|
PR INTRAUT COPPER CONTRACEPTIVE
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS J7300
|
| Min. Negotiated Rate |
$676.50 |
| Max. Negotiated Rate |
$104,550.00 |
| Rate for Payer: Aetna Commercial |
$1,085.00
|
| Rate for Payer: Aetna Medicare |
$676.50
|
| 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 |
$1,100.19
|
| Rate for Payer: BCN Commercial |
$896.88
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Mclaren Medicaid |
$1,207.34
|
| Rate for Payer: Meridian Medicaid |
$1,267.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104,550.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,207.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.60
|
| Rate for Payer: UHC Exchange |
$1,184.60
|
| Rate for Payer: UHCCP Medicaid |
$1,207.34
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 37253
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$12,490.00 |
| Rate for Payer: Aetna Commercial |
$90.87
|
| Rate for Payer: Aetna Medicare |
$70.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.65
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$67.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$250.20
|
| Rate for Payer: BCN Medicare Advantage |
$67.81
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Cofinity Commercial |
$90.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.81
|
| Rate for Payer: Healthscope Commercial |
$125.45
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.20
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,490.00
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: PACE SWMI |
$67.81
|
| Rate for Payer: PHP Medicare Advantage |
$67.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.55
|
| Rate for Payer: Priority Health Medicare |
$67.81
|
| Rate for Payer: Priority Health Narrow Network |
$109.55
|
| Rate for Payer: Priority Health SBD |
$109.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.81
|
| Rate for Payer: UHC Medicare Advantage |
$67.81
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 37252
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$15,777.00 |
| Rate for Payer: Aetna Commercial |
$114.09
|
| Rate for Payer: Aetna Medicare |
$88.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.60
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$85.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.58
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.14
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$122.60
|
| Rate for Payer: Cofinity Commercial |
$114.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.14
|
| Rate for Payer: Healthscope Commercial |
$136.22
|
| Rate for Payer: Healthscope Commercial |
$157.51
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.40
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,777.00
|
| Rate for Payer: Nomi Health Commercial |
$102.17
|
| Rate for Payer: PACE SWMI |
$85.14
|
| Rate for Payer: PHP Medicare Advantage |
$85.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.74
|
| Rate for Payer: Priority Health Medicare |
$85.14
|
| Rate for Payer: Priority Health Narrow Network |
$137.74
|
| Rate for Payer: Priority Health SBD |
$137.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.14
|
| Rate for Payer: UHC Medicare Advantage |
$85.14
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
|
|
PR INTRAVASC US DURING DX EVAL/ INTERVENTION,EA ADDN VESSEL
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 37251
|
| Min. Negotiated Rate |
$163.20 |
| Max. Negotiated Rate |
$265.20 |
| Rate for Payer: Aetna Medicare |
$204.00
|
| Rate for Payer: BCBS Complete |
$163.20
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.20
|
|
|
PR INTRA-VNTR MAPG TACHYCARDIA SITES W/CATH MNPJ
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 93609
|
| Min. Negotiated Rate |
$169.12 |
| Max. Negotiated Rate |
$54,788.00 |
| Rate for Payer: Aetna Commercial |
$507.22
|
| Rate for Payer: Aetna Medicare |
$292.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.22
|
| Rate for Payer: BCBS Complete |
$177.58
|
| Rate for Payer: BCBS Trust/PPO |
$995.32
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Mclaren Medicaid |
$169.12
|
| Rate for Payer: Meridian Medicaid |
$177.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,788.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.40
|
| Rate for Payer: Priority Health Narrow Network |
$518.40
|
| Rate for Payer: Priority Health SBD |
$373.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.19
|
| Rate for Payer: UHC Exchange |
$704.19
|
| Rate for Payer: UHCCP Medicaid |
$169.12
|
|
|
PR INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 57180
|
| Min. Negotiated Rate |
$77.75 |
| Max. Negotiated Rate |
$21,485.00 |
| Rate for Payer: Aetna Commercial |
$153.59
|
| Rate for Payer: Aetna Medicare |
$119.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.05
|
| Rate for Payer: BCBS Complete |
$81.64
|
| Rate for Payer: BCBS MAPPO |
$114.62
|
| Rate for Payer: BCBS Trust/PPO |
$527.77
|
| Rate for Payer: BCN Commercial |
$295.16
|
| Rate for Payer: BCN Medicare Advantage |
$114.62
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$165.05
|
| Rate for Payer: Cofinity Commercial |
$153.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.62
|
| Rate for Payer: Healthscope Commercial |
$212.05
|
| Rate for Payer: Healthscope Commercial |
$183.39
|
| Rate for Payer: Mclaren Medicaid |
$77.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.35
|
| Rate for Payer: Meridian Medicaid |
$81.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,485.00
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE SWMI |
$114.62
|
| Rate for Payer: PHP Medicare Advantage |
$114.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.55
|
| Rate for Payer: Priority Health Medicare |
$114.62
|
| Rate for Payer: Priority Health Narrow Network |
$181.55
|
| Rate for Payer: Priority Health SBD |
$181.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.62
|
| Rate for Payer: UHC Exchange |
$165.36
|
| Rate for Payer: UHC Medicare Advantage |
$114.62
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 36901
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$29,621.00 |
| Rate for Payer: Aetna Commercial |
$213.93
|
| Rate for Payer: Aetna Medicare |
$166.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.90
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$159.65
|
| Rate for Payer: BCBS Trust/PPO |
$647.17
|
| Rate for Payer: BCN Commercial |
$1,036.97
|
| Rate for Payer: BCN Medicare Advantage |
$159.65
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$229.90
|
| Rate for Payer: Cofinity Commercial |
$213.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.65
|
| Rate for Payer: Healthscope Commercial |
$255.44
|
| Rate for Payer: Healthscope Commercial |
$295.35
|
| Rate for Payer: Mclaren Medicaid |
$105.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.63
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,621.00
|
| Rate for Payer: Nomi Health Commercial |
$191.58
|
| Rate for Payer: PACE SWMI |
$159.65
|
| Rate for Payer: PHP Medicare Advantage |
$159.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.60
|
| Rate for Payer: Priority Health Medicare |
$159.65
|
| Rate for Payer: Priority Health Narrow Network |
$260.60
|
| Rate for Payer: Priority Health SBD |
$260.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.65
|
| Rate for Payer: UHC Medicare Advantage |
$159.65
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 36903
|
| Min. Negotiated Rate |
$196.39 |
| Max. Negotiated Rate |
$55,411.00 |
| Rate for Payer: Aetna Commercial |
$400.30
|
| Rate for Payer: Aetna Medicare |
$310.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.17
|
| Rate for Payer: BCBS Complete |
$206.21
|
| Rate for Payer: BCBS MAPPO |
$298.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.97
|
| Rate for Payer: BCN Commercial |
$6,303.94
|
| Rate for Payer: BCN Medicare Advantage |
$298.73
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$430.17
|
| Rate for Payer: Cofinity Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.73
|
| Rate for Payer: Healthscope Commercial |
$477.97
|
| Rate for Payer: Healthscope Commercial |
$552.65
|
| Rate for Payer: Mclaren Medicaid |
$196.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.67
|
| Rate for Payer: Meridian Medicaid |
$206.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,411.00
|
| Rate for Payer: Nomi Health Commercial |
$358.48
|
| Rate for Payer: PACE SWMI |
$298.73
|
| Rate for Payer: PHP Medicare Advantage |
$298.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.74
|
| Rate for Payer: Priority Health Medicare |
$298.73
|
| Rate for Payer: Priority Health Narrow Network |
$488.74
|
| Rate for Payer: Priority Health SBD |
$488.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.73
|
| Rate for Payer: UHC Medicare Advantage |
$298.73
|
| Rate for Payer: UHCCP Medicaid |
$196.39
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 36902
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$42,104.00 |
| Rate for Payer: Aetna Commercial |
$303.50
|
| Rate for Payer: Aetna Medicare |
$235.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.15
|
| Rate for Payer: BCBS Complete |
$156.78
|
| Rate for Payer: BCBS MAPPO |
$226.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.58
|
| Rate for Payer: BCN Commercial |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$226.49
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$326.15
|
| Rate for Payer: Cofinity Commercial |
$303.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.49
|
| Rate for Payer: Healthscope Commercial |
$362.38
|
| Rate for Payer: Healthscope Commercial |
$419.01
|
| Rate for Payer: Mclaren Medicaid |
$149.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.81
|
| Rate for Payer: Meridian Medicaid |
$156.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,104.00
|
| Rate for Payer: Nomi Health Commercial |
$271.79
|
| Rate for Payer: PACE SWMI |
$226.49
|
| Rate for Payer: PHP Medicare Advantage |
$226.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.75
|
| Rate for Payer: Priority Health Medicare |
$226.49
|
| Rate for Payer: Priority Health Narrow Network |
$371.75
|
| Rate for Payer: Priority Health SBD |
$371.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.49
|
| Rate for Payer: UHC Medicare Advantage |
$226.49
|
| Rate for Payer: UHCCP Medicaid |
$149.31
|
|
|
PR INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 36013
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$21,992.00 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Medicare |
$124.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.72
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$119.25
|
| Rate for Payer: BCBS Trust/PPO |
$800.37
|
| Rate for Payer: BCN Commercial |
$1,157.67
|
| Rate for Payer: BCN Medicare Advantage |
$119.25
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$171.72
|
| Rate for Payer: Cofinity Commercial |
$159.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.25
|
| Rate for Payer: Healthscope Commercial |
$220.61
|
| Rate for Payer: Healthscope Commercial |
$190.80
|
| Rate for Payer: Mclaren Medicaid |
$78.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.21
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,992.00
|
| Rate for Payer: Nomi Health Commercial |
$143.10
|
| Rate for Payer: PACE SWMI |
$119.25
|
| Rate for Payer: PHP Medicare Advantage |
$119.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.19
|
| Rate for Payer: Priority Health Medicare |
$119.25
|
| Rate for Payer: Priority Health Narrow Network |
$195.19
|
| Rate for Payer: Priority Health SBD |
$195.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.25
|
| Rate for Payer: UHC Exchange |
$188.04
|
| Rate for Payer: UHC Medicare Advantage |
$119.25
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 36010
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$19,125.00 |
| Rate for Payer: Aetna Commercial |
$137.62
|
| Rate for Payer: Aetna Medicare |
$106.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.89
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$102.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.84
|
| Rate for Payer: BCN Commercial |
$796.06
|
| Rate for Payer: BCN Medicare Advantage |
$102.70
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cofinity Commercial |
$147.89
|
| Rate for Payer: Cofinity Commercial |
$137.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.70
|
| Rate for Payer: Healthscope Commercial |
$190.00
|
| Rate for Payer: Healthscope Commercial |
$164.32
|
| Rate for Payer: Mclaren Medicaid |
$67.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.84
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,125.00
|
| Rate for Payer: Nomi Health Commercial |
$123.24
|
| Rate for Payer: PACE SWMI |
$102.70
|
| Rate for Payer: PHP Medicare Advantage |
$102.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.59
|
| Rate for Payer: Priority Health Medicare |
$102.70
|
| Rate for Payer: Priority Health Narrow Network |
$168.59
|
| Rate for Payer: Priority Health SBD |
$168.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.70
|
| Rate for Payer: UHC Exchange |
$233.69
|
| Rate for Payer: UHC Medicare Advantage |
$102.70
|
| Rate for Payer: UHCCP Medicaid |
$67.31
|
|
|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$87.33 |
| Max. Negotiated Rate |
$24,602.00 |
| Rate for Payer: Aetna Commercial |
$179.73
|
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.15
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$134.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.32
|
| Rate for Payer: BCN Commercial |
$870.82
|
| Rate for Payer: BCN Medicare Advantage |
$134.13
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$193.15
|
| Rate for Payer: Cofinity Commercial |
$179.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.13
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Healthscope Commercial |
$214.61
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.84
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,602.00
|
| Rate for Payer: Nomi Health Commercial |
$160.96
|
| Rate for Payer: PACE SWMI |
$134.13
|
| Rate for Payer: PHP Medicare Advantage |
$134.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.45
|
| Rate for Payer: Priority Health Medicare |
$134.13
|
| Rate for Payer: Priority Health Narrow Network |
$216.45
|
| Rate for Payer: Priority Health SBD |
$216.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.13
|
| Rate for Payer: UHC Exchange |
$311.71
|
| Rate for Payer: UHC Medicare Advantage |
$134.13
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$3,420.00 |
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: Aetna Medicare |
$18.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.29
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$18.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.90
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$18.26
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$24.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.26
|
| Rate for Payer: Healthscope Commercial |
$33.78
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Mclaren Medicaid |
$12.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.17
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.00
|
| Rate for Payer: Nomi Health Commercial |
$21.91
|
| Rate for Payer: PACE SWMI |
$18.26
|
| Rate for Payer: PHP Medicare Advantage |
$18.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.41
|
| Rate for Payer: Priority Health Medicare |
$18.26
|
| Rate for Payer: Priority Health Narrow Network |
$33.41
|
| Rate for Payer: Priority Health SBD |
$33.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.26
|
| Rate for Payer: UHC Exchange |
$35.96
|
| Rate for Payer: UHC Medicare Advantage |
$18.26
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$11.94 |
| Max. Negotiated Rate |
$1,618.00 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.94
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS Trust/PPO |
$772.37
|
| Rate for Payer: BCN Commercial |
$35.73
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,618.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.36
|
| Rate for Payer: Priority Health Narrow Network |
$14.36
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.93
|
| Rate for Payer: UHC Exchange |
$41.93
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$27,299.00 |
| Rate for Payer: Aetna Commercial |
$196.39
|
| Rate for Payer: Aetna Medicare |
$152.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.05
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$146.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$827.33
|
| Rate for Payer: BCN Medicare Advantage |
$146.56
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$211.05
|
| Rate for Payer: Cofinity Commercial |
$196.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.56
|
| Rate for Payer: Healthscope Commercial |
$271.14
|
| Rate for Payer: Healthscope Commercial |
$234.50
|
| Rate for Payer: Mclaren Medicaid |
$95.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.89
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,299.00
|
| Rate for Payer: Nomi Health Commercial |
$175.87
|
| Rate for Payer: PACE SWMI |
$146.56
|
| Rate for Payer: PHP Medicare Advantage |
$146.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.66
|
| Rate for Payer: Priority Health Medicare |
$146.56
|
| Rate for Payer: Priority Health Narrow Network |
$236.66
|
| Rate for Payer: Priority Health SBD |
$236.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.56
|
| Rate for Payer: UHC Exchange |
$207.75
|
| Rate for Payer: UHC Medicare Advantage |
$146.56
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$15,755.00 |
| Rate for Payer: Aetna Commercial |
$113.54
|
| Rate for Payer: Aetna Medicare |
$88.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.01
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$84.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.54
|
| Rate for Payer: BCN Commercial |
$749.63
|
| Rate for Payer: BCN Medicare Advantage |
$84.73
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$122.01
|
| Rate for Payer: Cofinity Commercial |
$113.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.73
|
| Rate for Payer: Healthscope Commercial |
$156.75
|
| Rate for Payer: Healthscope Commercial |
$135.57
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.97
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,755.00
|
| Rate for Payer: Nomi Health Commercial |
$101.68
|
| Rate for Payer: PACE SWMI |
$84.73
|
| Rate for Payer: PHP Medicare Advantage |
$84.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.28
|
| Rate for Payer: Priority Health Medicare |
$84.73
|
| Rate for Payer: Priority Health Narrow Network |
$138.28
|
| Rate for Payer: Priority Health SBD |
$138.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.73
|
| Rate for Payer: UHC Exchange |
$144.80
|
| Rate for Payer: UHC Medicare Advantage |
$84.73
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$190.72 |
| Max. Negotiated Rate |
$190,031.00 |
| Rate for Payer: Aetna Commercial |
$1,390.57
|
| Rate for Payer: Aetna Medicare |
$1,079.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.35
|
| Rate for Payer: BCBS Complete |
$721.05
|
| Rate for Payer: BCBS MAPPO |
$1,037.74
|
| Rate for Payer: BCBS Trust/PPO |
$190.72
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.74
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.35
|
| Rate for Payer: Cofinity Commercial |
$1,390.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.74
|
| Rate for Payer: Healthscope Commercial |
$1,919.82
|
| Rate for Payer: Healthscope Commercial |
$1,660.38
|
| Rate for Payer: Mclaren Medicaid |
$686.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.63
|
| Rate for Payer: Meridian Medicaid |
$721.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190,031.00
|
| Rate for Payer: Nomi Health Commercial |
$1,245.29
|
| Rate for Payer: PACE SWMI |
$1,037.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,905.52
|
| Rate for Payer: Priority Health Medicare |
$1,037.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,905.52
|
| Rate for Payer: Priority Health SBD |
$1,905.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,029.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.74
|
| Rate for Payer: UHC Exchange |
$1,029.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.74
|
| Rate for Payer: UHCCP Medicaid |
$686.71
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$25,234.00 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna Medicare |
$142.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.67
|
| Rate for Payer: BCBS Complete |
$94.60
|
| Rate for Payer: BCBS MAPPO |
$137.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.49
|
| Rate for Payer: BCN Commercial |
$203.78
|
| Rate for Payer: BCN Medicare Advantage |
$137.27
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$197.67
|
| Rate for Payer: Cofinity Commercial |
$183.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.27
|
| Rate for Payer: Healthscope Commercial |
$253.95
|
| Rate for Payer: Healthscope Commercial |
$219.63
|
| Rate for Payer: Mclaren Medicaid |
$90.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.13
|
| Rate for Payer: Meridian Medicaid |
$94.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,234.00
|
| Rate for Payer: Nomi Health Commercial |
$164.72
|
| Rate for Payer: PACE SWMI |
$137.27
|
| Rate for Payer: PHP Medicare Advantage |
$137.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.27
|
| Rate for Payer: Priority Health Medicare |
$137.27
|
| Rate for Payer: Priority Health Narrow Network |
$193.27
|
| Rate for Payer: Priority Health SBD |
$193.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.27
|
| Rate for Payer: UHC Exchange |
$164.14
|
| Rate for Payer: UHC Medicare Advantage |
$137.27
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$4,704.00 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.72
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$30.36
|
| Rate for Payer: BCBS Trust/PPO |
$595.92
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$30.36
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$43.72
|
| Rate for Payer: Cofinity Commercial |
$40.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.36
|
| Rate for Payer: Healthscope Commercial |
$48.58
|
| Rate for Payer: Healthscope Commercial |
$56.17
|
| Rate for Payer: Mclaren Medicaid |
$20.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.88
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,704.00
|
| Rate for Payer: Nomi Health Commercial |
$36.43
|
| Rate for Payer: PACE SWMI |
$30.36
|
| Rate for Payer: PHP Medicare Advantage |
$30.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.97
|
| Rate for Payer: Priority Health Medicare |
$30.36
|
| Rate for Payer: Priority Health Narrow Network |
$42.97
|
| Rate for Payer: Priority Health SBD |
$42.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.36
|
| Rate for Payer: UHC Medicare Advantage |
$30.36
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$299.74 |
| Rate for Payer: Aetna Commercial |
$299.74
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.74
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS Trust/PPO |
$126.79
|
| Rate for Payer: BCN Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$75.02 |
| Max. Negotiated Rate |
$27,492.00 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: Aetna Medicare |
$174.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.05
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS Trust/PPO |
$75.02
|
| Rate for Payer: BCN Commercial |
$269.75
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Mclaren Medicaid |
$117.58
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,492.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.14
|
| Rate for Payer: Priority Health Narrow Network |
$248.14
|
| Rate for Payer: Priority Health SBD |
$248.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.26
|
| Rate for Payer: UHC Exchange |
$229.26
|
| Rate for Payer: UHCCP Medicaid |
$117.58
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$14,712.00 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.14
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$144.65
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Mclaren Medicaid |
$63.26
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,712.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.81
|
| Rate for Payer: Priority Health Narrow Network |
$132.81
|
| Rate for Payer: Priority Health SBD |
$132.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.49
|
| Rate for Payer: UHC Exchange |
$115.49
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$20,451.00 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: Aetna Medicare |
$133.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.55
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS Trust/PPO |
$245.66
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Mclaren Medicaid |
$87.54
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,451.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.42
|
| Rate for Payer: Priority Health Narrow Network |
$184.42
|
| Rate for Payer: Priority Health SBD |
$184.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.61
|
| Rate for Payer: UHC Exchange |
$166.61
|
| Rate for Payer: UHCCP Medicaid |
$87.54
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$10,580.00 |
| Rate for Payer: Aetna Commercial |
$77.71
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.71
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Mclaren Medicaid |
$44.73
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,580.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.68
|
| Rate for Payer: Priority Health Narrow Network |
$94.68
|
| Rate for Payer: Priority Health SBD |
$94.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.11
|
| Rate for Payer: UHC Exchange |
$93.11
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
|
|
PR IPRATROPIUM BROMIDE NON-COMP
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J7644
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$32.00 |
| Rate for Payer: Aetna Commercial |
$0.53
|
| Rate for Payer: Aetna Medicare |
$0.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.57
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$0.39
|
| Rate for Payer: BCN Commercial |
$0.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.39
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$0.57
|
| Rate for Payer: Cofinity Commercial |
$0.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.39
|
| Rate for Payer: Healthscope Commercial |
$0.63
|
| Rate for Payer: Healthscope Commercial |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.00
|
| Rate for Payer: Nomi Health Commercial |
$0.47
|
| Rate for Payer: PACE SWMI |
$0.39
|
| Rate for Payer: PHP Medicare Advantage |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: Priority Health Medicare |
$0.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.39
|
| Rate for Payer: UHC Exchange |
$0.39
|
| Rate for Payer: UHC Medicare Advantage |
$0.39
|
|
