|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 96170
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$124.37 |
| Rate for Payer: Aetna Commercial |
$84.24
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.24
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.65
|
| Rate for Payer: Priority Health SBD |
$99.65
|
| Rate for Payer: Priority Health Tiered Network |
$99.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.37
|
| Rate for Payer: UHC Core |
$124.37
|
| Rate for Payer: UHC Exchange |
$124.37
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 96171
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$45.45 |
| Rate for Payer: Aetna Commercial |
$30.11
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.11
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCN Commercial |
$38.84
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.82
|
| Rate for Payer: Priority Health SBD |
$35.82
|
| Rate for Payer: Priority Health Tiered Network |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.45
|
| Rate for Payer: UHC Core |
$45.45
|
| Rate for Payer: UHC Exchange |
$45.45
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 96167
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$116.27 |
| Rate for Payer: Aetna Commercial |
$84.22
|
| Rate for Payer: Aetna Medicare |
$65.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.50
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$62.85
|
| Rate for Payer: BCN Commercial |
$97.11
|
| Rate for Payer: BCN Medicare Advantage |
$62.85
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$90.50
|
| Rate for Payer: Cofinity Commercial |
$84.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.85
|
| Rate for Payer: Healthscope Commercial |
$116.27
|
| Rate for Payer: Healthscope Commercial |
$100.56
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.99
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.24
|
| Rate for Payer: Nomi Health Commercial |
$75.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$62.85
|
| Rate for Payer: PHP Medicare Advantage |
$62.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.56
|
| Rate for Payer: Priority Health Medicare |
$62.85
|
| Rate for Payer: Priority Health SBD |
$89.56
|
| Rate for Payer: Priority Health Tiered Network |
$89.56
|
| Rate for Payer: Railroad Medicare Medicare |
$62.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.25
|
| Rate for Payer: UHC Core |
$105.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.85
|
| Rate for Payer: UHC Exchange |
$105.25
|
| Rate for Payer: UHC Medicaid |
$40.26
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 96168
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$41.88 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.60
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$22.64
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: BCN Medicare Advantage |
$22.64
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Cofinity Commercial |
$30.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.64
|
| Rate for Payer: Healthscope Commercial |
$41.88
|
| Rate for Payer: Healthscope Commercial |
$36.22
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.77
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.74
|
| Rate for Payer: Nomi Health Commercial |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$22.64
|
| Rate for Payer: PHP Medicare Advantage |
$22.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.14
|
| Rate for Payer: Priority Health Medicare |
$22.64
|
| Rate for Payer: Priority Health SBD |
$32.14
|
| Rate for Payer: Priority Health Tiered Network |
$32.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.64
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$14.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$110.04 |
| Rate for Payer: Aetna Commercial |
$79.70
|
| Rate for Payer: Aetna Medicare |
$61.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.65
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: BCN Medicare Advantage |
$59.48
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$85.65
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.48
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Healthscope Commercial |
$110.04
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.45
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.16
|
| Rate for Payer: Nomi Health Commercial |
$71.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.00
|
| Rate for Payer: PACE SWMI |
$59.48
|
| Rate for Payer: PHP Medicare Advantage |
$59.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$84.50
|
| Rate for Payer: Priority Health Medicare |
$59.48
|
| Rate for Payer: Priority Health SBD |
$84.50
|
| Rate for Payer: Priority Health Tiered Network |
$84.50
|
| Rate for Payer: Railroad Medicare Medicare |
$59.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.32
|
| Rate for Payer: UHC Core |
$98.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.48
|
| Rate for Payer: UHC Exchange |
$98.32
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$37.48 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$21.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCN Commercial |
$31.37
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$29.17
|
| Rate for Payer: Cofinity Commercial |
$27.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$32.42
|
| Rate for Payer: Mclaren Medicaid |
$12.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.21
|
| Rate for Payer: Nomi Health Commercial |
$24.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28.93
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health SBD |
$28.93
|
| Rate for Payer: Priority Health Tiered Network |
$28.93
|
| Rate for Payer: Railroad Medicare Medicare |
$20.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.94
|
| Rate for Payer: UHC Core |
$33.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.26
|
| Rate for Payer: UHC Exchange |
$33.94
|
| Rate for Payer: UHC Medicaid |
$12.99
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
|
|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$52.82 |
| Rate for Payer: Aetna Commercial |
$39.35
|
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.35
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCN Commercial |
$48.51
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$48.51 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.53
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCN Commercial |
$48.51
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.88
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.96
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR HEARING AID FITTING SERVICES 1ST 60 MINUTES
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92634
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID FITTING SERVICES EA ADDL 15 MINUTES
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92635
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID MEAS VERIF W/PROBE MICROPHONE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92639
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92636
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92637
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,681.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$4,260.75 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: Aetna Medicare |
$2,840.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$2,272.40
|
| Rate for Payer: Cash Price |
$4,544.80
|
| Rate for Payer: Cash Price |
$4,544.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,692.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,260.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,500.00
|
| Rate for Payer: UHC Core |
$2,500.00
|
| Rate for Payer: UHC Exchange |
$2,500.00
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$88.69 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Medicare |
$223.50
|
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: BCBS Complete |
$178.80
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.33
|
| Rate for Payer: UHC Core |
$148.33
|
| Rate for Payer: UHC Core |
$148.33
|
| Rate for Payer: UHC Core |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
|
|
PR HEARING AID SELECTION SERVICES 1ST 30 MINUTES
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 92631
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
|
|
PR HEARING AID SELECTION SERVICES EA ADDL 15 MIN
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 92632
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
|
|
PR HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92642
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
|
|
PR HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92641
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$660.51 |
| Max. Negotiated Rate |
$2,006.30 |
| Rate for Payer: Aetna Commercial |
$1,363.49
|
| Rate for Payer: Aetna Medicare |
$1,058.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,363.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.24
|
| Rate for Payer: BCBS Complete |
$693.54
|
| Rate for Payer: BCBS MAPPO |
$1,017.53
|
| Rate for Payer: BCN Commercial |
$1,713.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.53
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$1,465.24
|
| Rate for Payer: Cofinity Commercial |
$1,363.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.53
|
| Rate for Payer: Healthscope Commercial |
$1,882.43
|
| Rate for Payer: Healthscope Commercial |
$1,628.05
|
| Rate for Payer: Mclaren Medicaid |
$660.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.41
|
| Rate for Payer: Meridian Medicaid |
$693.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,119.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.30
|
| Rate for Payer: Nomi Health Commercial |
$1,221.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,802.25
|
| Rate for Payer: PACE SWMI |
$1,017.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,831.73
|
| Rate for Payer: Priority Health Medicare |
$1,017.53
|
| Rate for Payer: Priority Health SBD |
$1,831.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,831.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,017.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,986.05
|
| Rate for Payer: UHC Core |
$1,986.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,017.53
|
| Rate for Payer: UHC Exchange |
$1,986.05
|
| Rate for Payer: UHC Medicaid |
$660.51
|
| Rate for Payer: UHCCP Medicaid |
$660.51
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$718.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$538.50 |
| Rate for Payer: Aetna Commercial |
$331.09
|
| Rate for Payer: Aetna Medicare |
$256.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.80
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$247.08
|
| Rate for Payer: BCN Commercial |
$407.35
|
| Rate for Payer: BCN Medicare Advantage |
$247.08
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cofinity Commercial |
$355.80
|
| Rate for Payer: Cofinity Commercial |
$331.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.08
|
| Rate for Payer: Healthscope Commercial |
$457.10
|
| Rate for Payer: Healthscope Commercial |
$395.33
|
| Rate for Payer: Mclaren Medicaid |
$162.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.43
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.34
|
| Rate for Payer: Nomi Health Commercial |
$296.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.50
|
| Rate for Payer: PACE SWMI |
$247.08
|
| Rate for Payer: PHP Medicare Advantage |
$247.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$435.44
|
| Rate for Payer: Priority Health Medicare |
$247.08
|
| Rate for Payer: Priority Health SBD |
$435.44
|
| Rate for Payer: Priority Health Tiered Network |
$435.44
|
| Rate for Payer: Railroad Medicare Medicare |
$247.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.51
|
| Rate for Payer: UHC Core |
$464.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.08
|
| Rate for Payer: UHC Exchange |
$464.51
|
| Rate for Payer: UHC Medicaid |
$162.95
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Healthscope Commercial |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.24
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$96.44
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health SBD |
$96.44
|
| Rate for Payer: Priority Health Tiered Network |
$96.44
|
| Rate for Payer: Railroad Medicare Medicare |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.34
|
| Rate for Payer: UHC Core |
$118.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.87
|
| Rate for Payer: UHC Exchange |
$118.34
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
