|
PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 43255
|
| Min. Negotiated Rate |
$188.55 |
| Max. Negotiated Rate |
$749.45 |
| Rate for Payer: Aetna Commercial |
$252.66
|
| Rate for Payer: Aetna Medicare |
$196.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$461.20
|
| Rate for Payer: BCBS MAPPO |
$188.55
|
| Rate for Payer: BCN Medicare Advantage |
$188.55
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$271.51
|
| Rate for Payer: Cofinity Commercial |
$252.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.55
|
| Rate for Payer: Healthscope Commercial |
$348.82
|
| Rate for Payer: Healthscope Commercial |
$301.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.45
|
| Rate for Payer: Nomi Health Commercial |
$226.26
|
| Rate for Payer: PACE SWMI |
$188.55
|
| Rate for Payer: PHP Medicare Advantage |
$188.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health Medicare |
$188.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.55
|
| Rate for Payer: UHC Medicare Advantage |
$188.55
|
|
|
PR EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 43254
|
| Min. Negotiated Rate |
$254.09 |
| Max. Negotiated Rate |
$542.10 |
| Rate for Payer: Aetna Commercial |
$340.48
|
| Rate for Payer: Aetna Medicare |
$264.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.48
|
| Rate for Payer: BCBS Complete |
$333.60
|
| Rate for Payer: BCBS MAPPO |
$254.09
|
| Rate for Payer: BCN Medicare Advantage |
$254.09
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$365.89
|
| Rate for Payer: Cofinity Commercial |
$340.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.09
|
| Rate for Payer: Healthscope Commercial |
$406.54
|
| Rate for Payer: Healthscope Commercial |
$470.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.10
|
| Rate for Payer: Nomi Health Commercial |
$304.91
|
| Rate for Payer: PACE SWMI |
$254.09
|
| Rate for Payer: PHP Medicare Advantage |
$254.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.10
|
| Rate for Payer: Priority Health Medicare |
$254.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.09
|
| Rate for Payer: UHC Medicare Advantage |
$254.09
|
|
|
PR EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 43240
|
| Min. Negotiated Rate |
$367.67 |
| Max. Negotiated Rate |
$772.20 |
| Rate for Payer: Aetna Commercial |
$492.68
|
| Rate for Payer: Aetna Medicare |
$382.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.68
|
| Rate for Payer: BCBS Complete |
$475.20
|
| Rate for Payer: BCBS MAPPO |
$367.67
|
| Rate for Payer: BCN Medicare Advantage |
$367.67
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$529.44
|
| Rate for Payer: Cofinity Commercial |
$492.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.67
|
| Rate for Payer: Healthscope Commercial |
$680.19
|
| Rate for Payer: Healthscope Commercial |
$588.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.20
|
| Rate for Payer: Nomi Health Commercial |
$441.20
|
| Rate for Payer: PACE SWMI |
$367.67
|
| Rate for Payer: PHP Medicare Advantage |
$367.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.20
|
| Rate for Payer: Priority Health Medicare |
$367.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$367.67
|
| Rate for Payer: UHC Medicare Advantage |
$367.67
|
|
|
PR EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 43253
|
| Min. Negotiated Rate |
$247.03 |
| Max. Negotiated Rate |
$522.60 |
| Rate for Payer: Aetna Commercial |
$331.02
|
| Rate for Payer: Aetna Medicare |
$256.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.02
|
| Rate for Payer: BCBS Complete |
$321.60
|
| Rate for Payer: BCBS MAPPO |
$247.03
|
| Rate for Payer: BCN Medicare Advantage |
$247.03
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$355.72
|
| Rate for Payer: Cofinity Commercial |
$331.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.03
|
| Rate for Payer: Healthscope Commercial |
$395.25
|
| Rate for Payer: Healthscope Commercial |
$457.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.60
|
| Rate for Payer: Nomi Health Commercial |
$296.44
|
| Rate for Payer: PACE SWMI |
$247.03
|
| Rate for Payer: PHP Medicare Advantage |
$247.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health Medicare |
$247.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.03
|
| Rate for Payer: UHC Medicare Advantage |
$247.03
|
|
|
PR EKG FOR INITIAL PREVENT EXAM
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS G0403
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$27.95 |
| 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 |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$13.33
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| 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 |
$27.95
|
| 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 |
$27.95
|
| 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 EKG INTERPRET & REPORT PREVE
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS G0405
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$14.15 |
| Rate for Payer: Aetna Commercial |
$10.25
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| 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 |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$14.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.65
|
| 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 |
$13.65
|
| 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 EKG TRACING FOR INITIAL PREV
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS G0404
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Aetna Commercial |
$7.61
|
| Rate for Payer: Aetna Medicare |
$5.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.61
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$5.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.68
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$8.18
|
| Rate for Payer: Cofinity Commercial |
$7.61
|
| 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 |
$13.65
|
| 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 |
$13.65
|
| 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 ELASTIC GARMENT/COVERING
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS A4466
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: Aetna Medicare |
$8.50
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
|
|
PR ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 95983
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Aetna Commercial |
$61.68
|
| Rate for Payer: Aetna Medicare |
$47.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.28
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS MAPPO |
$46.03
|
| Rate for Payer: BCN Medicare Advantage |
$46.03
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$61.68
|
| Rate for Payer: Cofinity Commercial |
$66.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.03
|
| Rate for Payer: Healthscope Commercial |
$73.65
|
| Rate for Payer: Healthscope Commercial |
$85.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.25
|
| Rate for Payer: Nomi Health Commercial |
$55.24
|
| Rate for Payer: PACE SWMI |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$46.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.03
|
| Rate for Payer: UHC Medicare Advantage |
$46.03
|
|
|
PR ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 95984
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$75.13 |
| Rate for Payer: Aetna Commercial |
$54.42
|
| Rate for Payer: Aetna Medicare |
$42.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$40.61
|
| Rate for Payer: BCN Medicare Advantage |
$40.61
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.61
|
| Rate for Payer: Healthscope Commercial |
$75.13
|
| Rate for Payer: Healthscope Commercial |
$64.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.15
|
| Rate for Payer: Nomi Health Commercial |
$48.73
|
| Rate for Payer: PACE SWMI |
$40.61
|
| Rate for Payer: PHP Medicare Advantage |
$40.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$40.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.61
|
| Rate for Payer: UHC Medicare Advantage |
$40.61
|
|
|
PR ELEC ALYS IMPLT CPLX CN NPGT PRGRMG
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 95977
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$87.65 |
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna Medicare |
$49.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.49
|
| Rate for Payer: BCBS Complete |
$44.00
|
| Rate for Payer: BCBS MAPPO |
$47.38
|
| Rate for Payer: BCN Medicare Advantage |
$47.38
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$68.23
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.38
|
| Rate for Payer: Healthscope Commercial |
$75.81
|
| Rate for Payer: Healthscope Commercial |
$87.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.50
|
| Rate for Payer: Nomi Health Commercial |
$56.86
|
| Rate for Payer: PACE SWMI |
$47.38
|
| Rate for Payer: PHP Medicare Advantage |
$47.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health Medicare |
$47.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.38
|
| Rate for Payer: UHC Medicare Advantage |
$47.38
|
|
|
PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 95972
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$311.35 |
| Rate for Payer: Aetna Commercial |
$50.48
|
| Rate for Payer: Aetna Commercial |
$50.48
|
| Rate for Payer: Aetna Medicare |
$39.18
|
| Rate for Payer: Aetna Medicare |
$39.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.24
|
| Rate for Payer: BCBS Complete |
$191.60
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$37.67
|
| Rate for Payer: BCBS MAPPO |
$37.67
|
| Rate for Payer: BCN Medicare Advantage |
$37.67
|
| Rate for Payer: BCN Medicare Advantage |
$37.67
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$50.48
|
| Rate for Payer: Cofinity Commercial |
$54.24
|
| Rate for Payer: Cofinity Commercial |
$50.48
|
| Rate for Payer: Cofinity Commercial |
$54.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.67
|
| Rate for Payer: Healthscope Commercial |
$69.69
|
| Rate for Payer: Healthscope Commercial |
$69.69
|
| Rate for Payer: Healthscope Commercial |
$60.27
|
| Rate for Payer: Healthscope Commercial |
$60.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.20
|
| Rate for Payer: Nomi Health Commercial |
$45.20
|
| Rate for Payer: Nomi Health Commercial |
$45.20
|
| Rate for Payer: PACE SWMI |
$37.67
|
| Rate for Payer: PACE SWMI |
$37.67
|
| Rate for Payer: PHP Medicare Advantage |
$37.67
|
| Rate for Payer: PHP Medicare Advantage |
$37.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health Medicare |
$37.67
|
| Rate for Payer: Priority Health Medicare |
$37.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.67
|
| Rate for Payer: UHC Medicare Advantage |
$37.67
|
| Rate for Payer: UHC Medicare Advantage |
$37.67
|
|
|
PR ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95970
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$18.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$17.47
|
| Rate for Payer: BCN Medicare Advantage |
$17.47
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$25.16
|
| Rate for Payer: Cofinity Commercial |
$23.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.47
|
| Rate for Payer: Healthscope Commercial |
$32.32
|
| Rate for Payer: Healthscope Commercial |
$27.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.45
|
| Rate for Payer: Nomi Health Commercial |
$20.96
|
| Rate for Payer: PACE SWMI |
$17.47
|
| Rate for Payer: PHP Medicare Advantage |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$17.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.47
|
|
|
PR ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 95971
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Healthscope Commercial |
$58.62
|
| Rate for Payer: Healthscope Commercial |
$67.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.20
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
|
|
PR ELEC ALYS IMPLT SMPL CN NPGT PRGRMG
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 95976
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Aetna Commercial |
$47.21
|
| Rate for Payer: Aetna Medicare |
$36.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$35.23
|
| Rate for Payer: BCN Medicare Advantage |
$35.23
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$50.73
|
| Rate for Payer: Cofinity Commercial |
$47.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.23
|
| Rate for Payer: Healthscope Commercial |
$56.37
|
| Rate for Payer: Healthscope Commercial |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.60
|
| Rate for Payer: Nomi Health Commercial |
$42.28
|
| Rate for Payer: PACE SWMI |
$35.23
|
| Rate for Payer: PHP Medicare Advantage |
$35.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$35.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.23
|
| Rate for Payer: UHC Medicare Advantage |
$35.23
|
|
|
PR ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR
|
Professional
|
Both
|
$959.00
|
|
|
Service Code
|
HCPCS 95974
|
| Min. Negotiated Rate |
$383.60 |
| Max. Negotiated Rate |
$623.35 |
| Rate for Payer: Aetna Medicare |
$479.50
|
| Rate for Payer: BCBS Complete |
$383.60
|
| Rate for Payer: Cash Price |
$767.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.35
|
|
|
PR ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH EA 30 MIN
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 95973
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
|
|
PR ELEC STIM OTHER THAN WOUND
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS G0283
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$21.83 |
| Rate for Payer: Aetna Commercial |
$15.81
|
| Rate for Payer: Aetna Medicare |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$11.80
|
| Rate for Payer: BCN Medicare Advantage |
$11.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$15.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.80
|
| Rate for Payer: Healthscope Commercial |
$21.83
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.90
|
| Rate for Payer: Nomi Health Commercial |
$14.16
|
| Rate for Payer: PACE SWMI |
$11.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.80
|
|
|
PR ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 62368
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$136.50 |
| Rate for Payer: Aetna Commercial |
$43.66
|
| Rate for Payer: Aetna Medicare |
$33.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCBS MAPPO |
$32.58
|
| Rate for Payer: BCN Medicare Advantage |
$32.58
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.58
|
| Rate for Payer: Healthscope Commercial |
$52.13
|
| Rate for Payer: Healthscope Commercial |
$60.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.50
|
| Rate for Payer: Nomi Health Commercial |
$39.10
|
| Rate for Payer: PACE SWMI |
$32.58
|
| Rate for Payer: PHP Medicare Advantage |
$32.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.58
|
| Rate for Payer: UHC Medicare Advantage |
$32.58
|
|
|
PR ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 62367
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$248.95 |
| Rate for Payer: Aetna Commercial |
$31.25
|
| Rate for Payer: Aetna Medicare |
$24.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.25
|
| Rate for Payer: BCBS Complete |
$153.20
|
| Rate for Payer: BCBS MAPPO |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$23.32
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$33.58
|
| Rate for Payer: Cofinity Commercial |
$31.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$37.31
|
| Rate for Payer: Healthscope Commercial |
$43.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.95
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: PACE SWMI |
$23.32
|
| Rate for Payer: PHP Medicare Advantage |
$23.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health Medicare |
$23.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.32
|
| Rate for Payer: UHC Medicare Advantage |
$23.32
|
|
|
PR ELECTROACOUS EVAL HEARING AID BINAURAL
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 92595
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$51.35 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
|
|
PR ELECTROACOUS EVAL HEARING AID MONAURAL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 92594
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
|
|
PR ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95824
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
|
|
PR ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 95812
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$575.05 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna Medicare |
$323.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.61
|
| Rate for Payer: BCBS Complete |
$301.20
|
| Rate for Payer: BCBS MAPPO |
$310.84
|
| Rate for Payer: BCN Medicare Advantage |
$310.84
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$447.61
|
| Rate for Payer: Cofinity Commercial |
$416.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.84
|
| Rate for Payer: Healthscope Commercial |
$575.05
|
| Rate for Payer: Healthscope Commercial |
$497.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.45
|
| Rate for Payer: Nomi Health Commercial |
$373.01
|
| Rate for Payer: PACE SWMI |
$310.84
|
| Rate for Payer: PHP Medicare Advantage |
$310.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
| Rate for Payer: Priority Health Medicare |
$310.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.84
|
| Rate for Payer: UHC Medicare Advantage |
$310.84
|
|
|
PR ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 95822
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$689.00 |
| Rate for Payer: Aetna Commercial |
$499.06
|
| Rate for Payer: Aetna Medicare |
$387.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.30
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$372.43
|
| Rate for Payer: BCN Medicare Advantage |
$372.43
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$499.06
|
| Rate for Payer: Cofinity Commercial |
$536.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.43
|
| Rate for Payer: Healthscope Commercial |
$595.89
|
| Rate for Payer: Healthscope Commercial |
$689.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.55
|
| Rate for Payer: Nomi Health Commercial |
$446.92
|
| Rate for Payer: PACE SWMI |
$372.43
|
| Rate for Payer: PHP Medicare Advantage |
$372.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$372.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.43
|
| Rate for Payer: UHC Medicare Advantage |
$372.43
|
|
