|
PR ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS
|
Professional
|
Both
|
$426.00
|
|
|
Service Code
|
HCPCS 90961
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$559.14 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$314.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.23
|
| Rate for Payer: BCBS Complete |
$207.99
|
| Rate for Payer: BCBS MAPPO |
$302.24
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$302.24
|
| Rate for Payer: Cash Price |
$340.80
|
| Rate for Payer: Cash Price |
$340.80
|
| Rate for Payer: Cofinity Commercial |
$435.23
|
| Rate for Payer: Cofinity Commercial |
$405.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.24
|
| Rate for Payer: Healthscope Commercial |
$559.14
|
| Rate for Payer: Healthscope Commercial |
$483.58
|
| Rate for Payer: Mclaren Medicaid |
$198.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.35
|
| Rate for Payer: Meridian Medicaid |
$207.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.84
|
| Rate for Payer: Nomi Health Commercial |
$362.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.50
|
| Rate for Payer: PACE SWMI |
$302.24
|
| Rate for Payer: PHP Medicare Advantage |
$302.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$404.14
|
| Rate for Payer: Priority Health Medicare |
$302.24
|
| Rate for Payer: Priority Health SBD |
$404.14
|
| Rate for Payer: Priority Health Tiered Network |
$404.14
|
| Rate for Payer: Railroad Medicare Medicare |
$302.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.78
|
| Rate for Payer: UHC Core |
$382.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.24
|
| Rate for Payer: UHC Exchange |
$382.78
|
| Rate for Payer: UHC Medicaid |
$198.09
|
| Rate for Payer: UHCCP Medicaid |
$198.09
|
|
|
PR ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 90960
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$671.74 |
| Rate for Payer: Aetna Commercial |
$486.55
|
| Rate for Payer: Aetna Medicare |
$377.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.86
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$363.10
|
| Rate for Payer: BCN Commercial |
$527.86
|
| Rate for Payer: BCN Medicare Advantage |
$363.10
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$522.86
|
| Rate for Payer: Cofinity Commercial |
$486.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.10
|
| Rate for Payer: Healthscope Commercial |
$671.74
|
| Rate for Payer: Healthscope Commercial |
$580.96
|
| Rate for Payer: Mclaren Medicaid |
$237.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.25
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$399.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$516.03
|
| Rate for Payer: Nomi Health Commercial |
$435.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$380.25
|
| Rate for Payer: PACE SWMI |
$363.10
|
| Rate for Payer: PHP Medicare Advantage |
$363.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$486.79
|
| Rate for Payer: Priority Health Medicare |
$363.10
|
| Rate for Payer: Priority Health SBD |
$486.79
|
| Rate for Payer: Priority Health Tiered Network |
$486.79
|
| Rate for Payer: Railroad Medicare Medicare |
$363.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.15
|
| Rate for Payer: UHC Core |
$456.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$363.10
|
| Rate for Payer: UHC Exchange |
$456.15
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 90966
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$558.59 |
| Rate for Payer: Aetna Commercial |
$404.60
|
| Rate for Payer: Aetna Medicare |
$314.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.79
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$301.94
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$301.94
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$434.79
|
| Rate for Payer: Cofinity Commercial |
$404.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.94
|
| Rate for Payer: Healthscope Commercial |
$558.59
|
| Rate for Payer: Healthscope Commercial |
$483.10
|
| Rate for Payer: Mclaren Medicaid |
$197.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.04
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.39
|
| Rate for Payer: Nomi Health Commercial |
$362.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.50
|
| Rate for Payer: PACE SWMI |
$301.94
|
| Rate for Payer: PHP Medicare Advantage |
$301.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$404.14
|
| Rate for Payer: Priority Health Medicare |
$301.94
|
| Rate for Payer: Priority Health SBD |
$404.14
|
| Rate for Payer: Priority Health Tiered Network |
$404.14
|
| Rate for Payer: Railroad Medicare Medicare |
$301.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.25
|
| Rate for Payer: UHC Core |
$382.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.94
|
| Rate for Payer: UHC Exchange |
$382.25
|
| Rate for Payer: UHC Medicaid |
$197.88
|
| Rate for Payer: UHCCP Medicaid |
$197.88
|
|
|
PR ESW BY PHYS W/ANES INVG LAT HUMERL EPICONDYLE
|
Professional
|
Both
|
$2,735.00
|
|
|
Service Code
|
HCPCS 0102T
|
| Min. Negotiated Rate |
$391.44 |
| Max. Negotiated Rate |
$3,033.71 |
| Rate for Payer: Aetna Commercial |
$391.44
|
| Rate for Payer: Aetna Medicare |
$1,367.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.44
|
| Rate for Payer: BCBS Complete |
$1,094.00
|
| Rate for Payer: BCN Commercial |
$3,033.71
|
| Rate for Payer: Cash Price |
$2,188.00
|
| Rate for Payer: Cash Price |
$2,188.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,051.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.48
|
| Rate for Payer: UHC Core |
$442.48
|
| Rate for Payer: UHC Exchange |
$442.48
|
|
|
PR ETHMOIDECTOMY INTRANASAL ANTERIOR
|
Professional
|
Both
|
$2,627.00
|
|
|
Service Code
|
HCPCS 31200
|
| Min. Negotiated Rate |
$372.54 |
| Max. Negotiated Rate |
$1,970.25 |
| Rate for Payer: Aetna Commercial |
$738.37
|
| Rate for Payer: Aetna Medicare |
$573.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.47
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$551.02
|
| Rate for Payer: BCN Commercial |
$932.22
|
| Rate for Payer: BCN Medicare Advantage |
$551.02
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cofinity Commercial |
$793.47
|
| Rate for Payer: Cofinity Commercial |
$738.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.02
|
| Rate for Payer: Healthscope Commercial |
$1,019.39
|
| Rate for Payer: Healthscope Commercial |
$881.63
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.57
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$606.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,078.69
|
| Rate for Payer: Nomi Health Commercial |
$661.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,970.25
|
| Rate for Payer: PACE SWMI |
$551.02
|
| Rate for Payer: PHP Medicare Advantage |
$551.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$877.88
|
| Rate for Payer: Priority Health Medicare |
$551.02
|
| Rate for Payer: Priority Health SBD |
$877.88
|
| Rate for Payer: Priority Health Tiered Network |
$877.88
|
| Rate for Payer: Railroad Medicare Medicare |
$551.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.58
|
| Rate for Payer: UHC Core |
$1,009.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.02
|
| Rate for Payer: UHC Exchange |
$1,009.58
|
| Rate for Payer: UHC Medicaid |
$372.54
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
|
|
PR ETHMOIDECTOMY INTRANASAL TOTAL
|
Professional
|
Both
|
$1,580.00
|
|
|
Service Code
|
HCPCS 31201
|
| Min. Negotiated Rate |
$452.41 |
| Max. Negotiated Rate |
$1,399.97 |
| Rate for Payer: Aetna Commercial |
$912.50
|
| Rate for Payer: Aetna Medicare |
$708.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.60
|
| Rate for Payer: BCBS Complete |
$475.03
|
| Rate for Payer: BCBS MAPPO |
$680.97
|
| Rate for Payer: BCN Commercial |
$1,164.78
|
| Rate for Payer: BCN Medicare Advantage |
$680.97
|
| Rate for Payer: Cash Price |
$1,264.00
|
| Rate for Payer: Cash Price |
$1,264.00
|
| Rate for Payer: Cofinity Commercial |
$980.60
|
| Rate for Payer: Cofinity Commercial |
$912.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.97
|
| Rate for Payer: Healthscope Commercial |
$1,259.79
|
| Rate for Payer: Healthscope Commercial |
$1,089.55
|
| Rate for Payer: Mclaren Medicaid |
$452.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.02
|
| Rate for Payer: Meridian Medicaid |
$475.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$749.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,399.97
|
| Rate for Payer: Nomi Health Commercial |
$817.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,185.00
|
| Rate for Payer: PACE SWMI |
$680.97
|
| Rate for Payer: PHP Medicare Advantage |
$680.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,096.87
|
| Rate for Payer: Priority Health Medicare |
$680.97
|
| Rate for Payer: Priority Health SBD |
$1,096.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,096.87
|
| Rate for Payer: Railroad Medicare Medicare |
$680.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,315.94
|
| Rate for Payer: UHC Core |
$1,315.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$680.97
|
| Rate for Payer: UHC Exchange |
$1,315.94
|
| Rate for Payer: UHC Medicaid |
$452.41
|
| Rate for Payer: UHCCP Medicaid |
$452.41
|
|
|
PR ETONOGESTREL IMPLANT SYSTEM
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS J7307
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$1,351.89 |
| Rate for Payer: Aetna Commercial |
$1,092.48
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.48
|
| Rate for Payer: BCBS Complete |
$1,351.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.81
|
| Rate for Payer: BCN Commercial |
$1,235.28
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Mclaren Medicaid |
$1,287.51
|
| Rate for Payer: Meridian Medicaid |
$1,351.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,287.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,275.36
|
| Rate for Payer: UHC Core |
$1,275.36
|
| Rate for Payer: UHC Exchange |
$1,275.36
|
| Rate for Payer: UHC Medicaid |
$1,287.51
|
| Rate for Payer: UHCCP Medicaid |
$1,287.51
|
|
|
PR EUFLEXXA INJ PER DOSE
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS J7323
|
| Min. Negotiated Rate |
$105.46 |
| Max. Negotiated Rate |
$228.00 |
| Rate for Payer: Aetna Commercial |
$141.48
|
| Rate for Payer: Aetna Medicare |
$109.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.04
|
| Rate for Payer: BCBS MAPPO |
$105.58
|
| Rate for Payer: BCBS Trust/PPO |
$107.45
|
| Rate for Payer: BCN Commercial |
$137.68
|
| Rate for Payer: BCN Medicare Advantage |
$105.58
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$152.04
|
| Rate for Payer: Cofinity Commercial |
$141.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.58
|
| Rate for Payer: Healthscope Commercial |
$168.93
|
| Rate for Payer: Healthscope Commercial |
$195.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.14
|
| Rate for Payer: Nomi Health Commercial |
$126.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.00
|
| Rate for Payer: PACE SWMI |
$105.58
|
| Rate for Payer: PHP Medicare Advantage |
$105.58
|
| Rate for Payer: Priority Health Medicare |
$105.58
|
| Rate for Payer: Railroad Medicare Medicare |
$105.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.46
|
| Rate for Payer: UHC Core |
$105.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.58
|
| Rate for Payer: UHC Exchange |
$105.46
|
|
|
PR EVACUATION SUBUNGUAL HEMATOMA
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 11740
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$40.11
|
| Rate for Payer: Aetna Medicare |
$31.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$38.88
|
| Rate for Payer: BCN Medicare Advantage |
$29.93
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Cofinity Commercial |
$40.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.93
|
| Rate for Payer: Healthscope Commercial |
$55.37
|
| Rate for Payer: Healthscope Commercial |
$47.89
|
| Rate for Payer: Mclaren Medicaid |
$20.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.43
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.21
|
| Rate for Payer: Nomi Health Commercial |
$35.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$29.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.12
|
| Rate for Payer: Priority Health Medicare |
$29.93
|
| Rate for Payer: Priority Health SBD |
$45.12
|
| Rate for Payer: Priority Health Tiered Network |
$45.12
|
| Rate for Payer: Railroad Medicare Medicare |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.85
|
| Rate for Payer: UHC Core |
$53.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.93
|
| Rate for Payer: UHC Exchange |
$53.85
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 92626
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$78.70
|
| Rate for Payer: Aetna Medicare |
$61.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.57
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$58.73
|
| Rate for Payer: BCN Commercial |
$110.55
|
| Rate for Payer: BCN Medicare Advantage |
$58.73
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$84.57
|
| Rate for Payer: Cofinity Commercial |
$78.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$93.97
|
| Rate for Payer: Healthscope Commercial |
$108.65
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.67
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.01
|
| Rate for Payer: Nomi Health Commercial |
$70.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$58.73
|
| Rate for Payer: PHP Medicare Advantage |
$58.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.95
|
| Rate for Payer: Priority Health Medicare |
$58.73
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: Priority Health Tiered Network |
$101.95
|
| Rate for Payer: Railroad Medicare Medicare |
$58.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.52
|
| Rate for Payer: UHC Core |
$122.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.73
|
| Rate for Payer: UHC Exchange |
$122.52
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 92627
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.83
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCN Commercial |
$25.90
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Cofinity Commercial |
$18.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.65
|
| Rate for Payer: Nomi Health Commercial |
$16.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.88
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health SBD |
$23.88
|
| Rate for Payer: Priority Health Tiered Network |
$23.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.79
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.77
|
| Rate for Payer: UHC Exchange |
$28.79
|
| Rate for Payer: UHC Medicaid |
$8.95
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 92620
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$131.57 |
| Rate for Payer: Aetna Commercial |
$84.39
|
| Rate for Payer: Aetna Medicare |
$65.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.69
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS MAPPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$118.03
|
| Rate for Payer: BCN Medicare Advantage |
$62.98
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$90.69
|
| Rate for Payer: Cofinity Commercial |
$84.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.98
|
| Rate for Payer: Healthscope Commercial |
$100.77
|
| Rate for Payer: Healthscope Commercial |
$116.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.12
|
| Rate for Payer: Nomi Health Commercial |
$75.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$62.98
|
| Rate for Payer: PHP Medicare Advantage |
$62.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$108.84
|
| Rate for Payer: Priority Health Medicare |
$62.98
|
| Rate for Payer: Priority Health SBD |
$108.84
|
| Rate for Payer: Priority Health Tiered Network |
$108.84
|
| Rate for Payer: Railroad Medicare Medicare |
$62.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.57
|
| Rate for Payer: UHC Core |
$131.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.98
|
| Rate for Payer: UHC Exchange |
$131.57
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 92621
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$15.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.23
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS MAPPO |
$14.74
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: BCN Medicare Advantage |
$14.74
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$21.23
|
| Rate for Payer: Cofinity Commercial |
$19.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$27.27
|
| Rate for Payer: Healthscope Commercial |
$23.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.14
|
| Rate for Payer: Nomi Health Commercial |
$17.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$14.74
|
| Rate for Payer: PHP Medicare Advantage |
$14.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.71
|
| Rate for Payer: Priority Health Medicare |
$14.74
|
| Rate for Payer: Priority Health SBD |
$25.71
|
| Rate for Payer: Priority Health Tiered Network |
$25.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.49
|
| Rate for Payer: UHC Core |
$30.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.74
|
| Rate for Payer: UHC Exchange |
$30.49
|
|
|
PR EVAL OF ORTHOTIC/PROSTH USE, EA 15 MIN
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 97762
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
|
|
PR EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 92523
|
| Min. Negotiated Rate |
$217.99 |
| Max. Negotiated Rate |
$403.28 |
| Rate for Payer: Aetna Commercial |
$292.11
|
| Rate for Payer: Aetna Medicare |
$226.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.91
|
| Rate for Payer: BCBS MAPPO |
$217.99
|
| Rate for Payer: BCN Commercial |
$344.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.99
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$292.11
|
| Rate for Payer: Cofinity Commercial |
$313.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.99
|
| Rate for Payer: Healthscope Commercial |
$403.28
|
| Rate for Payer: Healthscope Commercial |
$348.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.64
|
| Rate for Payer: Nomi Health Commercial |
$261.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: PACE SWMI |
$217.99
|
| Rate for Payer: PHP Medicare Advantage |
$217.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$317.33
|
| Rate for Payer: Priority Health Medicare |
$217.99
|
| Rate for Payer: Priority Health SBD |
$317.33
|
| Rate for Payer: Priority Health Tiered Network |
$317.33
|
| Rate for Payer: Railroad Medicare Medicare |
$217.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.77
|
| Rate for Payer: UHC Core |
$307.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.99
|
| Rate for Payer: UHC Exchange |
$307.77
|
|
|
PR EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92628
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 92629
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$55.50 |
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.50
|
|
|
PR EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 92521
|
| Min. Negotiated Rate |
$128.26 |
| Max. Negotiated Rate |
$237.28 |
| Rate for Payer: Aetna Commercial |
$171.87
|
| Rate for Payer: Aetna Medicare |
$133.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.69
|
| Rate for Payer: BCBS MAPPO |
$128.26
|
| Rate for Payer: BCN Commercial |
$201.18
|
| Rate for Payer: BCN Medicare Advantage |
$128.26
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$171.87
|
| Rate for Payer: Cofinity Commercial |
$184.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.26
|
| Rate for Payer: Healthscope Commercial |
$205.22
|
| Rate for Payer: Healthscope Commercial |
$237.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.01
|
| Rate for Payer: Nomi Health Commercial |
$153.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.75
|
| Rate for Payer: PACE SWMI |
$128.26
|
| Rate for Payer: PHP Medicare Advantage |
$128.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$185.53
|
| Rate for Payer: Priority Health Medicare |
$128.26
|
| Rate for Payer: Priority Health SBD |
$185.53
|
| Rate for Payer: Priority Health Tiered Network |
$185.53
|
| Rate for Payer: Railroad Medicare Medicare |
$128.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.69
|
| Rate for Payer: UHC Core |
$179.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.26
|
| Rate for Payer: UHC Exchange |
$179.69
|
|
|
PR EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 92522
|
| Min. Negotiated Rate |
$108.03 |
| Max. Negotiated Rate |
$199.86 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Aetna Medicare |
$112.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.76
|
| Rate for Payer: BCBS MAPPO |
$108.03
|
| Rate for Payer: BCN Commercial |
$167.32
|
| Rate for Payer: BCN Medicare Advantage |
$108.03
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$155.56
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.03
|
| Rate for Payer: Healthscope Commercial |
$172.85
|
| Rate for Payer: Healthscope Commercial |
$199.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.56
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$108.03
|
| Rate for Payer: PHP Medicare Advantage |
$108.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$154.30
|
| Rate for Payer: Priority Health Medicare |
$108.03
|
| Rate for Payer: Priority Health SBD |
$154.30
|
| Rate for Payer: Priority Health Tiered Network |
$154.30
|
| Rate for Payer: Railroad Medicare Medicare |
$108.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.09
|
| Rate for Payer: UHC Core |
$147.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.03
|
| Rate for Payer: UHC Exchange |
$147.09
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST
|
Professional
|
Both
|
$1,138.00
|
|
|
Service Code
|
HCPCS 61650
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$1,030.10 |
| Rate for Payer: Aetna Commercial |
$709.13
|
| Rate for Payer: Aetna Medicare |
$550.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.05
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$529.20
|
| Rate for Payer: BCN Commercial |
$876.95
|
| Rate for Payer: BCN Medicare Advantage |
$529.20
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$762.05
|
| Rate for Payer: Cofinity Commercial |
$709.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.20
|
| Rate for Payer: Healthscope Commercial |
$979.02
|
| Rate for Payer: Healthscope Commercial |
$846.72
|
| Rate for Payer: Mclaren Medicaid |
$333.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.66
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.10
|
| Rate for Payer: Nomi Health Commercial |
$635.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$853.50
|
| Rate for Payer: PACE SWMI |
$529.20
|
| Rate for Payer: PHP Medicare Advantage |
$529.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,018.55
|
| Rate for Payer: Priority Health Medicare |
$529.20
|
| Rate for Payer: Priority Health SBD |
$1,018.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,018.55
|
| Rate for Payer: Railroad Medicare Medicare |
$529.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.67
|
| Rate for Payer: UHC Core |
$1,015.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.20
|
| Rate for Payer: UHC Exchange |
$1,015.67
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
HCPCS 61651
|
| Min. Negotiated Rate |
$142.71 |
| Max. Negotiated Rate |
$443.66 |
| Rate for Payer: Aetna Commercial |
$303.15
|
| Rate for Payer: Aetna Medicare |
$235.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.77
|
| Rate for Payer: BCBS Complete |
$149.85
|
| Rate for Payer: BCBS MAPPO |
$226.23
|
| Rate for Payer: BCN Commercial |
$374.49
|
| Rate for Payer: BCN Medicare Advantage |
$226.23
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cofinity Commercial |
$325.77
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.23
|
| Rate for Payer: Healthscope Commercial |
$418.53
|
| Rate for Payer: Healthscope Commercial |
$361.97
|
| Rate for Payer: Mclaren Medicaid |
$142.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.54
|
| Rate for Payer: Meridian Medicaid |
$149.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$443.66
|
| Rate for Payer: Nomi Health Commercial |
$271.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.00
|
| Rate for Payer: PACE SWMI |
$226.23
|
| Rate for Payer: PHP Medicare Advantage |
$226.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$434.96
|
| Rate for Payer: Priority Health Medicare |
$226.23
|
| Rate for Payer: Priority Health SBD |
$434.96
|
| Rate for Payer: Priority Health Tiered Network |
$434.96
|
| Rate for Payer: Railroad Medicare Medicare |
$226.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.77
|
| Rate for Payer: UHC Core |
$434.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.23
|
| Rate for Payer: UHC Exchange |
$434.77
|
| Rate for Payer: UHC Medicaid |
$142.71
|
| Rate for Payer: UHCCP Medicaid |
$142.71
|
|
|
PR EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 34808
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$361.05 |
| Rate for Payer: Aetna Commercial |
$247.91
|
| Rate for Payer: Aetna Medicare |
$192.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.41
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$185.01
|
| Rate for Payer: BCN Commercial |
$294.31
|
| Rate for Payer: BCN Medicare Advantage |
$185.01
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$266.41
|
| Rate for Payer: Cofinity Commercial |
$247.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.01
|
| Rate for Payer: Healthscope Commercial |
$342.27
|
| Rate for Payer: Healthscope Commercial |
$296.02
|
| Rate for Payer: Mclaren Medicaid |
$115.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.26
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.53
|
| Rate for Payer: Nomi Health Commercial |
$222.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.50
|
| Rate for Payer: PACE SWMI |
$185.01
|
| Rate for Payer: PHP Medicare Advantage |
$185.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$316.49
|
| Rate for Payer: Priority Health Medicare |
$185.01
|
| Rate for Payer: Priority Health SBD |
$316.49
|
| Rate for Payer: Priority Health Tiered Network |
$316.49
|
| Rate for Payer: Railroad Medicare Medicare |
$185.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.05
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.01
|
| Rate for Payer: UHC Exchange |
$361.05
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT
|
Professional
|
Both
|
$2,666.00
|
|
|
Service Code
|
HCPCS 34701
|
| Min. Negotiated Rate |
$711.63 |
| Max. Negotiated Rate |
$2,232.99 |
| Rate for Payer: Aetna Commercial |
$1,511.14
|
| Rate for Payer: Aetna Medicare |
$1,172.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,623.92
|
| Rate for Payer: BCBS Complete |
$747.21
|
| Rate for Payer: BCBS MAPPO |
$1,127.72
|
| Rate for Payer: BCN Commercial |
$1,805.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,127.72
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,623.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,127.72
|
| Rate for Payer: Healthscope Commercial |
$2,086.28
|
| Rate for Payer: Healthscope Commercial |
$1,804.35
|
| Rate for Payer: Mclaren Medicaid |
$711.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.11
|
| Rate for Payer: Meridian Medicaid |
$747.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,240.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,189.18
|
| Rate for Payer: Nomi Health Commercial |
$1,353.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,999.50
|
| Rate for Payer: PACE SWMI |
$1,127.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,127.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,941.24
|
| Rate for Payer: Priority Health Medicare |
$1,127.72
|
| Rate for Payer: Priority Health SBD |
$1,941.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,941.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,127.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,232.99
|
| Rate for Payer: UHC Core |
$2,232.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,127.72
|
| Rate for Payer: UHC Exchange |
$2,232.99
|
| Rate for Payer: UHC Medicaid |
$711.63
|
| Rate for Payer: UHCCP Medicaid |
$711.63
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT
|
Professional
|
Both
|
$4,030.00
|
|
|
Service Code
|
HCPCS 34702
|
| Min. Negotiated Rate |
$1,037.95 |
| Max. Negotiated Rate |
$3,337.11 |
| Rate for Payer: Aetna Commercial |
$2,214.86
|
| Rate for Payer: Aetna Medicare |
$1,719.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,214.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,380.15
|
| Rate for Payer: BCBS Complete |
$1,089.85
|
| Rate for Payer: BCBS MAPPO |
$1,652.88
|
| Rate for Payer: BCN Commercial |
$2,617.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,652.88
|
| Rate for Payer: Cash Price |
$3,224.00
|
| Rate for Payer: Cash Price |
$3,224.00
|
| Rate for Payer: Cofinity Commercial |
$2,380.15
|
| Rate for Payer: Cofinity Commercial |
$2,214.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,652.88
|
| Rate for Payer: Healthscope Commercial |
$3,057.83
|
| Rate for Payer: Healthscope Commercial |
$2,644.61
|
| Rate for Payer: Mclaren Medicaid |
$1,037.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,735.52
|
| Rate for Payer: Meridian Medicaid |
$1,089.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,818.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.33
|
| Rate for Payer: Nomi Health Commercial |
$1,983.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,022.50
|
| Rate for Payer: PACE SWMI |
$1,652.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,652.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,037.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,814.67
|
| Rate for Payer: Priority Health Medicare |
$1,652.88
|
| Rate for Payer: Priority Health SBD |
$2,814.67
|
| Rate for Payer: Priority Health Tiered Network |
$2,814.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,652.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,337.11
|
| Rate for Payer: UHC Core |
$3,337.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,652.88
|
| Rate for Payer: UHC Exchange |
$3,337.11
|
| Rate for Payer: UHC Medicaid |
$1,037.95
|
| Rate for Payer: UHCCP Medicaid |
$1,037.95
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT
|
Professional
|
Both
|
$3,261.00
|
|
|
Service Code
|
HCPCS 34705
|
| Min. Negotiated Rate |
$876.71 |
| Max. Negotiated Rate |
$2,752.26 |
| Rate for Payer: Aetna Commercial |
$1,864.03
|
| Rate for Payer: Aetna Medicare |
$1,446.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,864.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,003.14
|
| Rate for Payer: BCBS Complete |
$920.55
|
| Rate for Payer: BCBS MAPPO |
$1,391.07
|
| Rate for Payer: BCN Commercial |
$2,222.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.07
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cofinity Commercial |
$2,003.14
|
| Rate for Payer: Cofinity Commercial |
$1,864.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.07
|
| Rate for Payer: Healthscope Commercial |
$2,573.48
|
| Rate for Payer: Healthscope Commercial |
$2,225.71
|
| Rate for Payer: Mclaren Medicaid |
$876.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,460.62
|
| Rate for Payer: Meridian Medicaid |
$920.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,530.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,703.31
|
| Rate for Payer: Nomi Health Commercial |
$1,669.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,445.75
|
| Rate for Payer: PACE SWMI |
$1,391.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,390.54
|
| Rate for Payer: Priority Health Medicare |
$1,391.07
|
| Rate for Payer: Priority Health SBD |
$2,390.54
|
| Rate for Payer: Priority Health Tiered Network |
$2,390.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,391.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,752.26
|
| Rate for Payer: UHC Core |
$2,752.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,391.07
|
| Rate for Payer: UHC Exchange |
$2,752.26
|
| Rate for Payer: UHC Medicaid |
$876.71
|
| Rate for Payer: UHCCP Medicaid |
$876.71
|
|
