|
PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG
|
Facility
|
IP
|
$794.00
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
64624
|
| Min. Negotiated Rate |
$500.22 |
| Max. Negotiated Rate |
$714.60 |
| Rate for Payer: Aetna Commercial |
$674.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.10
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$555.80
|
| Rate for Payer: Cofinity Commercial |
$682.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$555.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$635.20
|
| Rate for Payer: Healthscope Commercial |
$714.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.90
|
| Rate for Payer: PHP Commercial |
$674.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health SBD |
$500.22
|
|
|
PR DESTRUCTION PREMALIGNANT LESION 15/>
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 17004
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$17,307.00 |
| Rate for Payer: Aetna Commercial |
$124.77
|
| Rate for Payer: Aetna Medicare |
$96.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.08
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$93.11
|
| Rate for Payer: BCBS Trust/PPO |
$39.53
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$93.11
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$134.08
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.11
|
| Rate for Payer: Healthscope Commercial |
$172.25
|
| Rate for Payer: Healthscope Commercial |
$148.98
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.77
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,307.00
|
| Rate for Payer: Nomi Health Commercial |
$111.73
|
| Rate for Payer: PACE SWMI |
$93.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.20
|
| Rate for Payer: Priority Health Medicare |
$93.11
|
| Rate for Payer: Priority Health Narrow Network |
$133.20
|
| Rate for Payer: Priority Health SBD |
$133.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.11
|
| Rate for Payer: UHC Exchange |
$214.93
|
| Rate for Payer: UHC Medicare Advantage |
$93.11
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR DESTRUCTION PREMALIGNANT LESION 1ST
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 17000
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$9,450.00 |
| Rate for Payer: Aetna Commercial |
$68.47
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.58
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$534.35
|
| Rate for Payer: BCN Commercial |
$78.92
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$68.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Healthscope Commercial |
$94.54
|
| Rate for Payer: Healthscope Commercial |
$81.76
|
| Rate for Payer: Mclaren Medicaid |
$35.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.00
|
| Rate for Payer: Nomi Health Commercial |
$61.32
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.96
|
| Rate for Payer: Priority Health Medicare |
$51.10
|
| Rate for Payer: Priority Health Narrow Network |
$74.96
|
| Rate for Payer: Priority Health SBD |
$74.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Exchange |
$64.12
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
PR DESTRUCTION PREMALIGNANT LESION 2-14 EA
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 17003
|
| Min. Negotiated Rate |
$1.28 |
| Max. Negotiated Rate |
$2,756.25 |
| Rate for Payer: Aetna Commercial |
$2.52
|
| Rate for Payer: Aetna Medicare |
$1.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.34
|
| Rate for Payer: BCBS MAPPO |
$1.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,756.25
|
| Rate for Payer: BCN Commercial |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$1.88
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$2.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.88
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$3.01
|
| Rate for Payer: Mclaren Medicaid |
$1.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.97
|
| Rate for Payer: Meridian Medicaid |
$1.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$355.00
|
| Rate for Payer: Nomi Health Commercial |
$2.26
|
| Rate for Payer: PACE SWMI |
$1.88
|
| Rate for Payer: PHP Medicare Advantage |
$1.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.71
|
| Rate for Payer: Priority Health Medicare |
$1.88
|
| Rate for Payer: Priority Health Narrow Network |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.88
|
| Rate for Payer: UHC Exchange |
$20.44
|
| Rate for Payer: UHC Medicare Advantage |
$1.88
|
| Rate for Payer: UHCCP Medicaid |
$1.28
|
|
|
PR DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 45190
|
| Min. Negotiated Rate |
$448.79 |
| Max. Negotiated Rate |
$123,032.00 |
| Rate for Payer: Aetna Commercial |
$889.33
|
| Rate for Payer: Aetna Medicare |
$690.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$889.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.70
|
| Rate for Payer: BCBS Complete |
$471.23
|
| Rate for Payer: BCBS MAPPO |
$663.68
|
| Rate for Payer: BCBS Trust/PPO |
$706.34
|
| Rate for Payer: BCN Commercial |
$1,018.41
|
| Rate for Payer: BCN Medicare Advantage |
$663.68
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$955.70
|
| Rate for Payer: Cofinity Commercial |
$889.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.68
|
| Rate for Payer: Healthscope Commercial |
$1,227.81
|
| Rate for Payer: Healthscope Commercial |
$1,061.89
|
| Rate for Payer: Mclaren Medicaid |
$448.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.86
|
| Rate for Payer: Meridian Medicaid |
$471.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123,032.00
|
| Rate for Payer: Nomi Health Commercial |
$796.42
|
| Rate for Payer: PACE SWMI |
$663.68
|
| Rate for Payer: PHP Medicare Advantage |
$663.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,251.06
|
| Rate for Payer: Priority Health Medicare |
$663.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,251.06
|
| Rate for Payer: Priority Health SBD |
$1,251.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.68
|
| Rate for Payer: UHC Exchange |
$681.81
|
| Rate for Payer: UHC Medicare Advantage |
$663.68
|
| Rate for Payer: UHCCP Medicaid |
$448.79
|
|
|
PR DESTRUCTION VAGINAL LESIONS EXTENSIVE
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 57065
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$32,996.00 |
| Rate for Payer: Aetna Commercial |
$236.78
|
| Rate for Payer: Aetna Medicare |
$183.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.45
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$176.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,603.46
|
| Rate for Payer: BCN Commercial |
$365.04
|
| Rate for Payer: BCN Medicare Advantage |
$176.70
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$254.45
|
| Rate for Payer: Cofinity Commercial |
$236.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.70
|
| Rate for Payer: Healthscope Commercial |
$326.90
|
| Rate for Payer: Healthscope Commercial |
$282.72
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.54
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,996.00
|
| Rate for Payer: Nomi Health Commercial |
$212.04
|
| Rate for Payer: PACE SWMI |
$176.70
|
| Rate for Payer: PHP Medicare Advantage |
$176.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.28
|
| Rate for Payer: Priority Health Medicare |
$176.70
|
| Rate for Payer: Priority Health Narrow Network |
$279.28
|
| Rate for Payer: Priority Health SBD |
$279.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.70
|
| Rate for Payer: UHC Exchange |
$367.71
|
| Rate for Payer: UHC Medicare Advantage |
$176.70
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR DESTRUCTION VAGINAL LESIONS SIMPLE
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 57061
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$20,264.00 |
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.04
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Healthscope Commercial |
$200.47
|
| Rate for Payer: Healthscope Commercial |
$173.38
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,264.00
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.62
|
| Rate for Payer: Priority Health Medicare |
$108.36
|
| Rate for Payer: Priority Health Narrow Network |
$173.62
|
| Rate for Payer: Priority Health SBD |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Exchange |
$191.68
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR DETERMINATION REFRACTIVE STATE
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 92015
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$2,736.00 |
| Rate for Payer: Aetna Commercial |
$21.33
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.33
|
| Rate for Payer: BCBS Complete |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.90
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$12.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.84
|
| Rate for Payer: Priority Health Narrow Network |
$22.84
|
| Rate for Payer: Priority Health SBD |
$22.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.00
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHCCP Medicaid |
$11.72
|
|
|
PR DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 96110
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$1,490.00 |
| Rate for Payer: Aetna Commercial |
$10.35
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$974.19
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,490.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.83
|
| Rate for Payer: Priority Health Narrow Network |
$15.83
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.38
|
| Rate for Payer: UHC Exchange |
$30.38
|
|
|
PR DEVELOPMENTAL TESTING W/INTERP & REPORT
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 96111
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
|
|
PR DEXAMETHASONE SODIUM PHOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1100
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$0.16
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.17
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$0.16
|
| Rate for Payer: Cofinity Commercial |
$0.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$0.22
|
| Rate for Payer: Healthscope Commercial |
$0.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$0.14
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
|
|
PR DIABETES PREVENTION PROGRAM
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00268
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
|
|
PR DIABETES PREVENTION PROG STANDARDIZED CURRICULUM
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 0403T
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$4,805.00 |
| Rate for Payer: Aetna Commercial |
$32.06
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.06
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: BCN Commercial |
$58.68
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,805.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 29805
|
| Min. Negotiated Rate |
$308.64 |
| Max. Negotiated Rate |
$83,171.00 |
| Rate for Payer: Aetna Commercial |
$608.83
|
| Rate for Payer: Aetna Medicare |
$472.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$654.26
|
| Rate for Payer: BCBS Complete |
$324.07
|
| Rate for Payer: BCBS MAPPO |
$454.35
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$454.35
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$654.26
|
| Rate for Payer: Cofinity Commercial |
$608.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.35
|
| Rate for Payer: Healthscope Commercial |
$840.55
|
| Rate for Payer: Healthscope Commercial |
$726.96
|
| Rate for Payer: Mclaren Medicaid |
$308.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.07
|
| Rate for Payer: Meridian Medicaid |
$324.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,171.00
|
| Rate for Payer: Nomi Health Commercial |
$545.22
|
| Rate for Payer: PACE SWMI |
$454.35
|
| Rate for Payer: PHP Medicare Advantage |
$454.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.64
|
| Rate for Payer: Priority Health Medicare |
$454.35
|
| Rate for Payer: Priority Health Narrow Network |
$725.64
|
| Rate for Payer: Priority Health SBD |
$725.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.35
|
| Rate for Payer: UHC Exchange |
$642.50
|
| Rate for Payer: UHC Medicare Advantage |
$454.35
|
| Rate for Payer: UHCCP Medicaid |
$308.64
|
|
|
PR DIAGNOSTIC BONE MARROW ASPIRATIONS
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 38220
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$11,866.00 |
| Rate for Payer: Aetna Commercial |
$85.13
|
| Rate for Payer: Aetna Medicare |
$66.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.48
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$63.53
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$63.53
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$91.48
|
| Rate for Payer: Cofinity Commercial |
$85.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.53
|
| Rate for Payer: Healthscope Commercial |
$117.53
|
| Rate for Payer: Healthscope Commercial |
$101.65
|
| Rate for Payer: Mclaren Medicaid |
$42.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.71
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,866.00
|
| Rate for Payer: Nomi Health Commercial |
$76.24
|
| Rate for Payer: PACE SWMI |
$63.53
|
| Rate for Payer: PHP Medicare Advantage |
$63.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.48
|
| Rate for Payer: Priority Health Medicare |
$63.53
|
| Rate for Payer: Priority Health Narrow Network |
$132.48
|
| Rate for Payer: Priority Health SBD |
$132.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.53
|
| Rate for Payer: UHC Exchange |
$227.96
|
| Rate for Payer: UHC Medicare Advantage |
$63.53
|
| Rate for Payer: UHCCP Medicaid |
$42.81
|
|
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 38221
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$12,298.00 |
| Rate for Payer: Aetna Commercial |
$87.81
|
| Rate for Payer: Aetna Medicare |
$68.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.36
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$65.53
|
| Rate for Payer: BCBS Trust/PPO |
$400.45
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: BCN Medicare Advantage |
$65.53
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$94.36
|
| Rate for Payer: Cofinity Commercial |
$87.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.53
|
| Rate for Payer: Healthscope Commercial |
$121.23
|
| Rate for Payer: Healthscope Commercial |
$104.85
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.81
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,298.00
|
| Rate for Payer: Nomi Health Commercial |
$78.64
|
| Rate for Payer: PACE SWMI |
$65.53
|
| Rate for Payer: PHP Medicare Advantage |
$65.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.48
|
| Rate for Payer: Priority Health Medicare |
$65.53
|
| Rate for Payer: Priority Health Narrow Network |
$138.48
|
| Rate for Payer: Priority Health SBD |
$138.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.53
|
| Rate for Payer: UHC Exchange |
$244.56
|
| Rate for Payer: UHC Medicare Advantage |
$65.53
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 38222
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$13,295.00 |
| Rate for Payer: Aetna Commercial |
$94.70
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$70.67
|
| Rate for Payer: BCBS Trust/PPO |
$367.17
|
| Rate for Payer: BCN Commercial |
$255.58
|
| Rate for Payer: BCN Medicare Advantage |
$70.67
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$94.70
|
| Rate for Payer: Cofinity Commercial |
$101.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.67
|
| Rate for Payer: Healthscope Commercial |
$113.07
|
| Rate for Payer: Healthscope Commercial |
$130.74
|
| Rate for Payer: Mclaren Medicaid |
$47.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.20
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,295.00
|
| Rate for Payer: Nomi Health Commercial |
$84.80
|
| Rate for Payer: PACE SWMI |
$70.67
|
| Rate for Payer: PHP Medicare Advantage |
$70.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.80
|
| Rate for Payer: Priority Health Medicare |
$70.67
|
| Rate for Payer: Priority Health Narrow Network |
$147.80
|
| Rate for Payer: Priority Health SBD |
$147.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.67
|
| Rate for Payer: UHC Medicare Advantage |
$70.67
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 62270
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$11,230.00 |
| Rate for Payer: Aetna Commercial |
$84.10
|
| Rate for Payer: Aetna Medicare |
$65.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.37
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$62.76
|
| Rate for Payer: BCBS Trust/PPO |
$874.34
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$62.76
|
| Rate for Payer: Cash Price |
$452.80
|
| Rate for Payer: Cash Price |
$452.80
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Commercial |
$84.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Healthscope Commercial |
$100.42
|
| Rate for Payer: Mclaren Medicaid |
$41.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.90
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,230.00
|
| Rate for Payer: Nomi Health Commercial |
$75.31
|
| Rate for Payer: PACE SWMI |
$62.76
|
| Rate for Payer: PHP Medicare Advantage |
$62.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.06
|
| Rate for Payer: Priority Health Medicare |
$62.76
|
| Rate for Payer: Priority Health Narrow Network |
$108.06
|
| Rate for Payer: Priority Health SBD |
$108.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.76
|
| Rate for Payer: UHC Exchange |
$201.64
|
| Rate for Payer: UHC Medicare Advantage |
$62.76
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 62328
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$15,300.00 |
| Rate for Payer: Aetna Commercial |
$108.39
|
| Rate for Payer: Aetna Medicare |
$84.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.48
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$80.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,578.56
|
| Rate for Payer: BCN Commercial |
$339.63
|
| Rate for Payer: BCN Medicare Advantage |
$80.89
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$116.48
|
| Rate for Payer: Cofinity Commercial |
$108.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.89
|
| Rate for Payer: Healthscope Commercial |
$129.42
|
| Rate for Payer: Healthscope Commercial |
$149.65
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.93
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,300.00
|
| Rate for Payer: Nomi Health Commercial |
$97.07
|
| Rate for Payer: PACE SWMI |
$80.89
|
| Rate for Payer: PHP Medicare Advantage |
$80.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.31
|
| Rate for Payer: Priority Health Medicare |
$80.89
|
| Rate for Payer: Priority Health Narrow Network |
$143.31
|
| Rate for Payer: Priority Health SBD |
$143.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.89
|
| Rate for Payer: UHC Medicare Advantage |
$80.89
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 36909
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$35,455.00 |
| Rate for Payer: Aetna Commercial |
$254.77
|
| Rate for Payer: Aetna Medicare |
$197.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.79
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$190.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.28
|
| Rate for Payer: BCN Commercial |
$2,818.21
|
| Rate for Payer: BCN Medicare Advantage |
$190.13
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Cofinity Commercial |
$254.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.13
|
| Rate for Payer: Healthscope Commercial |
$304.21
|
| Rate for Payer: Healthscope Commercial |
$351.74
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.64
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,455.00
|
| Rate for Payer: Nomi Health Commercial |
$228.16
|
| Rate for Payer: PACE SWMI |
$190.13
|
| Rate for Payer: PHP Medicare Advantage |
$190.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.11
|
| Rate for Payer: Priority Health Medicare |
$190.13
|
| Rate for Payer: Priority Health Narrow Network |
$311.11
|
| Rate for Payer: Priority Health SBD |
$311.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.13
|
| Rate for Payer: UHC Medicare Advantage |
$190.13
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 90945
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$12,459.00 |
| Rate for Payer: Aetna Commercial |
$108.63
|
| Rate for Payer: Aetna Medicare |
$84.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.74
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$81.07
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$81.07
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$108.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.07
|
| Rate for Payer: Healthscope Commercial |
$149.98
|
| Rate for Payer: Healthscope Commercial |
$129.71
|
| Rate for Payer: Mclaren Medicaid |
$54.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.12
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,459.00
|
| Rate for Payer: Nomi Health Commercial |
$97.28
|
| Rate for Payer: PACE SWMI |
$81.07
|
| Rate for Payer: PHP Medicare Advantage |
$81.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.89
|
| Rate for Payer: Priority Health Medicare |
$81.07
|
| Rate for Payer: Priority Health Narrow Network |
$114.89
|
| Rate for Payer: Priority Health SBD |
$114.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.07
|
| Rate for Payer: UHC Exchange |
$108.71
|
| Rate for Payer: UHC Medicare Advantage |
$81.07
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
|
|
PR DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 90947
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$18,008.00 |
| Rate for Payer: Aetna Commercial |
$154.98
|
| Rate for Payer: Aetna Medicare |
$120.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.55
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$115.66
|
| Rate for Payer: BCBS Trust/PPO |
$319.62
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$115.66
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$166.55
|
| Rate for Payer: Cofinity Commercial |
$154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.66
|
| Rate for Payer: Healthscope Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$185.06
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.44
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,008.00
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: PACE SWMI |
$115.66
|
| Rate for Payer: PHP Medicare Advantage |
$115.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.74
|
| Rate for Payer: Priority Health Medicare |
$115.66
|
| Rate for Payer: Priority Health Narrow Network |
$163.74
|
| Rate for Payer: Priority Health SBD |
$163.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.66
|
| Rate for Payer: UHC Exchange |
$176.82
|
| Rate for Payer: UHC Medicare Advantage |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$77.32
|
|
|
PR DIAPHRAGM
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS A4266
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.28
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCN Commercial |
$80.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
|
|
PR DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 57170
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$8,611.00 |
| Rate for Payer: Aetna Commercial |
$61.40
|
| Rate for Payer: Aetna Medicare |
$47.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.98
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$45.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.77
|
| Rate for Payer: BCN Commercial |
$115.33
|
| Rate for Payer: BCN Medicare Advantage |
$45.82
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$65.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.82
|
| Rate for Payer: Healthscope Commercial |
$73.31
|
| Rate for Payer: Healthscope Commercial |
$84.77
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.11
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,611.00
|
| Rate for Payer: Nomi Health Commercial |
$54.98
|
| Rate for Payer: PACE SWMI |
$45.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.95
|
| Rate for Payer: Priority Health Medicare |
$45.82
|
| Rate for Payer: Priority Health Narrow Network |
$69.95
|
| Rate for Payer: Priority Health SBD |
$69.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.82
|
| Rate for Payer: UHC Exchange |
$99.34
|
| Rate for Payer: UHC Medicare Advantage |
$45.82
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR DIGITAL ANALYSIS ELECTROENCEPHALOGRAM
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 95957
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$39,060.00 |
| Rate for Payer: Aetna Commercial |
$352.82
|
| Rate for Payer: Aetna Medicare |
$273.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.15
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$263.30
|
| Rate for Payer: BCBS Trust/PPO |
$346.56
|
| Rate for Payer: BCN Commercial |
$401.69
|
| Rate for Payer: BCN Medicare Advantage |
$263.30
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$379.15
|
| Rate for Payer: Cofinity Commercial |
$352.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.30
|
| Rate for Payer: Healthscope Commercial |
$487.10
|
| Rate for Payer: Healthscope Commercial |
$421.28
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.46
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,060.00
|
| Rate for Payer: Nomi Health Commercial |
$315.96
|
| Rate for Payer: PACE SWMI |
$263.30
|
| Rate for Payer: PHP Medicare Advantage |
$263.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.04
|
| Rate for Payer: Priority Health Medicare |
$263.30
|
| Rate for Payer: Priority Health Narrow Network |
$398.04
|
| Rate for Payer: Priority Health SBD |
$135.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.30
|
| Rate for Payer: UHC Exchange |
$196.39
|
| Rate for Payer: UHC Medicare Advantage |
$263.30
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
