|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 50431
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: Aetna Commercial |
$77.65
|
| Rate for Payer: Aetna Medicare |
$60.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.45
|
| Rate for Payer: BCBS Complete |
$39.59
|
| Rate for Payer: BCBS MAPPO |
$57.95
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$57.95
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$83.45
|
| Rate for Payer: Cofinity Commercial |
$77.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.95
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Healthscope Commercial |
$107.21
|
| Rate for Payer: Mclaren Medicaid |
$37.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.85
|
| Rate for Payer: Meridian Medicaid |
$39.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.32
|
| Rate for Payer: Nomi Health Commercial |
$69.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$57.95
|
| Rate for Payer: PHP Medicare Advantage |
$57.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$107.41
|
| Rate for Payer: Priority Health Medicare |
$57.95
|
| Rate for Payer: Priority Health SBD |
$107.41
|
| Rate for Payer: Priority Health Tiered Network |
$107.41
|
| Rate for Payer: Railroad Medicare Medicare |
$57.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.37
|
| Rate for Payer: UHC Core |
$114.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.95
|
| Rate for Payer: UHC Exchange |
$114.37
|
| Rate for Payer: UHC Medicaid |
$37.70
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 50430
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$273.16 |
| Rate for Payer: Aetna Commercial |
$180.22
|
| Rate for Payer: Aetna Medicare |
$139.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.67
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$134.49
|
| Rate for Payer: BCN Commercial |
$226.08
|
| Rate for Payer: BCN Medicare Advantage |
$134.49
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$193.67
|
| Rate for Payer: Cofinity Commercial |
$180.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.49
|
| Rate for Payer: Healthscope Commercial |
$248.81
|
| Rate for Payer: Healthscope Commercial |
$215.18
|
| Rate for Payer: Mclaren Medicaid |
$86.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.21
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.27
|
| Rate for Payer: Nomi Health Commercial |
$161.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PACE SWMI |
$134.49
|
| Rate for Payer: PHP Medicare Advantage |
$134.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$246.27
|
| Rate for Payer: Priority Health Medicare |
$134.49
|
| Rate for Payer: Priority Health SBD |
$246.27
|
| Rate for Payer: Priority Health Tiered Network |
$246.27
|
| Rate for Payer: Railroad Medicare Medicare |
$134.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.16
|
| Rate for Payer: UHC Core |
$273.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.49
|
| Rate for Payer: UHC Exchange |
$273.16
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 36005
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$444.00 |
| Rate for Payer: Aetna Commercial |
$56.25
|
| Rate for Payer: Aetna Medicare |
$43.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.45
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.98
|
| Rate for Payer: BCN Commercial |
$76.59
|
| Rate for Payer: BCN Medicare Advantage |
$41.98
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$56.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.98
|
| Rate for Payer: Healthscope Commercial |
$77.66
|
| Rate for Payer: Healthscope Commercial |
$67.17
|
| Rate for Payer: Mclaren Medicaid |
$26.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.08
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.21
|
| Rate for Payer: Nomi Health Commercial |
$50.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.00
|
| Rate for Payer: PACE SWMI |
$41.98
|
| Rate for Payer: PHP Medicare Advantage |
$41.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74.98
|
| Rate for Payer: Priority Health Medicare |
$41.98
|
| Rate for Payer: Priority Health SBD |
$74.98
|
| Rate for Payer: Priority Health Tiered Network |
$74.98
|
| Rate for Payer: Railroad Medicare Medicare |
$41.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.05
|
| Rate for Payer: UHC Core |
$85.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.98
|
| Rate for Payer: UHC Exchange |
$85.05
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR NJX RETROGRADE URETHROCSTOGRAPY
|
Professional
|
Both
|
$739.00
|
|
|
Service Code
|
HCPCS 51610
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$554.25 |
| Rate for Payer: Aetna Commercial |
$75.83
|
| Rate for Payer: Aetna Medicare |
$58.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.49
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$56.59
|
| Rate for Payer: BCN Commercial |
$97.11
|
| Rate for Payer: BCN Medicare Advantage |
$56.59
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cofinity Commercial |
$81.49
|
| Rate for Payer: Cofinity Commercial |
$75.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.59
|
| Rate for Payer: Healthscope Commercial |
$90.54
|
| Rate for Payer: Healthscope Commercial |
$104.69
|
| Rate for Payer: Mclaren Medicaid |
$36.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.42
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.92
|
| Rate for Payer: Nomi Health Commercial |
$67.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.25
|
| Rate for Payer: PACE SWMI |
$56.59
|
| Rate for Payer: PHP Medicare Advantage |
$56.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105.79
|
| Rate for Payer: Priority Health Medicare |
$56.59
|
| Rate for Payer: Priority Health SBD |
$105.79
|
| Rate for Payer: Priority Health Tiered Network |
$105.79
|
| Rate for Payer: Railroad Medicare Medicare |
$56.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.49
|
| Rate for Payer: UHC Core |
$112.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.59
|
| Rate for Payer: UHC Exchange |
$112.49
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 50690
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$164.25 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Healthscope Commercial |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Mclaren Medicaid |
$39.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.97
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114.46
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health SBD |
$114.46
|
| Rate for Payer: Priority Health Tiered Network |
$114.46
|
| Rate for Payer: Railroad Medicare Medicare |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.84
|
| Rate for Payer: UHC Core |
$122.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.87
|
| Rate for Payer: UHC Exchange |
$122.84
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
|
|
PR NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 54250
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$223.15 |
| Rate for Payer: Aetna Commercial |
$161.63
|
| Rate for Payer: Aetna Medicare |
$125.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.69
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: BCBS MAPPO |
$120.62
|
| Rate for Payer: BCN Commercial |
$181.27
|
| Rate for Payer: BCN Medicare Advantage |
$120.62
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Cofinity Commercial |
$161.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.62
|
| Rate for Payer: Healthscope Commercial |
$192.99
|
| Rate for Payer: Healthscope Commercial |
$223.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.67
|
| Rate for Payer: Nomi Health Commercial |
$144.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.50
|
| Rate for Payer: PACE SWMI |
$120.62
|
| Rate for Payer: PHP Medicare Advantage |
$120.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.45
|
| Rate for Payer: Priority Health Medicare |
$120.62
|
| Rate for Payer: Priority Health SBD |
$197.45
|
| Rate for Payer: Priority Health Tiered Network |
$197.45
|
| Rate for Payer: Railroad Medicare Medicare |
$120.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.52
|
| Rate for Payer: UHC Core |
$214.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.62
|
| Rate for Payer: UHC Exchange |
$214.52
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 94761
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$5.41
|
| Rate for Payer: Aetna Medicare |
$4.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.82
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$4.04
|
| Rate for Payer: BCN Commercial |
$5.97
|
| Rate for Payer: BCN Medicare Advantage |
$4.04
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$5.82
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.04
|
| Rate for Payer: Healthscope Commercial |
$7.47
|
| Rate for Payer: Healthscope Commercial |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.18
|
| Rate for Payer: Nomi Health Commercial |
$4.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$4.04
|
| Rate for Payer: PHP Medicare Advantage |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.51
|
| Rate for Payer: Priority Health Medicare |
$4.04
|
| Rate for Payer: Priority Health SBD |
$5.51
|
| Rate for Payer: Priority Health Tiered Network |
$5.51
|
| Rate for Payer: Railroad Medicare Medicare |
$4.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.89
|
| Rate for Payer: UHC Core |
$5.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.04
|
| Rate for Payer: UHC Exchange |
$5.89
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 94762
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$40.76 |
| Rate for Payer: Aetna Commercial |
$29.52
|
| Rate for Payer: Aetna Medicare |
$22.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.03
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$40.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.25
|
| Rate for Payer: PACE SWMI |
$22.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.99
|
| Rate for Payer: Priority Health Medicare |
$22.03
|
| Rate for Payer: Priority Health SBD |
$33.99
|
| Rate for Payer: Priority Health Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.40
|
| Rate for Payer: UHC Core |
$39.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.03
|
| Rate for Payer: UHC Exchange |
$39.40
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 94760
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$5.00
|
| Rate for Payer: Aetna Medicare |
$3.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.37
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$3.73
|
| Rate for Payer: BCN Commercial |
$5.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.73
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Cofinity Commercial |
$5.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.73
|
| Rate for Payer: Healthscope Commercial |
$6.90
|
| Rate for Payer: Healthscope Commercial |
$5.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.33
|
| Rate for Payer: Nomi Health Commercial |
$4.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$3.73
|
| Rate for Payer: PHP Medicare Advantage |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.05
|
| Rate for Payer: Priority Health Medicare |
$3.73
|
| Rate for Payer: Priority Health SBD |
$5.05
|
| Rate for Payer: Priority Health Tiered Network |
$5.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.77
|
| Rate for Payer: UHC Core |
$3.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.73
|
| Rate for Payer: UHC Exchange |
$3.77
|
|
|
PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 93923
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$229.23 |
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Medicare |
$128.87
|
| Rate for Payer: Aetna Medicare |
$128.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.04
|
| Rate for Payer: BCBS MAPPO |
$123.91
|
| Rate for Payer: BCBS MAPPO |
$123.91
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Medicare Advantage |
$123.91
|
| Rate for Payer: BCN Medicare Advantage |
$123.91
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.91
|
| Rate for Payer: Healthscope Commercial |
$229.23
|
| Rate for Payer: Healthscope Commercial |
$229.23
|
| Rate for Payer: Healthscope Commercial |
$198.26
|
| Rate for Payer: Healthscope Commercial |
$198.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.53
|
| Rate for Payer: Nomi Health Commercial |
$148.69
|
| Rate for Payer: Nomi Health Commercial |
$148.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$123.91
|
| Rate for Payer: PACE SWMI |
$123.91
|
| Rate for Payer: PHP Medicare Advantage |
$123.91
|
| Rate for Payer: PHP Medicare Advantage |
$123.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.65
|
| Rate for Payer: Priority Health Medicare |
$123.91
|
| Rate for Payer: Priority Health Medicare |
$123.91
|
| Rate for Payer: Priority Health SBD |
$178.65
|
| Rate for Payer: Priority Health SBD |
$178.65
|
| Rate for Payer: Priority Health Tiered Network |
$178.65
|
| Rate for Payer: Priority Health Tiered Network |
$178.65
|
| Rate for Payer: Railroad Medicare Medicare |
$123.91
|
| Rate for Payer: Railroad Medicare Medicare |
$123.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.39
|
| Rate for Payer: UHC Core |
$201.39
|
| Rate for Payer: UHC Core |
$201.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.91
|
| Rate for Payer: UHC Exchange |
$201.39
|
| Rate for Payer: UHC Exchange |
$201.39
|
|
|
PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 93922
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$142.43 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Medicare |
$80.07
|
| Rate for Payer: Aetna Medicare |
$80.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.17
|
| Rate for Payer: BCBS MAPPO |
$76.99
|
| Rate for Payer: BCBS MAPPO |
$76.99
|
| Rate for Payer: BCN Commercial |
$122.01
|
| Rate for Payer: BCN Commercial |
$122.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.99
|
| Rate for Payer: BCN Medicare Advantage |
$76.99
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$110.87
|
| Rate for Payer: Cofinity Commercial |
$103.17
|
| Rate for Payer: Cofinity Commercial |
$103.17
|
| Rate for Payer: Cofinity Commercial |
$110.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.99
|
| Rate for Payer: Healthscope Commercial |
$142.43
|
| Rate for Payer: Healthscope Commercial |
$142.43
|
| Rate for Payer: Healthscope Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$123.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.55
|
| Rate for Payer: Nomi Health Commercial |
$92.39
|
| Rate for Payer: Nomi Health Commercial |
$92.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: PACE SWMI |
$76.99
|
| Rate for Payer: PACE SWMI |
$76.99
|
| Rate for Payer: PHP Medicare Advantage |
$76.99
|
| Rate for Payer: PHP Medicare Advantage |
$76.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.52
|
| Rate for Payer: Priority Health Medicare |
$76.99
|
| Rate for Payer: Priority Health Medicare |
$76.99
|
| Rate for Payer: Priority Health SBD |
$112.52
|
| Rate for Payer: Priority Health SBD |
$112.52
|
| Rate for Payer: Priority Health Tiered Network |
$112.52
|
| Rate for Payer: Priority Health Tiered Network |
$112.52
|
| Rate for Payer: Railroad Medicare Medicare |
$76.99
|
| Rate for Payer: Railroad Medicare Medicare |
$76.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.03
|
| Rate for Payer: UHC Core |
$129.03
|
| Rate for Payer: UHC Core |
$129.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.99
|
| Rate for Payer: UHC Exchange |
$129.03
|
| Rate for Payer: UHC Exchange |
$129.03
|
|
|
PR NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 36221
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$880.50 |
| Rate for Payer: Aetna Commercial |
$241.37
|
| Rate for Payer: Aetna Medicare |
$187.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.39
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$180.13
|
| Rate for Payer: BCN Commercial |
$292.32
|
| Rate for Payer: BCN Medicare Advantage |
$180.13
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$259.39
|
| Rate for Payer: Cofinity Commercial |
$241.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.13
|
| Rate for Payer: Healthscope Commercial |
$333.24
|
| Rate for Payer: Healthscope Commercial |
$288.21
|
| Rate for Payer: Mclaren Medicaid |
$113.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.14
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$198.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.14
|
| Rate for Payer: Nomi Health Commercial |
$216.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$880.50
|
| Rate for Payer: PACE SWMI |
$180.13
|
| Rate for Payer: PHP Medicare Advantage |
$180.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$314.34
|
| Rate for Payer: Priority Health Medicare |
$180.13
|
| Rate for Payer: Priority Health SBD |
$314.34
|
| Rate for Payer: Priority Health Tiered Network |
$314.34
|
| Rate for Payer: Railroad Medicare Medicare |
$180.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.23
|
| Rate for Payer: UHC Core |
$360.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$180.13
|
| Rate for Payer: UHC Exchange |
$360.23
|
| Rate for Payer: UHC Medicaid |
$113.53
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J7050
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$0.94
|
| Rate for Payer: Aetna Medicare |
$0.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$0.70
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.70
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.94
|
| Rate for Payer: Cofinity Commercial |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.70
|
| Rate for Payer: Healthscope Commercial |
$1.29
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.65
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$0.70
|
| Rate for Payer: PHP Medicare Advantage |
$0.70
|
| Rate for Payer: Priority Health Medicare |
$0.70
|
| Rate for Payer: Railroad Medicare Medicare |
$0.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.66
|
| Rate for Payer: UHC Core |
$0.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.70
|
| Rate for Payer: UHC Exchange |
$0.66
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J7030
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$2.93
|
| Rate for Payer: Aetna Medicare |
$2.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$2.19
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$2.93
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.19
|
| Rate for Payer: Healthscope Commercial |
$4.05
|
| Rate for Payer: Healthscope Commercial |
$3.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.58
|
| Rate for Payer: Nomi Health Commercial |
$2.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$2.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.19
|
| Rate for Payer: Priority Health Medicare |
$2.19
|
| Rate for Payer: Railroad Medicare Medicare |
$2.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.99
|
| Rate for Payer: UHC Core |
$1.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.19
|
| Rate for Payer: UHC Exchange |
$1.99
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J7040
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$1.82
|
| Rate for Payer: Aetna Medicare |
$1.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$1.36
|
| Rate for Payer: BCBS Trust/PPO |
$0.62
|
| Rate for Payer: BCN Commercial |
$0.35
|
| Rate for Payer: BCN Medicare Advantage |
$1.36
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.36
|
| Rate for Payer: Healthscope Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.29
|
| Rate for Payer: Nomi Health Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$1.36
|
| Rate for Payer: PHP Medicare Advantage |
$1.36
|
| Rate for Payer: Priority Health Medicare |
$1.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.29
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.36
|
| Rate for Payer: UHC Exchange |
$1.29
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 98971
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$25.21
|
| Rate for Payer: Aetna Medicare |
$19.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.09
|
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: BCBS MAPPO |
$18.81
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.81
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.81
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Healthscope Commercial |
$30.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.40
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: PACE SWMI |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.31
|
| Rate for Payer: Priority Health Medicare |
$18.81
|
| Rate for Payer: Priority Health SBD |
$30.31
|
| Rate for Payer: Priority Health Tiered Network |
$30.31
|
| Rate for Payer: Railroad Medicare Medicare |
$18.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.13
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.81
|
| Rate for Payer: UHC Exchange |
$30.13
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 98972
|
| Min. Negotiated Rate |
$28.75 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$38.52
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.40
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$41.40
|
| Rate for Payer: Cofinity Commercial |
$38.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$53.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.44
|
| Rate for Payer: Nomi Health Commercial |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health SBD |
$45.46
|
| Rate for Payer: Priority Health Tiered Network |
$45.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.75
|
| Rate for Payer: UHC Core |
$46.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.75
|
| Rate for Payer: UHC Exchange |
$46.75
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 98970
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$13.73
|
| Rate for Payer: Aetna Medicare |
$10.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.76
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: BCN Medicare Advantage |
$10.25
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$14.76
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.25
|
| Rate for Payer: Healthscope Commercial |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$16.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
| Rate for Payer: PACE SWMI |
$10.25
|
| Rate for Payer: PHP Medicare Advantage |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.07
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.07
|
| Rate for Payer: UHC Core |
$17.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.25
|
| Rate for Payer: UHC Exchange |
$17.07
|
|
|
PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 31267
|
| Min. Negotiated Rate |
$142.92 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Aetna Commercial |
$298.32
|
| Rate for Payer: Aetna Medicare |
$231.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.59
|
| Rate for Payer: BCBS Complete |
$150.07
|
| Rate for Payer: BCBS MAPPO |
$222.63
|
| Rate for Payer: BCN Commercial |
$394.90
|
| Rate for Payer: BCN Medicare Advantage |
$222.63
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$320.59
|
| Rate for Payer: Cofinity Commercial |
$298.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.63
|
| Rate for Payer: Healthscope Commercial |
$411.87
|
| Rate for Payer: Healthscope Commercial |
$356.21
|
| Rate for Payer: Mclaren Medicaid |
$142.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.76
|
| Rate for Payer: Meridian Medicaid |
$150.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$244.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.48
|
| Rate for Payer: Nomi Health Commercial |
$267.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$222.63
|
| Rate for Payer: PHP Medicare Advantage |
$222.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.88
|
| Rate for Payer: Priority Health Medicare |
$222.63
|
| Rate for Payer: Priority Health SBD |
$371.88
|
| Rate for Payer: Priority Health Tiered Network |
$371.88
|
| Rate for Payer: Railroad Medicare Medicare |
$222.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.55
|
| Rate for Payer: UHC Core |
$465.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$222.63
|
| Rate for Payer: UHC Exchange |
$465.55
|
| Rate for Payer: UHC Medicaid |
$142.92
|
| Rate for Payer: UHCCP Medicaid |
$142.92
|
|
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 31288
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna Medicare |
$204.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.16
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$196.64
|
| Rate for Payer: BCN Commercial |
$349.08
|
| Rate for Payer: BCN Medicare Advantage |
$196.64
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$283.16
|
| Rate for Payer: Cofinity Commercial |
$263.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.64
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Healthscope Commercial |
$314.62
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.47
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$415.51
|
| Rate for Payer: Nomi Health Commercial |
$235.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: PACE SWMI |
$196.64
|
| Rate for Payer: PHP Medicare Advantage |
$196.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$328.74
|
| Rate for Payer: Priority Health Medicare |
$196.64
|
| Rate for Payer: Priority Health SBD |
$328.74
|
| Rate for Payer: Priority Health Tiered Network |
$328.74
|
| Rate for Payer: Railroad Medicare Medicare |
$196.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.38
|
| Rate for Payer: UHC Core |
$410.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$196.64
|
| Rate for Payer: UHC Exchange |
$410.38
|
| Rate for Payer: UHC Medicaid |
$126.31
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 99447
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$58.85 |
| Rate for Payer: Aetna Commercial |
$42.63
|
| Rate for Payer: Aetna Medicare |
$33.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.81
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$31.81
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$31.81
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$45.81
|
| Rate for Payer: Cofinity Commercial |
$42.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.81
|
| Rate for Payer: Healthscope Commercial |
$58.85
|
| Rate for Payer: Healthscope Commercial |
$50.90
|
| Rate for Payer: Mclaren Medicaid |
$20.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.40
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.29
|
| Rate for Payer: Nomi Health Commercial |
$38.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.00
|
| Rate for Payer: PACE SWMI |
$31.81
|
| Rate for Payer: PHP Medicare Advantage |
$31.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.56
|
| Rate for Payer: Priority Health Medicare |
$31.81
|
| Rate for Payer: Priority Health SBD |
$40.56
|
| Rate for Payer: Priority Health Tiered Network |
$40.56
|
| Rate for Payer: Railroad Medicare Medicare |
$31.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.60
|
| Rate for Payer: UHC Core |
$51.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.81
|
| Rate for Payer: UHC Exchange |
$51.60
|
| Rate for Payer: UHC Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 99448
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$87.52 |
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna Medicare |
$49.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.13
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.31
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: BCN Medicare Advantage |
$47.31
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$68.13
|
| Rate for Payer: Cofinity Commercial |
$63.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.31
|
| Rate for Payer: Healthscope Commercial |
$87.52
|
| Rate for Payer: Healthscope Commercial |
$75.70
|
| Rate for Payer: Mclaren Medicaid |
$30.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.68
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.68
|
| Rate for Payer: Nomi Health Commercial |
$56.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE SWMI |
$47.31
|
| Rate for Payer: PHP Medicare Advantage |
$47.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$60.27
|
| Rate for Payer: Priority Health Medicare |
$47.31
|
| Rate for Payer: Priority Health SBD |
$60.27
|
| Rate for Payer: Priority Health Tiered Network |
$60.27
|
| Rate for Payer: Railroad Medicare Medicare |
$47.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.18
|
| Rate for Payer: UHC Core |
$77.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.31
|
| Rate for Payer: UHC Exchange |
$77.18
|
| Rate for Payer: UHC Medicaid |
$30.46
|
| Rate for Payer: UHCCP Medicaid |
$30.46
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 99449
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$116.31 |
| Rate for Payer: Aetna Commercial |
$84.25
|
| Rate for Payer: Aetna Medicare |
$65.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.53
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$62.87
|
| Rate for Payer: BCN Commercial |
$107.07
|
| Rate for Payer: BCN Medicare Advantage |
$62.87
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cofinity Commercial |
$90.53
|
| Rate for Payer: Cofinity Commercial |
$84.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.87
|
| Rate for Payer: Healthscope Commercial |
$116.31
|
| Rate for Payer: Healthscope Commercial |
$100.59
|
| Rate for Payer: Mclaren Medicaid |
$40.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.01
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.42
|
| Rate for Payer: Nomi Health Commercial |
$75.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.00
|
| Rate for Payer: PACE SWMI |
$62.87
|
| Rate for Payer: PHP Medicare Advantage |
$62.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$81.50
|
| Rate for Payer: Priority Health Medicare |
$62.87
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| Rate for Payer: Priority Health Tiered Network |
$81.50
|
| Rate for Payer: Railroad Medicare Medicare |
$62.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.69
|
| Rate for Payer: UHC Core |
$102.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.87
|
| Rate for Payer: UHC Exchange |
$102.69
|
| Rate for Payer: UHC Medicaid |
$40.47
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 99446
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna Medicare |
$16.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.95
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$15.94
|
| Rate for Payer: BCN Commercial |
$26.40
|
| Rate for Payer: BCN Medicare Advantage |
$15.94
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.94
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Mclaren Medicaid |
$10.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.74
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.46
|
| Rate for Payer: Nomi Health Commercial |
$19.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: PACE SWMI |
$15.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.09
|
| Rate for Payer: Priority Health Medicare |
$15.94
|
| Rate for Payer: Priority Health SBD |
$20.09
|
| Rate for Payer: Priority Health Tiered Network |
$20.09
|
| Rate for Payer: Railroad Medicare Medicare |
$15.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.57
|
| Rate for Payer: UHC Core |
$25.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.94
|
| Rate for Payer: UHC Exchange |
$25.57
|
| Rate for Payer: UHC Medicaid |
$10.22
|
| Rate for Payer: UHCCP Medicaid |
$10.22
|
|
|
PR NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS
|
Professional
|
Both
|
$7,322.00
|
|
|
Service Code
|
HCPCS 62161
|
| Min. Negotiated Rate |
$958.29 |
| Max. Negotiated Rate |
$5,491.50 |
| Rate for Payer: Aetna Commercial |
$2,002.58
|
| Rate for Payer: Aetna Medicare |
$1,554.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,002.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,152.02
|
| Rate for Payer: BCBS Complete |
$1,006.20
|
| Rate for Payer: BCBS MAPPO |
$1,494.46
|
| Rate for Payer: BCN Commercial |
$3,215.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,494.46
|
| Rate for Payer: Cash Price |
$5,857.60
|
| Rate for Payer: Cash Price |
$5,857.60
|
| Rate for Payer: Cofinity Commercial |
$2,152.02
|
| Rate for Payer: Cofinity Commercial |
$2,002.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,494.46
|
| Rate for Payer: Healthscope Commercial |
$2,764.75
|
| Rate for Payer: Healthscope Commercial |
$2,391.14
|
| Rate for Payer: Mclaren Medicaid |
$958.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.18
|
| Rate for Payer: Meridian Medicaid |
$1,006.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,643.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,757.13
|
| Rate for Payer: Nomi Health Commercial |
$1,793.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,491.50
|
| Rate for Payer: PACE SWMI |
$1,494.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,494.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$958.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,703.43
|
| Rate for Payer: Priority Health Medicare |
$1,494.46
|
| Rate for Payer: Priority Health SBD |
$2,703.43
|
| Rate for Payer: Priority Health Tiered Network |
$2,703.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,494.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,661.94
|
| Rate for Payer: UHC Core |
$2,661.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,494.46
|
| Rate for Payer: UHC Exchange |
$2,661.94
|
| Rate for Payer: UHC Medicaid |
$958.29
|
| Rate for Payer: UHCCP Medicaid |
$958.29
|
|
