|
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 MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$205,517.00 |
| Rate for Payer: Aetna Commercial |
$1,486.89
|
| Rate for Payer: Aetna Medicare |
$1,154.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.85
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS MAPPO |
$1,109.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,685.94
|
| 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: Mclaren Medicaid |
$738.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.10
|
| Rate for Payer: Meridian Medicaid |
$775.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205,517.00
|
| 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 Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.61
|
| Rate for Payer: Priority Health Medicare |
$1,109.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,563.61
|
| Rate for Payer: Priority Health SBD |
$1,563.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,142.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.62
|
| Rate for Payer: UHC Exchange |
$1,142.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.62
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$2,544.29 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.54
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,544.29
|
| Rate for Payer: BCN Commercial |
$21.51
|
| 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 |
$25.10
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Mclaren Medicaid |
$1.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.25
|
| Rate for Payer: Meridian Medicaid |
$1.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.00
|
| 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 Choice Medicaid |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.35
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: Priority Health Narrow Network |
$20.35
|
| Rate for Payer: Priority Health SBD |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Exchange |
$30.81
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
| Rate for Payer: UHCCP Medicaid |
$1.70
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$904.98 |
| Max. Negotiated Rate |
$318,913.00 |
| Rate for Payer: Aetna Commercial |
$2,281.20
|
| Rate for Payer: Aetna Medicare |
$1,770.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,281.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.44
|
| Rate for Payer: BCBS Complete |
$1,209.27
|
| Rate for Payer: BCBS MAPPO |
$1,702.39
|
| Rate for Payer: BCBS Trust/PPO |
$904.98
|
| Rate for Payer: BCN Commercial |
$2,643.74
|
| 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 |
$3,149.42
|
| Rate for Payer: Healthscope Commercial |
$2,723.82
|
| Rate for Payer: Mclaren Medicaid |
$1,151.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.51
|
| Rate for Payer: Meridian Medicaid |
$1,209.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318,913.00
|
| 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 Choice Medicaid |
$1,151.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,505.97
|
| Rate for Payer: Priority Health Medicare |
$1,702.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,505.97
|
| Rate for Payer: Priority Health SBD |
$2,505.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,641.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.39
|
| Rate for Payer: UHC Exchange |
$1,641.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.39
|
| Rate for Payer: UHCCP Medicaid |
$1,151.69
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$136.23
|
| Rate for Payer: Cash Price |
$130.40
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$884.37 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS Trust/PPO |
$884.37
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: Cash Price |
$65.60
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$1,823.69 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.69
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$69.60
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$28.81
|
| Rate for Payer: Cash Price |
$32.80
|
| 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 |
$28.97 |
| Max. Negotiated Rate |
$7,731.00 |
| Rate for Payer: Aetna Commercial |
$57.96
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.28
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| 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 |
$62.28
|
| Rate for Payer: Cofinity Commercial |
$57.96
|
| 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: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,731.00
|
| 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 Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.73
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: Priority Health Narrow Network |
$70.73
|
| Rate for Payer: Priority Health SBD |
$70.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Exchange |
$206.80
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$31,766.00 |
| Rate for Payer: Aetna Commercial |
$228.68
|
| Rate for Payer: Aetna Medicare |
$177.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.75
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$170.66
|
| Rate for Payer: BCBS Trust/PPO |
$586.94
|
| Rate for Payer: BCN Commercial |
$871.31
|
| 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: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.19
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,766.00
|
| 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 Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.33
|
| Rate for Payer: Priority Health Medicare |
$170.66
|
| Rate for Payer: Priority Health Narrow Network |
$281.33
|
| Rate for Payer: Priority Health SBD |
$281.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.66
|
| Rate for Payer: UHC Exchange |
$941.35
|
| Rate for Payer: UHC Medicare Advantage |
$170.66
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$7,514.00 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.58
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$75.75
|
| 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 |
$7,514.00
|
| 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 HMO/PPO/Tiered Network |
$72.82
|
| Rate for Payer: Priority Health Medicare |
$49.71
|
| Rate for Payer: Priority Health Narrow Network |
$72.82
|
| Rate for Payer: Priority Health SBD |
$72.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.71
|
| Rate for Payer: UHC Exchange |
$75.63
|
| 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 |
$1,295.00 |
| Rate for Payer: Aetna Commercial |
$11.07
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.89
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$459.09
|
| Rate for Payer: BCN Commercial |
$12.71
|
| 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 |
$13.22
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.00
|
| 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 HMO/PPO/Tiered Network |
$11.66
|
| Rate for Payer: Priority Health Medicare |
$8.26
|
| Rate for Payer: Priority Health Narrow Network |
$11.66
|
| Rate for Payer: Priority Health SBD |
$11.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.26
|
| Rate for Payer: UHC Exchange |
$10.74
|
| 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 |
$5,933.00 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.12
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCBS Trust/PPO |
$83.63
|
| Rate for Payer: BCN Commercial |
$60.11
|
| 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 |
$72.09
|
| Rate for Payer: Healthscope Commercial |
$62.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,933.00
|
| 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 HMO/PPO/Tiered Network |
$56.99
|
| Rate for Payer: Priority Health Medicare |
$38.97
|
| Rate for Payer: Priority Health Narrow Network |
$56.99
|
| Rate for Payer: Priority Health SBD |
$56.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Exchange |
$58.14
|
| 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 |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.87
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$8.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$12.71
|
| 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 |
$1,290.00
|
| 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 HMO/PPO/Tiered Network |
$11.75
|
| Rate for Payer: Priority Health Medicare |
$8.24
|
| Rate for Payer: Priority Health Narrow Network |
$11.75
|
| Rate for Payer: Priority Health SBD |
$11.75
|
| 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 |
$27,504.00 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.04
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Trust/PPO |
$260.00
|
| Rate for Payer: BCN Commercial |
$258.46
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,504.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.69
|
| Rate for Payer: UHC Exchange |
$303.69
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$9,128.00 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.50
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.91
|
| Rate for Payer: UHC Exchange |
$100.91
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$3,662.70 |
| 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: BCBS Trust/PPO |
$3,662.70
|
| Rate for Payer: BCN Commercial |
$15.64
|
| 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 |
$1,787.00
|
| 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 HMO/PPO/Tiered Network |
$18.11
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: Priority Health Narrow Network |
$18.11
|
| Rate for Payer: Priority Health SBD |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.48
|
| Rate for Payer: UHC Exchange |
$23.08
|
| 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 |
$61.56 |
| Max. Negotiated Rate |
$16,963.00 |
| Rate for Payer: Aetna Commercial |
$123.33
|
| Rate for Payer: Aetna Medicare |
$95.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.54
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$92.04
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$138.79
|
| 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 |
$170.27
|
| Rate for Payer: Healthscope Commercial |
$147.26
|
| Rate for Payer: Mclaren Medicaid |
$61.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.64
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,963.00
|
| 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 Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.86
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow Network |
$152.86
|
| Rate for Payer: Priority Health SBD |
$152.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.04
|
| Rate for Payer: UHC Exchange |
$197.89
|
| Rate for Payer: UHC Medicare Advantage |
$92.04
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$11,979.00 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Medicare |
$68.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.78
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$65.82
|
| Rate for Payer: BCBS Trust/PPO |
$718.49
|
| Rate for Payer: BCN Commercial |
$98.72
|
| 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 |
$121.77
|
| Rate for Payer: Healthscope Commercial |
$105.31
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.11
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,979.00
|
| 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 Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.18
|
| Rate for Payer: Priority Health Medicare |
$65.82
|
| Rate for Payer: Priority Health Narrow Network |
$109.18
|
| Rate for Payer: Priority Health SBD |
$109.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.82
|
| Rate for Payer: UHC Exchange |
$201.05
|
| Rate for Payer: UHC Medicare Advantage |
$65.82
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
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 |
$195.53 |
| Max. Negotiated Rate |
$54,587.00 |
| 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 |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$297.19
|
| Rate for Payer: BCBS Trust/PPO |
$207.62
|
| Rate for Payer: BCN Commercial |
$442.74
|
| 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 |
$427.95
|
| Rate for Payer: Cofinity Commercial |
$398.23
|
| 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: Mclaren Medicaid |
$195.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.05
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,587.00
|
| 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 Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.49
|
| Rate for Payer: Priority Health Medicare |
$297.19
|
| Rate for Payer: Priority Health Narrow Network |
$484.49
|
| Rate for Payer: Priority Health SBD |
$484.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.19
|
| Rate for Payer: UHC Medicare Advantage |
$297.19
|
| Rate for Payer: UHCCP Medicaid |
$195.53
|
|
|
PR MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 39402
|
| Min. Negotiated Rate |
$254.96 |
| Max. Negotiated Rate |
$71,404.00 |
| Rate for Payer: Aetna Commercial |
$520.72
|
| Rate for Payer: Aetna Medicare |
$404.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.58
|
| Rate for Payer: BCBS Complete |
$267.71
|
| Rate for Payer: BCBS MAPPO |
$388.60
|
| Rate for Payer: BCBS Trust/PPO |
$487.62
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$388.60
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$559.58
|
| Rate for Payer: Cofinity Commercial |
$520.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.60
|
| Rate for Payer: Healthscope Commercial |
$621.76
|
| Rate for Payer: Healthscope Commercial |
$718.91
|
| Rate for Payer: Mclaren Medicaid |
$254.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.03
|
| Rate for Payer: Meridian Medicaid |
$267.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,404.00
|
| Rate for Payer: Nomi Health Commercial |
$466.32
|
| Rate for Payer: PACE SWMI |
$388.60
|
| Rate for Payer: PHP Medicare Advantage |
$388.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.34
|
| Rate for Payer: Priority Health Medicare |
$388.60
|
| Rate for Payer: Priority Health Narrow Network |
$632.34
|
| Rate for Payer: Priority Health SBD |
$632.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.60
|
| Rate for Payer: UHC Medicare Advantage |
$388.60
|
| Rate for Payer: UHCCP Medicaid |
$254.96
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR
|
Professional
|
Both
|
$2,549.00
|
|
|
Service Code
|
HCPCS 39000
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$85,318.00 |
| Rate for Payer: Aetna Commercial |
$648.87
|
| Rate for Payer: Aetna Medicare |
$503.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.29
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$484.23
|
| Rate for Payer: BCBS Trust/PPO |
$418.94
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$484.23
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cofinity Commercial |
$697.29
|
| Rate for Payer: Cofinity Commercial |
$648.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.23
|
| Rate for Payer: Healthscope Commercial |
$895.83
|
| Rate for Payer: Healthscope Commercial |
$774.77
|
| Rate for Payer: Mclaren Medicaid |
$323.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.44
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,318.00
|
| Rate for Payer: Nomi Health Commercial |
$581.08
|
| Rate for Payer: PACE SWMI |
$484.23
|
| Rate for Payer: PHP Medicare Advantage |
$484.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,656.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$805.72
|
| Rate for Payer: Priority Health Medicare |
$484.23
|
| Rate for Payer: Priority Health Narrow Network |
$805.72
|
| Rate for Payer: Priority Health SBD |
$805.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$589.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.23
|
| Rate for Payer: UHC Exchange |
$589.68
|
| Rate for Payer: UHC Medicare Advantage |
$484.23
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR
|
Professional
|
Both
|
$5,247.00
|
|
|
Service Code
|
HCPCS 39010
|
| Min. Negotiated Rate |
$502.68 |
| Max. Negotiated Rate |
$139,649.00 |
| Rate for Payer: Aetna Commercial |
$1,018.43
|
| Rate for Payer: Aetna Medicare |
$790.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.43
|
| Rate for Payer: BCBS Complete |
$527.81
|
| Rate for Payer: BCBS MAPPO |
$760.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.26
|
| Rate for Payer: BCN Commercial |
$1,138.13
|
| Rate for Payer: BCN Medicare Advantage |
$760.02
|
| Rate for Payer: Cash Price |
$4,197.60
|
| Rate for Payer: Cash Price |
$4,197.60
|
| Rate for Payer: Cofinity Commercial |
$1,094.43
|
| Rate for Payer: Cofinity Commercial |
$1,018.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.02
|
| Rate for Payer: Healthscope Commercial |
$1,406.04
|
| Rate for Payer: Healthscope Commercial |
$1,216.03
|
| Rate for Payer: Mclaren Medicaid |
$502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.02
|
| Rate for Payer: Meridian Medicaid |
$527.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139,649.00
|
| Rate for Payer: Nomi Health Commercial |
$912.02
|
| Rate for Payer: PACE SWMI |
$760.02
|
| Rate for Payer: PHP Medicare Advantage |
$760.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,410.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,248.20
|
| Rate for Payer: Priority Health Medicare |
$760.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.20
|
| Rate for Payer: Priority Health SBD |
$1,248.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$994.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.02
|
| Rate for Payer: UHC Exchange |
$994.32
|
| Rate for Payer: UHC Medicare Advantage |
$760.02
|
| Rate for Payer: UHCCP Medicaid |
$502.68
|
|
|
PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 97802
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$4,694.00 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: Aetna Medicare |
$31.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.47
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$30.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.07
|
| Rate for Payer: BCN Commercial |
$53.26
|
| Rate for Payer: BCN Medicare Advantage |
$30.19
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$43.47
|
| Rate for Payer: Cofinity Commercial |
$40.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$48.30
|
| Rate for Payer: Healthscope Commercial |
$55.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,694.00
|
| Rate for Payer: Nomi Health Commercial |
$36.23
|
| Rate for Payer: PACE SWMI |
$30.19
|
| Rate for Payer: PHP Medicare Advantage |
$30.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.34
|
| Rate for Payer: Priority Health Medicare |
$30.19
|
| Rate for Payer: Priority Health Narrow Network |
$33.34
|
| Rate for Payer: Priority Health SBD |
$33.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.19
|
| Rate for Payer: UHC Exchange |
$19.00
|
| Rate for Payer: UHC Medicare Advantage |
$30.19
|
|
