|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 93975
|
| Min. Negotiated Rate |
$234.50 |
| Max. Negotiated Rate |
$433.82 |
| Rate for Payer: Aetna Commercial |
$314.23
|
| Rate for Payer: Aetna Commercial |
$314.23
|
| Rate for Payer: Aetna Medicare |
$243.88
|
| Rate for Payer: Aetna Medicare |
$243.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.68
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS MAPPO |
$234.50
|
| Rate for Payer: BCBS MAPPO |
$234.50
|
| Rate for Payer: BCN Medicare Advantage |
$234.50
|
| Rate for Payer: BCN Medicare Advantage |
$234.50
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$314.23
|
| Rate for Payer: Cofinity Commercial |
$337.68
|
| Rate for Payer: Cofinity Commercial |
$314.23
|
| Rate for Payer: Cofinity Commercial |
$337.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.50
|
| Rate for Payer: Healthscope Commercial |
$433.82
|
| Rate for Payer: Healthscope Commercial |
$433.82
|
| Rate for Payer: Healthscope Commercial |
$375.20
|
| Rate for Payer: Healthscope Commercial |
$375.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.70
|
| Rate for Payer: Nomi Health Commercial |
$281.40
|
| Rate for Payer: Nomi Health Commercial |
$281.40
|
| Rate for Payer: PACE SWMI |
$234.50
|
| Rate for Payer: PACE SWMI |
$234.50
|
| Rate for Payer: PHP Medicare Advantage |
$234.50
|
| Rate for Payer: PHP Medicare Advantage |
$234.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
| Rate for Payer: Priority Health Medicare |
$234.50
|
| Rate for Payer: Priority Health Medicare |
$234.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.50
|
| Rate for Payer: UHC Medicare Advantage |
$234.50
|
| Rate for Payer: UHC Medicare Advantage |
$234.50
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 93976
|
| Min. Negotiated Rate |
$142.28 |
| Max. Negotiated Rate |
$417.95 |
| Rate for Payer: Aetna Commercial |
$190.66
|
| Rate for Payer: Aetna Commercial |
$190.66
|
| Rate for Payer: Aetna Medicare |
$147.97
|
| Rate for Payer: Aetna Medicare |
$147.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.88
|
| Rate for Payer: BCBS Complete |
$257.20
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS MAPPO |
$142.28
|
| Rate for Payer: BCBS MAPPO |
$142.28
|
| Rate for Payer: BCN Medicare Advantage |
$142.28
|
| Rate for Payer: BCN Medicare Advantage |
$142.28
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$190.66
|
| Rate for Payer: Cofinity Commercial |
$204.88
|
| Rate for Payer: Cofinity Commercial |
$190.66
|
| Rate for Payer: Cofinity Commercial |
$204.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.28
|
| Rate for Payer: Healthscope Commercial |
$263.22
|
| Rate for Payer: Healthscope Commercial |
$263.22
|
| Rate for Payer: Healthscope Commercial |
$227.65
|
| Rate for Payer: Healthscope Commercial |
$227.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.65
|
| Rate for Payer: Nomi Health Commercial |
$170.74
|
| Rate for Payer: Nomi Health Commercial |
$170.74
|
| Rate for Payer: PACE SWMI |
$142.28
|
| Rate for Payer: PACE SWMI |
$142.28
|
| Rate for Payer: PHP Medicare Advantage |
$142.28
|
| Rate for Payer: PHP Medicare Advantage |
$142.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health Medicare |
$142.28
|
| Rate for Payer: Priority Health Medicare |
$142.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.28
|
| Rate for Payer: UHC Medicare Advantage |
$142.28
|
| Rate for Payer: UHC Medicare Advantage |
$142.28
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 93925
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$391.79 |
| Rate for Payer: Aetna Commercial |
$283.79
|
| Rate for Payer: Aetna Commercial |
$283.79
|
| Rate for Payer: Aetna Medicare |
$220.25
|
| Rate for Payer: Aetna Medicare |
$220.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.96
|
| Rate for Payer: BCBS Complete |
$171.20
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$211.78
|
| Rate for Payer: BCBS MAPPO |
$211.78
|
| Rate for Payer: BCN Medicare Advantage |
$211.78
|
| Rate for Payer: BCN Medicare Advantage |
$211.78
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$283.79
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Cofinity Commercial |
$283.79
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.78
|
| Rate for Payer: Healthscope Commercial |
$391.79
|
| Rate for Payer: Healthscope Commercial |
$391.79
|
| Rate for Payer: Healthscope Commercial |
$338.85
|
| Rate for Payer: Healthscope Commercial |
$338.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Nomi Health Commercial |
$254.14
|
| Rate for Payer: Nomi Health Commercial |
$254.14
|
| Rate for Payer: PACE SWMI |
$211.78
|
| Rate for Payer: PACE SWMI |
$211.78
|
| Rate for Payer: PHP Medicare Advantage |
$211.78
|
| Rate for Payer: PHP Medicare Advantage |
$211.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.20
|
| Rate for Payer: Priority Health Medicare |
$211.78
|
| Rate for Payer: Priority Health Medicare |
$211.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.78
|
| Rate for Payer: UHC Medicare Advantage |
$211.78
|
| Rate for Payer: UHC Medicare Advantage |
$211.78
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 93926
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$235.45 |
| Rate for Payer: Aetna Commercial |
$170.54
|
| Rate for Payer: Aetna Commercial |
$170.54
|
| Rate for Payer: Aetna Medicare |
$132.36
|
| Rate for Payer: Aetna Medicare |
$132.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.27
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Complete |
$133.60
|
| Rate for Payer: BCBS MAPPO |
$127.27
|
| Rate for Payer: BCBS MAPPO |
$127.27
|
| Rate for Payer: BCN Medicare Advantage |
$127.27
|
| Rate for Payer: BCN Medicare Advantage |
$127.27
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$170.54
|
| Rate for Payer: Cofinity Commercial |
$183.27
|
| Rate for Payer: Cofinity Commercial |
$170.54
|
| Rate for Payer: Cofinity Commercial |
$183.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.27
|
| Rate for Payer: Healthscope Commercial |
$235.45
|
| Rate for Payer: Healthscope Commercial |
$235.45
|
| Rate for Payer: Healthscope Commercial |
$203.63
|
| Rate for Payer: Healthscope Commercial |
$203.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.10
|
| Rate for Payer: Nomi Health Commercial |
$152.72
|
| Rate for Payer: Nomi Health Commercial |
$152.72
|
| Rate for Payer: PACE SWMI |
$127.27
|
| Rate for Payer: PACE SWMI |
$127.27
|
| Rate for Payer: PHP Medicare Advantage |
$127.27
|
| Rate for Payer: PHP Medicare Advantage |
$127.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Medicare |
$127.27
|
| Rate for Payer: Priority Health Medicare |
$127.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.27
|
| Rate for Payer: UHC Medicare Advantage |
$127.27
|
| Rate for Payer: UHC Medicare Advantage |
$127.27
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93930
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$327.62 |
| Rate for Payer: Aetna Commercial |
$237.30
|
| Rate for Payer: Aetna Commercial |
$237.30
|
| Rate for Payer: Aetna Medicare |
$184.17
|
| Rate for Payer: Aetna Medicare |
$184.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.01
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS Complete |
$162.40
|
| Rate for Payer: BCBS MAPPO |
$177.09
|
| Rate for Payer: BCBS MAPPO |
$177.09
|
| Rate for Payer: BCN Medicare Advantage |
$177.09
|
| Rate for Payer: BCN Medicare Advantage |
$177.09
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$237.30
|
| Rate for Payer: Cofinity Commercial |
$255.01
|
| Rate for Payer: Cofinity Commercial |
$237.30
|
| Rate for Payer: Cofinity Commercial |
$255.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.09
|
| Rate for Payer: Healthscope Commercial |
$327.62
|
| Rate for Payer: Healthscope Commercial |
$327.62
|
| Rate for Payer: Healthscope Commercial |
$283.34
|
| Rate for Payer: Healthscope Commercial |
$283.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.90
|
| Rate for Payer: Nomi Health Commercial |
$212.51
|
| Rate for Payer: Nomi Health Commercial |
$212.51
|
| Rate for Payer: PACE SWMI |
$177.09
|
| Rate for Payer: PACE SWMI |
$177.09
|
| Rate for Payer: PHP Medicare Advantage |
$177.09
|
| Rate for Payer: PHP Medicare Advantage |
$177.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Medicare |
$177.09
|
| Rate for Payer: Priority Health Medicare |
$177.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.09
|
| Rate for Payer: UHC Medicare Advantage |
$177.09
|
| Rate for Payer: UHC Medicare Advantage |
$177.09
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 93931
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$203.13 |
| Rate for Payer: Aetna Commercial |
$147.13
|
| Rate for Payer: Aetna Commercial |
$147.13
|
| Rate for Payer: Aetna Medicare |
$114.19
|
| Rate for Payer: Aetna Medicare |
$114.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.11
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$109.80
|
| Rate for Payer: BCBS MAPPO |
$109.80
|
| Rate for Payer: BCN Medicare Advantage |
$109.80
|
| Rate for Payer: BCN Medicare Advantage |
$109.80
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$147.13
|
| Rate for Payer: Cofinity Commercial |
$158.11
|
| Rate for Payer: Cofinity Commercial |
$147.13
|
| Rate for Payer: Cofinity Commercial |
$158.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.80
|
| Rate for Payer: Healthscope Commercial |
$203.13
|
| Rate for Payer: Healthscope Commercial |
$203.13
|
| Rate for Payer: Healthscope Commercial |
$175.68
|
| Rate for Payer: Healthscope Commercial |
$175.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.80
|
| Rate for Payer: Nomi Health Commercial |
$131.76
|
| Rate for Payer: Nomi Health Commercial |
$131.76
|
| Rate for Payer: PACE SWMI |
$109.80
|
| Rate for Payer: PACE SWMI |
$109.80
|
| Rate for Payer: PHP Medicare Advantage |
$109.80
|
| Rate for Payer: PHP Medicare Advantage |
$109.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$109.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.80
|
| Rate for Payer: UHC Medicare Advantage |
$109.80
|
| Rate for Payer: UHC Medicare Advantage |
$109.80
|
|
|
PR DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 93970
|
| Min. Negotiated Rate |
$165.65 |
| Max. Negotiated Rate |
$306.45 |
| Rate for Payer: Aetna Commercial |
$221.97
|
| Rate for Payer: Aetna Commercial |
$221.97
|
| Rate for Payer: Aetna Medicare |
$172.28
|
| Rate for Payer: Aetna Medicare |
$172.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.54
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$165.65
|
| Rate for Payer: BCBS MAPPO |
$165.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.65
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$221.97
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Cofinity Commercial |
$221.97
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.65
|
| Rate for Payer: Healthscope Commercial |
$306.45
|
| Rate for Payer: Healthscope Commercial |
$306.45
|
| Rate for Payer: Healthscope Commercial |
$265.04
|
| Rate for Payer: Healthscope Commercial |
$265.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$198.78
|
| Rate for Payer: Nomi Health Commercial |
$198.78
|
| Rate for Payer: PACE SWMI |
$165.65
|
| Rate for Payer: PACE SWMI |
$165.65
|
| Rate for Payer: PHP Medicare Advantage |
$165.65
|
| Rate for Payer: PHP Medicare Advantage |
$165.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
| Rate for Payer: Priority Health Medicare |
$165.65
|
| Rate for Payer: Priority Health Medicare |
$165.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.65
|
| Rate for Payer: UHC Medicare Advantage |
$165.65
|
| Rate for Payer: UHC Medicare Advantage |
$165.65
|
|
|
PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 93971
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$196.16 |
| Rate for Payer: Aetna Commercial |
$142.08
|
| Rate for Payer: Aetna Commercial |
$142.08
|
| Rate for Payer: Aetna Medicare |
$110.27
|
| Rate for Payer: Aetna Medicare |
$110.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.68
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS MAPPO |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$106.03
|
| Rate for Payer: BCN Medicare Advantage |
$106.03
|
| Rate for Payer: BCN Medicare Advantage |
$106.03
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$142.08
|
| Rate for Payer: Cofinity Commercial |
$152.68
|
| Rate for Payer: Cofinity Commercial |
$142.08
|
| Rate for Payer: Cofinity Commercial |
$152.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.03
|
| Rate for Payer: Healthscope Commercial |
$196.16
|
| Rate for Payer: Healthscope Commercial |
$196.16
|
| Rate for Payer: Healthscope Commercial |
$169.65
|
| Rate for Payer: Healthscope Commercial |
$169.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$127.24
|
| Rate for Payer: Nomi Health Commercial |
$127.24
|
| Rate for Payer: PACE SWMI |
$106.03
|
| Rate for Payer: PACE SWMI |
$106.03
|
| Rate for Payer: PHP Medicare Advantage |
$106.03
|
| Rate for Payer: PHP Medicare Advantage |
$106.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.03
|
| Rate for Payer: UHC Medicare Advantage |
$106.03
|
| Rate for Payer: UHC Medicare Advantage |
$106.03
|
|
|
PR DURAL GRAFT SPINAL
|
Professional
|
Both
|
$5,092.00
|
|
|
Service Code
|
HCPCS 63710
|
| Min. Negotiated Rate |
$1,061.01 |
| Max. Negotiated Rate |
$3,309.80 |
| Rate for Payer: Aetna Commercial |
$1,421.75
|
| Rate for Payer: Aetna Medicare |
$1,103.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,527.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.75
|
| Rate for Payer: BCBS Complete |
$2,036.80
|
| Rate for Payer: BCBS MAPPO |
$1,061.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.01
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,527.85
|
| Rate for Payer: Cofinity Commercial |
$1,421.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.01
|
| Rate for Payer: Healthscope Commercial |
$1,962.87
|
| Rate for Payer: Healthscope Commercial |
$1,697.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,309.80
|
| Rate for Payer: Nomi Health Commercial |
$1,273.21
|
| Rate for Payer: PACE SWMI |
$1,061.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,309.80
|
| Rate for Payer: Priority Health Medicare |
$1,061.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.01
|
|
|
PR DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR 1ST 60
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 92622
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$115.07 |
| Rate for Payer: Aetna Commercial |
$83.35
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.35
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$89.57
|
| Rate for Payer: Cofinity Commercial |
$83.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$115.07
|
| Rate for Payer: Healthscope Commercial |
$99.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.90
|
| Rate for Payer: Nomi Health Commercial |
$74.64
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Medicare |
$62.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
|
|
PR DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR EA ADL
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 92623
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$30.27 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Medicare |
$17.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.92
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$16.36
|
| Rate for Payer: BCN Medicare Advantage |
$16.36
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.36
|
| Rate for Payer: Healthscope Commercial |
$26.18
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.95
|
| Rate for Payer: Nomi Health Commercial |
$19.63
|
| Rate for Payer: PACE SWMI |
$16.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$16.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.36
|
| Rate for Payer: UHC Medicare Advantage |
$16.36
|
|
|
PR DYSPORT
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 00385
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
|
|
PR EAR MOLD/INSERT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS V5264
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR EAR PIERCING
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 69090
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$46.15 |
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: BCBS Complete |
$28.40
|
| 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 ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 93010
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Commercial |
$10.25
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.02
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$10.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$14.15
|
| Rate for Payer: Healthscope Commercial |
$12.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.95
|
| Rate for Payer: Nomi Health Commercial |
$9.18
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 93005
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$7.61
|
| Rate for Payer: Aetna Medicare |
$5.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.18
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$5.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.68
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$7.61
|
| Rate for Payer: Cofinity Commercial |
$8.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.68
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Healthscope Commercial |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.95
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: PACE SWMI |
$5.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$5.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.68
|
| Rate for Payer: UHC Medicare Advantage |
$5.68
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93000
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$51.35 |
| Rate for Payer: Aetna Commercial |
$17.86
|
| Rate for Payer: Aetna Medicare |
$13.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$13.33
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.33
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Nomi Health Commercial |
$16.00
|
| Rate for Payer: PACE SWMI |
$13.33
|
| Rate for Payer: PHP Medicare Advantage |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$13.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.33
|
| Rate for Payer: UHC Medicare Advantage |
$13.33
|
|
|
PR ECHO GUIDANCE RADIOTHERAPY
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS G6001
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$293.04 |
| Rate for Payer: Aetna Commercial |
$212.26
|
| Rate for Payer: Aetna Medicare |
$164.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.26
|
| Rate for Payer: BCBS Complete |
$153.20
|
| Rate for Payer: BCBS MAPPO |
$158.40
|
| Rate for Payer: BCN Medicare Advantage |
$158.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$228.10
|
| Rate for Payer: Cofinity Commercial |
$212.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$253.44
|
| Rate for Payer: Healthscope Commercial |
$293.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.95
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: PACE SWMI |
$158.40
|
| Rate for Payer: PHP Medicare Advantage |
$158.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health Medicare |
$158.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.40
|
| Rate for Payer: UHC Medicare Advantage |
$158.40
|
|
|
PR ECHO R-T 2D W/PROBE PLACEMENT ONLY
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 93313
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$494.65 |
| Rate for Payer: Aetna Commercial |
$14.26
|
| Rate for Payer: Aetna Medicare |
$11.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.26
|
| Rate for Payer: BCBS Complete |
$304.40
|
| Rate for Payer: BCBS MAPPO |
$10.64
|
| Rate for Payer: BCN Medicare Advantage |
$10.64
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cofinity Commercial |
$15.32
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.64
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Healthscope Commercial |
$17.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.65
|
| Rate for Payer: Nomi Health Commercial |
$12.77
|
| Rate for Payer: PACE SWMI |
$10.64
|
| Rate for Payer: PHP Medicare Advantage |
$10.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
| Rate for Payer: Priority Health Medicare |
$10.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$10.64
|
|
|
PR ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 93355
|
| Min. Negotiated Rate |
$184.40 |
| Max. Negotiated Rate |
$389.80 |
| Rate for Payer: Aetna Commercial |
$282.34
|
| Rate for Payer: Aetna Medicare |
$219.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.34
|
| Rate for Payer: BCBS Complete |
$184.40
|
| Rate for Payer: BCBS MAPPO |
$210.70
|
| Rate for Payer: BCN Medicare Advantage |
$210.70
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$303.41
|
| Rate for Payer: Cofinity Commercial |
$282.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.70
|
| Rate for Payer: Healthscope Commercial |
$337.12
|
| Rate for Payer: Healthscope Commercial |
$389.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.65
|
| Rate for Payer: Nomi Health Commercial |
$252.84
|
| Rate for Payer: PACE SWMI |
$210.70
|
| Rate for Payer: PHP Medicare Advantage |
$210.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.65
|
| Rate for Payer: Priority Health Medicare |
$210.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.70
|
| Rate for Payer: UHC Medicare Advantage |
$210.70
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Facility
|
OP
|
$592.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna Commercial |
$503.20
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$414.40
|
| Rate for Payer: Cofinity Commercial |
$509.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$414.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$532.80
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.20
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$503.20
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$372.96
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$301.06
|
| Rate for Payer: VA VA |
$534.75
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$236.80 |
| Max. Negotiated Rate |
$384.80 |
| Rate for Payer: Aetna Medicare |
$296.00
|
| Rate for Payer: BCBS Complete |
$236.80
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$372.96 |
| Max. Negotiated Rate |
$532.80 |
| Rate for Payer: Aetna Commercial |
$503.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.80
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$414.40
|
| Rate for Payer: Cofinity Commercial |
$509.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$414.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.60
|
| Rate for Payer: Healthscope Commercial |
$532.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.20
|
| Rate for Payer: PHP Commercial |
$503.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
| Rate for Payer: Priority Health SBD |
$372.96
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 93315
|
| Min. Negotiated Rate |
$236.80 |
| Max. Negotiated Rate |
$384.80 |
| Rate for Payer: Aetna Medicare |
$296.00
|
| Rate for Payer: BCBS Complete |
$236.80
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.80
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 93316
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$98.15 |
| Rate for Payer: Aetna Commercial |
$32.39
|
| Rate for Payer: Aetna Medicare |
$25.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.39
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS MAPPO |
$24.17
|
| Rate for Payer: BCN Medicare Advantage |
$24.17
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$32.39
|
| Rate for Payer: Cofinity Commercial |
$34.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.17
|
| Rate for Payer: Healthscope Commercial |
$44.71
|
| Rate for Payer: Healthscope Commercial |
$38.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.15
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE SWMI |
$24.17
|
| Rate for Payer: PHP Medicare Advantage |
$24.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.15
|
| Rate for Payer: Priority Health Medicare |
$24.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.17
|
| Rate for Payer: UHC Medicare Advantage |
$24.17
|
|
