|
PR IMMUNIZE COUNS < 21YR 6-30 M
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS G0313
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
|
|
PR IMMUNIZE COUNSEL 16-30 MINS
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS G0311
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
|
|
PR IMMUNIZE COUNSEL 5-15 MIN
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0310
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
PR IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 15778
|
| Min. Negotiated Rate |
$250.49 |
| Max. Negotiated Rate |
$68,967.00 |
| Rate for Payer: Aetna Commercial |
$511.09
|
| Rate for Payer: Aetna Medicare |
$396.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.23
|
| Rate for Payer: BCBS Complete |
$263.01
|
| Rate for Payer: BCBS MAPPO |
$381.41
|
| Rate for Payer: BCN Commercial |
$559.05
|
| Rate for Payer: BCN Medicare Advantage |
$381.41
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$549.23
|
| Rate for Payer: Cofinity Commercial |
$511.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.41
|
| Rate for Payer: Healthscope Commercial |
$705.61
|
| Rate for Payer: Healthscope Commercial |
$610.26
|
| Rate for Payer: Mclaren Medicaid |
$250.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.48
|
| Rate for Payer: Meridian Medicaid |
$263.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,967.00
|
| Rate for Payer: Nomi Health Commercial |
$457.69
|
| Rate for Payer: PACE SWMI |
$381.41
|
| Rate for Payer: PHP Medicare Advantage |
$381.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.79
|
| Rate for Payer: Priority Health Medicare |
$381.41
|
| Rate for Payer: Priority Health Narrow Network |
$518.79
|
| Rate for Payer: Priority Health SBD |
$518.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.41
|
| Rate for Payer: UHC Medicare Advantage |
$381.41
|
| Rate for Payer: UHCCP Medicaid |
$250.49
|
|
|
PR IMPLANTABLE TISSUE MARKER
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS A4648
|
| Min. Negotiated Rate |
$102.14 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: Aetna Medicare |
$612.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.14
|
| Rate for Payer: BCBS Complete |
$489.60
|
| Rate for Payer: BCN Commercial |
$136.96
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$795.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
|
|
PR IMPLANTATION NERVE END BONE/MUSCLE
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 64787
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$41,895.00 |
| Rate for Payer: Aetna Commercial |
$302.42
|
| Rate for Payer: Aetna Medicare |
$234.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.99
|
| Rate for Payer: BCBS Complete |
$157.23
|
| Rate for Payer: BCBS MAPPO |
$225.69
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$341.58
|
| Rate for Payer: BCN Medicare Advantage |
$225.69
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$302.42
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.69
|
| Rate for Payer: Healthscope Commercial |
$361.10
|
| Rate for Payer: Healthscope Commercial |
$417.53
|
| Rate for Payer: Mclaren Medicaid |
$149.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.97
|
| Rate for Payer: Meridian Medicaid |
$157.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,895.00
|
| Rate for Payer: Nomi Health Commercial |
$270.83
|
| Rate for Payer: PACE SWMI |
$225.69
|
| Rate for Payer: PHP Medicare Advantage |
$225.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.70
|
| Rate for Payer: Priority Health Medicare |
$225.69
|
| Rate for Payer: Priority Health Narrow Network |
$394.70
|
| Rate for Payer: Priority Health SBD |
$394.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.69
|
| Rate for Payer: UHC Exchange |
$334.27
|
| Rate for Payer: UHC Medicare Advantage |
$225.69
|
| Rate for Payer: UHCCP Medicaid |
$149.74
|
|
|
PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 33282
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna Medicare |
$315.00
|
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
|
|
PR IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 49568
|
| Min. Negotiated Rate |
$404.00 |
| Max. Negotiated Rate |
$656.50 |
| Rate for Payer: Aetna Medicare |
$505.00
|
| Rate for Payer: BCBS Complete |
$404.00
|
| Rate for Payer: Cash Price |
$808.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.50
|
|
|
PR IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 15777
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$38,074.00 |
| Rate for Payer: Aetna Commercial |
$275.42
|
| Rate for Payer: Aetna Medicare |
$213.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.98
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS MAPPO |
$205.54
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$205.54
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.54
|
| Rate for Payer: Healthscope Commercial |
$380.25
|
| Rate for Payer: Healthscope Commercial |
$328.86
|
| Rate for Payer: Mclaren Medicaid |
$136.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.82
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,074.00
|
| Rate for Payer: Nomi Health Commercial |
$246.65
|
| Rate for Payer: PACE SWMI |
$205.54
|
| Rate for Payer: PHP Medicare Advantage |
$205.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.61
|
| Rate for Payer: Priority Health Medicare |
$205.54
|
| Rate for Payer: Priority Health Narrow Network |
$287.61
|
| Rate for Payer: Priority Health SBD |
$287.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.54
|
| Rate for Payer: UHC Medicare Advantage |
$205.54
|
| Rate for Payer: UHCCP Medicaid |
$136.75
|
|
|
PR IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 69716
|
| Min. Negotiated Rate |
$176.45 |
| Max. Negotiated Rate |
$109,714.00 |
| Rate for Payer: Aetna Commercial |
$787.60
|
| Rate for Payer: Aetna Medicare |
$611.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.37
|
| Rate for Payer: BCBS Complete |
$418.00
|
| Rate for Payer: BCBS MAPPO |
$587.76
|
| Rate for Payer: BCBS Trust/PPO |
$176.45
|
| Rate for Payer: BCN Commercial |
$910.40
|
| Rate for Payer: BCN Medicare Advantage |
$587.76
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$846.37
|
| Rate for Payer: Cofinity Commercial |
$787.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.76
|
| Rate for Payer: Healthscope Commercial |
$1,087.36
|
| Rate for Payer: Healthscope Commercial |
$940.42
|
| Rate for Payer: Mclaren Medicaid |
$398.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.15
|
| Rate for Payer: Meridian Medicaid |
$418.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109,714.00
|
| Rate for Payer: Nomi Health Commercial |
$705.31
|
| Rate for Payer: PACE SWMI |
$587.76
|
| Rate for Payer: PHP Medicare Advantage |
$587.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.55
|
| Rate for Payer: Priority Health Medicare |
$587.76
|
| Rate for Payer: Priority Health Narrow Network |
$908.55
|
| Rate for Payer: Priority Health SBD |
$908.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.76
|
| Rate for Payer: UHC Medicare Advantage |
$587.76
|
| Rate for Payer: UHCCP Medicaid |
$398.10
|
|
|
PR IMPL OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$1,953.00
|
|
|
Service Code
|
HCPCS 69714
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$87,046.00 |
| Rate for Payer: Aetna Commercial |
$626.44
|
| Rate for Payer: Aetna Medicare |
$486.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.19
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS MAPPO |
$467.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,343.08
|
| Rate for Payer: BCN Commercial |
$725.20
|
| Rate for Payer: BCN Medicare Advantage |
$467.49
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cofinity Commercial |
$673.19
|
| Rate for Payer: Cofinity Commercial |
$626.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.49
|
| Rate for Payer: Healthscope Commercial |
$864.86
|
| Rate for Payer: Healthscope Commercial |
$747.98
|
| Rate for Payer: Mclaren Medicaid |
$318.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.86
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87,046.00
|
| Rate for Payer: Nomi Health Commercial |
$560.99
|
| Rate for Payer: PACE SWMI |
$467.49
|
| Rate for Payer: PHP Medicare Advantage |
$467.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,269.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$726.15
|
| Rate for Payer: Priority Health Medicare |
$467.49
|
| Rate for Payer: Priority Health Narrow Network |
$726.15
|
| Rate for Payer: Priority Health SBD |
$726.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$467.49
|
| Rate for Payer: UHC Exchange |
$1,100.83
|
| Rate for Payer: UHC Medicare Advantage |
$467.49
|
| Rate for Payer: UHCCP Medicaid |
$318.01
|
|
|
PR IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 61517
|
| Min. Negotiated Rate |
$56.23 |
| Max. Negotiated Rate |
$15,750.00 |
| Rate for Payer: Aetna Commercial |
$116.15
|
| Rate for Payer: Aetna Medicare |
$90.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.82
|
| Rate for Payer: BCBS Complete |
$59.04
|
| Rate for Payer: BCBS MAPPO |
$86.68
|
| Rate for Payer: BCBS Trust/PPO |
$975.77
|
| Rate for Payer: BCN Commercial |
$127.06
|
| Rate for Payer: BCN Medicare Advantage |
$86.68
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$124.82
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.68
|
| Rate for Payer: Healthscope Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$138.69
|
| Rate for Payer: Mclaren Medicaid |
$56.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.01
|
| Rate for Payer: Meridian Medicaid |
$59.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,750.00
|
| Rate for Payer: Nomi Health Commercial |
$104.02
|
| Rate for Payer: PACE SWMI |
$86.68
|
| Rate for Payer: PHP Medicare Advantage |
$86.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.00
|
| Rate for Payer: Priority Health Medicare |
$86.68
|
| Rate for Payer: Priority Health Narrow Network |
$149.00
|
| Rate for Payer: Priority Health SBD |
$149.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.68
|
| Rate for Payer: UHC Exchange |
$85.74
|
| Rate for Payer: UHC Medicare Advantage |
$86.68
|
| Rate for Payer: UHCCP Medicaid |
$56.23
|
|
|
PR IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 0437T
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$49,507.00 |
| Rate for Payer: Aetna Commercial |
$294.80
|
| Rate for Payer: Aetna Medicare |
$245.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.80
|
| Rate for Payer: BCBS Complete |
$196.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,507.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
|
|
PR IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM
|
Professional
|
Both
|
$821.00
|
|
|
Service Code
|
HCPCS 62350
|
| Min. Negotiated Rate |
$258.58 |
| Max. Negotiated Rate |
$70,589.00 |
| Rate for Payer: Aetna Commercial |
$516.68
|
| Rate for Payer: Aetna Medicare |
$401.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.24
|
| Rate for Payer: BCBS Complete |
$271.51
|
| Rate for Payer: BCBS MAPPO |
$385.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$385.58
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cofinity Commercial |
$555.24
|
| Rate for Payer: Cofinity Commercial |
$516.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.58
|
| Rate for Payer: Healthscope Commercial |
$616.93
|
| Rate for Payer: Healthscope Commercial |
$713.32
|
| Rate for Payer: Mclaren Medicaid |
$258.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.86
|
| Rate for Payer: Meridian Medicaid |
$271.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70,589.00
|
| Rate for Payer: Nomi Health Commercial |
$462.70
|
| Rate for Payer: PACE SWMI |
$385.58
|
| Rate for Payer: PHP Medicare Advantage |
$385.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.73
|
| Rate for Payer: Priority Health Medicare |
$385.58
|
| Rate for Payer: Priority Health Narrow Network |
$684.73
|
| Rate for Payer: Priority Health SBD |
$684.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.58
|
| Rate for Payer: UHC Exchange |
$538.77
|
| Rate for Payer: UHC Medicare Advantage |
$385.58
|
| Rate for Payer: UHCCP Medicaid |
$258.58
|
|
|
PR IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 62362
|
| Min. Negotiated Rate |
$250.06 |
| Max. Negotiated Rate |
$68,510.00 |
| Rate for Payer: Aetna Commercial |
$499.94
|
| Rate for Payer: Aetna Medicare |
$388.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.25
|
| Rate for Payer: BCBS Complete |
$262.56
|
| Rate for Payer: BCBS MAPPO |
$373.09
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$564.43
|
| Rate for Payer: BCN Medicare Advantage |
$373.09
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cofinity Commercial |
$537.25
|
| Rate for Payer: Cofinity Commercial |
$499.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.09
|
| Rate for Payer: Healthscope Commercial |
$690.22
|
| Rate for Payer: Healthscope Commercial |
$596.94
|
| Rate for Payer: Mclaren Medicaid |
$250.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.74
|
| Rate for Payer: Meridian Medicaid |
$262.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,510.00
|
| Rate for Payer: Nomi Health Commercial |
$447.71
|
| Rate for Payer: PACE SWMI |
$373.09
|
| Rate for Payer: PHP Medicare Advantage |
$373.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$664.26
|
| Rate for Payer: Priority Health Medicare |
$373.09
|
| Rate for Payer: Priority Health Narrow Network |
$664.26
|
| Rate for Payer: Priority Health SBD |
$664.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.09
|
| Rate for Payer: UHC Exchange |
$541.53
|
| Rate for Payer: UHC Medicare Advantage |
$373.09
|
| Rate for Payer: UHCCP Medicaid |
$250.06
|
|
|
PR IMPREG GAUZE NO H20/SAL/YARD
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS A6266
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$254.00 |
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCN Commercial |
$2.11
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
|
|
PR INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW
|
Professional
|
Both
|
$1,497.00
|
|
|
Service Code
|
HCPCS 23935
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$91,091.00 |
| Rate for Payer: Aetna Commercial |
$665.69
|
| Rate for Payer: Aetna Medicare |
$516.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.36
|
| Rate for Payer: BCBS Complete |
$354.93
|
| Rate for Payer: BCBS MAPPO |
$496.78
|
| Rate for Payer: BCBS Trust/PPO |
$67.50
|
| Rate for Payer: BCN Commercial |
$759.90
|
| Rate for Payer: BCN Medicare Advantage |
$496.78
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cofinity Commercial |
$665.69
|
| Rate for Payer: Cofinity Commercial |
$715.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.78
|
| Rate for Payer: Healthscope Commercial |
$919.04
|
| Rate for Payer: Healthscope Commercial |
$794.85
|
| Rate for Payer: Mclaren Medicaid |
$338.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.62
|
| Rate for Payer: Meridian Medicaid |
$354.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,091.00
|
| Rate for Payer: Nomi Health Commercial |
$596.14
|
| Rate for Payer: PACE SWMI |
$496.78
|
| Rate for Payer: PHP Medicare Advantage |
$496.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$800.95
|
| Rate for Payer: Priority Health Medicare |
$496.78
|
| Rate for Payer: Priority Health Narrow Network |
$800.95
|
| Rate for Payer: Priority Health SBD |
$800.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$786.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.78
|
| Rate for Payer: UHC Exchange |
$786.00
|
| Rate for Payer: UHC Medicare Advantage |
$496.78
|
| Rate for Payer: UHCCP Medicaid |
$338.03
|
|
|
PR INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 27303
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$113,314.00 |
| Rate for Payer: Aetna Commercial |
$831.67
|
| Rate for Payer: Aetna Medicare |
$645.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.74
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$620.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,493.05
|
| Rate for Payer: BCN Commercial |
$939.73
|
| Rate for Payer: BCN Medicare Advantage |
$620.65
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$893.74
|
| Rate for Payer: Cofinity Commercial |
$831.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.65
|
| Rate for Payer: Healthscope Commercial |
$993.04
|
| Rate for Payer: Healthscope Commercial |
$1,148.20
|
| Rate for Payer: Mclaren Medicaid |
$419.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.68
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,314.00
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE SWMI |
$620.65
|
| Rate for Payer: PHP Medicare Advantage |
$620.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$993.80
|
| Rate for Payer: Priority Health Medicare |
$620.65
|
| Rate for Payer: Priority Health Narrow Network |
$993.80
|
| Rate for Payer: Priority Health SBD |
$993.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.65
|
| Rate for Payer: UHC Exchange |
$961.20
|
| Rate for Payer: UHC Medicare Advantage |
$620.65
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 62148
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$22,784.00 |
| Rate for Payer: Aetna Commercial |
$167.07
|
| Rate for Payer: Aetna Medicare |
$129.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.54
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS MAPPO |
$124.68
|
| Rate for Payer: BCBS Trust/PPO |
$50.72
|
| Rate for Payer: BCN Commercial |
$254.90
|
| Rate for Payer: BCN Medicare Advantage |
$124.68
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$179.54
|
| Rate for Payer: Cofinity Commercial |
$167.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.68
|
| Rate for Payer: Healthscope Commercial |
$230.66
|
| Rate for Payer: Healthscope Commercial |
$199.49
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.91
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,784.00
|
| Rate for Payer: Nomi Health Commercial |
$149.62
|
| Rate for Payer: PACE SWMI |
$124.68
|
| Rate for Payer: PHP Medicare Advantage |
$124.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.98
|
| Rate for Payer: Priority Health Medicare |
$124.68
|
| Rate for Payer: Priority Health Narrow Network |
$214.98
|
| Rate for Payer: Priority Health SBD |
$214.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.68
|
| Rate for Payer: UHC Exchange |
$145.46
|
| Rate for Payer: UHC Medicare Advantage |
$124.68
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR INCIS HEART SAC TUBE
|
Professional
|
Both
|
$1,683.00
|
|
|
Service Code
|
HCPCS 33015
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,093.95 |
| Rate for Payer: Aetna Medicare |
$841.50
|
| Rate for Payer: BCBS Complete |
$673.20
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,093.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,093.95
|
|
|
PR INCISIONAL BIOPSY EYELID SKIN W/LID MARGIN
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 67810
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$11,921.00 |
| Rate for Payer: Aetna Commercial |
$86.47
|
| Rate for Payer: Aetna Medicare |
$67.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.92
|
| Rate for Payer: BCBS Complete |
$45.62
|
| Rate for Payer: BCBS MAPPO |
$64.53
|
| Rate for Payer: BCBS Trust/PPO |
$562.64
|
| Rate for Payer: BCN Commercial |
$271.22
|
| Rate for Payer: BCN Medicare Advantage |
$64.53
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$92.92
|
| Rate for Payer: Cofinity Commercial |
$86.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.53
|
| Rate for Payer: Healthscope Commercial |
$119.38
|
| Rate for Payer: Healthscope Commercial |
$103.25
|
| Rate for Payer: Mclaren Medicaid |
$43.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.76
|
| Rate for Payer: Meridian Medicaid |
$45.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,921.00
|
| Rate for Payer: Nomi Health Commercial |
$77.44
|
| Rate for Payer: PACE SWMI |
$64.53
|
| Rate for Payer: PHP Medicare Advantage |
$64.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.57
|
| Rate for Payer: Priority Health Medicare |
$64.53
|
| Rate for Payer: Priority Health Narrow Network |
$117.57
|
| Rate for Payer: Priority Health SBD |
$117.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.53
|
| Rate for Payer: UHC Exchange |
$285.44
|
| Rate for Payer: UHC Medicare Advantage |
$64.53
|
| Rate for Payer: UHCCP Medicaid |
$43.45
|
|
|
PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 11107
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$5,420.00 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$30.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCBS Trust/PPO |
$11.47
|
| Rate for Payer: BCN Commercial |
$84.42
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$46.21
|
| Rate for Payer: Healthscope Commercial |
$53.43
|
| Rate for Payer: Mclaren Medicaid |
$19.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,420.00
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.09
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: Priority Health Narrow Network |
$41.09
|
| Rate for Payer: Priority Health SBD |
$41.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 11106
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$9,949.00 |
| Rate for Payer: Aetna Commercial |
$72.11
|
| Rate for Payer: Aetna Medicare |
$55.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.49
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$53.81
|
| Rate for Payer: BCBS Trust/PPO |
$13.57
|
| Rate for Payer: BCN Commercial |
$183.77
|
| Rate for Payer: BCN Medicare Advantage |
$53.81
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$77.49
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.81
|
| Rate for Payer: Healthscope Commercial |
$86.10
|
| Rate for Payer: Healthscope Commercial |
$99.55
|
| Rate for Payer: Mclaren Medicaid |
$36.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.50
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,949.00
|
| Rate for Payer: Nomi Health Commercial |
$64.57
|
| Rate for Payer: PACE SWMI |
$53.81
|
| Rate for Payer: PHP Medicare Advantage |
$53.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.85
|
| Rate for Payer: Priority Health Medicare |
$53.81
|
| Rate for Payer: Priority Health Narrow Network |
$75.85
|
| Rate for Payer: Priority Health SBD |
$75.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.81
|
| Rate for Payer: UHC Medicare Advantage |
$53.81
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
|
PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 44900
|
| Min. Negotiated Rate |
$378.79 |
| Max. Negotiated Rate |
$140,656.00 |
| Rate for Payer: Aetna Commercial |
$1,022.25
|
| Rate for Payer: Aetna Medicare |
$793.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,022.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.53
|
| Rate for Payer: BCBS Complete |
$530.94
|
| Rate for Payer: BCBS MAPPO |
$762.87
|
| Rate for Payer: BCBS Trust/PPO |
$378.79
|
| Rate for Payer: BCN Commercial |
$1,148.88
|
| Rate for Payer: BCN Medicare Advantage |
$762.87
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,098.53
|
| Rate for Payer: Cofinity Commercial |
$1,022.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.87
|
| Rate for Payer: Healthscope Commercial |
$1,411.31
|
| Rate for Payer: Healthscope Commercial |
$1,220.59
|
| Rate for Payer: Mclaren Medicaid |
$505.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.01
|
| Rate for Payer: Meridian Medicaid |
$530.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140,656.00
|
| Rate for Payer: Nomi Health Commercial |
$915.44
|
| Rate for Payer: PACE SWMI |
$762.87
|
| Rate for Payer: PHP Medicare Advantage |
$762.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,408.56
|
| Rate for Payer: Priority Health Medicare |
$762.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.56
|
| Rate for Payer: Priority Health SBD |
$1,408.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.87
|
| Rate for Payer: UHC Exchange |
$676.74
|
| Rate for Payer: UHC Medicare Advantage |
$762.87
|
| Rate for Payer: UHCCP Medicaid |
$505.66
|
|
|
PR INCISION BONE CORTEX FOOT
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 28005
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$100,532.00 |
| Rate for Payer: Aetna Commercial |
$732.24
|
| Rate for Payer: Aetna Medicare |
$568.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.89
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$546.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$831.24
|
| Rate for Payer: BCN Medicare Advantage |
$546.45
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$786.89
|
| Rate for Payer: Cofinity Commercial |
$732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.45
|
| Rate for Payer: Healthscope Commercial |
$874.32
|
| Rate for Payer: Healthscope Commercial |
$1,010.93
|
| Rate for Payer: Mclaren Medicaid |
$369.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.77
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,532.00
|
| Rate for Payer: Nomi Health Commercial |
$655.74
|
| Rate for Payer: PACE SWMI |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$546.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$876.76
|
| Rate for Payer: Priority Health Medicare |
$546.45
|
| Rate for Payer: Priority Health Narrow Network |
$876.76
|
| Rate for Payer: Priority Health SBD |
$876.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.45
|
| Rate for Payer: UHC Exchange |
$865.64
|
| Rate for Payer: UHC Medicare Advantage |
$546.45
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
|
