|
PR HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<
|
Professional
|
Both
|
$555.00
|
|
|
Service Code
|
HCPCS 15040
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$162.09
|
| Rate for Payer: Aetna Medicare |
$125.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.09
|
| Rate for Payer: BCBS Complete |
$222.00
|
| Rate for Payer: BCBS MAPPO |
$120.96
|
| Rate for Payer: BCN Medicare Advantage |
$120.96
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cofinity Commercial |
$174.18
|
| Rate for Payer: Cofinity Commercial |
$162.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$223.78
|
| Rate for Payer: Healthscope Commercial |
$193.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$145.15
|
| Rate for Payer: PACE SWMI |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.75
|
| Rate for Payer: Priority Health Medicare |
$120.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.96
|
| Rate for Payer: UHC Medicare Advantage |
$120.96
|
|
|
PR HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 35500
|
| Min. Negotiated Rate |
$305.60 |
| Max. Negotiated Rate |
$732.55 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$317.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.50
|
| Rate for Payer: BCBS Complete |
$450.80
|
| Rate for Payer: BCBS MAPPO |
$305.60
|
| Rate for Payer: BCN Medicare Advantage |
$305.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cofinity Commercial |
$440.06
|
| Rate for Payer: Cofinity Commercial |
$409.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.60
|
| Rate for Payer: Healthscope Commercial |
$488.96
|
| Rate for Payer: Healthscope Commercial |
$565.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.55
|
| Rate for Payer: Nomi Health Commercial |
$366.72
|
| Rate for Payer: PACE SWMI |
$305.60
|
| Rate for Payer: PHP Medicare Advantage |
$305.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.55
|
| Rate for Payer: Priority Health Medicare |
$305.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.60
|
| Rate for Payer: UHC Medicare Advantage |
$305.60
|
|
|
PR HBOT, FULL BODY CHAMBER, 30M
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS G0277
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$287.38 |
| Rate for Payer: Aetna Commercial |
$208.16
|
| Rate for Payer: Aetna Medicare |
$161.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.16
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$155.34
|
| Rate for Payer: BCN Medicare Advantage |
$155.34
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Commercial |
$208.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.34
|
| Rate for Payer: Healthscope Commercial |
$248.54
|
| Rate for Payer: Healthscope Commercial |
$287.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.65
|
| Rate for Payer: Nomi Health Commercial |
$186.41
|
| Rate for Payer: PACE SWMI |
$155.34
|
| Rate for Payer: PHP Medicare Advantage |
$155.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$155.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.34
|
| Rate for Payer: UHC Medicare Advantage |
$155.34
|
|
|
PR HEAL & BEHAV ASSESS,EA 15 MIN,INIT
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 96150
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$27.30 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
|
|
PR HEAL & BEHAV ASSESS,EA 15 MIN,RE-ASSESS
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 96151
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
|
|
PR HEAL & BEHAV INTERV,EA 15 MIN,FAM W/O PT
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 96155
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
PR HEAL & BEHAV INTERV,EA 15 MIN,FAM W/PT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 96154
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
|
|
PR HEAL & BEHAV INTERVENT,EA 15 MIN,INDIV
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 96152
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
PR HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 96156
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$159.28 |
| Rate for Payer: Aetna Commercial |
$115.37
|
| Rate for Payer: Aetna Medicare |
$89.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.98
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$86.10
|
| Rate for Payer: BCN Medicare Advantage |
$86.10
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$115.37
|
| Rate for Payer: Cofinity Commercial |
$123.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$159.28
|
| Rate for Payer: Healthscope Commercial |
$137.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.70
|
| Rate for Payer: Nomi Health Commercial |
$103.32
|
| Rate for Payer: PACE SWMI |
$86.10
|
| Rate for Payer: PHP Medicare Advantage |
$86.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$86.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.10
|
| Rate for Payer: UHC Medicare Advantage |
$86.10
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 96170
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 96171
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$37.05 |
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 96167
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$115.98 |
| Rate for Payer: Aetna Commercial |
$84.00
|
| Rate for Payer: Aetna Medicare |
$65.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.00
|
| Rate for Payer: BCBS Complete |
$58.00
|
| Rate for Payer: BCBS MAPPO |
$62.69
|
| Rate for Payer: BCN Medicare Advantage |
$62.69
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.69
|
| Rate for Payer: Healthscope Commercial |
$115.98
|
| Rate for Payer: Healthscope Commercial |
$100.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.25
|
| Rate for Payer: Nomi Health Commercial |
$75.23
|
| Rate for Payer: PACE SWMI |
$62.69
|
| Rate for Payer: PHP Medicare Advantage |
$62.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health Medicare |
$62.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.69
|
| Rate for Payer: UHC Medicare Advantage |
$62.69
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 96168
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$41.66 |
| Rate for Payer: Aetna Commercial |
$30.18
|
| Rate for Payer: Aetna Medicare |
$23.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.18
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$22.52
|
| Rate for Payer: BCN Medicare Advantage |
$22.52
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$32.43
|
| Rate for Payer: Cofinity Commercial |
$30.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.52
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$27.02
|
| Rate for Payer: PACE SWMI |
$22.52
|
| Rate for Payer: PHP Medicare Advantage |
$22.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$22.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.52
|
| Rate for Payer: UHC Medicare Advantage |
$22.52
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$109.41 |
| Rate for Payer: Aetna Commercial |
$79.25
|
| Rate for Payer: Aetna Medicare |
$61.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.25
|
| Rate for Payer: BCBS Complete |
$54.40
|
| Rate for Payer: BCBS MAPPO |
$59.14
|
| Rate for Payer: BCN Medicare Advantage |
$59.14
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.14
|
| Rate for Payer: Healthscope Commercial |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$94.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.40
|
| Rate for Payer: Nomi Health Commercial |
$70.97
|
| Rate for Payer: PACE SWMI |
$59.14
|
| Rate for Payer: PHP Medicare Advantage |
$59.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.40
|
| Rate for Payer: Priority Health Medicare |
$59.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.14
|
| Rate for Payer: UHC Medicare Advantage |
$59.14
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$37.43 |
| Rate for Payer: Aetna Commercial |
$27.11
|
| Rate for Payer: Aetna Medicare |
$21.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.11
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$20.23
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.23
|
| Rate for Payer: Healthscope Commercial |
$32.37
|
| Rate for Payer: Healthscope Commercial |
$37.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Nomi Health Commercial |
$24.28
|
| Rate for Payer: PACE SWMI |
$20.23
|
| Rate for Payer: PHP Medicare Advantage |
$20.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Medicare |
$20.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.23
|
| Rate for Payer: UHC Medicare Advantage |
$20.23
|
|
|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,516.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$2,206.40 |
| Max. Negotiated Rate |
$3,585.40 |
| Rate for Payer: Aetna Medicare |
$2,758.00
|
| Rate for Payer: BCBS Complete |
$2,206.40
|
| Rate for Payer: Cash Price |
$4,412.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,585.40
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna Medicare |
$217.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Complete |
$173.60
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.10
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$2,017.48 |
| Rate for Payer: Aetna Commercial |
$1,461.31
|
| Rate for Payer: Aetna Medicare |
$1,134.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,570.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.31
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: BCBS MAPPO |
$1,090.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.53
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,570.36
|
| Rate for Payer: Cofinity Commercial |
$1,461.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.53
|
| Rate for Payer: Healthscope Commercial |
$2,017.48
|
| Rate for Payer: Healthscope Commercial |
$1,744.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,516.45
|
| Rate for Payer: Nomi Health Commercial |
$1,308.64
|
| Rate for Payer: PACE SWMI |
$1,090.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health Medicare |
$1,090.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,090.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.53
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$255.44 |
| Max. Negotiated Rate |
$472.56 |
| Rate for Payer: Aetna Commercial |
$342.29
|
| Rate for Payer: Aetna Medicare |
$265.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.29
|
| Rate for Payer: BCBS Complete |
$278.80
|
| Rate for Payer: BCBS MAPPO |
$255.44
|
| Rate for Payer: BCN Medicare Advantage |
$255.44
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$367.83
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.44
|
| Rate for Payer: Healthscope Commercial |
$408.70
|
| Rate for Payer: Healthscope Commercial |
$472.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$453.05
|
| Rate for Payer: Nomi Health Commercial |
$306.53
|
| Rate for Payer: PACE SWMI |
$255.44
|
| Rate for Payer: PHP Medicare Advantage |
$255.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health Medicare |
$255.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.44
|
| Rate for Payer: UHC Medicare Advantage |
$255.44
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$123.62 |
| Rate for Payer: Aetna Commercial |
$89.54
|
| Rate for Payer: Aetna Medicare |
$69.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.54
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$66.82
|
| Rate for Payer: BCN Medicare Advantage |
$66.82
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$96.22
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.82
|
| Rate for Payer: Healthscope Commercial |
$123.62
|
| Rate for Payer: Healthscope Commercial |
$106.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.25
|
| Rate for Payer: Nomi Health Commercial |
$80.18
|
| Rate for Payer: PACE SWMI |
$66.82
|
| Rate for Payer: PHP Medicare Advantage |
$66.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$66.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.82
|
| Rate for Payer: UHC Medicare Advantage |
$66.82
|
|
