| Rate for Payer: Priority Health SBD |
$568.00
|
| Rate for Payer: Priority Health Tiered Network |
$568.00
|
| Rate for Payer: Railroad Medicare Medicare |
$332.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$636.91
|
| Rate for Payer: UHC Core |
$636.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.62
|
| Rate for Payer: UHC Exchange |
$636.91
|
| Rate for Payer: UHC Medicaid |
$211.94
|
| Rate for Payer: UHCCP Medicaid |
$211.94
|
|
|
PR DIVISION STRICTURE RECTUM
|
Professional
|
Both
|
$1,421.00
|
|
|
Service Code
|
HCPCS 45150
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$1,065.75 |
| Rate for Payer: Aetna Commercial |
$548.41
|
| Rate for Payer: Aetna Medicare |
$425.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.33
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$409.26
|
| Rate for Payer: BCN Commercial |
$644.38
|
| Rate for Payer: BCN Medicare Advantage |
$409.26
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$589.33
|
| Rate for Payer: Cofinity Commercial |
$548.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.26
|
| Rate for Payer: Healthscope Commercial |
$757.13
|
| Rate for Payer: Healthscope Commercial |
$654.82
|
| Rate for Payer: Mclaren Medicaid |
$266.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.72
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.60
|
| Rate for Payer: Nomi Health Commercial |
$491.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,065.75
|
| Rate for Payer: PACE SWMI |
$409.26
|
| Rate for Payer: PHP Medicare Advantage |
$409.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$785.14
|
| Rate for Payer: Priority Health Medicare |
$409.26
|
| Rate for Payer: Priority Health SBD |
$785.14
|
| Rate for Payer: Priority Health Tiered Network |
$785.14
|
| Rate for Payer: Railroad Medicare Medicare |
$409.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.84
|
| Rate for Payer: UHC Core |
$736.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.26
|
| Rate for Payer: UHC Exchange |
$736.84
|
| Rate for Payer: UHC Medicaid |
$266.68
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL
|
Professional
|
Both
|
$1,731.00
|
|
|
Service Code
|
HCPCS 34710
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,437.34 |
| Rate for Payer: Aetna Commercial |
$976.12
|
| Rate for Payer: Aetna Medicare |
$757.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,048.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$976.12
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$728.45
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: BCN Medicare Advantage |
$728.45
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Cofinity Commercial |
$976.12
|
| Rate for Payer: Cofinity Commercial |
$1,048.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.45
|
| Rate for Payer: Healthscope Commercial |
$1,347.63
|
| Rate for Payer: Healthscope Commercial |
$1,165.52
|
| Rate for Payer: Mclaren Medicaid |
$460.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.87
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,405.39
|
| Rate for Payer: Nomi Health Commercial |
$874.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,298.25
|
| Rate for Payer: PACE SWMI |
$728.45
|
| Rate for Payer: PHP Medicare Advantage |
$728.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,249.90
|
| Rate for Payer: Priority Health Medicare |
$728.45
|
| Rate for Payer: Priority Health SBD |
$1,249.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,249.90
|
| Rate for Payer: Railroad Medicare Medicare |
$728.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,437.34
|
| Rate for Payer: UHC Core |
$1,437.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$728.45
|
| Rate for Payer: UHC Exchange |
$1,437.34
|
| Rate for Payer: UHC Medicaid |
$460.72
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 34711
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$538.04 |
| Rate for Payer: Aetna Commercial |
$360.12
|
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.00
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS MAPPO |
$268.75
|
| Rate for Payer: BCN Commercial |
$428.76
|
| Rate for Payer: BCN Medicare Advantage |
$268.75
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Cofinity Commercial |
$360.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.75
|
| Rate for Payer: Healthscope Commercial |
$497.19
|
| Rate for Payer: Healthscope Commercial |
$430.00
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.32
|
| Rate for Payer: Nomi Health Commercial |
$322.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.00
|
| Rate for Payer: PACE SWMI |
$268.75
|
| Rate for Payer: PHP Medicare Advantage |
$268.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$461.07
|
| Rate for Payer: Priority Health Medicare |
$268.75
|
| Rate for Payer: Priority Health SBD |
$461.07
|
| Rate for Payer: Priority Health Tiered Network |
$461.07
|
| Rate for Payer: Railroad Medicare Medicare |
$268.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.04
|
| Rate for Payer: UHC Core |
$538.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.75
|
| Rate for Payer: UHC Exchange |
$538.04
|
| Rate for Payer: UHC Medicaid |
$168.48
|
| Rate for Payer: UHCCP Medicaid |
$168.48
|
|
|
PR DLYD PLMT PROX XTN PROSTH NOT COV LSA ORIGIN
|
Professional
|
Both
|
$2,346.00
|
|
|
Service Code
|
HCPCS 33883
|
| Min. Negotiated Rate |
$613.23 |
| Max. Negotiated Rate |
$1,996.35 |
| Rate for Payer: Aetna Commercial |
$1,298.25
|
| Rate for Payer: Aetna Medicare |
$1,007.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,298.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.13
|
| Rate for Payer: BCBS Complete |
$643.89
|
| Rate for Payer: BCBS MAPPO |
$968.84
|
| Rate for Payer: BCN Commercial |
$1,619.44
|
| Rate for Payer: BCN Medicare Advantage |
$968.84
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$1,395.13
|
| Rate for Payer: Cofinity Commercial |
$1,298.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.84
|
| Rate for Payer: Healthscope Commercial |
$1,792.35
|
| Rate for Payer: Healthscope Commercial |
$1,550.14
|
| Rate for Payer: Mclaren Medicaid |
$613.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.28
|
| Rate for Payer: Meridian Medicaid |
$643.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,065.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,967.26
|
| Rate for Payer: Nomi Health Commercial |
$1,162.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,759.50
|
| Rate for Payer: PACE SWMI |
$968.84
|
| Rate for Payer: PHP Medicare Advantage |
$968.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,741.50
|
| Rate for Payer: Priority Health Medicare |
$968.84
|
| Rate for Payer: Priority Health SBD |
$1,741.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,741.50
|
| Rate for Payer: Railroad Medicare Medicare |
$968.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,996.35
|
| Rate for Payer: UHC Core |
$1,996.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$968.84
|
| Rate for Payer: UHC Exchange |
$1,996.35
|
| Rate for Payer: UHC Medicaid |
$613.23
|
| Rate for Payer: UHCCP Medicaid |
$613.23
|
|
|
PR DOG EAR REVISION
|
Professional
|
Both
|
$2,704.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,081.60 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna Medicare |
$1,352.00
|
| Rate for Payer: BCBS Complete |
$1,081.60
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
|
|
PR DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 99324
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Aetna Medicare |
$47.50
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
|
|
PR DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99335
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 99336
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Medicare |
$104.00
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.00
|
|
|
PR DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 99334
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
|
|
PR DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
HCPCS 99337
|
| Min. Negotiated Rate |
$119.20 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Aetna Medicare |
$149.00
|
| Rate for Payer: BCBS Complete |
$119.20
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.50
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$21.85 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$29.28
|
| Rate for Payer: Aetna Commercial |
$29.28
|
| Rate for Payer: Aetna Medicare |
$22.72
|
| Rate for Payer: Aetna Medicare |
$22.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.46
|
| Rate for Payer: BCBS MAPPO |
$21.85
|
| Rate for Payer: BCBS MAPPO |
$21.85
|
| Rate for Payer: BCN Commercial |
$33.87
|
| Rate for Payer: BCN Commercial |
$33.87
|
| Rate for Payer: BCN Medicare Advantage |
$21.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.85
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$40.42
|
| Rate for Payer: Healthscope Commercial |
$40.42
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.73
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$21.85
|
| Rate for Payer: PACE SWMI |
$21.85
|
| Rate for Payer: PHP Medicare Advantage |
$21.85
|
| Rate for Payer: PHP Medicare Advantage |
$21.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.19
|
| Rate for Payer: Priority Health Medicare |
$21.85
|
| Rate for Payer: Priority Health Medicare |
$21.85
|
| Rate for Payer: Priority Health SBD |
$32.19
|
| Rate for Payer: Priority Health SBD |
$32.19
|
| Rate for Payer: Priority Health Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Tiered Network |
$32.19
|
| Rate for Payer: Railroad Medicare Medicare |
$21.85
|
| Rate for Payer: Railroad Medicare Medicare |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.56
|
| Rate for Payer: UHC Core |
$37.56
|
| Rate for Payer: UHC Core |
$37.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.85
|
| Rate for Payer: UHC Exchange |
$37.56
|
| Rate for Payer: UHC Exchange |
$37.56
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$200.25 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$50.11
|
| Rate for Payer: Aetna Medicare |
$50.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.56
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Healthscope Commercial |
$89.13
|
| Rate for Payer: Healthscope Commercial |
$89.13
|
| Rate for Payer: Healthscope Commercial |
$77.09
|
| Rate for Payer: Healthscope Commercial |
$77.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.81
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.25
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.00
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: Priority Health SBD |
$71.00
|
| Rate for Payer: Priority Health SBD |
$71.00
|
| Rate for Payer: Priority Health Tiered Network |
$71.00
|
| Rate for Payer: Priority Health Tiered Network |
$71.00
|
| Rate for Payer: Railroad Medicare Medicare |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.25
|
| Rate for Payer: UHC Core |
$82.25
|
| Rate for Payer: UHC Core |
$82.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.18
|
| Rate for Payer: UHC Exchange |
$82.25
|
| Rate for Payer: UHC Exchange |
$82.25
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$43.81 |
| Rate for Payer: Aetna Commercial |
$31.73
|
| Rate for Payer: Aetna Medicare |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.10
|
| Rate for Payer: BCBS MAPPO |
$23.68
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$23.68
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$34.10
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.68
|
| Rate for Payer: Healthscope Commercial |
$43.81
|
| Rate for Payer: Healthscope Commercial |
$37.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.49
|
| Rate for Payer: Nomi Health Commercial |
$28.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$23.68
|
| Rate for Payer: PHP Medicare Advantage |
$23.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.03
|
| Rate for Payer: Priority Health Medicare |
$23.68
|
| Rate for Payer: Priority Health SBD |
$35.03
|
| Rate for Payer: Priority Health Tiered Network |
$35.03
|
| Rate for Payer: Railroad Medicare Medicare |
$23.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.67
|
| Rate for Payer: UHC Core |
$40.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.68
|
| Rate for Payer: UHC Exchange |
$40.67
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$255.20 |
| Max. Negotiated Rate |
$478.50 |
| Rate for Payer: Aetna Medicare |
$319.00
|
| Rate for Payer: BCBS Complete |
$255.20
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$478.50
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Aetna Commercial |
$142.90
|
| Rate for Payer: Aetna Medicare |
$110.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.56
|
| Rate for Payer: BCBS Complete |
$74.03
|
| Rate for Payer: BCBS MAPPO |
$106.64
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$106.64
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$153.56
|
| Rate for Payer: Cofinity Commercial |
$142.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.64
|
| Rate for Payer: Healthscope Commercial |
$197.28
|
| Rate for Payer: Healthscope Commercial |
$170.62
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.97
|
| Rate for Payer: Meridian Medicaid |
$74.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.07
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.75
|
| Rate for Payer: PACE SWMI |
$106.64
|
| Rate for Payer: PHP Medicare Advantage |
$106.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$173.99
|
| Rate for Payer: Priority Health Medicare |
$106.64
|
| Rate for Payer: Priority Health SBD |
$173.99
|
| Rate for Payer: Priority Health Tiered Network |
$173.99
|
| Rate for Payer: Railroad Medicare Medicare |
$106.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.27
|
| Rate for Payer: UHC Core |
$203.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.64
|
| Rate for Payer: UHC Exchange |
$203.27
|
| Rate for Payer: UHC Medicaid |
$70.50
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$144.12
|
| Rate for Payer: Aetna Medicare |
$111.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.87
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS MAPPO |
$107.55
|
| Rate for Payer: BCN Commercial |
$185.25
|
| Rate for Payer: BCN Medicare Advantage |
$107.55
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$154.87
|
| Rate for Payer: Cofinity Commercial |
$144.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.55
|
| Rate for Payer: Healthscope Commercial |
$198.97
|
| Rate for Payer: Healthscope Commercial |
$172.08
|
| Rate for Payer: Mclaren Medicaid |
$71.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.93
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.74
|
| Rate for Payer: Nomi Health Commercial |
$129.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.75
|
| Rate for Payer: PACE SWMI |
$107.55
|
| Rate for Payer: PHP Medicare Advantage |
$107.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$174.45
|
| Rate for Payer: Priority Health Medicare |
$107.55
|
| Rate for Payer: Priority Health SBD |
$174.45
|
| Rate for Payer: Priority Health Tiered Network |
$174.45
|
| Rate for Payer: Railroad Medicare Medicare |
$107.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.42
|
| Rate for Payer: UHC Core |
$204.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.55
|
| Rate for Payer: UHC Exchange |
$204.42
|
| Rate for Payer: UHC Medicaid |
$71.14
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: BCBS MAPPO |
$95.50
|
| Rate for Payer: Aetna Commercial |
$127.97
|
| Rate for Payer: Aetna Medicare |
$99.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.52
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: BCN Medicare Advantage |
$95.50
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cofinity Commercial |
$137.52
|
| Rate for Payer: Cofinity Commercial |
$127.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$176.68
|
| Rate for Payer: Healthscope Commercial |
$152.80
|
| Rate for Payer: Mclaren Medicaid |
$63.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.28
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.57
|
| Rate for Payer: Nomi Health Commercial |
$114.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.50
|
| Rate for Payer: PACE SWMI |
$95.50
|
| Rate for Payer: PHP Medicare Advantage |
$95.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$201.44
|
| Rate for Payer: Priority Health Medicare |
$95.50
|
| Rate for Payer: Priority Health SBD |
$201.44
|
| Rate for Payer: Priority Health Tiered Network |
$201.44
|
| Rate for Payer: Railroad Medicare Medicare |
$95.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.01
|
| Rate for Payer: UHC Core |
$179.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.50
|
| Rate for Payer: UHC Exchange |
$179.01
|
| Rate for Payer: UHC Medicaid |
$63.26
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$245.38 |
| Max. Negotiated Rate |
$798.49 |
| Rate for Payer: Aetna Commercial |
$503.40
|
| Rate for Payer: Aetna Medicare |
$390.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.96
|
| Rate for Payer: BCBS Complete |
$257.65
|
| Rate for Payer: BCBS MAPPO |
$375.67
|
| Rate for Payer: BCN Commercial |
$655.34
|
| Rate for Payer: BCN Medicare Advantage |
$375.67
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$540.96
|
| Rate for Payer: Cofinity Commercial |
$503.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.67
|
| Rate for Payer: Healthscope Commercial |
$694.99
|
| Rate for Payer: Healthscope Commercial |
$601.07
|
| Rate for Payer: Mclaren Medicaid |
$245.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.45
|
| Rate for Payer: Meridian Medicaid |
$257.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.65
|
| Rate for Payer: Nomi Health Commercial |
$450.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.50
|
| Rate for Payer: PACE SWMI |
$375.67
|
| Rate for Payer: PHP Medicare Advantage |
$375.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$798.49
|
| Rate for Payer: Priority Health Medicare |
$375.67
|
| Rate for Payer: Priority Health SBD |
$798.49
|
| Rate for Payer: Priority Health Tiered Network |
$798.49
|
| Rate for Payer: Railroad Medicare Medicare |
$375.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.02
|
| Rate for Payer: UHC Core |
$742.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$375.67
|
| Rate for Payer: UHC Exchange |
$742.02
|
| Rate for Payer: UHC Medicaid |
$245.38
|
| Rate for Payer: UHCCP Medicaid |
$245.38
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$90.31 |
| Max. Negotiated Rate |
$288.22 |
| Rate for Payer: Aetna Commercial |
$183.29
|
| Rate for Payer: Aetna Medicare |
$142.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.96
|
| Rate for Payer: BCBS Complete |
$94.83
|
| Rate for Payer: BCBS MAPPO |
$136.78
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: BCN Medicare Advantage |
$136.78
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$196.96
|
| Rate for Payer: Cofinity Commercial |
$183.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.78
|
| Rate for Payer: Healthscope Commercial |
$253.04
|
| Rate for Payer: Healthscope Commercial |
$218.85
|
| Rate for Payer: Mclaren Medicaid |
$90.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.62
|
| Rate for Payer: Meridian Medicaid |
$94.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.40
|
| Rate for Payer: Nomi Health Commercial |
$164.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$136.78
|
| Rate for Payer: PHP Medicare Advantage |
$136.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$288.22
|
| Rate for Payer: Priority Health Medicare |
$136.78
|
| Rate for Payer: Priority Health SBD |
$288.22
|
| Rate for Payer: Priority Health Tiered Network |
$288.22
|
| Rate for Payer: Railroad Medicare Medicare |
$136.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.29
|
| Rate for Payer: UHC Core |
$264.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.78
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicaid |
$90.31
|
| Rate for Payer: UHCCP Medicaid |
$90.31
|
|
