|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$5,490.00
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$935.28 |
| Max. Negotiated Rate |
$4,117.50 |
| Rate for Payer: Aetna Commercial |
$1,936.74
|
| Rate for Payer: Aetna Medicare |
$1,503.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,936.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.28
|
| Rate for Payer: BCBS Complete |
$982.04
|
| Rate for Payer: BCBS MAPPO |
$1,445.33
|
| Rate for Payer: BCN Commercial |
$2,449.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,445.33
|
| Rate for Payer: Cash Price |
$4,392.00
|
| Rate for Payer: Cash Price |
$4,392.00
|
| Rate for Payer: Cofinity Commercial |
$2,081.28
|
| Rate for Payer: Cofinity Commercial |
$1,936.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,445.33
|
| Rate for Payer: Healthscope Commercial |
$2,673.86
|
| Rate for Payer: Healthscope Commercial |
$2,312.53
|
| Rate for Payer: Mclaren Medicaid |
$935.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,517.60
|
| Rate for Payer: Meridian Medicaid |
$982.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,589.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,879.71
|
| Rate for Payer: Nomi Health Commercial |
$1,734.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.50
|
| Rate for Payer: PACE SWMI |
$1,445.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,445.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,618.51
|
| Rate for Payer: Priority Health Medicare |
$1,445.33
|
| Rate for Payer: Priority Health SBD |
$2,618.51
|
| Rate for Payer: Priority Health Tiered Network |
$2,618.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,445.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,856.59
|
| Rate for Payer: UHC Core |
$2,856.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,445.33
|
| Rate for Payer: UHC Exchange |
$2,856.59
|
| Rate for Payer: UHC Medicaid |
$935.28
|
| Rate for Payer: UHCCP Medicaid |
$935.28
|
|
|
PR INTERPJ/EXPLNAJ RSLTS PSYC/OTH XM&PX/DATA FAMILY
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$56.09 |
| Max. Negotiated Rate |
$122.68 |
| Rate for Payer: Aetna Commercial |
$83.11
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.11
|
| Rate for Payer: BCBS Complete |
$58.89
|
| Rate for Payer: BCN Commercial |
$84.04
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Mclaren Medicaid |
$56.09
|
| Rate for Payer: Meridian Medicaid |
$58.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$96.85
|
| Rate for Payer: Priority Health SBD |
$96.85
|
| Rate for Payer: Priority Health Tiered Network |
$96.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.68
|
| Rate for Payer: UHC Core |
$122.68
|
| Rate for Payer: UHC Exchange |
$122.68
|
| Rate for Payer: UHC Medicaid |
$56.09
|
| Rate for Payer: UHCCP Medicaid |
$56.09
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$66.12 |
| Max. Negotiated Rate |
$122.32 |
| Rate for Payer: Aetna Commercial |
$88.60
|
| Rate for Payer: Aetna Medicare |
$68.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.21
|
| Rate for Payer: BCBS MAPPO |
$66.12
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$66.12
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$95.21
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.12
|
| Rate for Payer: Healthscope Commercial |
$122.32
|
| Rate for Payer: Healthscope Commercial |
$105.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.85
|
| Rate for Payer: Nomi Health Commercial |
$79.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.00
|
| Rate for Payer: PACE SWMI |
$66.12
|
| Rate for Payer: PHP Medicare Advantage |
$66.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.45
|
| Rate for Payer: Priority Health Medicare |
$66.12
|
| Rate for Payer: Priority Health SBD |
$98.45
|
| Rate for Payer: Priority Health Tiered Network |
$98.45
|
| Rate for Payer: Railroad Medicare Medicare |
$66.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$103.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.12
|
| Rate for Payer: UHC Exchange |
$103.22
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$89.41 |
| Rate for Payer: Aetna Commercial |
$64.76
|
| Rate for Payer: Aetna Medicare |
$50.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.76
|
| Rate for Payer: BCBS MAPPO |
$48.33
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$48.33
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$64.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.33
|
| Rate for Payer: Healthscope Commercial |
$77.33
|
| Rate for Payer: Healthscope Commercial |
$89.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.05
|
| Rate for Payer: Nomi Health Commercial |
$58.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: PACE SWMI |
$48.33
|
| Rate for Payer: PHP Medicare Advantage |
$48.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.46
|
| Rate for Payer: Priority Health Medicare |
$48.33
|
| Rate for Payer: Priority Health SBD |
$71.46
|
| Rate for Payer: Priority Health Tiered Network |
$71.46
|
| Rate for Payer: Railroad Medicare Medicare |
$48.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.79
|
| Rate for Payer: UHC Core |
$69.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.33
|
| Rate for Payer: UHC Exchange |
$69.79
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$47.42
|
| Rate for Payer: Aetna Medicare |
$36.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.96
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$35.39
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$35.39
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$50.96
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.39
|
| Rate for Payer: Healthscope Commercial |
$65.47
|
| Rate for Payer: Healthscope Commercial |
$56.62
|
| Rate for Payer: Mclaren Medicaid |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.16
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: Nomi Health Commercial |
$42.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$35.39
|
| Rate for Payer: PHP Medicare Advantage |
$35.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.64
|
| Rate for Payer: Priority Health Medicare |
$35.39
|
| Rate for Payer: Priority Health SBD |
$50.64
|
| Rate for Payer: Priority Health Tiered Network |
$50.64
|
| Rate for Payer: Railroad Medicare Medicare |
$35.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.86
|
| Rate for Payer: UHC Core |
$61.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.39
|
| Rate for Payer: UHC Exchange |
$61.86
|
| Rate for Payer: UHC Medicaid |
$23.00
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$91.09 |
| Rate for Payer: Aetna Commercial |
$65.98
|
| Rate for Payer: Aetna Medicare |
$51.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.91
|
| Rate for Payer: BCBS MAPPO |
$49.24
|
| Rate for Payer: BCN Commercial |
$77.69
|
| Rate for Payer: BCN Medicare Advantage |
$49.24
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$70.91
|
| Rate for Payer: Cofinity Commercial |
$65.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$91.09
|
| Rate for Payer: Healthscope Commercial |
$78.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.76
|
| Rate for Payer: Nomi Health Commercial |
$59.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.25
|
| Rate for Payer: PACE SWMI |
$49.24
|
| Rate for Payer: PHP Medicare Advantage |
$49.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.83
|
| Rate for Payer: Priority Health Medicare |
$49.24
|
| Rate for Payer: Priority Health SBD |
$73.83
|
| Rate for Payer: Priority Health Tiered Network |
$73.83
|
| Rate for Payer: Railroad Medicare Medicare |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.51
|
| Rate for Payer: UHC Core |
$73.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.24
|
| Rate for Payer: UHC Exchange |
$73.51
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$51.99 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$69.67
|
| Rate for Payer: Aetna Commercial |
$69.67
|
| Rate for Payer: Aetna Medicare |
$54.07
|
| Rate for Payer: Aetna Medicare |
$54.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.87
|
| Rate for Payer: BCBS MAPPO |
$51.99
|
| Rate for Payer: BCBS MAPPO |
$51.99
|
| Rate for Payer: BCN Commercial |
$82.66
|
| Rate for Payer: BCN Commercial |
$82.66
|
| Rate for Payer: BCN Medicare Advantage |
$51.99
|
| Rate for Payer: BCN Medicare Advantage |
$51.99
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$69.67
|
| Rate for Payer: Cofinity Commercial |
$74.87
|
| Rate for Payer: Cofinity Commercial |
$69.67
|
| Rate for Payer: Cofinity Commercial |
$74.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.99
|
| Rate for Payer: Healthscope Commercial |
$96.18
|
| Rate for Payer: Healthscope Commercial |
$96.18
|
| Rate for Payer: Healthscope Commercial |
$83.18
|
| Rate for Payer: Healthscope Commercial |
$83.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.37
|
| Rate for Payer: Nomi Health Commercial |
$62.39
|
| Rate for Payer: Nomi Health Commercial |
$62.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$51.99
|
| Rate for Payer: PACE SWMI |
$51.99
|
| Rate for Payer: PHP Medicare Advantage |
$51.99
|
| Rate for Payer: PHP Medicare Advantage |
$51.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.58
|
| Rate for Payer: Priority Health Medicare |
$51.99
|
| Rate for Payer: Priority Health Medicare |
$51.99
|
| Rate for Payer: Priority Health SBD |
$78.58
|
| Rate for Payer: Priority Health SBD |
$78.58
|
| Rate for Payer: Priority Health Tiered Network |
$78.58
|
| Rate for Payer: Priority Health Tiered Network |
$78.58
|
| Rate for Payer: Railroad Medicare Medicare |
$51.99
|
| Rate for Payer: Railroad Medicare Medicare |
$51.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.12
|
| Rate for Payer: UHC Core |
$76.12
|
| Rate for Payer: UHC Core |
$76.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.99
|
| Rate for Payer: UHC Exchange |
$76.12
|
| Rate for Payer: UHC Exchange |
$76.12
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$45.10 |
| Max. Negotiated Rate |
$83.44 |
| Rate for Payer: Aetna Commercial |
$60.43
|
| Rate for Payer: Aetna Medicare |
$46.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.43
|
| Rate for Payer: BCBS MAPPO |
$45.10
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$45.10
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$64.94
|
| Rate for Payer: Cofinity Commercial |
$60.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.10
|
| Rate for Payer: Healthscope Commercial |
$83.44
|
| Rate for Payer: Healthscope Commercial |
$72.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.85
|
| Rate for Payer: Nomi Health Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$68.16
|
| Rate for Payer: Priority Health Medicare |
$45.10
|
| Rate for Payer: Priority Health SBD |
$68.16
|
| Rate for Payer: Priority Health Tiered Network |
$68.16
|
| Rate for Payer: Railroad Medicare Medicare |
$45.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.78
|
| Rate for Payer: UHC Core |
$66.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.10
|
| Rate for Payer: UHC Exchange |
$66.78
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 93289
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$90.26
|
| Rate for Payer: Aetna Medicare |
$70.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.00
|
| Rate for Payer: BCBS MAPPO |
$67.36
|
| Rate for Payer: BCN Commercial |
$105.57
|
| Rate for Payer: BCN Medicare Advantage |
$67.36
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$97.00
|
| Rate for Payer: Cofinity Commercial |
$90.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.36
|
| Rate for Payer: Healthscope Commercial |
$124.62
|
| Rate for Payer: Healthscope Commercial |
$107.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.76
|
| Rate for Payer: Nomi Health Commercial |
$80.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.00
|
| Rate for Payer: PACE SWMI |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$100.33
|
| Rate for Payer: Priority Health Medicare |
$67.36
|
| Rate for Payer: Priority Health SBD |
$100.33
|
| Rate for Payer: Priority Health Tiered Network |
$100.33
|
| Rate for Payer: Railroad Medicare Medicare |
$67.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.31
|
| Rate for Payer: UHC Core |
$103.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.36
|
| Rate for Payer: UHC Exchange |
$103.31
|
|
|
PR INTERTHORACOSCAPULAR AMPUTATION
|
Professional
|
Both
|
$6,169.00
|
|
|
Service Code
|
HCPCS 23900
|
| Min. Negotiated Rate |
$801.52 |
| Max. Negotiated Rate |
$4,626.75 |
| Rate for Payer: Aetna Commercial |
$1,657.91
|
| Rate for Payer: Aetna Medicare |
$1,286.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.64
|
| Rate for Payer: BCBS Complete |
$841.60
|
| Rate for Payer: BCBS MAPPO |
$1,237.25
|
| Rate for Payer: BCN Commercial |
$2,092.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.25
|
| Rate for Payer: Cash Price |
$4,935.20
|
| Rate for Payer: Cash Price |
$4,935.20
|
| Rate for Payer: Cofinity Commercial |
$1,781.64
|
| Rate for Payer: Cofinity Commercial |
$1,657.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.25
|
| Rate for Payer: Healthscope Commercial |
$2,288.91
|
| Rate for Payer: Healthscope Commercial |
$1,979.60
|
| Rate for Payer: Mclaren Medicaid |
$801.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.11
|
| Rate for Payer: Meridian Medicaid |
$841.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,360.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.75
|
| Rate for Payer: Nomi Health Commercial |
$1,484.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,626.75
|
| Rate for Payer: PACE SWMI |
$1,237.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,236.84
|
| Rate for Payer: Priority Health Medicare |
$1,237.25
|
| Rate for Payer: Priority Health SBD |
$2,236.84
|
| Rate for Payer: Priority Health Tiered Network |
$2,236.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,237.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,435.77
|
| Rate for Payer: UHC Core |
$2,435.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,237.25
|
| Rate for Payer: UHC Exchange |
$2,435.77
|
| Rate for Payer: UHC Medicaid |
$801.52
|
| Rate for Payer: UHCCP Medicaid |
$801.52
|
|
|
PR INTESTINAL PLICATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 44680
|
| Min. Negotiated Rate |
$643.69 |
| Max. Negotiated Rate |
$2,292.00 |
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Aetna Commercial |
$1,348.42
|
| Rate for Payer: Aetna Medicare |
$1,046.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.04
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$1,006.28
|
| Rate for Payer: BCN Commercial |
$1,618.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.28
|
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Cofinity Commercial |
$1,449.04
|
| Rate for Payer: Cofinity Commercial |
$1,348.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.28
|
| Rate for Payer: Healthscope Commercial |
$1,861.62
|
| Rate for Payer: Healthscope Commercial |
$1,610.05
|
| Rate for Payer: Mclaren Medicaid |
$643.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,056.59
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,106.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,931.08
|
| Rate for Payer: Nomi Health Commercial |
$1,207.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.00
|
| Rate for Payer: PACE SWMI |
$1,006.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,972.56
|
| Rate for Payer: Priority Health Medicare |
$1,006.28
|
| Rate for Payer: Priority Health SBD |
$1,972.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,972.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,890.70
|
| Rate for Payer: UHC Core |
$1,890.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,006.28
|
| Rate for Payer: UHC Exchange |
$1,890.70
|
| Rate for Payer: UHC Medicaid |
$643.69
|
| Rate for Payer: UHCCP Medicaid |
$643.69
|
|
|
PR INT HRHC BY LIGATION 2+ HROID W/O IMG GDN
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 46946
|
| Min. Negotiated Rate |
$244.74 |
| Max. Negotiated Rate |
$702.02 |
| Rate for Payer: Aetna Commercial |
$493.09
|
| Rate for Payer: Aetna Medicare |
$382.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.89
|
| Rate for Payer: BCBS Complete |
$256.98
|
| Rate for Payer: BCBS MAPPO |
$367.98
|
| Rate for Payer: BCN Commercial |
$576.17
|
| Rate for Payer: BCN Medicare Advantage |
$367.98
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cofinity Commercial |
$529.89
|
| Rate for Payer: Cofinity Commercial |
$493.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.98
|
| Rate for Payer: Healthscope Commercial |
$680.76
|
| Rate for Payer: Healthscope Commercial |
$588.77
|
| Rate for Payer: Mclaren Medicaid |
$244.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.38
|
| Rate for Payer: Meridian Medicaid |
$256.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$404.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.83
|
| Rate for Payer: Nomi Health Commercial |
$441.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: PACE SWMI |
$367.98
|
| Rate for Payer: PHP Medicare Advantage |
$367.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$702.02
|
| Rate for Payer: Priority Health Medicare |
$367.98
|
| Rate for Payer: Priority Health SBD |
$702.02
|
| Rate for Payer: Priority Health Tiered Network |
$702.02
|
| Rate for Payer: Railroad Medicare Medicare |
$367.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.93
|
| Rate for Payer: UHC Core |
$651.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$367.98
|
| Rate for Payer: UHC Exchange |
$651.93
|
| Rate for Payer: UHC Medicaid |
$244.74
|
| Rate for Payer: UHCCP Medicaid |
$244.74
|
|
|
PR INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 46945
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$631.02 |
| Rate for Payer: Aetna Commercial |
$448.67
|
| Rate for Payer: Aetna Medicare |
$348.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.16
|
| Rate for Payer: BCBS Complete |
$234.61
|
| Rate for Payer: BCBS MAPPO |
$334.83
|
| Rate for Payer: BCN Commercial |
$517.90
|
| Rate for Payer: BCN Medicare Advantage |
$334.83
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$482.16
|
| Rate for Payer: Cofinity Commercial |
$448.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.83
|
| Rate for Payer: Healthscope Commercial |
$619.44
|
| Rate for Payer: Healthscope Commercial |
$535.73
|
| Rate for Payer: Mclaren Medicaid |
$223.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.57
|
| Rate for Payer: Meridian Medicaid |
$234.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$592.22
|
| Rate for Payer: Nomi Health Commercial |
$401.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$356.25
|
| Rate for Payer: PACE SWMI |
$334.83
|
| Rate for Payer: PHP Medicare Advantage |
$334.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$631.02
|
| Rate for Payer: Priority Health Medicare |
$334.83
|
| Rate for Payer: Priority Health SBD |
$631.02
|
| Rate for Payer: Priority Health Tiered Network |
$631.02
|
| Rate for Payer: Railroad Medicare Medicare |
$334.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.34
|
| Rate for Payer: UHC Core |
$576.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$334.83
|
| Rate for Payer: UHC Exchange |
$576.34
|
| Rate for Payer: UHC Medicaid |
$223.44
|
| Rate for Payer: UHCCP Medicaid |
$223.44
|
|
|
PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 93662
|
| Min. Negotiated Rate |
$102.60 |
| Max. Negotiated Rate |
$604.56 |
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Medicare |
$151.00
|
| Rate for Payer: Aetna Medicare |
$288.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.64
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$130.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$130.15
|
| Rate for Payer: Priority Health SBD |
$130.15
|
| Rate for Payer: Priority Health SBD |
$130.15
|
| Rate for Payer: Priority Health Tiered Network |
$130.15
|
| Rate for Payer: Priority Health Tiered Network |
$130.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.56
|
| Rate for Payer: UHC Core |
$604.56
|
| Rate for Payer: UHC Core |
$604.56
|
| Rate for Payer: UHC Exchange |
$604.56
|
| Rate for Payer: UHC Exchange |
$604.56
|
|
|
PR INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING
|
Professional
|
Both
|
$1,237.00
|
|
|
Service Code
|
HCPCS 93613
|
| Min. Negotiated Rate |
$158.05 |
| Max. Negotiated Rate |
$927.75 |
| Rate for Payer: Aetna Commercial |
$334.76
|
| Rate for Payer: Aetna Medicare |
$259.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$334.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.74
|
| Rate for Payer: BCBS Complete |
$165.95
|
| Rate for Payer: BCBS MAPPO |
$249.82
|
| Rate for Payer: BCN Commercial |
$423.78
|
| Rate for Payer: BCN Medicare Advantage |
$249.82
|
| Rate for Payer: Cash Price |
$989.60
|
| Rate for Payer: Cash Price |
$989.60
|
| Rate for Payer: Cofinity Commercial |
$359.74
|
| Rate for Payer: Cofinity Commercial |
$334.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.82
|
| Rate for Payer: Healthscope Commercial |
$462.17
|
| Rate for Payer: Healthscope Commercial |
$399.71
|
| Rate for Payer: Mclaren Medicaid |
$158.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.31
|
| Rate for Payer: Meridian Medicaid |
$165.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.55
|
| Rate for Payer: Nomi Health Commercial |
$299.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.75
|
| Rate for Payer: PACE SWMI |
$249.82
|
| Rate for Payer: PHP Medicare Advantage |
$249.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$402.79
|
| Rate for Payer: Priority Health Medicare |
$249.82
|
| Rate for Payer: Priority Health SBD |
$402.79
|
| Rate for Payer: Priority Health Tiered Network |
$402.79
|
| Rate for Payer: Railroad Medicare Medicare |
$249.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.31
|
| Rate for Payer: UHC Core |
$490.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.82
|
| Rate for Payer: UHC Exchange |
$490.31
|
| Rate for Payer: UHC Medicaid |
$158.05
|
| Rate for Payer: UHCCP Medicaid |
$158.05
|
|
|
PR INTRA COPP CONTRA (PARAGARD)
|
Professional
|
Both
|
$1,394.00
|
|
|
Service Code
|
HCPCS J7300
|
| Min. Negotiated Rate |
$697.00 |
| Max. Negotiated Rate |
$1,267.71 |
| Rate for Payer: Aetna Commercial |
$1,085.00
|
| Rate for Payer: Aetna Medicare |
$697.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,085.00
|
| Rate for Payer: BCBS Complete |
$1,267.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.15
|
| Rate for Payer: BCN Commercial |
$1,150.85
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Mclaren Medicaid |
$1,207.34
|
| Rate for Payer: Meridian Medicaid |
$1,267.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,045.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,207.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.00
|
| Rate for Payer: UHC Core |
$1,187.00
|
| Rate for Payer: UHC Exchange |
$1,187.00
|
| Rate for Payer: UHC Medicaid |
$1,207.34
|
| Rate for Payer: UHCCP Medicaid |
$1,207.34
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL CMPL
|
Professional
|
Both
|
$9,488.00
|
|
|
Service Code
|
HCPCS 61692
|
| Min. Negotiated Rate |
$2,210.73 |
| Max. Negotiated Rate |
$7,116.00 |
| Rate for Payer: Aetna Commercial |
$4,665.71
|
| Rate for Payer: Aetna Medicare |
$3,621.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,665.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,013.89
|
| Rate for Payer: BCBS Complete |
$2,321.27
|
| Rate for Payer: BCBS MAPPO |
$3,481.87
|
| Rate for Payer: BCN Commercial |
$5,524.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,481.87
|
| Rate for Payer: Cash Price |
$7,590.40
|
| Rate for Payer: Cash Price |
$7,590.40
|
| Rate for Payer: Cofinity Commercial |
$4,665.71
|
| Rate for Payer: Cofinity Commercial |
$5,013.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,481.87
|
| Rate for Payer: Healthscope Commercial |
$6,441.46
|
| Rate for Payer: Healthscope Commercial |
$5,570.99
|
| Rate for Payer: Mclaren Medicaid |
$2,210.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,655.96
|
| Rate for Payer: Meridian Medicaid |
$2,321.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,830.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,614.71
|
| Rate for Payer: Nomi Health Commercial |
$4,178.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,116.00
|
| Rate for Payer: PACE SWMI |
$3,481.87
|
| Rate for Payer: PHP Medicare Advantage |
$3,481.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,210.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,416.15
|
| Rate for Payer: Priority Health Medicare |
$3,481.87
|
| Rate for Payer: Priority Health SBD |
$6,416.15
|
| Rate for Payer: Priority Health Tiered Network |
$6,416.15
|
| Rate for Payer: Railroad Medicare Medicare |
$3,481.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,497.58
|
| Rate for Payer: UHC Core |
$6,497.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,481.87
|
| Rate for Payer: UHC Exchange |
$6,497.58
|
| Rate for Payer: UHC Medicaid |
$2,210.73
|
| Rate for Payer: UHCCP Medicaid |
$2,210.73
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL SMPL
|
Professional
|
Both
|
$8,055.00
|
|
|
Service Code
|
HCPCS 61690
|
| Min. Negotiated Rate |
$1,354.25 |
| Max. Negotiated Rate |
$6,041.25 |
| Rate for Payer: Aetna Commercial |
$2,841.80
|
| Rate for Payer: Aetna Medicare |
$2,205.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,841.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,053.88
|
| Rate for Payer: BCBS Complete |
$1,421.96
|
| Rate for Payer: BCBS MAPPO |
$2,120.75
|
| Rate for Payer: BCN Commercial |
$3,323.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,120.75
|
| Rate for Payer: Cash Price |
$6,444.00
|
| Rate for Payer: Cash Price |
$6,444.00
|
| Rate for Payer: Cofinity Commercial |
$3,053.88
|
| Rate for Payer: Cofinity Commercial |
$2,841.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,120.75
|
| Rate for Payer: Healthscope Commercial |
$3,923.39
|
| Rate for Payer: Healthscope Commercial |
$3,393.20
|
| Rate for Payer: Mclaren Medicaid |
$1,354.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,226.79
|
| Rate for Payer: Meridian Medicaid |
$1,421.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,332.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,953.48
|
| Rate for Payer: Nomi Health Commercial |
$2,544.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,041.25
|
| Rate for Payer: PACE SWMI |
$2,120.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,120.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,860.22
|
| Rate for Payer: Priority Health Medicare |
$2,120.75
|
| Rate for Payer: Priority Health SBD |
$3,860.22
|
| Rate for Payer: Priority Health Tiered Network |
$3,860.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2,120.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,850.74
|
| Rate for Payer: UHC Core |
$3,850.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,120.75
|
| Rate for Payer: UHC Exchange |
$3,850.74
|
| Rate for Payer: UHC Medicaid |
$1,354.25
|
| Rate for Payer: UHCCP Medicaid |
$1,354.25
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL
|
Professional
|
Both
|
$12,487.00
|
|
|
Service Code
|
HCPCS 61686
|
| Min. Negotiated Rate |
$2,709.36 |
| Max. Negotiated Rate |
$9,383.95 |
| Rate for Payer: Aetna Commercial |
$5,722.63
|
| Rate for Payer: Aetna Medicare |
$4,441.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,722.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,149.69
|
| Rate for Payer: BCBS Complete |
$2,844.83
|
| Rate for Payer: BCBS MAPPO |
$4,270.62
|
| Rate for Payer: BCN Commercial |
$9,383.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,270.62
|
| Rate for Payer: Cash Price |
$9,989.60
|
| Rate for Payer: Cash Price |
$9,989.60
|
| Rate for Payer: Cofinity Commercial |
$6,149.69
|
| Rate for Payer: Cofinity Commercial |
$5,722.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,270.62
|
| Rate for Payer: Healthscope Commercial |
$7,900.65
|
| Rate for Payer: Healthscope Commercial |
$6,832.99
|
| Rate for Payer: Mclaren Medicaid |
$2,709.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,484.15
|
| Rate for Payer: Meridian Medicaid |
$2,844.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,697.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,138.86
|
| Rate for Payer: Nomi Health Commercial |
$5,124.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,365.25
|
| Rate for Payer: PACE SWMI |
$4,270.62
|
| Rate for Payer: PHP Medicare Advantage |
$4,270.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,709.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,889.31
|
| Rate for Payer: Priority Health Medicare |
$4,270.62
|
| Rate for Payer: Priority Health SBD |
$7,889.31
|
| Rate for Payer: Priority Health Tiered Network |
$7,889.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4,270.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,223.71
|
| Rate for Payer: UHC Core |
$8,223.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,270.62
|
| Rate for Payer: UHC Exchange |
$8,223.71
|
| Rate for Payer: UHC Medicaid |
$2,709.36
|
| Rate for Payer: UHCCP Medicaid |
$2,709.36
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL
|
Professional
|
Both
|
$6,167.00
|
|
|
Service Code
|
HCPCS 61684
|
| Min. Negotiated Rate |
$1,741.70 |
| Max. Negotiated Rate |
$5,962.66 |
| Rate for Payer: Aetna Commercial |
$3,665.09
|
| Rate for Payer: Aetna Medicare |
$2,844.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,665.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,938.60
|
| Rate for Payer: BCBS Complete |
$1,828.79
|
| Rate for Payer: BCBS MAPPO |
$2,735.14
|
| Rate for Payer: BCN Commercial |
$5,962.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,735.14
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Cofinity Commercial |
$3,938.60
|
| Rate for Payer: Cofinity Commercial |
$3,665.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,735.14
|
| Rate for Payer: Healthscope Commercial |
$5,060.01
|
| Rate for Payer: Healthscope Commercial |
$4,376.22
|
| Rate for Payer: Mclaren Medicaid |
$1,741.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,871.90
|
| Rate for Payer: Meridian Medicaid |
$1,828.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,008.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,154.05
|
| Rate for Payer: Nomi Health Commercial |
$3,282.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,625.25
|
| Rate for Payer: PACE SWMI |
$2,735.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,735.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,741.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,012.95
|
| Rate for Payer: Priority Health Medicare |
$2,735.14
|
| Rate for Payer: Priority Health SBD |
$5,012.95
|
| Rate for Payer: Priority Health Tiered Network |
$5,012.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,735.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,034.52
|
| Rate for Payer: UHC Core |
$5,034.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,735.14
|
| Rate for Payer: UHC Exchange |
$5,034.52
|
| Rate for Payer: UHC Medicaid |
$1,741.70
|
| Rate for Payer: UHCCP Medicaid |
$1,741.70
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL
|
Professional
|
Both
|
$9,183.00
|
|
|
Service Code
|
HCPCS 61682
|
| Min. Negotiated Rate |
$2,476.13 |
| Max. Negotiated Rate |
$8,649.20 |
| Rate for Payer: Aetna Commercial |
$5,237.99
|
| Rate for Payer: Aetna Medicare |
$4,065.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,628.89
|
| Rate for Payer: BCBS Complete |
$2,599.94
|
| Rate for Payer: BCBS MAPPO |
$3,908.95
|
| Rate for Payer: BCN Commercial |
$8,649.20
|
| Rate for Payer: BCN Medicare Advantage |
$3,908.95
|
| Rate for Payer: Cash Price |
$7,346.40
|
| Rate for Payer: Cash Price |
$7,346.40
|
| Rate for Payer: Cofinity Commercial |
$5,628.89
|
| Rate for Payer: Cofinity Commercial |
$5,237.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,908.95
|
| Rate for Payer: Healthscope Commercial |
$7,231.56
|
| Rate for Payer: Healthscope Commercial |
$6,254.32
|
| Rate for Payer: Mclaren Medicaid |
$2,476.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,104.40
|
| Rate for Payer: Meridian Medicaid |
$2,599.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,299.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,533.32
|
| Rate for Payer: Nomi Health Commercial |
$4,690.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,887.25
|
| Rate for Payer: PACE SWMI |
$3,908.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,908.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,476.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,271.59
|
| Rate for Payer: Priority Health Medicare |
$3,908.95
|
| Rate for Payer: Priority Health SBD |
$7,271.59
|
| Rate for Payer: Priority Health Tiered Network |
$7,271.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3,908.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,586.61
|
| Rate for Payer: UHC Core |
$7,586.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,908.95
|
| Rate for Payer: UHC Exchange |
$7,586.61
|
| Rate for Payer: UHC Medicaid |
$2,476.13
|
| Rate for Payer: UHCCP Medicaid |
$2,476.13
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL
|
Professional
|
Both
|
$4,897.00
|
|
|
Service Code
|
HCPCS 61680
|
| Min. Negotiated Rate |
$1,407.72 |
| Max. Negotiated Rate |
$4,742.20 |
| Rate for Payer: Aetna Commercial |
$2,953.99
|
| Rate for Payer: Aetna Medicare |
$2,292.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,174.44
|
| Rate for Payer: BCBS Complete |
$1,478.11
|
| Rate for Payer: BCBS MAPPO |
$2,204.47
|
| Rate for Payer: BCN Commercial |
$4,742.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,204.47
|
| Rate for Payer: Cash Price |
$3,917.60
|
| Rate for Payer: Cash Price |
$3,917.60
|
| Rate for Payer: Cofinity Commercial |
$3,174.44
|
| Rate for Payer: Cofinity Commercial |
$2,953.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,204.47
|
| Rate for Payer: Healthscope Commercial |
$4,078.27
|
| Rate for Payer: Healthscope Commercial |
$3,527.15
|
| Rate for Payer: Mclaren Medicaid |
$1,407.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,314.69
|
| Rate for Payer: Meridian Medicaid |
$1,478.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,424.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,048.36
|
| Rate for Payer: Nomi Health Commercial |
$2,645.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.75
|
| Rate for Payer: PACE SWMI |
$2,204.47
|
| Rate for Payer: PHP Medicare Advantage |
$2,204.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,407.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,986.87
|
| Rate for Payer: Priority Health Medicare |
$2,204.47
|
| Rate for Payer: Priority Health SBD |
$3,986.87
|
| Rate for Payer: Priority Health Tiered Network |
$3,986.87
|
| Rate for Payer: Railroad Medicare Medicare |
$2,204.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,978.67
|
| Rate for Payer: UHC Core |
$3,978.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,204.47
|
| Rate for Payer: UHC Exchange |
$3,978.67
|
| Rate for Payer: UHC Medicaid |
$1,407.72
|
| Rate for Payer: UHCCP Medicaid |
$1,407.72
|
|
|
PR INTRAFRACTION TRACK MOTION
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS G6017
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$94.22
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.22
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCN Commercial |
$105.75
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
|
|
PR INTRAOPERATIVE COLONIC LAVAGE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 44701
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$318.00 |
| Rate for Payer: Aetna Commercial |
$205.93
|
| Rate for Payer: Aetna Medicare |
$159.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.93
|
| Rate for Payer: BCBS Complete |
$101.99
|
| Rate for Payer: BCBS MAPPO |
$153.68
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$153.68
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.68
|
| Rate for Payer: Healthscope Commercial |
$284.31
|
| Rate for Payer: Healthscope Commercial |
$245.89
|
| Rate for Payer: Mclaren Medicaid |
$97.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.36
|
| Rate for Payer: Meridian Medicaid |
$101.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$169.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Nomi Health Commercial |
$184.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$153.68
|
| Rate for Payer: PHP Medicare Advantage |
$153.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$307.63
|
| Rate for Payer: Priority Health Medicare |
$153.68
|
| Rate for Payer: Priority Health SBD |
$307.63
|
| Rate for Payer: Priority Health Tiered Network |
$307.63
|
| Rate for Payer: Railroad Medicare Medicare |
$153.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.12
|
| Rate for Payer: UHC Core |
$306.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$153.68
|
| Rate for Payer: UHC Exchange |
$306.12
|
| Rate for Payer: UHC Medicaid |
$97.13
|
| Rate for Payer: UHCCP Medicaid |
$97.13
|
|
|
PR INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 38900
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$272.32 |
| Rate for Payer: Aetna Commercial |
$165.58
|
| Rate for Payer: Aetna Medicare |
$128.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.94
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$123.57
|
| Rate for Payer: BCN Commercial |
$204.67
|
| Rate for Payer: BCN Medicare Advantage |
$123.57
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$177.94
|
| Rate for Payer: Cofinity Commercial |
$165.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.57
|
| Rate for Payer: Healthscope Commercial |
$228.60
|
| Rate for Payer: Healthscope Commercial |
$197.71
|
| Rate for Payer: Mclaren Medicaid |
$78.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.75
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.02
|
| Rate for Payer: Nomi Health Commercial |
$148.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$123.57
|
| Rate for Payer: PHP Medicare Advantage |
$123.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$272.32
|
| Rate for Payer: Priority Health Medicare |
$123.57
|
| Rate for Payer: Priority Health SBD |
$272.32
|
| Rate for Payer: Priority Health Tiered Network |
$272.32
|
| Rate for Payer: Railroad Medicare Medicare |
$123.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.07
|
| Rate for Payer: UHC Core |
$248.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.57
|
| Rate for Payer: UHC Exchange |
$248.07
|
| Rate for Payer: UHC Medicaid |
$78.38
|
| Rate for Payer: UHCCP Medicaid |
$78.38
|
|
