|
PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 50972
|
| Min. Negotiated Rate |
$200.43 |
| Max. Negotiated Rate |
$635.01 |
| Rate for Payer: Aetna Commercial |
$419.06
|
| Rate for Payer: Aetna Medicare |
$325.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.33
|
| Rate for Payer: BCBS Complete |
$210.45
|
| Rate for Payer: BCBS MAPPO |
$312.73
|
| Rate for Payer: BCN Commercial |
$528.36
|
| Rate for Payer: BCN Medicare Advantage |
$312.73
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$450.33
|
| Rate for Payer: Cofinity Commercial |
$419.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.73
|
| Rate for Payer: Healthscope Commercial |
$578.55
|
| Rate for Payer: Healthscope Commercial |
$500.37
|
| Rate for Payer: Mclaren Medicaid |
$200.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.37
|
| Rate for Payer: Meridian Medicaid |
$210.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.29
|
| Rate for Payer: Nomi Health Commercial |
$375.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$535.50
|
| Rate for Payer: PACE SWMI |
$312.73
|
| Rate for Payer: PHP Medicare Advantage |
$312.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$575.56
|
| Rate for Payer: Priority Health Medicare |
$312.73
|
| Rate for Payer: Priority Health SBD |
$575.56
|
| Rate for Payer: Priority Health Tiered Network |
$575.56
|
| Rate for Payer: Railroad Medicare Medicare |
$312.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.01
|
| Rate for Payer: UHC Core |
$635.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.73
|
| Rate for Payer: UHC Exchange |
$635.01
|
| Rate for Payer: UHC Medicaid |
$200.43
|
| Rate for Payer: UHCCP Medicaid |
$200.43
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$309.70 |
| Max. Negotiated Rate |
$1,449.75 |
| Rate for Payer: Aetna Commercial |
$630.11
|
| Rate for Payer: Aetna Medicare |
$489.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.13
|
| Rate for Payer: BCBS Complete |
$325.19
|
| Rate for Payer: BCBS MAPPO |
$470.23
|
| Rate for Payer: BCN Commercial |
$789.30
|
| Rate for Payer: BCN Medicare Advantage |
$470.23
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cash Price |
$1,546.40
|
| Rate for Payer: Cofinity Commercial |
$677.13
|
| Rate for Payer: Cofinity Commercial |
$630.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.23
|
| Rate for Payer: Healthscope Commercial |
$869.93
|
| Rate for Payer: Healthscope Commercial |
$752.37
|
| Rate for Payer: Mclaren Medicaid |
$309.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.74
|
| Rate for Payer: Meridian Medicaid |
$325.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.86
|
| Rate for Payer: Nomi Health Commercial |
$564.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,449.75
|
| Rate for Payer: PACE SWMI |
$470.23
|
| Rate for Payer: PHP Medicare Advantage |
$470.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$843.74
|
| Rate for Payer: Priority Health Medicare |
$470.23
|
| Rate for Payer: Priority Health SBD |
$843.74
|
| Rate for Payer: Priority Health Tiered Network |
$843.74
|
| Rate for Payer: Railroad Medicare Medicare |
$470.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.29
|
| Rate for Payer: UHC Core |
$884.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.23
|
| Rate for Payer: UHC Exchange |
$884.29
|
| Rate for Payer: UHC Medicaid |
$309.70
|
| Rate for Payer: UHCCP Medicaid |
$309.70
|
|
|
PR NECK LIFT
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$121.79 |
| Max. Negotiated Rate |
$225.31 |
| Rate for Payer: Aetna Commercial |
$163.20
|
| Rate for Payer: Aetna Medicare |
$126.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.38
|
| Rate for Payer: BCBS MAPPO |
$121.79
|
| Rate for Payer: BCN Commercial |
$186.75
|
| Rate for Payer: BCN Medicare Advantage |
$121.79
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.79
|
| Rate for Payer: Healthscope Commercial |
$225.31
|
| Rate for Payer: Healthscope Commercial |
$194.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.39
|
| Rate for Payer: Nomi Health Commercial |
$146.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.75
|
| Rate for Payer: PACE SWMI |
$121.79
|
| Rate for Payer: PHP Medicare Advantage |
$121.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$172.22
|
| Rate for Payer: Priority Health Medicare |
$121.79
|
| Rate for Payer: Priority Health SBD |
$172.22
|
| Rate for Payer: Priority Health Tiered Network |
$172.22
|
| Rate for Payer: Railroad Medicare Medicare |
$121.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.78
|
| Rate for Payer: UHC Core |
$218.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.79
|
| Rate for Payer: UHC Exchange |
$218.78
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$100.42 |
| Max. Negotiated Rate |
$185.78 |
| Rate for Payer: Aetna Commercial |
$134.56
|
| Rate for Payer: Aetna Medicare |
$104.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.56
|
| Rate for Payer: BCBS MAPPO |
$100.42
|
| Rate for Payer: BCN Commercial |
$154.87
|
| Rate for Payer: BCN Medicare Advantage |
$100.42
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$144.60
|
| Rate for Payer: Cofinity Commercial |
$134.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.42
|
| Rate for Payer: Healthscope Commercial |
$185.78
|
| Rate for Payer: Healthscope Commercial |
$160.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.18
|
| Rate for Payer: Nomi Health Commercial |
$120.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.75
|
| Rate for Payer: PACE SWMI |
$100.42
|
| Rate for Payer: PHP Medicare Advantage |
$100.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$142.83
|
| Rate for Payer: Priority Health Medicare |
$100.42
|
| Rate for Payer: Priority Health SBD |
$142.83
|
| Rate for Payer: Priority Health Tiered Network |
$142.83
|
| Rate for Payer: Railroad Medicare Medicare |
$100.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.35
|
| Rate for Payer: UHC Core |
$166.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.42
|
| Rate for Payer: UHC Exchange |
$166.35
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$128.33 |
| Max. Negotiated Rate |
$237.41 |
| Rate for Payer: Aetna Commercial |
$171.96
|
| Rate for Payer: Aetna Medicare |
$133.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.80
|
| Rate for Payer: BCBS MAPPO |
$128.33
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Medicare Advantage |
$128.33
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$171.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.33
|
| Rate for Payer: Healthscope Commercial |
$237.41
|
| Rate for Payer: Healthscope Commercial |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.11
|
| Rate for Payer: Nomi Health Commercial |
$154.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.00
|
| Rate for Payer: PACE SWMI |
$128.33
|
| Rate for Payer: PHP Medicare Advantage |
$128.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.65
|
| Rate for Payer: Priority Health Medicare |
$128.33
|
| Rate for Payer: Priority Health SBD |
$178.65
|
| Rate for Payer: Priority Health Tiered Network |
$178.65
|
| Rate for Payer: Railroad Medicare Medicare |
$128.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.09
|
| Rate for Payer: UHC Core |
$210.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.33
|
| Rate for Payer: UHC Exchange |
$210.09
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$145.30 |
| Max. Negotiated Rate |
$287.25 |
| Rate for Payer: Aetna Commercial |
$194.70
|
| Rate for Payer: Aetna Medicare |
$151.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.23
|
| Rate for Payer: BCBS MAPPO |
$145.30
|
| Rate for Payer: BCN Commercial |
$217.12
|
| Rate for Payer: BCN Medicare Advantage |
$145.30
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$209.23
|
| Rate for Payer: Cofinity Commercial |
$194.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.30
|
| Rate for Payer: Healthscope Commercial |
$268.81
|
| Rate for Payer: Healthscope Commercial |
$232.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.22
|
| Rate for Payer: Nomi Health Commercial |
$174.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.25
|
| Rate for Payer: PACE SWMI |
$145.30
|
| Rate for Payer: PHP Medicare Advantage |
$145.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$200.23
|
| Rate for Payer: Priority Health Medicare |
$145.30
|
| Rate for Payer: Priority Health SBD |
$200.23
|
| Rate for Payer: Priority Health Tiered Network |
$200.23
|
| Rate for Payer: Railroad Medicare Medicare |
$145.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.92
|
| Rate for Payer: UHC Core |
$238.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$145.30
|
| Rate for Payer: UHC Exchange |
$238.92
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$59.92 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Aetna Commercial |
$80.29
|
| Rate for Payer: Aetna Commercial |
$80.29
|
| Rate for Payer: Aetna Medicare |
$62.32
|
| Rate for Payer: Aetna Medicare |
$62.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$59.92
|
| Rate for Payer: BCBS MAPPO |
$59.92
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Medicare Advantage |
$59.92
|
| Rate for Payer: BCN Medicare Advantage |
$59.92
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$80.29
|
| Rate for Payer: Cofinity Commercial |
$86.28
|
| Rate for Payer: Cofinity Commercial |
$80.29
|
| Rate for Payer: Cofinity Commercial |
$86.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.92
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Commercial |
$110.85
|
| Rate for Payer: Healthscope Commercial |
$110.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.33
|
| Rate for Payer: Nomi Health Commercial |
$71.90
|
| Rate for Payer: Nomi Health Commercial |
$71.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: PACE SWMI |
$59.92
|
| Rate for Payer: PACE SWMI |
$59.92
|
| Rate for Payer: PHP Medicare Advantage |
$59.92
|
| Rate for Payer: PHP Medicare Advantage |
$59.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$59.92
|
| Rate for Payer: Priority Health Medicare |
$59.92
|
| Rate for Payer: Priority Health SBD |
$82.20
|
| Rate for Payer: Priority Health SBD |
$82.20
|
| Rate for Payer: Priority Health Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Tiered Network |
$82.20
|
| Rate for Payer: Railroad Medicare Medicare |
$59.92
|
| Rate for Payer: Railroad Medicare Medicare |
$59.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.88
|
| Rate for Payer: UHC Core |
$95.88
|
| Rate for Payer: UHC Core |
$95.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.92
|
| Rate for Payer: UHC Exchange |
$95.88
|
| Rate for Payer: UHC Exchange |
$95.88
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$186.75 |
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.75
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCN Commercial |
$139.44
|
| Rate for Payer: BCN Commercial |
$139.44
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$173.60
|
| Rate for Payer: Healthscope Commercial |
$173.60
|
| Rate for Payer: Healthscope Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$150.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.98
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.75
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.11
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health SBD |
$141.11
|
| Rate for Payer: Priority Health SBD |
$141.11
|
| Rate for Payer: Priority Health Tiered Network |
$141.11
|
| Rate for Payer: Priority Health Tiered Network |
$141.11
|
| Rate for Payer: Railroad Medicare Medicare |
$93.84
|
| Rate for Payer: Railroad Medicare Medicare |
$93.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.60
|
| Rate for Payer: UHC Core |
$150.60
|
| Rate for Payer: UHC Core |
$150.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.84
|
| Rate for Payer: UHC Exchange |
$150.60
|
| Rate for Payer: UHC Exchange |
$150.60
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$74.61 |
| Max. Negotiated Rate |
$138.03 |
| Rate for Payer: Aetna Commercial |
$99.98
|
| Rate for Payer: Aetna Medicare |
$77.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.44
|
| Rate for Payer: BCBS MAPPO |
$74.61
|
| Rate for Payer: BCN Commercial |
$109.55
|
| Rate for Payer: BCN Medicare Advantage |
$74.61
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$99.98
|
| Rate for Payer: Cofinity Commercial |
$107.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.61
|
| Rate for Payer: Healthscope Commercial |
$138.03
|
| Rate for Payer: Healthscope Commercial |
$119.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.72
|
| Rate for Payer: Nomi Health Commercial |
$89.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$74.61
|
| Rate for Payer: PHP Medicare Advantage |
$74.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.03
|
| Rate for Payer: Priority Health Medicare |
$74.61
|
| Rate for Payer: Priority Health SBD |
$101.03
|
| Rate for Payer: Priority Health Tiered Network |
$101.03
|
| Rate for Payer: Railroad Medicare Medicare |
$74.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.43
|
| Rate for Payer: UHC Core |
$120.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.61
|
| Rate for Payer: UHC Exchange |
$120.43
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$80.24 |
| Max. Negotiated Rate |
$148.44 |
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: Aetna Medicare |
$83.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.55
|
| Rate for Payer: BCBS MAPPO |
$80.24
|
| Rate for Payer: BCN Commercial |
$119.51
|
| Rate for Payer: BCN Medicare Advantage |
$80.24
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$115.55
|
| Rate for Payer: Cofinity Commercial |
$107.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.24
|
| Rate for Payer: Healthscope Commercial |
$148.44
|
| Rate for Payer: Healthscope Commercial |
$128.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.23
|
| Rate for Payer: Nomi Health Commercial |
$96.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$80.24
|
| Rate for Payer: PHP Medicare Advantage |
$80.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.22
|
| Rate for Payer: Priority Health Medicare |
$80.24
|
| Rate for Payer: Priority Health SBD |
$110.22
|
| Rate for Payer: Priority Health Tiered Network |
$110.22
|
| Rate for Payer: Railroad Medicare Medicare |
$80.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.07
|
| Rate for Payer: UHC Core |
$138.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.24
|
| Rate for Payer: UHC Exchange |
$138.07
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$82.73 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$110.86
|
| Rate for Payer: Aetna Commercial |
$110.86
|
| Rate for Payer: Aetna Medicare |
$86.04
|
| Rate for Payer: Aetna Medicare |
$86.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.86
|
| Rate for Payer: BCBS MAPPO |
$82.73
|
| Rate for Payer: BCBS MAPPO |
$82.73
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$82.73
|
| Rate for Payer: BCN Medicare Advantage |
$82.73
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$119.13
|
| Rate for Payer: Cofinity Commercial |
$110.86
|
| Rate for Payer: Cofinity Commercial |
$110.86
|
| Rate for Payer: Cofinity Commercial |
$119.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.73
|
| Rate for Payer: Healthscope Commercial |
$153.05
|
| Rate for Payer: Healthscope Commercial |
$153.05
|
| Rate for Payer: Healthscope Commercial |
$132.37
|
| Rate for Payer: Healthscope Commercial |
$132.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.31
|
| Rate for Payer: Nomi Health Commercial |
$99.28
|
| Rate for Payer: Nomi Health Commercial |
$99.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$82.73
|
| Rate for Payer: PACE SWMI |
$82.73
|
| Rate for Payer: PHP Medicare Advantage |
$82.73
|
| Rate for Payer: PHP Medicare Advantage |
$82.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.06
|
| Rate for Payer: Priority Health Medicare |
$82.73
|
| Rate for Payer: Priority Health Medicare |
$82.73
|
| Rate for Payer: Priority Health SBD |
$112.06
|
| Rate for Payer: Priority Health SBD |
$112.06
|
| Rate for Payer: Priority Health Tiered Network |
$112.06
|
| Rate for Payer: Priority Health Tiered Network |
$112.06
|
| Rate for Payer: Railroad Medicare Medicare |
$82.73
|
| Rate for Payer: Railroad Medicare Medicare |
$82.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.25
|
| Rate for Payer: UHC Core |
$131.25
|
| Rate for Payer: UHC Core |
$131.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.73
|
| Rate for Payer: UHC Exchange |
$131.25
|
| Rate for Payer: UHC Exchange |
$131.25
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$163.11 |
| Rate for Payer: Aetna Commercial |
$118.15
|
| Rate for Payer: Aetna Medicare |
$91.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.15
|
| Rate for Payer: BCBS MAPPO |
$88.17
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$88.17
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$126.96
|
| Rate for Payer: Cofinity Commercial |
$118.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.17
|
| Rate for Payer: Healthscope Commercial |
$163.11
|
| Rate for Payer: Healthscope Commercial |
$141.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.82
|
| Rate for Payer: Nomi Health Commercial |
$105.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PACE SWMI |
$88.17
|
| Rate for Payer: PHP Medicare Advantage |
$88.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$124.91
|
| Rate for Payer: Priority Health Medicare |
$88.17
|
| Rate for Payer: Priority Health SBD |
$124.91
|
| Rate for Payer: Priority Health Tiered Network |
$124.91
|
| Rate for Payer: Railroad Medicare Medicare |
$88.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.06
|
| Rate for Payer: UHC Core |
$146.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.17
|
| Rate for Payer: UHC Exchange |
$146.06
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 95872
|
| Min. Negotiated Rate |
$206.01 |
| Max. Negotiated Rate |
$381.12 |
| Rate for Payer: Aetna Commercial |
$276.05
|
| Rate for Payer: Aetna Medicare |
$214.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.65
|
| Rate for Payer: BCBS MAPPO |
$206.01
|
| Rate for Payer: BCN Commercial |
$272.89
|
| Rate for Payer: BCN Medicare Advantage |
$206.01
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$296.65
|
| Rate for Payer: Cofinity Commercial |
$276.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.01
|
| Rate for Payer: Healthscope Commercial |
$381.12
|
| Rate for Payer: Healthscope Commercial |
$329.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.83
|
| Rate for Payer: Nomi Health Commercial |
$247.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.50
|
| Rate for Payer: PACE SWMI |
$206.01
|
| Rate for Payer: PHP Medicare Advantage |
$206.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.67
|
| Rate for Payer: Priority Health Medicare |
$206.01
|
| Rate for Payer: Priority Health SBD |
$251.67
|
| Rate for Payer: Priority Health Tiered Network |
$251.67
|
| Rate for Payer: Railroad Medicare Medicare |
$206.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.82
|
| Rate for Payer: UHC Core |
$315.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.01
|
| Rate for Payer: UHC Exchange |
$315.82
|
|
|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$16.43
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.65
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$12.26
|
| Rate for Payer: BCN Commercial |
$22.41
|
| Rate for Payer: BCN Medicare Advantage |
$12.26
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$17.65
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.26
|
| Rate for Payer: Healthscope Commercial |
$19.62
|
| Rate for Payer: Healthscope Commercial |
$22.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Nomi Health Commercial |
$14.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.50
|
| Rate for Payer: PACE SWMI |
$12.26
|
| Rate for Payer: PHP Medicare Advantage |
$12.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.96
|
| Rate for Payer: Priority Health Medicare |
$12.26
|
| Rate for Payer: Priority Health SBD |
$23.96
|
| Rate for Payer: Priority Health Tiered Network |
$23.96
|
| Rate for Payer: Railroad Medicare Medicare |
$12.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.87
|
| Rate for Payer: UHC Core |
$28.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.26
|
| Rate for Payer: UHC Exchange |
$28.87
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$19.57 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$20.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.18
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$33.87
|
| Rate for Payer: BCN Medicare Advantage |
$19.57
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Cofinity Commercial |
$26.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$36.20
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$23.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$19.57
|
| Rate for Payer: PHP Medicare Advantage |
$19.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$19.57
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Priority Health Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$19.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.62
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.57
|
| Rate for Payer: UHC Exchange |
$43.62
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: Aetna Medicare |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.02
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$20.85
|
| Rate for Payer: BCN Commercial |
$36.35
|
| Rate for Payer: BCN Medicare Advantage |
$20.85
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$30.02
|
| Rate for Payer: Cofinity Commercial |
$27.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.85
|
| Rate for Payer: Healthscope Commercial |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$33.36
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.89
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.38
|
| Rate for Payer: Nomi Health Commercial |
$25.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.75
|
| Rate for Payer: PACE SWMI |
$20.85
|
| Rate for Payer: PHP Medicare Advantage |
$20.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$20.85
|
| Rate for Payer: Priority Health SBD |
$34.51
|
| Rate for Payer: Priority Health Tiered Network |
$34.51
|
| Rate for Payer: Railroad Medicare Medicare |
$20.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.56
|
| Rate for Payer: UHC Core |
$23.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.85
|
| Rate for Payer: UHC Exchange |
$23.56
|
| Rate for Payer: UHC Medicaid |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare |
$23.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.88
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS MAPPO |
$22.83
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$22.83
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$32.88
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$36.53
|
| Rate for Payer: Mclaren Medicaid |
$14.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.97
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.38
|
| Rate for Payer: Nomi Health Commercial |
$27.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
| Rate for Payer: PACE SWMI |
$22.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37.30
|
| Rate for Payer: Priority Health Medicare |
$22.83
|
| Rate for Payer: Priority Health SBD |
$37.30
|
| Rate for Payer: Priority Health Tiered Network |
$37.30
|
| Rate for Payer: Railroad Medicare Medicare |
$22.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.49
|
| Rate for Payer: UHC Core |
$25.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.83
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicaid |
$14.70
|
| Rate for Payer: UHCCP Medicaid |
$14.70
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$25.02
|
| Rate for Payer: Aetna Medicare |
$19.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.88
|
| Rate for Payer: BCBS Complete |
$12.53
|
| Rate for Payer: BCBS MAPPO |
$18.67
|
| Rate for Payer: BCN Commercial |
$31.37
|
| Rate for Payer: BCN Medicare Advantage |
$18.67
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$26.88
|
| Rate for Payer: Cofinity Commercial |
$25.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.67
|
| Rate for Payer: Healthscope Commercial |
$34.54
|
| Rate for Payer: Healthscope Commercial |
$29.87
|
| Rate for Payer: Mclaren Medicaid |
$11.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.60
|
| Rate for Payer: Meridian Medicaid |
$12.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.54
|
| Rate for Payer: Nomi Health Commercial |
$22.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$18.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.82
|
| Rate for Payer: Priority Health Medicare |
$18.67
|
| Rate for Payer: Priority Health SBD |
$35.82
|
| Rate for Payer: Priority Health Tiered Network |
$35.82
|
| Rate for Payer: Railroad Medicare Medicare |
$18.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.66
|
| Rate for Payer: UHC Core |
$20.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.67
|
| Rate for Payer: UHC Exchange |
$20.66
|
| Rate for Payer: UHC Medicaid |
$11.93
|
| Rate for Payer: UHCCP Medicaid |
$11.93
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$29.09
|
| Rate for Payer: Aetna Medicare |
$22.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.26
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$21.71
|
| Rate for Payer: BCN Commercial |
$36.35
|
| Rate for Payer: BCN Medicare Advantage |
$21.71
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$31.26
|
| Rate for Payer: Cofinity Commercial |
$29.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.71
|
| Rate for Payer: Healthscope Commercial |
$40.16
|
| Rate for Payer: Healthscope Commercial |
$34.74
|
| Rate for Payer: Mclaren Medicaid |
$13.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.80
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.65
|
| Rate for Payer: Nomi Health Commercial |
$26.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$21.71
|
| Rate for Payer: PHP Medicare Advantage |
$21.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.48
|
| Rate for Payer: Priority Health Medicare |
$21.71
|
| Rate for Payer: Priority Health SBD |
$39.48
|
| Rate for Payer: Priority Health Tiered Network |
$39.48
|
| Rate for Payer: Railroad Medicare Medicare |
$21.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.21
|
| Rate for Payer: UHC Core |
$23.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.71
|
| Rate for Payer: UHC Exchange |
$23.21
|
| Rate for Payer: UHC Medicaid |
$13.85
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,606.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$759.35 |
| Max. Negotiated Rate |
$2,343.81 |
| Rate for Payer: Aetna Commercial |
$1,579.42
|
| Rate for Payer: Aetna Medicare |
$1,225.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,579.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,697.28
|
| Rate for Payer: BCBS Complete |
$797.32
|
| Rate for Payer: BCBS MAPPO |
$1,178.67
|
| Rate for Payer: BCN Commercial |
$1,979.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,178.67
|
| Rate for Payer: Cash Price |
$2,084.80
|
| Rate for Payer: Cash Price |
$2,084.80
|
| Rate for Payer: Cofinity Commercial |
$1,697.28
|
| Rate for Payer: Cofinity Commercial |
$1,579.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,178.67
|
| Rate for Payer: Healthscope Commercial |
$2,180.54
|
| Rate for Payer: Healthscope Commercial |
$1,885.87
|
| Rate for Payer: Mclaren Medicaid |
$759.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,237.60
|
| Rate for Payer: Meridian Medicaid |
$797.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,296.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,329.69
|
| Rate for Payer: Nomi Health Commercial |
$1,414.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.50
|
| Rate for Payer: PACE SWMI |
$1,178.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,178.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,156.84
|
| Rate for Payer: Priority Health Medicare |
$1,178.67
|
| Rate for Payer: Priority Health SBD |
$2,156.84
|
| Rate for Payer: Priority Health Tiered Network |
$2,156.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,178.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,343.81
|
| Rate for Payer: UHC Core |
$2,343.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,178.67
|
| Rate for Payer: UHC Exchange |
$2,343.81
|
| Rate for Payer: UHC Medicaid |
$759.35
|
| Rate for Payer: UHCCP Medicaid |
$759.35
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,892.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$833.68 |
| Max. Negotiated Rate |
$2,590.63 |
| Rate for Payer: Aetna Commercial |
$1,734.27
|
| Rate for Payer: Aetna Medicare |
$1,346.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,734.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,863.69
|
| Rate for Payer: BCBS Complete |
$875.36
|
| Rate for Payer: BCBS MAPPO |
$1,294.23
|
| Rate for Payer: BCN Commercial |
$2,176.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.23
|
| Rate for Payer: Cash Price |
$2,313.60
|
| Rate for Payer: Cash Price |
$2,313.60
|
| Rate for Payer: Cofinity Commercial |
$1,863.69
|
| Rate for Payer: Cofinity Commercial |
$1,734.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.23
|
| Rate for Payer: Healthscope Commercial |
$2,394.33
|
| Rate for Payer: Healthscope Commercial |
$2,070.77
|
| Rate for Payer: Mclaren Medicaid |
$833.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,358.94
|
| Rate for Payer: Meridian Medicaid |
$875.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,423.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,570.51
|
| Rate for Payer: Nomi Health Commercial |
$1,553.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,169.00
|
| Rate for Payer: PACE SWMI |
$1,294.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,371.11
|
| Rate for Payer: Priority Health Medicare |
$1,294.23
|
| Rate for Payer: Priority Health SBD |
$2,371.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,371.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,294.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,590.63
|
| Rate for Payer: UHC Core |
$2,590.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,294.23
|
| Rate for Payer: UHC Exchange |
$2,590.63
|
| Rate for Payer: UHC Medicaid |
$833.68
|
| Rate for Payer: UHCCP Medicaid |
$833.68
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,816.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$614.29 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Aetna Commercial |
$1,278.79
|
| Rate for Payer: Aetna Medicare |
$992.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.22
|
| Rate for Payer: BCBS Complete |
$645.00
|
| Rate for Payer: BCBS MAPPO |
$954.32
|
| Rate for Payer: BCN Commercial |
$1,581.09
|
| Rate for Payer: BCN Medicare Advantage |
$954.32
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,374.22
|
| Rate for Payer: Cofinity Commercial |
$1,278.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$954.32
|
| Rate for Payer: Healthscope Commercial |
$1,765.49
|
| Rate for Payer: Healthscope Commercial |
$1,526.91
|
| Rate for Payer: Mclaren Medicaid |
$614.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.04
|
| Rate for Payer: Meridian Medicaid |
$645.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,049.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,860.03
|
| Rate for Payer: Nomi Health Commercial |
$1,145.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,862.00
|
| Rate for Payer: PACE SWMI |
$954.32
|
| Rate for Payer: PHP Medicare Advantage |
$954.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,722.32
|
| Rate for Payer: Priority Health Medicare |
$954.32
|
| Rate for Payer: Priority Health SBD |
$1,722.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,722.32
|
| Rate for Payer: Railroad Medicare Medicare |
$954.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,855.19
|
| Rate for Payer: UHC Core |
$1,855.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$954.32
|
| Rate for Payer: UHC Exchange |
$1,855.19
|
| Rate for Payer: UHC Medicaid |
$614.29
|
| Rate for Payer: UHCCP Medicaid |
$614.29
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,516.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$728.67 |
| Max. Negotiated Rate |
$3,387.00 |
| Rate for Payer: Aetna Commercial |
$1,519.92
|
| Rate for Payer: Aetna Medicare |
$1,179.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,519.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.35
|
| Rate for Payer: BCBS Complete |
$765.10
|
| Rate for Payer: BCBS MAPPO |
$1,134.27
|
| Rate for Payer: BCN Commercial |
$1,904.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.27
|
| Rate for Payer: Cash Price |
$3,612.80
|
| Rate for Payer: Cash Price |
$3,612.80
|
| Rate for Payer: Cofinity Commercial |
$1,633.35
|
| Rate for Payer: Cofinity Commercial |
$1,519.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.27
|
| Rate for Payer: Healthscope Commercial |
$2,098.40
|
| Rate for Payer: Healthscope Commercial |
$1,814.83
|
| Rate for Payer: Mclaren Medicaid |
$728.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,190.98
|
| Rate for Payer: Meridian Medicaid |
$765.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,247.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,252.70
|
| Rate for Payer: Nomi Health Commercial |
$1,361.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,387.00
|
| Rate for Payer: PACE SWMI |
$1,134.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,074.38
|
| Rate for Payer: Priority Health Medicare |
$1,134.27
|
| Rate for Payer: Priority Health SBD |
$2,074.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,074.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,134.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,270.91
|
| Rate for Payer: UHC Core |
$2,270.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,134.27
|
| Rate for Payer: UHC Exchange |
$2,270.91
|
| Rate for Payer: UHC Medicaid |
$728.67
|
| Rate for Payer: UHCCP Medicaid |
$728.67
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,558.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$675.64 |
| Max. Negotiated Rate |
$2,668.50 |
| Rate for Payer: Aetna Commercial |
$1,405.82
|
| Rate for Payer: Aetna Medicare |
$1,091.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,510.73
|
| Rate for Payer: BCBS Complete |
$709.42
|
| Rate for Payer: BCBS MAPPO |
$1,049.12
|
| Rate for Payer: BCN Commercial |
$1,766.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.12
|
| Rate for Payer: Cash Price |
$2,846.40
|
| Rate for Payer: Cash Price |
$2,846.40
|
| Rate for Payer: Cofinity Commercial |
$1,510.73
|
| Rate for Payer: Cofinity Commercial |
$1,405.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.12
|
| Rate for Payer: Healthscope Commercial |
$1,940.87
|
| Rate for Payer: Healthscope Commercial |
$1,678.59
|
| Rate for Payer: Mclaren Medicaid |
$675.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,101.58
|
| Rate for Payer: Meridian Medicaid |
$709.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,154.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,122.96
|
| Rate for Payer: Nomi Health Commercial |
$1,258.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,668.50
|
| Rate for Payer: PACE SWMI |
$1,049.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,924.65
|
| Rate for Payer: Priority Health Medicare |
$1,049.12
|
| Rate for Payer: Priority Health SBD |
$1,924.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,924.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,049.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,127.45
|
| Rate for Payer: UHC Core |
$2,127.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,049.12
|
| Rate for Payer: UHC Exchange |
$2,127.45
|
| Rate for Payer: UHC Medicaid |
$675.64
|
| Rate for Payer: UHCCP Medicaid |
$675.64
|
|
