|
PR INJECTION PROCEDURE FOR ELBOW ARTHROGRAPHY
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 24220
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: Aetna Commercial |
$74.89
|
| Rate for Payer: Aetna Medicare |
$58.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.48
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.89
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Medicare Advantage |
$55.89
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cofinity Commercial |
$80.48
|
| Rate for Payer: Cofinity Commercial |
$74.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.89
|
| Rate for Payer: Healthscope Commercial |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$89.42
|
| Rate for Payer: Mclaren Medicaid |
$35.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.68
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.99
|
| Rate for Payer: Nomi Health Commercial |
$67.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.00
|
| Rate for Payer: PACE SWMI |
$55.89
|
| Rate for Payer: PHP Medicare Advantage |
$55.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$104.86
|
| Rate for Payer: Priority Health Medicare |
$55.89
|
| Rate for Payer: Priority Health SBD |
$104.86
|
| Rate for Payer: Priority Health Tiered Network |
$104.86
|
| Rate for Payer: Railroad Medicare Medicare |
$55.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.68
|
| Rate for Payer: UHC Core |
$119.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.89
|
| Rate for Payer: UHC Exchange |
$119.68
|
| Rate for Payer: UHC Medicaid |
$35.78
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
|
|
PR INJECTION PROCEDURE FOR PEYRONIE DISEASE
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 54200
|
| Min. Negotiated Rate |
$53.25 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$107.72
|
| Rate for Payer: Aetna Medicare |
$83.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.76
|
| Rate for Payer: BCBS Complete |
$55.91
|
| Rate for Payer: BCBS MAPPO |
$80.39
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.39
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$115.76
|
| Rate for Payer: Cofinity Commercial |
$107.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.39
|
| Rate for Payer: Healthscope Commercial |
$148.72
|
| Rate for Payer: Healthscope Commercial |
$128.62
|
| Rate for Payer: Mclaren Medicaid |
$53.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.41
|
| Rate for Payer: Meridian Medicaid |
$55.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.25
|
| Rate for Payer: Nomi Health Commercial |
$96.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$80.39
|
| Rate for Payer: PHP Medicare Advantage |
$80.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$145.38
|
| Rate for Payer: Priority Health Medicare |
$80.39
|
| Rate for Payer: Priority Health SBD |
$145.38
|
| Rate for Payer: Priority Health Tiered Network |
$145.38
|
| Rate for Payer: Railroad Medicare Medicare |
$80.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.03
|
| Rate for Payer: UHC Core |
$145.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.39
|
| Rate for Payer: UHC Exchange |
$145.03
|
| Rate for Payer: UHC Medicaid |
$53.25
|
| Rate for Payer: UHCCP Medicaid |
$53.25
|
|
|
PR INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 62284
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Aetna Commercial |
$95.25
|
| Rate for Payer: Aetna Medicare |
$73.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.25
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.08
|
| Rate for Payer: BCN Commercial |
$135.13
|
| Rate for Payer: BCN Medicare Advantage |
$71.08
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cofinity Commercial |
$95.25
|
| Rate for Payer: Cofinity Commercial |
$102.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.08
|
| Rate for Payer: Healthscope Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$113.73
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.63
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.54
|
| Rate for Payer: Nomi Health Commercial |
$85.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$465.00
|
| Rate for Payer: PACE SWMI |
$71.08
|
| Rate for Payer: PHP Medicare Advantage |
$71.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.87
|
| Rate for Payer: Priority Health Medicare |
$71.08
|
| Rate for Payer: Priority Health SBD |
$142.87
|
| Rate for Payer: Priority Health Tiered Network |
$142.87
|
| Rate for Payer: Railroad Medicare Medicare |
$71.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.81
|
| Rate for Payer: UHC Core |
$152.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.08
|
| Rate for Payer: UHC Exchange |
$152.81
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 62290
|
| Min. Negotiated Rate |
$90.95 |
| Max. Negotiated Rate |
$1,112.25 |
| Rate for Payer: Mclaren Medicaid |
$90.95
|
| Rate for Payer: Aetna Commercial |
$188.40
|
| Rate for Payer: Aetna Medicare |
$146.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.46
|
| Rate for Payer: BCBS Complete |
$95.50
|
| Rate for Payer: BCBS MAPPO |
$140.60
|
| Rate for Payer: BCN Commercial |
$256.03
|
| Rate for Payer: BCN Medicare Advantage |
$140.60
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$202.46
|
| Rate for Payer: Cofinity Commercial |
$188.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.60
|
| Rate for Payer: Healthscope Commercial |
$260.11
|
| Rate for Payer: Healthscope Commercial |
$224.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.63
|
| Rate for Payer: Meridian Medicaid |
$95.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.40
|
| Rate for Payer: Nomi Health Commercial |
$168.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,112.25
|
| Rate for Payer: PACE SWMI |
$140.60
|
| Rate for Payer: PHP Medicare Advantage |
$140.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.69
|
| Rate for Payer: Priority Health Medicare |
$140.60
|
| Rate for Payer: Priority Health SBD |
$270.69
|
| Rate for Payer: Priority Health Tiered Network |
$270.69
|
| Rate for Payer: Railroad Medicare Medicare |
$140.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.72
|
| Rate for Payer: UHC Core |
$292.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.60
|
| Rate for Payer: UHC Exchange |
$292.72
|
| Rate for Payer: UHC Medicaid |
$90.95
|
| Rate for Payer: UHCCP Medicaid |
$90.95
|
|
|
PR INJECTION PX ONLY MAMMARY DUCTOGRAM/GALACTOGRAM
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 19030
|
| Min. Negotiated Rate |
$40.90 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$85.71
|
| Rate for Payer: Aetna Medicare |
$66.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.10
|
| Rate for Payer: BCBS Complete |
$42.95
|
| Rate for Payer: BCBS MAPPO |
$63.96
|
| Rate for Payer: BCN Commercial |
$111.55
|
| Rate for Payer: BCN Medicare Advantage |
$63.96
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cofinity Commercial |
$92.10
|
| Rate for Payer: Cofinity Commercial |
$85.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.96
|
| Rate for Payer: Healthscope Commercial |
$118.33
|
| Rate for Payer: Healthscope Commercial |
$102.34
|
| Rate for Payer: Mclaren Medicaid |
$40.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.16
|
| Rate for Payer: Meridian Medicaid |
$42.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.59
|
| Rate for Payer: Nomi Health Commercial |
$76.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: PACE SWMI |
$63.96
|
| Rate for Payer: PHP Medicare Advantage |
$63.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$102.10
|
| Rate for Payer: Priority Health Medicare |
$63.96
|
| Rate for Payer: Priority Health SBD |
$102.10
|
| Rate for Payer: Priority Health Tiered Network |
$102.10
|
| Rate for Payer: Railroad Medicare Medicare |
$63.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.36
|
| Rate for Payer: UHC Core |
$136.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.96
|
| Rate for Payer: UHC Exchange |
$136.36
|
| Rate for Payer: UHC Medicaid |
$40.90
|
| Rate for Payer: UHCCP Medicaid |
$40.90
|
|
|
PR INJECTION PX PEYRONIE DS W/SURG EXPOSURE PLAQUE
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 54205
|
| Min. Negotiated Rate |
$311.41 |
| Max. Negotiated Rate |
$935.88 |
| Rate for Payer: Aetna Commercial |
$642.42
|
| Rate for Payer: Aetna Medicare |
$498.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$690.36
|
| Rate for Payer: BCBS Complete |
$326.98
|
| Rate for Payer: BCBS MAPPO |
$479.42
|
| Rate for Payer: BCN Commercial |
$800.75
|
| Rate for Payer: BCN Medicare Advantage |
$479.42
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cofinity Commercial |
$690.36
|
| Rate for Payer: Cofinity Commercial |
$642.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.42
|
| Rate for Payer: Healthscope Commercial |
$886.93
|
| Rate for Payer: Healthscope Commercial |
$767.07
|
| Rate for Payer: Mclaren Medicaid |
$311.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.39
|
| Rate for Payer: Meridian Medicaid |
$326.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$527.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$934.00
|
| Rate for Payer: Nomi Health Commercial |
$575.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.00
|
| Rate for Payer: PACE SWMI |
$479.42
|
| Rate for Payer: PHP Medicare Advantage |
$479.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$872.28
|
| Rate for Payer: Priority Health Medicare |
$479.42
|
| Rate for Payer: Priority Health SBD |
$872.28
|
| Rate for Payer: Priority Health Tiered Network |
$872.28
|
| Rate for Payer: Railroad Medicare Medicare |
$479.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.88
|
| Rate for Payer: UHC Core |
$935.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$479.42
|
| Rate for Payer: UHC Exchange |
$935.88
|
| Rate for Payer: UHC Medicaid |
$311.41
|
| Rate for Payer: UHCCP Medicaid |
$311.41
|
|
|
PR INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 36002
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$352.50 |
| Rate for Payer: Aetna Commercial |
$122.72
|
| Rate for Payer: Aetna Medicare |
$95.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.88
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$91.58
|
| Rate for Payer: BCN Commercial |
$152.88
|
| Rate for Payer: BCN Medicare Advantage |
$91.58
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$131.88
|
| Rate for Payer: Cofinity Commercial |
$122.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.58
|
| Rate for Payer: Healthscope Commercial |
$169.42
|
| Rate for Payer: Healthscope Commercial |
$146.53
|
| Rate for Payer: Mclaren Medicaid |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.16
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.69
|
| Rate for Payer: Nomi Health Commercial |
$109.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.50
|
| Rate for Payer: PACE SWMI |
$91.58
|
| Rate for Payer: PHP Medicare Advantage |
$91.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$164.40
|
| Rate for Payer: Priority Health Medicare |
$91.58
|
| Rate for Payer: Priority Health SBD |
$164.40
|
| Rate for Payer: Priority Health Tiered Network |
$164.40
|
| Rate for Payer: Railroad Medicare Medicare |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.62
|
| Rate for Payer: UHC Core |
$186.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.58
|
| Rate for Payer: UHC Exchange |
$186.62
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 36471
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$90.21
|
| Rate for Payer: Aetna Medicare |
$70.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.94
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$67.32
|
| Rate for Payer: BCN Commercial |
$87.57
|
| Rate for Payer: BCN Medicare Advantage |
$67.32
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$96.94
|
| Rate for Payer: Cofinity Commercial |
$90.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$124.54
|
| Rate for Payer: Healthscope Commercial |
$107.71
|
| Rate for Payer: Mclaren Medicaid |
$42.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.69
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.98
|
| Rate for Payer: Nomi Health Commercial |
$80.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.00
|
| Rate for Payer: PACE SWMI |
$67.32
|
| Rate for Payer: PHP Medicare Advantage |
$67.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$119.42
|
| Rate for Payer: Priority Health Medicare |
$67.32
|
| Rate for Payer: Priority Health SBD |
$119.42
|
| Rate for Payer: Priority Health Tiered Network |
$119.42
|
| Rate for Payer: Railroad Medicare Medicare |
$67.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.04
|
| Rate for Payer: UHC Core |
$137.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.32
|
| Rate for Payer: UHC Exchange |
$137.04
|
| Rate for Payer: UHC Medicaid |
$42.60
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR INJECTION SCLEROSANT SINGLE INCMPTNT VEIN
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 36470
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$45.56
|
| Rate for Payer: Aetna Medicare |
$35.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.96
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$44.77
|
| Rate for Payer: BCN Medicare Advantage |
$34.00
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$45.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.00
|
| Rate for Payer: Healthscope Commercial |
$62.90
|
| Rate for Payer: Healthscope Commercial |
$54.40
|
| Rate for Payer: Mclaren Medicaid |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.70
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.14
|
| Rate for Payer: Nomi Health Commercial |
$40.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: PACE SWMI |
$34.00
|
| Rate for Payer: PHP Medicare Advantage |
$34.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.06
|
| Rate for Payer: Priority Health Medicare |
$34.00
|
| Rate for Payer: Priority Health SBD |
$61.06
|
| Rate for Payer: Priority Health Tiered Network |
$61.06
|
| Rate for Payer: Railroad Medicare Medicare |
$34.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.89
|
| Rate for Payer: UHC Core |
$67.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.00
|
| Rate for Payer: UHC Exchange |
$67.89
|
| Rate for Payer: UHC Medicaid |
$21.51
|
| Rate for Payer: UHCCP Medicaid |
$21.51
|
|
|
PR INJECTION SCLEROSING SOLUTION HEMORRHOIDS
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 46500
|
| Min. Negotiated Rate |
$123.97 |
| Max. Negotiated Rate |
$341.08 |
| Rate for Payer: Aetna Commercial |
$247.06
|
| Rate for Payer: Aetna Medicare |
$191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.49
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$184.37
|
| Rate for Payer: BCN Commercial |
$278.37
|
| Rate for Payer: BCN Medicare Advantage |
$184.37
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$265.49
|
| Rate for Payer: Cofinity Commercial |
$247.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.37
|
| Rate for Payer: Healthscope Commercial |
$341.08
|
| Rate for Payer: Healthscope Commercial |
$294.99
|
| Rate for Payer: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.59
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.47
|
| Rate for Payer: Nomi Health Commercial |
$221.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$184.37
|
| Rate for Payer: PHP Medicare Advantage |
$184.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$339.18
|
| Rate for Payer: Priority Health Medicare |
$184.37
|
| Rate for Payer: Priority Health SBD |
$339.18
|
| Rate for Payer: Priority Health Tiered Network |
$339.18
|
| Rate for Payer: Railroad Medicare Medicare |
$184.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.49
|
| Rate for Payer: UHC Core |
$309.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.37
|
| Rate for Payer: UHC Exchange |
$309.49
|
| Rate for Payer: UHC Medicaid |
$123.97
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
20552
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$78.12 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Aetna Commercial |
$105.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.60
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Advantage |
$86.80
|
| Rate for Payer: Cofinity Commercial |
$106.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.20
|
| Rate for Payer: Healthscope Commercial |
$111.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PHP Commercial |
$105.40
|
| Rate for Payer: Priority Health SBD |
$78.12
|
|
|
PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 20552
|
| Hospital Charge Code |
20552
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$46.89
|
| Rate for Payer: Aetna Medicare |
$36.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.39
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.99
|
| Rate for Payer: BCN Commercial |
$54.28
|
| Rate for Payer: BCN Medicare Advantage |
$34.99
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$50.39
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.99
|
| Rate for Payer: Healthscope Commercial |
$64.73
|
| Rate for Payer: Healthscope Commercial |
$55.98
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.74
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.52
|
| Rate for Payer: Nomi Health Commercial |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$34.99
|
| Rate for Payer: PHP Medicare Advantage |
$34.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.03
|
| Rate for Payer: Priority Health Medicare |
$34.99
|
| Rate for Payer: Priority Health SBD |
$58.03
|
| Rate for Payer: Priority Health Tiered Network |
$58.03
|
| Rate for Payer: Railroad Medicare Medicare |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.77
|
| Rate for Payer: UHC Core |
$67.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.99
|
| Rate for Payer: UHC Exchange |
$67.77
|
| Rate for Payer: UHC Medicaid |
$22.79
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 20552
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$46.89
|
| Rate for Payer: Aetna Medicare |
$36.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.39
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.99
|
| Rate for Payer: BCN Commercial |
$54.28
|
| Rate for Payer: BCN Medicare Advantage |
$34.99
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$50.39
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.99
|
| Rate for Payer: Healthscope Commercial |
$64.73
|
| Rate for Payer: Healthscope Commercial |
$55.98
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.74
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.52
|
| Rate for Payer: Nomi Health Commercial |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$34.99
|
| Rate for Payer: PHP Medicare Advantage |
$34.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.03
|
| Rate for Payer: Priority Health Medicare |
$34.99
|
| Rate for Payer: Priority Health SBD |
$58.03
|
| Rate for Payer: Priority Health Tiered Network |
$58.03
|
| Rate for Payer: Railroad Medicare Medicare |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.77
|
| Rate for Payer: UHC Core |
$67.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.99
|
| Rate for Payer: UHC Exchange |
$67.77
|
| Rate for Payer: UHC Medicaid |
$22.79
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
20552
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$78.12 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna Commercial |
$105.40
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$224.17
|
| Rate for Payer: BCN Commercial |
$224.17
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Advantage |
$86.80
|
| Rate for Payer: Cofinity Commercial |
$106.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$111.60
|
| Rate for Payer: Mclaren Medicaid |
$159.96
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.40
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$105.40
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$78.12
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
PR INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 20553
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Aetna Commercial |
$53.47
|
| Rate for Payer: Aetna Medicare |
$41.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.46
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$39.90
|
| Rate for Payer: BCN Commercial |
$48.69
|
| Rate for Payer: BCN Medicare Advantage |
$39.90
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$57.46
|
| Rate for Payer: Cofinity Commercial |
$53.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$73.81
|
| Rate for Payer: Healthscope Commercial |
$63.84
|
| Rate for Payer: Mclaren Medicaid |
$25.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.90
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.10
|
| Rate for Payer: Nomi Health Commercial |
$47.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.50
|
| Rate for Payer: PACE SWMI |
$39.90
|
| Rate for Payer: PHP Medicare Advantage |
$39.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.01
|
| Rate for Payer: Priority Health Medicare |
$39.90
|
| Rate for Payer: Priority Health SBD |
$66.01
|
| Rate for Payer: Priority Health Tiered Network |
$66.01
|
| Rate for Payer: Railroad Medicare Medicare |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$76.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.90
|
| Rate for Payer: UHC Exchange |
$76.30
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
|
|
PR INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 20551
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$44.07
|
| Rate for Payer: Aetna Medicare |
$34.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.36
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$32.89
|
| Rate for Payer: BCN Commercial |
$45.16
|
| Rate for Payer: BCN Medicare Advantage |
$32.89
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$47.36
|
| Rate for Payer: Cofinity Commercial |
$44.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.89
|
| Rate for Payer: Healthscope Commercial |
$60.85
|
| Rate for Payer: Healthscope Commercial |
$52.62
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.53
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.53
|
| Rate for Payer: Nomi Health Commercial |
$39.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: PACE SWMI |
$32.89
|
| Rate for Payer: PHP Medicare Advantage |
$32.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.22
|
| Rate for Payer: Priority Health Medicare |
$32.89
|
| Rate for Payer: Priority Health SBD |
$61.22
|
| Rate for Payer: Priority Health Tiered Network |
$61.22
|
| Rate for Payer: Railroad Medicare Medicare |
$32.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.56
|
| Rate for Payer: UHC Core |
$70.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.89
|
| Rate for Payer: UHC Exchange |
$70.56
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
PR INJECTION SINUS TRACT DIAGNOSTIC
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 20501
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$218.25 |
| Rate for Payer: Aetna Commercial |
$41.57
|
| Rate for Payer: Aetna Medicare |
$32.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.67
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$31.02
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$31.02
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$44.67
|
| Rate for Payer: Cofinity Commercial |
$41.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.02
|
| Rate for Payer: Healthscope Commercial |
$57.39
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Mclaren Medicaid |
$19.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.57
|
| Rate for Payer: Meridian Medicaid |
$20.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.84
|
| Rate for Payer: Nomi Health Commercial |
$37.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.25
|
| Rate for Payer: PACE SWMI |
$31.02
|
| Rate for Payer: PHP Medicare Advantage |
$31.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.96
|
| Rate for Payer: Priority Health Medicare |
$31.02
|
| Rate for Payer: Priority Health SBD |
$56.96
|
| Rate for Payer: Priority Health Tiered Network |
$56.96
|
| Rate for Payer: Railroad Medicare Medicare |
$31.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.69
|
| Rate for Payer: UHC Core |
$67.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.02
|
| Rate for Payer: UHC Exchange |
$67.69
|
| Rate for Payer: UHC Medicaid |
$19.81
|
| Rate for Payer: UHCCP Medicaid |
$19.81
|
|
|
PR INJECTION SINUS TRACT THERAPEUTIC SEPARATE PX
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 20500
|
| Min. Negotiated Rate |
$53.25 |
| Max. Negotiated Rate |
$190.50 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare |
$84.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.57
|
| Rate for Payer: BCBS Complete |
$55.91
|
| Rate for Payer: BCBS MAPPO |
$80.95
|
| Rate for Payer: BCN Commercial |
$136.44
|
| Rate for Payer: BCN Medicare Advantage |
$80.95
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$116.57
|
| Rate for Payer: Cofinity Commercial |
$108.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$149.76
|
| Rate for Payer: Healthscope Commercial |
$129.52
|
| Rate for Payer: Mclaren Medicaid |
$53.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.00
|
| Rate for Payer: Meridian Medicaid |
$55.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.47
|
| Rate for Payer: Nomi Health Commercial |
$97.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$80.95
|
| Rate for Payer: PHP Medicare Advantage |
$80.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$145.86
|
| Rate for Payer: Priority Health Medicare |
$80.95
|
| Rate for Payer: Priority Health SBD |
$145.86
|
| Rate for Payer: Priority Health Tiered Network |
$145.86
|
| Rate for Payer: Railroad Medicare Medicare |
$80.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.60
|
| Rate for Payer: UHC Core |
$150.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.95
|
| Rate for Payer: UHC Exchange |
$150.60
|
| Rate for Payer: UHC Medicaid |
$53.25
|
| Rate for Payer: UHCCP Medicaid |
$53.25
|
|
|
PR INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 36468
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$373.56 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$80.50
|
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.00
|
| Rate for Payer: BCBS Complete |
$98.27
|
| Rate for Payer: BCBS Complete |
$98.27
|
| Rate for Payer: BCN Commercial |
$373.56
|
| Rate for Payer: BCN Commercial |
$373.56
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Mclaren Medicaid |
$93.59
|
| Rate for Payer: Mclaren Medicaid |
$93.59
|
| Rate for Payer: Meridian Medicaid |
$98.27
|
| Rate for Payer: Meridian Medicaid |
$98.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.76
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: Priority Health Tiered Network |
$169.76
|
| Rate for Payer: Priority Health Tiered Network |
$169.76
|
| Rate for Payer: UHC Medicaid |
$93.59
|
| Rate for Payer: UHC Medicaid |
$93.59
|
| Rate for Payer: UHCCP Medicaid |
$93.59
|
| Rate for Payer: UHCCP Medicaid |
$93.59
|
|
|
PR INJECTION THERAPEUTIC CARPAL TUNNEL
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 20526
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$120.75 |
| Rate for Payer: Aetna Commercial |
$65.70
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.60
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$70.60
|
| Rate for Payer: Cofinity Commercial |
$65.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$90.71
|
| Rate for Payer: Healthscope Commercial |
$78.45
|
| Rate for Payer: Mclaren Medicaid |
$31.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.38
|
| Rate for Payer: Nomi Health Commercial |
$58.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$91.02
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$91.02
|
| Rate for Payer: Priority Health Tiered Network |
$91.02
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.66
|
| Rate for Payer: UHC Core |
$100.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$100.66
|
| Rate for Payer: UHC Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
|
|
PR INJECTION THRU KIDNEY TUBE FOR XRAY
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 50394
|
| Min. Negotiated Rate |
$98.40 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Medicare |
$123.00
|
| Rate for Payer: BCBS Complete |
$98.40
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
|
|
PR INJECTION TURBINATE THERAPEUTIC
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 30200
|
| Min. Negotiated Rate |
$34.51 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$70.22
|
| Rate for Payer: Aetna Medicare |
$54.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.46
|
| Rate for Payer: BCBS Complete |
$36.24
|
| Rate for Payer: BCBS MAPPO |
$52.40
|
| Rate for Payer: BCN Commercial |
$71.86
|
| Rate for Payer: BCN Medicare Advantage |
$52.40
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$75.46
|
| Rate for Payer: Cofinity Commercial |
$70.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.40
|
| Rate for Payer: Healthscope Commercial |
$83.84
|
| Rate for Payer: Healthscope Commercial |
$96.94
|
| Rate for Payer: Mclaren Medicaid |
$34.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.02
|
| Rate for Payer: Meridian Medicaid |
$36.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.26
|
| Rate for Payer: Nomi Health Commercial |
$62.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.00
|
| Rate for Payer: PACE SWMI |
$52.40
|
| Rate for Payer: PHP Medicare Advantage |
$52.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.81
|
| Rate for Payer: Priority Health Medicare |
$52.40
|
| Rate for Payer: Priority Health SBD |
$85.81
|
| Rate for Payer: Priority Health Tiered Network |
$85.81
|
| Rate for Payer: Railroad Medicare Medicare |
$52.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.12
|
| Rate for Payer: UHC Core |
$100.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.40
|
| Rate for Payer: UHC Exchange |
$100.12
|
| Rate for Payer: UHC Medicaid |
$34.51
|
| Rate for Payer: UHCCP Medicaid |
$34.51
|
|
|
PR INJECTION WRIST ARTHROGRAPHY
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 25246
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$221.25 |
| Rate for Payer: Aetna Commercial |
$82.03
|
| Rate for Payer: Aetna Medicare |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.16
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$61.22
|
| Rate for Payer: BCN Commercial |
$107.56
|
| Rate for Payer: BCN Medicare Advantage |
$61.22
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$88.16
|
| Rate for Payer: Cofinity Commercial |
$82.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.22
|
| Rate for Payer: Healthscope Commercial |
$97.95
|
| Rate for Payer: Healthscope Commercial |
$113.26
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.28
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.75
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$221.25
|
| Rate for Payer: PACE SWMI |
$61.22
|
| Rate for Payer: PHP Medicare Advantage |
$61.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114.99
|
| Rate for Payer: Priority Health Medicare |
$61.22
|
| Rate for Payer: Priority Health SBD |
$114.99
|
| Rate for Payer: Priority Health Tiered Network |
$114.99
|
| Rate for Payer: Railroad Medicare Medicare |
$61.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.34
|
| Rate for Payer: UHC Core |
$131.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.22
|
| Rate for Payer: UHC Exchange |
$131.34
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR INJECT NERV BLCK,CERV PLEXUS
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 64413
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 27096
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$498.75 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$75.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.27
|
| Rate for Payer: BCBS Complete |
$49.42
|
| Rate for Payer: BCBS MAPPO |
$72.59
|
| Rate for Payer: BCN Commercial |
$124.50
|
| Rate for Payer: BCN Medicare Advantage |
$72.59
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$97.27
|
| Rate for Payer: Cofinity Commercial |
$104.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.59
|
| Rate for Payer: Healthscope Commercial |
$116.14
|
| Rate for Payer: Healthscope Commercial |
$134.29
|
| Rate for Payer: Mclaren Medicaid |
$47.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.22
|
| Rate for Payer: Meridian Medicaid |
$49.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.58
|
| Rate for Payer: Nomi Health Commercial |
$87.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.75
|
| Rate for Payer: PACE SWMI |
$72.59
|
| Rate for Payer: PHP Medicare Advantage |
$72.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$133.09
|
| Rate for Payer: Priority Health Medicare |
$72.59
|
| Rate for Payer: Priority Health SBD |
$133.09
|
| Rate for Payer: Priority Health Tiered Network |
$133.09
|
| Rate for Payer: Railroad Medicare Medicare |
$72.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.92
|
| Rate for Payer: UHC Core |
$145.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.59
|
| Rate for Payer: UHC Exchange |
$145.92
|
| Rate for Payer: UHC Medicaid |
$47.07
|
| Rate for Payer: UHCCP Medicaid |
$47.07
|
|
