|
PR INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE
|
Professional
|
Both
|
$703.00
|
|
|
Service Code
|
HCPCS 41009
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$529.69 |
| Rate for Payer: Aetna Commercial |
$341.97
|
| Rate for Payer: Aetna Medicare |
$265.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.49
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS MAPPO |
$255.20
|
| Rate for Payer: BCN Commercial |
$434.74
|
| Rate for Payer: BCN Medicare Advantage |
$255.20
|
| Rate for Payer: Cash Price |
$562.40
|
| Rate for Payer: Cash Price |
$562.40
|
| Rate for Payer: Cofinity Commercial |
$367.49
|
| Rate for Payer: Cofinity Commercial |
$341.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.20
|
| Rate for Payer: Healthscope Commercial |
$472.12
|
| Rate for Payer: Healthscope Commercial |
$408.32
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.96
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$280.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.60
|
| Rate for Payer: Nomi Health Commercial |
$306.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.25
|
| Rate for Payer: PACE SWMI |
$255.20
|
| Rate for Payer: PHP Medicare Advantage |
$255.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$529.69
|
| Rate for Payer: Priority Health Medicare |
$255.20
|
| Rate for Payer: Priority Health SBD |
$529.69
|
| Rate for Payer: Priority Health Tiered Network |
$529.69
|
| Rate for Payer: Railroad Medicare Medicare |
$255.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.39
|
| Rate for Payer: UHC Core |
$492.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$255.20
|
| Rate for Payer: UHC Exchange |
$492.39
|
| Rate for Payer: UHC Medicaid |
$168.48
|
| Rate for Payer: UHCCP Medicaid |
$168.48
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 41006
|
| Min. Negotiated Rate |
$137.39 |
| Max. Negotiated Rate |
$464.25 |
| Rate for Payer: Aetna Commercial |
$279.94
|
| Rate for Payer: Aetna Medicare |
$217.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.83
|
| Rate for Payer: BCBS Complete |
$144.26
|
| Rate for Payer: BCBS MAPPO |
$208.91
|
| Rate for Payer: BCN Commercial |
$354.07
|
| Rate for Payer: BCN Medicare Advantage |
$208.91
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cofinity Commercial |
$300.83
|
| Rate for Payer: Cofinity Commercial |
$279.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.91
|
| Rate for Payer: Healthscope Commercial |
$386.48
|
| Rate for Payer: Healthscope Commercial |
$334.26
|
| Rate for Payer: Mclaren Medicaid |
$137.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.36
|
| Rate for Payer: Meridian Medicaid |
$144.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$404.42
|
| Rate for Payer: Nomi Health Commercial |
$250.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$464.25
|
| Rate for Payer: PACE SWMI |
$208.91
|
| Rate for Payer: PHP Medicare Advantage |
$208.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$431.40
|
| Rate for Payer: Priority Health Medicare |
$208.91
|
| Rate for Payer: Priority Health SBD |
$431.40
|
| Rate for Payer: Priority Health Tiered Network |
$431.40
|
| Rate for Payer: Railroad Medicare Medicare |
$208.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.90
|
| Rate for Payer: UHC Core |
$412.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$208.91
|
| Rate for Payer: UHC Exchange |
$412.90
|
| Rate for Payer: UHC Medicaid |
$137.39
|
| Rate for Payer: UHCCP Medicaid |
$137.39
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 41005
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$143.42
|
| Rate for Payer: Aetna Medicare |
$111.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.12
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$107.03
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: BCN Medicare Advantage |
$107.03
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$154.12
|
| Rate for Payer: Cofinity Commercial |
$143.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.03
|
| Rate for Payer: Healthscope Commercial |
$198.01
|
| Rate for Payer: Healthscope Commercial |
$171.25
|
| Rate for Payer: Mclaren Medicaid |
$71.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.38
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.31
|
| Rate for Payer: Nomi Health Commercial |
$128.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: PACE SWMI |
$107.03
|
| Rate for Payer: PHP Medicare Advantage |
$107.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$217.22
|
| Rate for Payer: Priority Health Medicare |
$107.03
|
| Rate for Payer: Priority Health SBD |
$217.22
|
| Rate for Payer: Priority Health Tiered Network |
$217.22
|
| Rate for Payer: Railroad Medicare Medicare |
$107.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.18
|
| Rate for Payer: UHC Core |
$197.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.03
|
| Rate for Payer: UHC Exchange |
$197.18
|
| Rate for Payer: UHC Medicaid |
$71.36
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
|
|
PR INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 41008
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna Commercial |
$317.39
|
| Rate for Payer: Aetna Medicare |
$246.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.08
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS MAPPO |
$236.86
|
| Rate for Payer: BCN Commercial |
$397.89
|
| Rate for Payer: BCN Medicare Advantage |
$236.86
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$341.08
|
| Rate for Payer: Cofinity Commercial |
$317.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.86
|
| Rate for Payer: Healthscope Commercial |
$438.19
|
| Rate for Payer: Healthscope Commercial |
$378.98
|
| Rate for Payer: Mclaren Medicaid |
$156.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.70
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$260.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.01
|
| Rate for Payer: Nomi Health Commercial |
$284.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.00
|
| Rate for Payer: PACE SWMI |
$236.86
|
| Rate for Payer: PHP Medicare Advantage |
$236.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$484.80
|
| Rate for Payer: Priority Health Medicare |
$236.86
|
| Rate for Payer: Priority Health SBD |
$484.80
|
| Rate for Payer: Priority Health Tiered Network |
$484.80
|
| Rate for Payer: Railroad Medicare Medicare |
$236.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.38
|
| Rate for Payer: UHC Core |
$448.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.86
|
| Rate for Payer: UHC Exchange |
$448.38
|
| Rate for Payer: UHC Medicaid |
$156.13
|
| Rate for Payer: UHCCP Medicaid |
$156.13
|
|
|
PR INTRAPULMONARY SURFACTANT ADMN PHYS/QHP
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 94610
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$90.71 |
| Rate for Payer: Aetna Commercial |
$63.52
|
| Rate for Payer: Aetna Medicare |
$49.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.26
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.40
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: BCN Medicare Advantage |
$47.40
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$68.26
|
| Rate for Payer: Cofinity Commercial |
$63.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.40
|
| Rate for Payer: Healthscope Commercial |
$87.69
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$30.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.77
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.79
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$47.40
|
| Rate for Payer: PHP Medicare Advantage |
$47.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.77
|
| Rate for Payer: Priority Health Medicare |
$47.40
|
| Rate for Payer: Priority Health SBD |
$75.77
|
| Rate for Payer: Priority Health Tiered Network |
$75.77
|
| Rate for Payer: Railroad Medicare Medicare |
$47.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.71
|
| Rate for Payer: UHC Core |
$90.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.40
|
| Rate for Payer: UHC Exchange |
$90.71
|
| Rate for Payer: UHC Medicaid |
$30.46
|
| Rate for Payer: UHCCP Medicaid |
$30.46
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 37253
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$327.75 |
| Rate for Payer: Aetna Commercial |
$84.57
|
| Rate for Payer: Aetna Medicare |
$65.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.88
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$63.11
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$63.11
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$90.88
|
| Rate for Payer: Cofinity Commercial |
$84.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.11
|
| Rate for Payer: Healthscope Commercial |
$116.75
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$39.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.27
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.90
|
| Rate for Payer: Nomi Health Commercial |
$75.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: PACE SWMI |
$63.11
|
| Rate for Payer: PHP Medicare Advantage |
$63.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.39
|
| Rate for Payer: Priority Health Medicare |
$63.11
|
| Rate for Payer: Priority Health SBD |
$111.39
|
| Rate for Payer: Priority Health Tiered Network |
$111.39
|
| Rate for Payer: Railroad Medicare Medicare |
$63.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.50
|
| Rate for Payer: UHC Core |
$130.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.11
|
| Rate for Payer: UHC Exchange |
$130.50
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL
|
Professional
|
Both
|
$199.00
|
|
|
Service Code
|
HCPCS 37252
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$162.67 |
| Rate for Payer: Aetna Commercial |
$107.28
|
| Rate for Payer: Aetna Medicare |
$83.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.29
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$80.06
|
| Rate for Payer: BCN Commercial |
$129.97
|
| Rate for Payer: BCN Medicare Advantage |
$80.06
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cofinity Commercial |
$115.29
|
| Rate for Payer: Cofinity Commercial |
$107.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.06
|
| Rate for Payer: Healthscope Commercial |
$148.11
|
| Rate for Payer: Healthscope Commercial |
$128.10
|
| Rate for Payer: Mclaren Medicaid |
$50.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.06
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.77
|
| Rate for Payer: Nomi Health Commercial |
$96.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.25
|
| Rate for Payer: PACE SWMI |
$80.06
|
| Rate for Payer: PHP Medicare Advantage |
$80.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.76
|
| Rate for Payer: Priority Health Medicare |
$80.06
|
| Rate for Payer: Priority Health SBD |
$139.76
|
| Rate for Payer: Priority Health Tiered Network |
$139.76
|
| Rate for Payer: Railroad Medicare Medicare |
$80.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.67
|
| Rate for Payer: UHC Core |
$162.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.06
|
| Rate for Payer: UHC Exchange |
$162.67
|
| Rate for Payer: UHC Medicaid |
$50.48
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR INTRAVASC US DURING DX EVAL/ INTERVENTION,EA ADDN VESSEL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
HCPCS 37251
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Medicare |
$210.00
|
| Rate for Payer: BCBS Complete |
$168.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.00
|
|
|
PR INTRA-VNTR MAPG TACHYCARDIA SITES W/CATH MNPJ
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 93609
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$657.65 |
| Rate for Payer: Aetna Commercial |
$507.22
|
| Rate for Payer: Aetna Medicare |
$301.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.22
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$522.05
|
| Rate for Payer: Priority Health SBD |
$522.05
|
| Rate for Payer: Priority Health Tiered Network |
$522.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.65
|
| Rate for Payer: UHC Core |
$657.65
|
| Rate for Payer: UHC Exchange |
$657.65
|
|
|
PR INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 57180
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$214.85 |
| Rate for Payer: Aetna Commercial |
$139.56
|
| Rate for Payer: Aetna Medicare |
$108.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.56
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS MAPPO |
$104.15
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: BCN Medicare Advantage |
$104.15
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$149.98
|
| Rate for Payer: Cofinity Commercial |
$139.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.15
|
| Rate for Payer: Healthscope Commercial |
$192.68
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Mclaren Medicaid |
$68.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.36
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.85
|
| Rate for Payer: Nomi Health Commercial |
$124.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$104.15
|
| Rate for Payer: PHP Medicare Advantage |
$104.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$184.08
|
| Rate for Payer: Priority Health Medicare |
$104.15
|
| Rate for Payer: Priority Health SBD |
$184.08
|
| Rate for Payer: Priority Health Tiered Network |
$184.08
|
| Rate for Payer: Railroad Medicare Medicare |
$104.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.83
|
| Rate for Payer: UHC Core |
$200.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.15
|
| Rate for Payer: UHC Exchange |
$200.83
|
| Rate for Payer: UHC Medicaid |
$68.16
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 36901
|
| Min. Negotiated Rate |
$93.93 |
| Max. Negotiated Rate |
$302.01 |
| Rate for Payer: Aetna Commercial |
$197.90
|
| Rate for Payer: Aetna Medicare |
$153.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.67
|
| Rate for Payer: BCBS Complete |
$98.63
|
| Rate for Payer: BCBS MAPPO |
$147.69
|
| Rate for Payer: BCN Commercial |
$246.00
|
| Rate for Payer: BCN Medicare Advantage |
$147.69
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cash Price |
$311.20
|
| Rate for Payer: Cofinity Commercial |
$212.67
|
| Rate for Payer: Cofinity Commercial |
$197.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.69
|
| Rate for Payer: Healthscope Commercial |
$273.23
|
| Rate for Payer: Healthscope Commercial |
$236.30
|
| Rate for Payer: Mclaren Medicaid |
$93.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.07
|
| Rate for Payer: Meridian Medicaid |
$98.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$162.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.21
|
| Rate for Payer: Nomi Health Commercial |
$177.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.75
|
| Rate for Payer: PACE SWMI |
$147.69
|
| Rate for Payer: PHP Medicare Advantage |
$147.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$264.54
|
| Rate for Payer: Priority Health Medicare |
$147.69
|
| Rate for Payer: Priority Health SBD |
$264.54
|
| Rate for Payer: Priority Health Tiered Network |
$264.54
|
| Rate for Payer: Railroad Medicare Medicare |
$147.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.01
|
| Rate for Payer: UHC Core |
$302.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.69
|
| Rate for Payer: UHC Exchange |
$302.01
|
| Rate for Payer: UHC Medicaid |
$93.93
|
| Rate for Payer: UHCCP Medicaid |
$93.93
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 36903
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$595.50 |
| Rate for Payer: Aetna Commercial |
$373.79
|
| Rate for Payer: Aetna Medicare |
$290.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.69
|
| Rate for Payer: BCBS Complete |
$185.85
|
| Rate for Payer: BCBS MAPPO |
$278.95
|
| Rate for Payer: BCN Commercial |
$459.14
|
| Rate for Payer: BCN Medicare Advantage |
$278.95
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$401.69
|
| Rate for Payer: Cofinity Commercial |
$373.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.95
|
| Rate for Payer: Healthscope Commercial |
$516.06
|
| Rate for Payer: Healthscope Commercial |
$446.32
|
| Rate for Payer: Mclaren Medicaid |
$177.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.90
|
| Rate for Payer: Meridian Medicaid |
$185.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.11
|
| Rate for Payer: Nomi Health Commercial |
$334.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.50
|
| Rate for Payer: PACE SWMI |
$278.95
|
| Rate for Payer: PHP Medicare Advantage |
$278.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$493.74
|
| Rate for Payer: Priority Health Medicare |
$278.95
|
| Rate for Payer: Priority Health SBD |
$493.74
|
| Rate for Payer: Priority Health Tiered Network |
$493.74
|
| Rate for Payer: Railroad Medicare Medicare |
$278.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.62
|
| Rate for Payer: UHC Core |
$567.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.95
|
| Rate for Payer: UHC Exchange |
$567.62
|
| Rate for Payer: UHC Medicaid |
$177.00
|
| Rate for Payer: UHCCP Medicaid |
$177.00
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 36902
|
| Min. Negotiated Rate |
$133.98 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$282.32
|
| Rate for Payer: Aetna Medicare |
$219.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.39
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$210.69
|
| Rate for Payer: BCN Commercial |
$349.08
|
| Rate for Payer: BCN Medicare Advantage |
$210.69
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$303.39
|
| Rate for Payer: Cofinity Commercial |
$282.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.69
|
| Rate for Payer: Healthscope Commercial |
$389.78
|
| Rate for Payer: Healthscope Commercial |
$337.10
|
| Rate for Payer: Mclaren Medicaid |
$133.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.22
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.04
|
| Rate for Payer: Nomi Health Commercial |
$252.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$210.69
|
| Rate for Payer: PHP Medicare Advantage |
$210.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$375.40
|
| Rate for Payer: Priority Health Medicare |
$210.69
|
| Rate for Payer: Priority Health SBD |
$375.40
|
| Rate for Payer: Priority Health Tiered Network |
$375.40
|
| Rate for Payer: Railroad Medicare Medicare |
$210.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.92
|
| Rate for Payer: UHC Core |
$427.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$210.69
|
| Rate for Payer: UHC Exchange |
$427.92
|
| Rate for Payer: UHC Medicaid |
$133.98
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
|
PR INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 36013
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$576.75 |
| Rate for Payer: Aetna Commercial |
$150.75
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.00
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$112.50
|
| Rate for Payer: BCN Commercial |
$184.25
|
| Rate for Payer: BCN Medicare Advantage |
$112.50
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$162.00
|
| Rate for Payer: Cofinity Commercial |
$150.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.50
|
| Rate for Payer: Healthscope Commercial |
$208.12
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.12
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.92
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.75
|
| Rate for Payer: PACE SWMI |
$112.50
|
| Rate for Payer: PHP Medicare Advantage |
$112.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.14
|
| Rate for Payer: Priority Health Medicare |
$112.50
|
| Rate for Payer: Priority Health SBD |
$198.14
|
| Rate for Payer: Priority Health Tiered Network |
$198.14
|
| Rate for Payer: Railroad Medicare Medicare |
$112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.76
|
| Rate for Payer: UHC Core |
$217.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.50
|
| Rate for Payer: UHC Exchange |
$217.76
|
| Rate for Payer: UHC Medicaid |
$71.57
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
PR INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 36010
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$752.25 |
| Rate for Payer: Aetna Commercial |
$128.72
|
| Rate for Payer: Aetna Medicare |
$99.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.33
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$96.06
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$138.33
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.06
|
| Rate for Payer: Healthscope Commercial |
$177.71
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.86
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.25
|
| Rate for Payer: Nomi Health Commercial |
$115.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.25
|
| Rate for Payer: PACE SWMI |
$96.06
|
| Rate for Payer: PHP Medicare Advantage |
$96.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.21
|
| Rate for Payer: Priority Health Medicare |
$96.06
|
| Rate for Payer: Priority Health SBD |
$169.21
|
| Rate for Payer: Priority Health Tiered Network |
$169.21
|
| Rate for Payer: Railroad Medicare Medicare |
$96.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.93
|
| Rate for Payer: UHC Core |
$196.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.06
|
| Rate for Payer: UHC Exchange |
$196.93
|
| Rate for Payer: UHC Medicaid |
$60.71
|
| Rate for Payer: UHCCP Medicaid |
$60.71
|
|
|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Aetna Commercial |
$166.88
|
| Rate for Payer: Aetna Medicare |
$129.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.34
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$124.54
|
| Rate for Payer: BCN Commercial |
$204.18
|
| Rate for Payer: BCN Medicare Advantage |
$124.54
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cofinity Commercial |
$179.34
|
| Rate for Payer: Cofinity Commercial |
$166.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.54
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Healthscope Commercial |
$199.26
|
| Rate for Payer: Mclaren Medicaid |
$78.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.77
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.02
|
| Rate for Payer: Nomi Health Commercial |
$149.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.75
|
| Rate for Payer: PACE SWMI |
$124.54
|
| Rate for Payer: PHP Medicare Advantage |
$124.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$219.56
|
| Rate for Payer: Priority Health Medicare |
$124.54
|
| Rate for Payer: Priority Health SBD |
$219.56
|
| Rate for Payer: Priority Health Tiered Network |
$219.56
|
| Rate for Payer: Railroad Medicare Medicare |
$124.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.24
|
| Rate for Payer: UHC Core |
$251.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.54
|
| Rate for Payer: UHC Exchange |
$251.24
|
| Rate for Payer: UHC Medicaid |
$78.38
|
| Rate for Payer: UHCCP Medicaid |
$78.38
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$10.44 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Aetna Commercial |
$21.90
|
| Rate for Payer: Aetna Medicare |
$16.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.53
|
| Rate for Payer: BCBS Complete |
$10.96
|
| Rate for Payer: BCBS MAPPO |
$16.34
|
| Rate for Payer: BCN Commercial |
$28.39
|
| Rate for Payer: BCN Medicare Advantage |
$16.34
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$23.53
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.34
|
| Rate for Payer: Healthscope Commercial |
$30.23
|
| Rate for Payer: Healthscope Commercial |
$26.14
|
| Rate for Payer: Mclaren Medicaid |
$10.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.16
|
| Rate for Payer: Meridian Medicaid |
$10.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.20
|
| Rate for Payer: Nomi Health Commercial |
$19.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.25
|
| Rate for Payer: PACE SWMI |
$16.34
|
| Rate for Payer: PHP Medicare Advantage |
$16.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34.59
|
| Rate for Payer: Priority Health Medicare |
$16.34
|
| Rate for Payer: Priority Health SBD |
$34.59
|
| Rate for Payer: Priority Health Tiered Network |
$34.59
|
| Rate for Payer: Railroad Medicare Medicare |
$16.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.42
|
| Rate for Payer: UHC Core |
$34.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.34
|
| Rate for Payer: UHC Exchange |
$34.42
|
| Rate for Payer: UHC Medicaid |
$10.44
|
| Rate for Payer: UHCCP Medicaid |
$10.44
|
|
|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$138.75 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Medicare |
$92.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.94
|
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: BCN Commercial |
$10.60
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.45
|
| Rate for Payer: Priority Health SBD |
$14.45
|
| Rate for Payer: Priority Health Tiered Network |
$14.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.96
|
| Rate for Payer: UHC Core |
$15.96
|
| Rate for Payer: UHC Exchange |
$15.96
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$757.00
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$567.75 |
| Rate for Payer: Aetna Commercial |
$182.08
|
| Rate for Payer: Aetna Medicare |
$141.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.67
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: BCBS MAPPO |
$135.88
|
| Rate for Payer: BCN Commercial |
$223.09
|
| Rate for Payer: BCN Medicare Advantage |
$135.88
|
| Rate for Payer: Cash Price |
$605.60
|
| Rate for Payer: Cash Price |
$605.60
|
| Rate for Payer: Cofinity Commercial |
$195.67
|
| Rate for Payer: Cofinity Commercial |
$182.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.88
|
| Rate for Payer: Healthscope Commercial |
$251.38
|
| Rate for Payer: Healthscope Commercial |
$217.41
|
| Rate for Payer: Mclaren Medicaid |
$85.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.67
|
| Rate for Payer: Meridian Medicaid |
$89.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.99
|
| Rate for Payer: Nomi Health Commercial |
$163.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.75
|
| Rate for Payer: PACE SWMI |
$135.88
|
| Rate for Payer: PHP Medicare Advantage |
$135.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$239.91
|
| Rate for Payer: Priority Health Medicare |
$135.88
|
| Rate for Payer: Priority Health SBD |
$239.91
|
| Rate for Payer: Priority Health Tiered Network |
$239.91
|
| Rate for Payer: Railroad Medicare Medicare |
$135.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.19
|
| Rate for Payer: UHC Core |
$274.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.88
|
| Rate for Payer: UHC Exchange |
$274.19
|
| Rate for Payer: UHC Medicaid |
$85.41
|
| Rate for Payer: UHCCP Medicaid |
$85.41
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$50.27 |
| Max. Negotiated Rate |
$727.50 |
| Rate for Payer: Aetna Commercial |
$106.72
|
| Rate for Payer: Aetna Medicare |
$82.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.68
|
| Rate for Payer: BCBS Complete |
$52.78
|
| Rate for Payer: BCBS MAPPO |
$79.64
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$79.64
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$114.68
|
| Rate for Payer: Cofinity Commercial |
$106.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.64
|
| Rate for Payer: Healthscope Commercial |
$147.33
|
| Rate for Payer: Healthscope Commercial |
$127.42
|
| Rate for Payer: Mclaren Medicaid |
$50.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.62
|
| Rate for Payer: Meridian Medicaid |
$52.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.55
|
| Rate for Payer: Nomi Health Commercial |
$95.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.50
|
| Rate for Payer: PACE SWMI |
$79.64
|
| Rate for Payer: PHP Medicare Advantage |
$79.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.23
|
| Rate for Payer: Priority Health Medicare |
$79.64
|
| Rate for Payer: Priority Health SBD |
$139.23
|
| Rate for Payer: Priority Health Tiered Network |
$139.23
|
| Rate for Payer: Railroad Medicare Medicare |
$79.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.64
|
| Rate for Payer: UHC Core |
$160.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.64
|
| Rate for Payer: UHC Exchange |
$160.64
|
| Rate for Payer: UHC Medicaid |
$50.27
|
| Rate for Payer: UHCCP Medicaid |
$50.27
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$3,056.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$634.53 |
| Max. Negotiated Rate |
$2,292.00 |
| Rate for Payer: Aetna Commercial |
$1,326.31
|
| Rate for Payer: Aetna Medicare |
$1,029.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.28
|
| Rate for Payer: BCBS Complete |
$666.26
|
| Rate for Payer: BCBS MAPPO |
$989.78
|
| Rate for Payer: BCN Commercial |
$1,605.49
|
| Rate for Payer: BCN Medicare Advantage |
$989.78
|
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Cash Price |
$2,444.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.28
|
| Rate for Payer: Cofinity Commercial |
$1,326.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$989.78
|
| Rate for Payer: Healthscope Commercial |
$1,831.09
|
| Rate for Payer: Healthscope Commercial |
$1,583.65
|
| Rate for Payer: Mclaren Medicaid |
$634.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,039.27
|
| Rate for Payer: Meridian Medicaid |
$666.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,088.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,900.31
|
| Rate for Payer: Nomi Health Commercial |
$1,187.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.00
|
| Rate for Payer: PACE SWMI |
$989.78
|
| Rate for Payer: PHP Medicare Advantage |
$989.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,956.18
|
| Rate for Payer: Priority Health Medicare |
$989.78
|
| Rate for Payer: Priority Health SBD |
$1,956.18
|
| Rate for Payer: Priority Health Tiered Network |
$1,956.18
|
| Rate for Payer: Railroad Medicare Medicare |
$989.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,920.51
|
| Rate for Payer: UHC Core |
$1,920.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$989.78
|
| Rate for Payer: UHC Exchange |
$1,920.51
|
| Rate for Payer: UHC Medicaid |
$634.53
|
| Rate for Payer: UHCCP Medicaid |
$634.53
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Aetna Commercial |
$178.69
|
| Rate for Payer: Aetna Medicare |
$138.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.02
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS MAPPO |
$133.35
|
| Rate for Payer: BCN Commercial |
$210.65
|
| Rate for Payer: BCN Medicare Advantage |
$133.35
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$192.02
|
| Rate for Payer: Cofinity Commercial |
$178.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.35
|
| Rate for Payer: Healthscope Commercial |
$246.70
|
| Rate for Payer: Healthscope Commercial |
$213.36
|
| Rate for Payer: Mclaren Medicaid |
$84.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.02
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.34
|
| Rate for Payer: Nomi Health Commercial |
$160.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE SWMI |
$133.35
|
| Rate for Payer: PHP Medicare Advantage |
$133.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.37
|
| Rate for Payer: Priority Health Medicare |
$133.35
|
| Rate for Payer: Priority Health SBD |
$198.37
|
| Rate for Payer: Priority Health Tiered Network |
$198.37
|
| Rate for Payer: Railroad Medicare Medicare |
$133.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.16
|
| Rate for Payer: UHC Core |
$256.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.35
|
| Rate for Payer: UHC Exchange |
$256.16
|
| Rate for Payer: UHC Medicaid |
$84.77
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$53.18 |
| Rate for Payer: Aetna Commercial |
$35.32
|
| Rate for Payer: Aetna Medicare |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.96
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$26.36
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Medicare Advantage |
$26.36
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$35.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.36
|
| Rate for Payer: Healthscope Commercial |
$48.77
|
| Rate for Payer: Healthscope Commercial |
$42.18
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.68
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.04
|
| Rate for Payer: Nomi Health Commercial |
$31.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$26.36
|
| Rate for Payer: PHP Medicare Advantage |
$26.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44.08
|
| Rate for Payer: Priority Health Medicare |
$26.36
|
| Rate for Payer: Priority Health SBD |
$44.08
|
| Rate for Payer: Priority Health Tiered Network |
$44.08
|
| Rate for Payer: Railroad Medicare Medicare |
$26.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.18
|
| Rate for Payer: UHC Core |
$53.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.36
|
| Rate for Payer: UHC Exchange |
$53.18
|
| Rate for Payer: UHC Medicaid |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$299.74 |
| Rate for Payer: Aetna Commercial |
$299.74
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.74
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCN Commercial |
$105.89
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: Aetna Medicare |
$179.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.05
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCN Commercial |
$274.89
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Mclaren Medicaid |
$117.79
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$247.25
|
| Rate for Payer: Priority Health SBD |
$247.25
|
| Rate for Payer: Priority Health Tiered Network |
$247.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.90
|
| Rate for Payer: UHC Core |
$288.90
|
| Rate for Payer: UHC Exchange |
$288.90
|
| Rate for Payer: UHC Medicaid |
$117.79
|
| Rate for Payer: UHCCP Medicaid |
$117.79
|
|
