|
PR MASTOPEXY
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19316
|
| Min. Negotiated Rate |
$759.14 |
| Max. Negotiated Rate |
$1,404.41 |
| Rate for Payer: Aetna Commercial |
$1,017.25
|
| Rate for Payer: Aetna Medicare |
$789.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.25
|
| Rate for Payer: BCBS Complete |
$775.20
|
| Rate for Payer: BCBS MAPPO |
$759.14
|
| Rate for Payer: BCN Medicare Advantage |
$759.14
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.16
|
| Rate for Payer: Cofinity Commercial |
$1,017.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.14
|
| Rate for Payer: Healthscope Commercial |
$1,404.41
|
| Rate for Payer: Healthscope Commercial |
$1,214.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$910.97
|
| Rate for Payer: PACE SWMI |
$759.14
|
| Rate for Payer: PHP Medicare Advantage |
$759.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health Medicare |
$759.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.14
|
| Rate for Payer: UHC Medicare Advantage |
$759.14
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Min. Negotiated Rate |
$299.98 |
| Max. Negotiated Rate |
$554.96 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.97
|
| Rate for Payer: BCBS Complete |
$325.60
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$479.97
|
| Rate for Payer: Healthscope Commercial |
$554.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.10
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health Medicare |
$299.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
IP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$512.82 |
| Max. Negotiated Rate |
$732.60 |
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.10
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$569.80
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health SBD |
$512.82
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$299.98 |
| Max. Negotiated Rate |
$554.96 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.97
|
| Rate for Payer: BCBS Complete |
$325.60
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$554.96
|
| Rate for Payer: Healthscope Commercial |
$479.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.10
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health Medicare |
$299.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
OP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$512.82 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Cofinity Commercial |
$569.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$512.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$966.40 |
| Max. Negotiated Rate |
$2,052.80 |
| Rate for Payer: Aetna Commercial |
$1,486.89
|
| Rate for Payer: Aetna Medicare |
$1,154.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.89
|
| Rate for Payer: BCBS Complete |
$966.40
|
| Rate for Payer: BCBS MAPPO |
$1,109.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.62
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,597.85
|
| Rate for Payer: Cofinity Commercial |
$1,486.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.62
|
| Rate for Payer: Healthscope Commercial |
$2,052.80
|
| Rate for Payer: Healthscope Commercial |
$1,775.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,570.40
|
| Rate for Payer: Nomi Health Commercial |
$1,331.54
|
| Rate for Payer: PACE SWMI |
$1,109.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health Medicare |
$1,109.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.62
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.18
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCN Medicare Advantage |
$13.57
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.57
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Healthscope Commercial |
$25.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: PACE SWMI |
$13.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$1,321.60 |
| Max. Negotiated Rate |
$3,149.42 |
| Rate for Payer: Aetna Commercial |
$2,281.20
|
| Rate for Payer: Aetna Medicare |
$1,770.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,281.20
|
| Rate for Payer: BCBS Complete |
$1,321.60
|
| Rate for Payer: BCBS MAPPO |
$1,702.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.39
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cofinity Commercial |
$2,451.44
|
| Rate for Payer: Cofinity Commercial |
$2,281.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.39
|
| Rate for Payer: Healthscope Commercial |
$2,723.82
|
| Rate for Payer: Healthscope Commercial |
$3,149.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,147.60
|
| Rate for Payer: Nomi Health Commercial |
$2,042.87
|
| Rate for Payer: PACE SWMI |
$1,702.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.60
|
| Rate for Payer: Priority Health Medicare |
$1,702.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.39
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$105.95 |
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.95
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$56.55 |
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
|
|
PR MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$43.25 |
| Max. Negotiated Rate |
$153.40 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.95
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCN Medicare Advantage |
$43.25
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$57.95
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$80.01
|
| Rate for Payer: Healthscope Commercial |
$69.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.40
|
| Rate for Payer: Nomi Health Commercial |
$51.90
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$170.66 |
| Max. Negotiated Rate |
$742.30 |
| Rate for Payer: Aetna Commercial |
$228.68
|
| Rate for Payer: Aetna Medicare |
$177.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.68
|
| Rate for Payer: BCBS Complete |
$456.80
|
| Rate for Payer: BCBS MAPPO |
$170.66
|
| Rate for Payer: BCN Medicare Advantage |
$170.66
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$245.75
|
| Rate for Payer: Cofinity Commercial |
$228.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.66
|
| Rate for Payer: Healthscope Commercial |
$315.72
|
| Rate for Payer: Healthscope Commercial |
$273.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$742.30
|
| Rate for Payer: Nomi Health Commercial |
$204.79
|
| Rate for Payer: PACE SWMI |
$170.66
|
| Rate for Payer: PHP Medicare Advantage |
$170.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health Medicare |
$170.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.66
|
| Rate for Payer: UHC Medicare Advantage |
$170.66
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$91.96 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCN Medicare Advantage |
$49.71
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$66.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.71
|
| Rate for Payer: Healthscope Commercial |
$79.54
|
| Rate for Payer: Healthscope Commercial |
$91.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.60
|
| Rate for Payer: Nomi Health Commercial |
$59.65
|
| Rate for Payer: PACE SWMI |
$49.71
|
| Rate for Payer: PHP Medicare Advantage |
$49.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health Medicare |
$49.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.71
|
| Rate for Payer: UHC Medicare Advantage |
$49.71
|
|
|
PR MD INR TEST REVIE INTER MGMT
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$11.07
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.07
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCN Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$11.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.26
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$13.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.15
|
| Rate for Payer: Nomi Health Commercial |
$9.91
|
| Rate for Payer: PACE SWMI |
$8.26
|
| Rate for Payer: PHP Medicare Advantage |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$8.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.26
|
| Rate for Payer: UHC Medicare Advantage |
$8.26
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$72.09 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.22
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCN Medicare Advantage |
$38.97
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| Rate for Payer: Cofinity Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.97
|
| Rate for Payer: Healthscope Commercial |
$62.35
|
| Rate for Payer: Healthscope Commercial |
$72.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Nomi Health Commercial |
$46.76
|
| Rate for Payer: PACE SWMI |
$38.97
|
| Rate for Payer: PHP Medicare Advantage |
$38.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$38.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Medicare Advantage |
$38.97
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$18.85 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$8.24
|
| Rate for Payer: BCN Medicare Advantage |
$8.24
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$11.87
|
| Rate for Payer: Cofinity Commercial |
$11.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.24
|
| Rate for Payer: Healthscope Commercial |
$13.18
|
| Rate for Payer: Healthscope Commercial |
$15.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.85
|
| Rate for Payer: Nomi Health Commercial |
$9.89
|
| Rate for Payer: PACE SWMI |
$8.24
|
| Rate for Payer: PHP Medicare Advantage |
$8.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$8.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.24
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$69.55 |
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna Medicare |
$10.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.04
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$10.48
|
| Rate for Payer: BCN Medicare Advantage |
$10.48
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$15.09
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.48
|
| Rate for Payer: Healthscope Commercial |
$19.39
|
| Rate for Payer: Healthscope Commercial |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Nomi Health Commercial |
$12.58
|
| Rate for Payer: PACE SWMI |
$10.48
|
| Rate for Payer: PHP Medicare Advantage |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.48
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 53020
|
| Min. Negotiated Rate |
$92.04 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Aetna Commercial |
$123.33
|
| Rate for Payer: Aetna Medicare |
$95.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.33
|
| Rate for Payer: BCBS Complete |
$136.80
|
| Rate for Payer: BCBS MAPPO |
$92.04
|
| Rate for Payer: BCN Medicare Advantage |
$92.04
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$132.54
|
| Rate for Payer: Cofinity Commercial |
$123.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.04
|
| Rate for Payer: Healthscope Commercial |
$147.26
|
| Rate for Payer: Healthscope Commercial |
$170.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.30
|
| Rate for Payer: Nomi Health Commercial |
$110.45
|
| Rate for Payer: PACE SWMI |
$92.04
|
| Rate for Payer: PHP Medicare Advantage |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.04
|
| Rate for Payer: UHC Medicare Advantage |
$92.04
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Medicare |
$68.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.20
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS MAPPO |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$65.82
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$88.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.82
|
| Rate for Payer: Healthscope Commercial |
$105.31
|
| Rate for Payer: Healthscope Commercial |
$121.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.05
|
| Rate for Payer: Nomi Health Commercial |
$78.98
|
| Rate for Payer: PACE SWMI |
$65.82
|
| Rate for Payer: PHP Medicare Advantage |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health Medicare |
$65.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.82
|
| Rate for Payer: UHC Medicare Advantage |
$65.82
|
|
|
PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 39400
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$1,457.95 |
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
|
|
PR MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 39401
|
| Min. Negotiated Rate |
$297.19 |
| Max. Negotiated Rate |
$630.50 |
| Rate for Payer: Aetna Commercial |
$398.23
|
| Rate for Payer: Aetna Medicare |
$309.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.95
|
| Rate for Payer: BCBS Complete |
$388.00
|
| Rate for Payer: BCBS MAPPO |
$297.19
|
| Rate for Payer: BCN Medicare Advantage |
$297.19
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$398.23
|
| Rate for Payer: Cofinity Commercial |
$427.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.19
|
| Rate for Payer: Healthscope Commercial |
$475.50
|
| Rate for Payer: Healthscope Commercial |
$549.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.50
|
| Rate for Payer: Nomi Health Commercial |
$356.63
|
| Rate for Payer: PACE SWMI |
$297.19
|
| Rate for Payer: PHP Medicare Advantage |
$297.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health Medicare |
$297.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.19
|
| Rate for Payer: UHC Medicare Advantage |
$297.19
|
|
