|
PR IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0144A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML 1 DOSE
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0121A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0124A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML 1ST
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0171A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML 2ND
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0172A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML 3RD
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0173A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML ADDL
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0174A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 0134A
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$54.65 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
|
|
PR IMM ADMN SARSCOV2 VACCINE 1ST/ONLY COMPONENT
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 90480
|
| Min. Negotiated Rate |
$27.07 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$40.00
|
| Rate for Payer: Aetna Medicare |
$44.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.00
|
| Rate for Payer: BCN Commercial |
$27.07
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.53
|
| Rate for Payer: Priority Health SBD |
$61.53
|
| Rate for Payer: Priority Health Tiered Network |
$61.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.98
|
| Rate for Payer: UHC Core |
$39.98
|
| Rate for Payer: UHC Exchange |
$39.98
|
|
|
PR IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 90484
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Aetna Medicare |
$50.50
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48.76
|
| Rate for Payer: Priority Health SBD |
$48.76
|
| Rate for Payer: Priority Health Tiered Network |
$48.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.94
|
| Rate for Payer: UHC Core |
$49.94
|
| Rate for Payer: UHC Exchange |
$49.94
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
PR IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 90482
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.76
|
| Rate for Payer: Priority Health SBD |
$15.76
|
| Rate for Payer: Priority Health Tiered Network |
$15.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.13
|
| Rate for Payer: UHC Core |
$16.13
|
| Rate for Payer: UHC Exchange |
$16.13
|
| Rate for Payer: UHC Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
PR IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 90483
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Medicare |
$34.50
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Mclaren Medicaid |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32.50
|
| Rate for Payer: Priority Health SBD |
$32.50
|
| Rate for Payer: Priority Health Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.30
|
| Rate for Payer: UHC Core |
$33.30
|
| Rate for Payer: UHC Exchange |
$33.30
|
| Rate for Payer: UHC Medicaid |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
|
|
PR IMMUNIZE COUNS < 21YR 5-15 M
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0312
|
| 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 IMMUNIZE COUNS < 21YR 6-30 M
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS G0313
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
|
|
PR IMMUNIZE COUNSEL 16-30 MINS
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS G0311
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
|
|
PR IMMUNIZE COUNSEL 5-15 MIN
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0310
|
| 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 IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 15778
|
| Min. Negotiated Rate |
$225.35 |
| Max. Negotiated Rate |
$703.19 |
| Rate for Payer: Aetna Commercial |
$475.53
|
| Rate for Payer: Aetna Medicare |
$369.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.01
|
| Rate for Payer: BCBS Complete |
$236.62
|
| Rate for Payer: BCBS MAPPO |
$354.87
|
| Rate for Payer: BCN Commercial |
$585.63
|
| Rate for Payer: BCN Medicare Advantage |
$354.87
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$511.01
|
| Rate for Payer: Cofinity Commercial |
$475.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.87
|
| Rate for Payer: Healthscope Commercial |
$567.79
|
| Rate for Payer: Healthscope Commercial |
$656.51
|
| Rate for Payer: Mclaren Medicaid |
$225.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$372.61
|
| Rate for Payer: Meridian Medicaid |
$236.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$390.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.67
|
| Rate for Payer: Nomi Health Commercial |
$425.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$619.50
|
| Rate for Payer: PACE SWMI |
$354.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$535.99
|
| Rate for Payer: Priority Health Medicare |
$354.87
|
| Rate for Payer: Priority Health SBD |
$535.99
|
| Rate for Payer: Priority Health Tiered Network |
$535.99
|
| Rate for Payer: Railroad Medicare Medicare |
$354.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.19
|
| Rate for Payer: UHC Core |
$703.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$354.87
|
| Rate for Payer: UHC Exchange |
$703.19
|
| Rate for Payer: UHC Medicaid |
$225.35
|
| Rate for Payer: UHCCP Medicaid |
$225.35
|
|
|
PR IMPLANTABLE TISSUE MARKER
|
Professional
|
Both
|
$1,261.00
|
|
|
Service Code
|
HCPCS A4648
|
| Min. Negotiated Rate |
$102.14 |
| Max. Negotiated Rate |
$945.75 |
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: Aetna Medicare |
$630.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.14
|
| Rate for Payer: BCBS Complete |
$504.40
|
| Rate for Payer: BCN Commercial |
$136.96
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$945.75
|
|
|
PR IMPLANTATION NERVE END BONE/MUSCLE
|
Professional
|
Both
|
$1,909.00
|
|
|
Service Code
|
HCPCS 64787
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$1,431.75 |
| Rate for Payer: Aetna Commercial |
$272.80
|
| Rate for Payer: Aetna Medicare |
$211.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.80
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$203.58
|
| Rate for Payer: BCN Commercial |
$350.08
|
| Rate for Payer: BCN Medicare Advantage |
$203.58
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cofinity Commercial |
$293.16
|
| Rate for Payer: Cofinity Commercial |
$272.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.58
|
| Rate for Payer: Healthscope Commercial |
$376.62
|
| Rate for Payer: Healthscope Commercial |
$325.73
|
| Rate for Payer: Mclaren Medicaid |
$129.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.76
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.95
|
| Rate for Payer: Nomi Health Commercial |
$244.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,431.75
|
| Rate for Payer: PACE SWMI |
$203.58
|
| Rate for Payer: PHP Medicare Advantage |
$203.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$406.62
|
| Rate for Payer: Priority Health Medicare |
$203.58
|
| Rate for Payer: Priority Health SBD |
$406.62
|
| Rate for Payer: Priority Health Tiered Network |
$406.62
|
| Rate for Payer: Railroad Medicare Medicare |
$203.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.33
|
| Rate for Payer: UHC Core |
$426.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$203.58
|
| Rate for Payer: UHC Exchange |
$426.33
|
| Rate for Payer: UHC Medicaid |
$129.93
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 33282
|
| Min. Negotiated Rate |
$259.60 |
| Max. Negotiated Rate |
$486.75 |
| Rate for Payer: Aetna Medicare |
$324.50
|
| Rate for Payer: BCBS Complete |
$259.60
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.75
|
|
|
PR IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE
|
Professional
|
Both
|
$1,040.00
|
|
|
Service Code
|
HCPCS 49568
|
| Min. Negotiated Rate |
$416.00 |
| Max. Negotiated Rate |
$780.00 |
| Rate for Payer: Aetna Medicare |
$520.00
|
| Rate for Payer: BCBS Complete |
$416.00
|
| Rate for Payer: Cash Price |
$832.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.00
|
|
|
PR IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 15777
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$381.96 |
| Rate for Payer: Aetna Commercial |
$243.45
|
| Rate for Payer: Aetna Medicare |
$188.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.62
|
| Rate for Payer: BCBS Complete |
$122.11
|
| Rate for Payer: BCBS MAPPO |
$181.68
|
| Rate for Payer: BCN Commercial |
$319.70
|
| Rate for Payer: BCN Medicare Advantage |
$181.68
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$261.62
|
| Rate for Payer: Cofinity Commercial |
$243.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.68
|
| Rate for Payer: Healthscope Commercial |
$336.11
|
| Rate for Payer: Healthscope Commercial |
$290.69
|
| Rate for Payer: Mclaren Medicaid |
$116.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.76
|
| Rate for Payer: Meridian Medicaid |
$122.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.74
|
| Rate for Payer: Nomi Health Commercial |
$218.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.75
|
| Rate for Payer: PACE SWMI |
$181.68
|
| Rate for Payer: PHP Medicare Advantage |
$181.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$292.61
|
| Rate for Payer: Priority Health Medicare |
$181.68
|
| Rate for Payer: Priority Health SBD |
$292.61
|
| Rate for Payer: Priority Health Tiered Network |
$292.61
|
| Rate for Payer: Railroad Medicare Medicare |
$181.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.96
|
| Rate for Payer: UHC Core |
$381.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.68
|
| Rate for Payer: UHC Exchange |
$381.96
|
| Rate for Payer: UHC Medicaid |
$116.30
|
| Rate for Payer: UHCCP Medicaid |
$116.30
|
|
|
PR IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 69716
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$1,097.14 |
| Rate for Payer: Aetna Commercial |
$713.00
|
| Rate for Payer: Aetna Medicare |
$553.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$766.21
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$532.09
|
| Rate for Payer: BCN Commercial |
$930.73
|
| Rate for Payer: BCN Medicare Advantage |
$532.09
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$766.21
|
| Rate for Payer: Cofinity Commercial |
$713.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.09
|
| Rate for Payer: Healthscope Commercial |
$984.37
|
| Rate for Payer: Healthscope Commercial |
$851.34
|
| Rate for Payer: Mclaren Medicaid |
$347.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.69
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$585.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,097.14
|
| Rate for Payer: Nomi Health Commercial |
$638.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$532.09
|
| Rate for Payer: PHP Medicare Advantage |
$532.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$919.66
|
| Rate for Payer: Priority Health Medicare |
$532.09
|
| Rate for Payer: Priority Health SBD |
$919.66
|
| Rate for Payer: Priority Health Tiered Network |
$919.66
|
| Rate for Payer: Railroad Medicare Medicare |
$532.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.41
|
| Rate for Payer: UHC Core |
$1,089.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.09
|
| Rate for Payer: UHC Exchange |
$1,089.41
|
| Rate for Payer: UHC Medicaid |
$347.19
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
|
PR IMPL OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$2,012.00
|
|
|
Service Code
|
HCPCS 69714
|
| Min. Negotiated Rate |
$279.03 |
| Max. Negotiated Rate |
$1,818.21 |
| Rate for Payer: Aetna Commercial |
$569.94
|
| Rate for Payer: Aetna Medicare |
$442.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.48
|
| Rate for Payer: BCBS Complete |
$292.98
|
| Rate for Payer: BCBS MAPPO |
$425.33
|
| Rate for Payer: BCN Commercial |
$743.48
|
| Rate for Payer: BCN Medicare Advantage |
$425.33
|
| Rate for Payer: Cash Price |
$1,609.60
|
| Rate for Payer: Cash Price |
$1,609.60
|
| Rate for Payer: Cofinity Commercial |
$612.48
|
| Rate for Payer: Cofinity Commercial |
$569.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.33
|
| Rate for Payer: Healthscope Commercial |
$786.86
|
| Rate for Payer: Healthscope Commercial |
$680.53
|
| Rate for Payer: Mclaren Medicaid |
$279.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.60
|
| Rate for Payer: Meridian Medicaid |
$292.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.46
|
| Rate for Payer: Nomi Health Commercial |
$510.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,509.00
|
| Rate for Payer: PACE SWMI |
$425.33
|
| Rate for Payer: PHP Medicare Advantage |
$425.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$734.63
|
| Rate for Payer: Priority Health Medicare |
$425.33
|
| Rate for Payer: Priority Health SBD |
$734.63
|
| Rate for Payer: Priority Health Tiered Network |
$734.63
|
| Rate for Payer: Railroad Medicare Medicare |
$425.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,818.21
|
| Rate for Payer: UHC Core |
$1,818.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.33
|
| Rate for Payer: UHC Exchange |
$1,818.21
|
| Rate for Payer: UHC Medicaid |
$279.03
|
| Rate for Payer: UHCCP Medicaid |
$279.03
|
|
|
PR IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 61517
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$107.92
|
| Rate for Payer: Aetna Medicare |
$83.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.98
|
| Rate for Payer: BCBS Complete |
$53.22
|
| Rate for Payer: BCBS MAPPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$131.47
|
| Rate for Payer: BCN Medicare Advantage |
$80.54
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cofinity Commercial |
$115.98
|
| Rate for Payer: Cofinity Commercial |
$107.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.54
|
| Rate for Payer: Healthscope Commercial |
$149.00
|
| Rate for Payer: Healthscope Commercial |
$128.86
|
| Rate for Payer: Mclaren Medicaid |
$50.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.57
|
| Rate for Payer: Meridian Medicaid |
$53.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$96.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.00
|
| Rate for Payer: PACE SWMI |
$80.54
|
| Rate for Payer: PHP Medicare Advantage |
$80.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$152.69
|
| Rate for Payer: Priority Health Medicare |
$80.54
|
| Rate for Payer: Priority Health SBD |
$152.69
|
| Rate for Payer: Priority Health Tiered Network |
$152.69
|
| Rate for Payer: Railroad Medicare Medicare |
$80.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.43
|
| Rate for Payer: UHC Core |
$155.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.54
|
| Rate for Payer: UHC Exchange |
$155.43
|
| Rate for Payer: UHC Medicaid |
$50.69
|
| Rate for Payer: UHCCP Medicaid |
$50.69
|
|
