|
PR MASTECTOMY, SUBCUTANEOUS
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 19304
|
| Min. Negotiated Rate |
$454.00 |
| Max. Negotiated Rate |
$851.25 |
| Rate for Payer: Aetna Medicare |
$567.50
|
| Rate for Payer: BCBS Complete |
$454.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.25
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Facility
|
OP
|
$1,135.00
|
|
|
Service Code
|
CPT 19304
|
| Hospital Charge Code |
19304
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$454.00 |
| Max. Negotiated Rate |
$1,021.50 |
| Rate for Payer: Aetna Commercial |
$964.75
|
| Rate for Payer: Aetna Medicare |
$567.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.75
|
| Rate for Payer: BCBS Complete |
$454.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cofinity Advantage |
$794.50
|
| Rate for Payer: Cofinity Commercial |
$976.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.00
|
| Rate for Payer: Healthscope Commercial |
$1,021.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$908.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$964.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.25
|
| Rate for Payer: PHP Commercial |
$964.75
|
| Rate for Payer: Priority Health SBD |
$715.05
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 19304
|
| Hospital Charge Code |
19304
|
| Min. Negotiated Rate |
$454.00 |
| Max. Negotiated Rate |
$851.25 |
| Rate for Payer: Aetna Medicare |
$567.50
|
| Rate for Payer: BCBS Complete |
$454.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.25
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 19307
|
| Min. Negotiated Rate |
$718.45 |
| Max. Negotiated Rate |
$2,130.25 |
| Rate for Payer: Aetna Commercial |
$1,490.41
|
| Rate for Payer: Aetna Medicare |
$1,156.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,490.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.64
|
| Rate for Payer: BCBS Complete |
$754.37
|
| Rate for Payer: BCBS MAPPO |
$1,112.25
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.25
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,601.64
|
| Rate for Payer: Cofinity Commercial |
$1,490.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.25
|
| Rate for Payer: Healthscope Commercial |
$1,779.60
|
| Rate for Payer: Healthscope Commercial |
$2,057.66
|
| Rate for Payer: Mclaren Medicaid |
$718.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,167.86
|
| Rate for Payer: Meridian Medicaid |
$754.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,223.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,106.59
|
| Rate for Payer: Nomi Health Commercial |
$1,334.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PACE SWMI |
$1,112.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,627.59
|
| Rate for Payer: Priority Health Medicare |
$1,112.25
|
| Rate for Payer: Priority Health SBD |
$1,627.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,627.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,112.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,130.25
|
| Rate for Payer: UHC Core |
$2,130.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,112.25
|
| Rate for Payer: UHC Exchange |
$2,130.25
|
| Rate for Payer: UHC Medicaid |
$718.45
|
| Rate for Payer: UHCCP Medicaid |
$718.45
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
IP
|
$2,105.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,326.15 |
| Max. Negotiated Rate |
$1,894.50 |
| Rate for Payer: Aetna Commercial |
$1,789.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.25
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Advantage |
$1,473.50
|
| Rate for Payer: Cofinity Commercial |
$1,810.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.00
|
| Rate for Payer: Healthscope Commercial |
$1,894.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PHP Commercial |
$1,789.25
|
| Rate for Payer: Priority Health SBD |
$1,326.15
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
OP
|
$2,105.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,326.15 |
| Max. Negotiated Rate |
$21,396.49 |
| Rate for Payer: Aetna Commercial |
$1,789.25
|
| Rate for Payer: Aetna Medicare |
$6,880.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,270.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,270.36
|
| Rate for Payer: BCBS Complete |
$3,633.67
|
| Rate for Payer: BCBS MAPPO |
$6,616.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,187.82
|
| Rate for Payer: BCN Commercial |
$5,187.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,616.29
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Advantage |
$1,473.50
|
| Rate for Payer: Cofinity Commercial |
$1,810.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,616.29
|
| Rate for Payer: Healthscope Commercial |
$1,894.50
|
| Rate for Payer: Mclaren Medicaid |
$3,460.32
|
| Rate for Payer: Mclaren Medicare |
$6,616.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,947.10
|
| Rate for Payer: Meridian Medicaid |
$6,947.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,608.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,277.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,789.25
|
| Rate for Payer: Nomi Health Commercial |
$19,848.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PACE Medicare |
$6,285.48
|
| Rate for Payer: PACE SWMI |
$6,616.29
|
| Rate for Payer: PHP Commercial |
$1,789.25
|
| Rate for Payer: PHP Medicare Advantage |
$6,616.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,460.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,396.49
|
| Rate for Payer: Priority Health Medicare |
$6,616.29
|
| Rate for Payer: Priority Health SBD |
$1,326.15
|
| Rate for Payer: Priority Health Tiered Network |
$17,117.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,616.29
|
| Rate for Payer: UHC Medicaid |
$3,460.32
|
| Rate for Payer: UHCCP Medicaid |
$3,460.32
|
| Rate for Payer: VA VA |
$6,616.29
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 19307
|
| Hospital Charge Code |
19307
|
| Min. Negotiated Rate |
$718.45 |
| Max. Negotiated Rate |
$2,130.25 |
| Rate for Payer: Aetna Commercial |
$1,490.41
|
| Rate for Payer: Aetna Medicare |
$1,156.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,490.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,601.64
|
| Rate for Payer: BCBS Complete |
$754.37
|
| Rate for Payer: BCBS MAPPO |
$1,112.25
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.25
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,601.64
|
| Rate for Payer: Cofinity Commercial |
$1,490.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.25
|
| Rate for Payer: Healthscope Commercial |
$2,057.66
|
| Rate for Payer: Healthscope Commercial |
$1,779.60
|
| Rate for Payer: Mclaren Medicaid |
$718.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,167.86
|
| Rate for Payer: Meridian Medicaid |
$754.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,223.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,106.59
|
| Rate for Payer: Nomi Health Commercial |
$1,334.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.75
|
| Rate for Payer: PACE SWMI |
$1,112.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,627.59
|
| Rate for Payer: Priority Health Medicare |
$1,112.25
|
| Rate for Payer: Priority Health SBD |
$1,627.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,627.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,112.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,130.25
|
| Rate for Payer: UHC Core |
$2,130.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,112.25
|
| Rate for Payer: UHC Exchange |
$2,130.25
|
| Rate for Payer: UHC Medicaid |
$718.45
|
| Rate for Payer: UHCCP Medicaid |
$718.45
|
|
|
PR MASTOIDECTOMY COMPLETE
|
Professional
|
Both
|
$2,785.00
|
|
|
Service Code
|
HCPCS 69502
|
| Min. Negotiated Rate |
$535.91 |
| Max. Negotiated Rate |
$2,088.75 |
| Rate for Payer: Aetna Commercial |
$1,093.23
|
| Rate for Payer: Aetna Medicare |
$848.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,174.81
|
| Rate for Payer: BCBS Complete |
$562.71
|
| Rate for Payer: BCBS MAPPO |
$815.84
|
| Rate for Payer: BCN Commercial |
$1,409.78
|
| Rate for Payer: BCN Medicare Advantage |
$815.84
|
| Rate for Payer: Cash Price |
$2,228.00
|
| Rate for Payer: Cash Price |
$2,228.00
|
| Rate for Payer: Cofinity Commercial |
$1,174.81
|
| Rate for Payer: Cofinity Commercial |
$1,093.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$815.84
|
| Rate for Payer: Healthscope Commercial |
$1,509.30
|
| Rate for Payer: Healthscope Commercial |
$1,305.34
|
| Rate for Payer: Mclaren Medicaid |
$535.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$856.63
|
| Rate for Payer: Meridian Medicaid |
$562.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$897.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,670.35
|
| Rate for Payer: Nomi Health Commercial |
$979.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,088.75
|
| Rate for Payer: PACE SWMI |
$815.84
|
| Rate for Payer: PHP Medicare Advantage |
$815.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,393.01
|
| Rate for Payer: Priority Health Medicare |
$815.84
|
| Rate for Payer: Priority Health SBD |
$1,393.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,393.01
|
| Rate for Payer: Railroad Medicare Medicare |
$815.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,633.81
|
| Rate for Payer: UHC Core |
$1,633.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$815.84
|
| Rate for Payer: UHC Exchange |
$1,633.81
|
| Rate for Payer: UHC Medicaid |
$535.91
|
| Rate for Payer: UHCCP Medicaid |
$535.91
|
|
|
PR MASTOID OBLITERATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,583.00
|
|
|
Service Code
|
HCPCS 69670
|
| Min. Negotiated Rate |
$535.70 |
| Max. Negotiated Rate |
$2,687.25 |
| Rate for Payer: Aetna Commercial |
$1,088.40
|
| Rate for Payer: Aetna Medicare |
$844.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.63
|
| Rate for Payer: BCBS Complete |
$562.49
|
| Rate for Payer: BCBS MAPPO |
$812.24
|
| Rate for Payer: BCN Commercial |
$1,409.29
|
| Rate for Payer: BCN Medicare Advantage |
$812.24
|
| Rate for Payer: Cash Price |
$2,866.40
|
| Rate for Payer: Cash Price |
$2,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,169.63
|
| Rate for Payer: Cofinity Commercial |
$1,088.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.24
|
| Rate for Payer: Healthscope Commercial |
$1,502.64
|
| Rate for Payer: Healthscope Commercial |
$1,299.58
|
| Rate for Payer: Mclaren Medicaid |
$535.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$852.85
|
| Rate for Payer: Meridian Medicaid |
$562.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$893.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.85
|
| Rate for Payer: Nomi Health Commercial |
$974.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,687.25
|
| Rate for Payer: PACE SWMI |
$812.24
|
| Rate for Payer: PHP Medicare Advantage |
$812.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,392.52
|
| Rate for Payer: Priority Health Medicare |
$812.24
|
| Rate for Payer: Priority Health SBD |
$1,392.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,392.52
|
| Rate for Payer: Railroad Medicare Medicare |
$812.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,613.50
|
| Rate for Payer: UHC Core |
$1,613.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$812.24
|
| Rate for Payer: UHC Exchange |
$1,613.50
|
| Rate for Payer: UHC Medicaid |
$535.70
|
| Rate for Payer: UHCCP Medicaid |
$535.70
|
|
|
PR MASTOPEXY
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 19316
|
| Min. Negotiated Rate |
$464.98 |
| Max. Negotiated Rate |
$1,497.00 |
| Rate for Payer: PHP Medicare Advantage |
$712.49
|
| Rate for Payer: Aetna Commercial |
$954.74
|
| Rate for Payer: Aetna Medicare |
$740.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.74
|
| Rate for Payer: BCBS Complete |
$488.23
|
| Rate for Payer: BCBS MAPPO |
$712.49
|
| Rate for Payer: BCN Commercial |
$1,198.15
|
| Rate for Payer: BCN Medicare Advantage |
$712.49
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$954.74
|
| Rate for Payer: Cofinity Commercial |
$1,025.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.49
|
| Rate for Payer: Healthscope Commercial |
$1,318.11
|
| Rate for Payer: Healthscope Commercial |
$1,139.98
|
| Rate for Payer: Mclaren Medicaid |
$464.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$748.11
|
| Rate for Payer: Meridian Medicaid |
$488.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$783.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,400.38
|
| Rate for Payer: Nomi Health Commercial |
$854.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,497.00
|
| Rate for Payer: PACE SWMI |
$712.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,096.61
|
| Rate for Payer: Priority Health Medicare |
$712.49
|
| Rate for Payer: Priority Health SBD |
$1,096.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,096.61
|
| Rate for Payer: Railroad Medicare Medicare |
$712.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,355.46
|
| Rate for Payer: UHC Core |
$1,355.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$712.49
|
| Rate for Payer: UHC Exchange |
$1,355.46
|
| Rate for Payer: UHC Medicaid |
$464.98
|
| Rate for Payer: UHCCP Medicaid |
$464.98
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 19020
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$628.50 |
| Rate for Payer: Aetna Commercial |
$410.39
|
| Rate for Payer: Aetna Medicare |
$318.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.01
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$306.26
|
| Rate for Payer: BCN Commercial |
$475.57
|
| Rate for Payer: BCN Medicare Advantage |
$306.26
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$441.01
|
| Rate for Payer: Cofinity Commercial |
$410.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.26
|
| Rate for Payer: Healthscope Commercial |
$566.58
|
| Rate for Payer: Healthscope Commercial |
$490.02
|
| Rate for Payer: Mclaren Medicaid |
$201.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.57
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.19
|
| Rate for Payer: Nomi Health Commercial |
$367.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$628.50
|
| Rate for Payer: PACE SWMI |
$306.26
|
| Rate for Payer: PHP Medicare Advantage |
$306.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$435.27
|
| Rate for Payer: Priority Health Medicare |
$306.26
|
| Rate for Payer: Priority Health SBD |
$435.27
|
| Rate for Payer: Priority Health Tiered Network |
$435.27
|
| Rate for Payer: Railroad Medicare Medicare |
$306.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.08
|
| Rate for Payer: UHC Core |
$538.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$306.26
|
| Rate for Payer: UHC Exchange |
$538.08
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$699.28 |
| Max. Negotiated Rate |
$2,055.17 |
| Rate for Payer: Aetna Commercial |
$1,450.26
|
| Rate for Payer: Aetna Medicare |
$1,125.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,450.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.48
|
| Rate for Payer: BCBS Complete |
$734.24
|
| Rate for Payer: BCBS MAPPO |
$1,082.28
|
| Rate for Payer: BCN Commercial |
$1,727.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,082.28
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cofinity Commercial |
$1,558.48
|
| Rate for Payer: Cofinity Commercial |
$1,450.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,082.28
|
| Rate for Payer: Healthscope Commercial |
$2,002.22
|
| Rate for Payer: Healthscope Commercial |
$1,731.65
|
| Rate for Payer: Mclaren Medicaid |
$699.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,136.39
|
| Rate for Payer: Meridian Medicaid |
$734.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,190.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,055.17
|
| Rate for Payer: Nomi Health Commercial |
$1,298.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,866.00
|
| Rate for Payer: PACE SWMI |
$1,082.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,082.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$699.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,581.11
|
| Rate for Payer: Priority Health Medicare |
$1,082.28
|
| Rate for Payer: Priority Health SBD |
$1,581.11
|
| Rate for Payer: Priority Health Tiered Network |
$1,581.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,082.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,014.24
|
| Rate for Payer: UHC Core |
$2,014.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,082.28
|
| Rate for Payer: UHC Exchange |
$2,014.24
|
| Rate for Payer: UHC Medicaid |
$699.28
|
| Rate for Payer: UHCCP Medicaid |
$699.28
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$15.23 |
| Max. Negotiated Rate |
$33.84 |
| Rate for Payer: Aetna Commercial |
$20.41
|
| Rate for Payer: Aetna Medicare |
$15.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.41
|
| Rate for Payer: BCBS MAPPO |
$15.23
|
| Rate for Payer: BCN Commercial |
$22.41
|
| Rate for Payer: BCN Medicare Advantage |
$15.23
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.23
|
| Rate for Payer: Healthscope Commercial |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.78
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PACE SWMI |
$15.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.67
|
| Rate for Payer: Priority Health Medicare |
$15.23
|
| Rate for Payer: Priority Health SBD |
$20.67
|
| Rate for Payer: Priority Health Tiered Network |
$20.67
|
| Rate for Payer: Railroad Medicare Medicare |
$15.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.84
|
| Rate for Payer: UHC Core |
$33.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.23
|
| Rate for Payer: UHC Exchange |
$33.84
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,403.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$1,006.00 |
| Max. Negotiated Rate |
$3,189.13 |
| Rate for Payer: Aetna Commercial |
$2,068.08
|
| Rate for Payer: Aetna Medicare |
$1,605.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,068.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,222.41
|
| Rate for Payer: BCBS Complete |
$1,056.30
|
| Rate for Payer: BCBS MAPPO |
$1,543.34
|
| Rate for Payer: BCN Commercial |
$2,692.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.34
|
| Rate for Payer: Cash Price |
$2,722.40
|
| Rate for Payer: Cash Price |
$2,722.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.41
|
| Rate for Payer: Cofinity Commercial |
$2,068.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.34
|
| Rate for Payer: Healthscope Commercial |
$2,855.18
|
| Rate for Payer: Healthscope Commercial |
$2,469.34
|
| Rate for Payer: Mclaren Medicaid |
$1,006.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,620.51
|
| Rate for Payer: Meridian Medicaid |
$1,056.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,697.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,189.13
|
| Rate for Payer: Nomi Health Commercial |
$1,852.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,552.25
|
| Rate for Payer: PACE SWMI |
$1,543.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,006.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,535.62
|
| Rate for Payer: Priority Health Medicare |
$1,543.34
|
| Rate for Payer: Priority Health SBD |
$2,535.62
|
| Rate for Payer: Priority Health Tiered Network |
$2,535.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,543.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,158.64
|
| Rate for Payer: UHC Core |
$3,158.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,543.34
|
| Rate for Payer: UHC Exchange |
$3,158.64
|
| Rate for Payer: UHC Medicaid |
$1,006.00
|
| Rate for Payer: UHCCP Medicaid |
$1,006.00
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$154.19 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCN Commercial |
$137.71
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$154.19
|
| Rate for Payer: Priority Health SBD |
$154.19
|
| Rate for Payer: Priority Health Tiered Network |
$154.19
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$76.88 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCN Commercial |
$68.86
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.88
|
| Rate for Payer: Priority Health SBD |
$76.88
|
| Rate for Payer: Priority Health Tiered Network |
$76.88
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.22
|
| Rate for Payer: Priority Health SBD |
$65.22
|
| Rate for Payer: Priority Health Tiered Network |
$65.22
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$39.13 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCN Commercial |
$29.13
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.13
|
| Rate for Payer: Priority Health SBD |
$39.13
|
| Rate for Payer: Priority Health Tiered Network |
$39.13
|
|
|
PR MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$54.16
|
| Rate for Payer: Aetna Medicare |
$42.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.20
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$40.42
|
| Rate for Payer: BCN Commercial |
$67.72
|
| Rate for Payer: BCN Medicare Advantage |
$40.42
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$58.20
|
| Rate for Payer: Cofinity Commercial |
$54.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.42
|
| Rate for Payer: Healthscope Commercial |
$64.67
|
| Rate for Payer: Healthscope Commercial |
$74.78
|
| Rate for Payer: Mclaren Medicaid |
$26.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.44
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.31
|
| Rate for Payer: Nomi Health Commercial |
$48.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.25
|
| Rate for Payer: PACE SWMI |
$40.42
|
| Rate for Payer: PHP Medicare Advantage |
$40.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.83
|
| Rate for Payer: Priority Health Medicare |
$40.42
|
| Rate for Payer: Priority Health SBD |
$72.83
|
| Rate for Payer: Priority Health Tiered Network |
$72.83
|
| Rate for Payer: Railroad Medicare Medicare |
$40.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.87
|
| Rate for Payer: UHC Core |
$76.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.42
|
| Rate for Payer: UHC Exchange |
$76.87
|
| Rate for Payer: UHC Medicaid |
$26.20
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$882.00 |
| Rate for Payer: Aetna Commercial |
$210.57
|
| Rate for Payer: Aetna Medicare |
$163.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.28
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS MAPPO |
$157.14
|
| Rate for Payer: BCN Commercial |
$264.92
|
| Rate for Payer: BCN Medicare Advantage |
$157.14
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$226.28
|
| Rate for Payer: Cofinity Commercial |
$210.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.14
|
| Rate for Payer: Healthscope Commercial |
$290.71
|
| Rate for Payer: Healthscope Commercial |
$251.42
|
| Rate for Payer: Mclaren Medicaid |
$100.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.00
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.66
|
| Rate for Payer: Nomi Health Commercial |
$188.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.00
|
| Rate for Payer: PACE SWMI |
$157.14
|
| Rate for Payer: PHP Medicare Advantage |
$157.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$284.89
|
| Rate for Payer: Priority Health Medicare |
$157.14
|
| Rate for Payer: Priority Health SBD |
$284.89
|
| Rate for Payer: Priority Health Tiered Network |
$284.89
|
| Rate for Payer: Railroad Medicare Medicare |
$157.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.92
|
| Rate for Payer: UHC Core |
$323.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.14
|
| Rate for Payer: UHC Exchange |
$323.92
|
| Rate for Payer: UHC Medicaid |
$100.54
|
| Rate for Payer: UHCCP Medicaid |
$100.54
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$100.07 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: Aetna Medicare |
$56.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.89
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS MAPPO |
$54.09
|
| Rate for Payer: BCN Commercial |
$80.18
|
| Rate for Payer: BCN Medicare Advantage |
$54.09
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cofinity Commercial |
$77.89
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.09
|
| Rate for Payer: Healthscope Commercial |
$100.07
|
| Rate for Payer: Healthscope Commercial |
$86.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.14
|
| Rate for Payer: Nomi Health Commercial |
$64.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.25
|
| Rate for Payer: PACE SWMI |
$54.09
|
| Rate for Payer: PHP Medicare Advantage |
$54.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.94
|
| Rate for Payer: Priority Health Medicare |
$54.09
|
| Rate for Payer: Priority Health SBD |
$73.94
|
| Rate for Payer: Priority Health Tiered Network |
$73.94
|
| Rate for Payer: Railroad Medicare Medicare |
$54.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.30
|
| Rate for Payer: UHC Core |
$83.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.09
|
| Rate for Payer: UHC Exchange |
$83.30
|
|
|
PR MD INR TEST REVIE INTER MGMT
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$11.83
|
| Rate for Payer: Aetna Medicare |
$9.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.72
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$8.83
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$8.83
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$12.72
|
| Rate for Payer: Cofinity Commercial |
$11.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.83
|
| Rate for Payer: Healthscope Commercial |
$16.34
|
| Rate for Payer: Healthscope Commercial |
$14.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.95
|
| Rate for Payer: Nomi Health Commercial |
$10.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$8.83
|
| Rate for Payer: PHP Medicare Advantage |
$8.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.64
|
| Rate for Payer: Priority Health Medicare |
$8.83
|
| Rate for Payer: Priority Health SBD |
$11.64
|
| Rate for Payer: Priority Health Tiered Network |
$11.64
|
| Rate for Payer: Railroad Medicare Medicare |
$8.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.76
|
| Rate for Payer: UHC Core |
$14.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.83
|
| Rate for Payer: UHC Exchange |
$14.76
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare |
$43.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.55
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$42.05
|
| Rate for Payer: BCN Commercial |
$63.24
|
| Rate for Payer: BCN Medicare Advantage |
$42.05
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$60.55
|
| Rate for Payer: Cofinity Commercial |
$56.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.05
|
| Rate for Payer: Healthscope Commercial |
$67.28
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.33
|
| Rate for Payer: Nomi Health Commercial |
$50.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$42.05
|
| Rate for Payer: PHP Medicare Advantage |
$42.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.32
|
| Rate for Payer: Priority Health Medicare |
$42.05
|
| Rate for Payer: Priority Health SBD |
$58.32
|
| Rate for Payer: Priority Health Tiered Network |
$58.32
|
| Rate for Payer: Railroad Medicare Medicare |
$42.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.05
|
| Rate for Payer: UHC Exchange |
$63.51
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$10.16
|
| Rate for Payer: Aetna Medicare |
$7.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.92
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$7.58
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$7.58
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$10.92
|
| Rate for Payer: Cofinity Commercial |
$10.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.58
|
| Rate for Payer: Healthscope Commercial |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$12.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.90
|
| Rate for Payer: Nomi Health Commercial |
$9.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: PACE SWMI |
$7.58
|
| Rate for Payer: PHP Medicare Advantage |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.94
|
| Rate for Payer: Priority Health Medicare |
$7.58
|
| Rate for Payer: Priority Health SBD |
$11.94
|
| Rate for Payer: Priority Health Tiered Network |
$11.94
|
| Rate for Payer: Railroad Medicare Medicare |
$7.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.72
|
| Rate for Payer: UHC Core |
$14.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.58
|
| Rate for Payer: UHC Exchange |
$14.72
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$289.17 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.04
|
| Rate for Payer: BCBS Trust/PPO |
$289.17
|
| Rate for Payer: BCN Commercial |
$273.21
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.17
|
| Rate for Payer: UHC Core |
$289.17
|
| Rate for Payer: UHC Exchange |
$289.17
|
|
