|
PR NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID
|
Professional
|
Both
|
$2,909.00
|
|
|
Service Code
|
HCPCS 62165
|
| Min. Negotiated Rate |
$893.11 |
| Max. Negotiated Rate |
$2,733.97 |
| Rate for Payer: Aetna Commercial |
$1,865.60
|
| Rate for Payer: Aetna Medicare |
$1,447.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,865.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,004.83
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS MAPPO |
$1,392.24
|
| Rate for Payer: BCN Commercial |
$2,294.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,392.24
|
| Rate for Payer: Cash Price |
$2,327.20
|
| Rate for Payer: Cash Price |
$2,327.20
|
| Rate for Payer: Cofinity Commercial |
$2,004.83
|
| Rate for Payer: Cofinity Commercial |
$1,865.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,392.24
|
| Rate for Payer: Healthscope Commercial |
$2,575.64
|
| Rate for Payer: Healthscope Commercial |
$2,227.58
|
| Rate for Payer: Mclaren Medicaid |
$893.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,461.85
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,531.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,733.97
|
| Rate for Payer: Nomi Health Commercial |
$1,670.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.75
|
| Rate for Payer: PACE SWMI |
$1,392.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,392.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,665.25
|
| Rate for Payer: Priority Health Medicare |
$1,392.24
|
| Rate for Payer: Priority Health SBD |
$2,665.25
|
| Rate for Payer: Priority Health Tiered Network |
$2,665.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,392.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,679.27
|
| Rate for Payer: UHC Core |
$2,679.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,392.24
|
| Rate for Payer: UHC Exchange |
$2,679.27
|
| Rate for Payer: UHC Medicaid |
$893.11
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
|
|
PR NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG
|
Professional
|
Both
|
$8,069.00
|
|
|
Service Code
|
HCPCS 62162
|
| Min. Negotiated Rate |
$1,181.94 |
| Max. Negotiated Rate |
$6,051.75 |
| Rate for Payer: Aetna Commercial |
$2,476.08
|
| Rate for Payer: Aetna Medicare |
$1,921.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,476.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,660.86
|
| Rate for Payer: BCBS Complete |
$1,241.04
|
| Rate for Payer: BCBS MAPPO |
$1,847.82
|
| Rate for Payer: BCN Commercial |
$2,881.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,847.82
|
| Rate for Payer: Cash Price |
$6,455.20
|
| Rate for Payer: Cash Price |
$6,455.20
|
| Rate for Payer: Cofinity Commercial |
$2,660.86
|
| Rate for Payer: Cofinity Commercial |
$2,476.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,847.82
|
| Rate for Payer: Healthscope Commercial |
$3,418.47
|
| Rate for Payer: Healthscope Commercial |
$2,956.51
|
| Rate for Payer: Mclaren Medicaid |
$1,181.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,940.21
|
| Rate for Payer: Meridian Medicaid |
$1,241.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,032.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,427.07
|
| Rate for Payer: Nomi Health Commercial |
$2,217.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,051.75
|
| Rate for Payer: PACE SWMI |
$1,847.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,847.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,181.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,347.17
|
| Rate for Payer: Priority Health Medicare |
$1,847.82
|
| Rate for Payer: Priority Health SBD |
$3,347.17
|
| Rate for Payer: Priority Health Tiered Network |
$3,347.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,847.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,328.46
|
| Rate for Payer: UHC Core |
$3,328.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,847.82
|
| Rate for Payer: UHC Exchange |
$3,328.46
|
| Rate for Payer: UHC Medicaid |
$1,181.94
|
| Rate for Payer: UHCCP Medicaid |
$1,181.94
|
|
|
PR NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 62160
|
| Min. Negotiated Rate |
$109.91 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: Aetna Medicare |
$181.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.42
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$174.60
|
| Rate for Payer: BCN Commercial |
$390.76
|
| Rate for Payer: BCN Medicare Advantage |
$174.60
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Cofinity Commercial |
$233.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.60
|
| Rate for Payer: Healthscope Commercial |
$323.01
|
| Rate for Payer: Healthscope Commercial |
$279.36
|
| Rate for Payer: Mclaren Medicaid |
$109.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.33
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.21
|
| Rate for Payer: Nomi Health Commercial |
$209.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$630.00
|
| Rate for Payer: PACE SWMI |
$174.60
|
| Rate for Payer: PHP Medicare Advantage |
$174.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$328.53
|
| Rate for Payer: Priority Health Medicare |
$174.60
|
| Rate for Payer: Priority Health SBD |
$328.53
|
| Rate for Payer: Priority Health Tiered Network |
$328.53
|
| Rate for Payer: Railroad Medicare Medicare |
$174.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.06
|
| Rate for Payer: UHC Core |
$336.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.60
|
| Rate for Payer: UHC Exchange |
$336.06
|
| Rate for Payer: UHC Medicaid |
$109.91
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
|
|
PR NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 99316
|
| Min. Negotiated Rate |
$103.46 |
| Max. Negotiated Rate |
$214.29 |
| Rate for Payer: Aetna Commercial |
$155.21
|
| Rate for Payer: Aetna Medicare |
$120.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.80
|
| Rate for Payer: BCBS Complete |
$108.63
|
| Rate for Payer: BCBS MAPPO |
$115.83
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Medicare Advantage |
$115.83
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$155.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.83
|
| Rate for Payer: Healthscope Commercial |
$214.29
|
| Rate for Payer: Healthscope Commercial |
$185.33
|
| Rate for Payer: Mclaren Medicaid |
$103.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.62
|
| Rate for Payer: Meridian Medicaid |
$108.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.50
|
| Rate for Payer: Nomi Health Commercial |
$139.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.25
|
| Rate for Payer: PACE SWMI |
$115.83
|
| Rate for Payer: PHP Medicare Advantage |
$115.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$174.25
|
| Rate for Payer: Priority Health Medicare |
$115.83
|
| Rate for Payer: Priority Health SBD |
$174.25
|
| Rate for Payer: Priority Health Tiered Network |
$174.25
|
| Rate for Payer: Railroad Medicare Medicare |
$115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.02
|
| Rate for Payer: UHC Core |
$148.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.83
|
| Rate for Payer: UHC Exchange |
$148.02
|
| Rate for Payer: UHC Medicaid |
$103.46
|
| Rate for Payer: UHCCP Medicaid |
$103.46
|
|
|
PR NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 99315
|
| Min. Negotiated Rate |
$64.37 |
| Max. Negotiated Rate |
$132.81 |
| Rate for Payer: Aetna Commercial |
$96.20
|
| Rate for Payer: Aetna Medicare |
$74.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.20
|
| Rate for Payer: BCBS Complete |
$67.59
|
| Rate for Payer: BCBS MAPPO |
$71.79
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: BCN Medicare Advantage |
$71.79
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$96.20
|
| Rate for Payer: Cofinity Commercial |
$103.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.79
|
| Rate for Payer: Healthscope Commercial |
$132.81
|
| Rate for Payer: Healthscope Commercial |
$114.86
|
| Rate for Payer: Mclaren Medicaid |
$64.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.38
|
| Rate for Payer: Meridian Medicaid |
$67.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.22
|
| Rate for Payer: Nomi Health Commercial |
$86.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
| Rate for Payer: PACE SWMI |
$71.79
|
| Rate for Payer: PHP Medicare Advantage |
$71.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$108.84
|
| Rate for Payer: Priority Health Medicare |
$71.79
|
| Rate for Payer: Priority Health SBD |
$108.84
|
| Rate for Payer: Priority Health Tiered Network |
$108.84
|
| Rate for Payer: Railroad Medicare Medicare |
$71.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.02
|
| Rate for Payer: UHC Core |
$103.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.79
|
| Rate for Payer: UHC Exchange |
$103.02
|
| Rate for Payer: UHC Medicaid |
$64.37
|
| Rate for Payer: UHCCP Medicaid |
$64.37
|
|
|
PR O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 94690
|
| Min. Negotiated Rate |
$48.22 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.61
|
| Rate for Payer: BCBS MAPPO |
$48.22
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$48.22
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$69.44
|
| Rate for Payer: Cofinity Commercial |
$64.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.22
|
| Rate for Payer: Healthscope Commercial |
$89.21
|
| Rate for Payer: Healthscope Commercial |
$77.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.24
|
| Rate for Payer: Nomi Health Commercial |
$57.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.50
|
| Rate for Payer: PACE SWMI |
$48.22
|
| Rate for Payer: PHP Medicare Advantage |
$48.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$48.22
|
| Rate for Payer: Priority Health SBD |
$66.59
|
| Rate for Payer: Priority Health Tiered Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$48.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.48
|
| Rate for Payer: UHC Core |
$76.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.22
|
| Rate for Payer: UHC Exchange |
$76.48
|
|
|
PR O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMPLE
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 94680
|
| Min. Negotiated Rate |
$53.70 |
| Max. Negotiated Rate |
$99.34 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.33
|
| Rate for Payer: BCBS MAPPO |
$53.70
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$53.70
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$77.33
|
| Rate for Payer: Cofinity Commercial |
$71.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.70
|
| Rate for Payer: Healthscope Commercial |
$99.34
|
| Rate for Payer: Healthscope Commercial |
$85.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.22
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$53.70
|
| Rate for Payer: PHP Medicare Advantage |
$53.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.56
|
| Rate for Payer: Priority Health Medicare |
$53.70
|
| Rate for Payer: Priority Health SBD |
$72.56
|
| Rate for Payer: Priority Health Tiered Network |
$72.56
|
| Rate for Payer: Railroad Medicare Medicare |
$53.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.66
|
| Rate for Payer: UHC Core |
$81.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.70
|
| Rate for Payer: UHC Exchange |
$81.66
|
|
|
PROAIR HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
76821
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
|
|
PROAIR HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
76821
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.76
|
| Rate for Payer: UHC Core |
$26.26
|
| Rate for Payer: UHC Exchange |
$19.81
|
|
|
PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM
|
Professional
|
Both
|
$4,376.00
|
|
|
Service Code
|
HCPCS 59510
|
| Min. Negotiated Rate |
$2,347.96 |
| Max. Negotiated Rate |
$4,759.07 |
| Rate for Payer: Aetna Commercial |
$3,311.45
|
| Rate for Payer: Aetna Medicare |
$2,570.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,311.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,558.57
|
| Rate for Payer: BCBS Complete |
$2,465.36
|
| Rate for Payer: BCBS MAPPO |
$2,471.23
|
| Rate for Payer: BCN Commercial |
$3,276.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,471.23
|
| Rate for Payer: Cash Price |
$3,500.80
|
| Rate for Payer: Cash Price |
$3,500.80
|
| Rate for Payer: Cofinity Commercial |
$3,558.57
|
| Rate for Payer: Cofinity Commercial |
$3,311.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,471.23
|
| Rate for Payer: Healthscope Commercial |
$4,571.78
|
| Rate for Payer: Healthscope Commercial |
$3,953.97
|
| Rate for Payer: Mclaren Medicaid |
$2,347.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,594.79
|
| Rate for Payer: Meridian Medicaid |
$2,465.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,718.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,759.07
|
| Rate for Payer: Nomi Health Commercial |
$2,965.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,282.00
|
| Rate for Payer: PACE SWMI |
$2,471.23
|
| Rate for Payer: PHP Medicare Advantage |
$2,471.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,347.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,802.61
|
| Rate for Payer: Priority Health Medicare |
$2,471.23
|
| Rate for Payer: Priority Health SBD |
$3,802.61
|
| Rate for Payer: Priority Health Tiered Network |
$3,802.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,471.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,966.43
|
| Rate for Payer: UHC Core |
$2,966.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,471.23
|
| Rate for Payer: UHC Exchange |
$2,966.43
|
| Rate for Payer: UHC Medicaid |
$2,347.96
|
| Rate for Payer: UHCCP Medicaid |
$2,347.96
|
|
|
PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM
|
Professional
|
Both
|
$3,945.00
|
|
|
Service Code
|
HCPCS 59400
|
| Min. Negotiated Rate |
$2,094.75 |
| Max. Negotiated Rate |
$4,291.67 |
| Rate for Payer: Aetna Commercial |
$2,955.21
|
| Rate for Payer: Aetna Medicare |
$2,293.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,955.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,175.75
|
| Rate for Payer: BCBS Complete |
$2,199.49
|
| Rate for Payer: BCBS MAPPO |
$2,205.38
|
| Rate for Payer: BCN Commercial |
$3,276.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,205.38
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cofinity Commercial |
$3,175.75
|
| Rate for Payer: Cofinity Commercial |
$2,955.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,205.38
|
| Rate for Payer: Healthscope Commercial |
$4,079.95
|
| Rate for Payer: Healthscope Commercial |
$3,528.61
|
| Rate for Payer: Mclaren Medicaid |
$2,094.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,315.65
|
| Rate for Payer: Meridian Medicaid |
$2,199.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,425.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,291.67
|
| Rate for Payer: Nomi Health Commercial |
$2,646.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,958.75
|
| Rate for Payer: PACE SWMI |
$2,205.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,205.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,094.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,423.23
|
| Rate for Payer: Priority Health Medicare |
$2,205.38
|
| Rate for Payer: Priority Health SBD |
$3,423.23
|
| Rate for Payer: Priority Health Tiered Network |
$3,423.23
|
| Rate for Payer: Railroad Medicare Medicare |
$2,205.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,672.37
|
| Rate for Payer: UHC Core |
$2,672.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,205.38
|
| Rate for Payer: UHC Exchange |
$2,672.37
|
| Rate for Payer: UHC Medicaid |
$2,094.75
|
| Rate for Payer: UHCCP Medicaid |
$2,094.75
|
|
|
PR OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS
|
Professional
|
Both
|
$2,478.00
|
|
|
Service Code
|
HCPCS 33813
|
| Min. Negotiated Rate |
$991.20 |
| Max. Negotiated Rate |
$2,199.82 |
| Rate for Payer: Aetna Commercial |
$1,663.43
|
| Rate for Payer: Aetna Medicare |
$1,239.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,663.43
|
| Rate for Payer: BCBS Complete |
$991.20
|
| Rate for Payer: BCN Commercial |
$1,811.49
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,858.50
|
|
|
PR OBLTRJ AORTOPULMONARY SEPTAL DFCT W/CARD BYPASS
|
Professional
|
Both
|
$3,184.00
|
|
|
Service Code
|
HCPCS 33814
|
| Min. Negotiated Rate |
$924.42 |
| Max. Negotiated Rate |
$2,705.35 |
| Rate for Payer: Aetna Commercial |
$1,937.49
|
| Rate for Payer: Aetna Medicare |
$1,503.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,082.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,937.49
|
| Rate for Payer: BCBS Complete |
$970.64
|
| Rate for Payer: BCBS MAPPO |
$1,445.89
|
| Rate for Payer: BCN Commercial |
$2,255.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,445.89
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cash Price |
$2,547.20
|
| Rate for Payer: Cofinity Commercial |
$2,082.08
|
| Rate for Payer: Cofinity Commercial |
$1,937.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,445.89
|
| Rate for Payer: Healthscope Commercial |
$2,674.90
|
| Rate for Payer: Healthscope Commercial |
$2,313.42
|
| Rate for Payer: Mclaren Medicaid |
$924.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,518.18
|
| Rate for Payer: Meridian Medicaid |
$970.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,590.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,702.00
|
| Rate for Payer: Nomi Health Commercial |
$1,735.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,388.00
|
| Rate for Payer: PACE SWMI |
$1,445.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,445.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$924.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,425.34
|
| Rate for Payer: Priority Health Medicare |
$1,445.89
|
| Rate for Payer: Priority Health SBD |
$2,425.34
|
| Rate for Payer: Priority Health Tiered Network |
$2,425.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,445.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,705.35
|
| Rate for Payer: UHC Core |
$2,705.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,445.89
|
| Rate for Payer: UHC Exchange |
$2,705.35
|
| Rate for Payer: UHC Medicaid |
$924.42
|
| Rate for Payer: UHCCP Medicaid |
$924.42
|
|
|
PR OBSERVATION CARE DISCHARGE MANAGEMENT
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 99217
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
|
|
PR OBTAINING SCREEN PAP SMEAR
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS Q0091
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Aetna Commercial |
$20.90
|
| Rate for Payer: Aetna Medicare |
$16.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.46
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$15.60
|
| Rate for Payer: BCN Commercial |
$18.70
|
| Rate for Payer: BCN Medicare Advantage |
$15.60
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$22.46
|
| Rate for Payer: Cofinity Commercial |
$20.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$24.96
|
| Rate for Payer: Healthscope Commercial |
$28.86
|
| Rate for Payer: Mclaren Medicaid |
$10.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.38
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.85
|
| Rate for Payer: Nomi Health Commercial |
$18.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$15.60
|
| Rate for Payer: PHP Medicare Advantage |
$15.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.38
|
| Rate for Payer: Priority Health Medicare |
$15.60
|
| Rate for Payer: Priority Health SBD |
$23.38
|
| Rate for Payer: Priority Health Tiered Network |
$23.38
|
| Rate for Payer: Railroad Medicare Medicare |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.07
|
| Rate for Payer: UHC Core |
$27.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.60
|
| Rate for Payer: UHC Exchange |
$27.07
|
| Rate for Payer: UHC Medicaid |
$10.01
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
|
|
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$1,696.32
|
|
|
Service Code
|
HCPCS J2690
|
| Hospital Charge Code |
6562
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,068.68 |
| Max. Negotiated Rate |
$1,526.69 |
| Rate for Payer: Aetna Commercial |
$1,441.87
|
| Rate for Payer: Aetna Commercial |
$1,029.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.22
|
| Rate for Payer: Cash Price |
$968.89
|
| Rate for Payer: Cash Price |
$1,357.06
|
| Rate for Payer: Cofinity Advantage |
$1,187.42
|
| Rate for Payer: Cofinity Advantage |
$847.78
|
| Rate for Payer: Cofinity Commercial |
$1,041.55
|
| Rate for Payer: Cofinity Commercial |
$1,458.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.89
|
| Rate for Payer: Healthscope Commercial |
$1,526.69
|
| Rate for Payer: Healthscope Commercial |
$1,090.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$908.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,272.24
|
| Rate for Payer: PHP Commercial |
$1,029.44
|
| Rate for Payer: PHP Commercial |
$1,441.87
|
| Rate for Payer: Priority Health SBD |
$1,068.68
|
| Rate for Payer: Priority Health SBD |
$763.00
|
|
|
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,696.32
|
|
|
Service Code
|
HCPCS J2690
|
| Hospital Charge Code |
6562
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$112.35 |
| Max. Negotiated Rate |
$1,526.69 |
| Rate for Payer: Aetna Commercial |
$1,441.87
|
| Rate for Payer: Aetna Commercial |
$1,029.44
|
| Rate for Payer: Aetna Medicare |
$223.40
|
| Rate for Payer: Aetna Medicare |
$223.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,102.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.51
|
| Rate for Payer: BCBS Complete |
$117.97
|
| Rate for Payer: BCBS Complete |
$117.97
|
| Rate for Payer: BCBS MAPPO |
$214.81
|
| Rate for Payer: BCBS MAPPO |
$214.81
|
| Rate for Payer: BCBS Trust/PPO |
$864.38
|
| Rate for Payer: BCBS Trust/PPO |
$864.38
|
| Rate for Payer: BCN Commercial |
$864.38
|
| Rate for Payer: BCN Commercial |
$864.38
|
| Rate for Payer: BCN Medicare Advantage |
$214.81
|
| Rate for Payer: BCN Medicare Advantage |
$214.81
|
| Rate for Payer: Cash Price |
$968.89
|
| Rate for Payer: Cash Price |
$968.89
|
| Rate for Payer: Cash Price |
$1,357.06
|
| Rate for Payer: Cash Price |
$1,357.06
|
| Rate for Payer: Cofinity Advantage |
$1,187.42
|
| Rate for Payer: Cofinity Advantage |
$847.78
|
| Rate for Payer: Cofinity Commercial |
$1,458.84
|
| Rate for Payer: Cofinity Commercial |
$1,041.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.81
|
| Rate for Payer: Healthscope Commercial |
$1,090.00
|
| Rate for Payer: Healthscope Commercial |
$1,526.69
|
| Rate for Payer: Mclaren Medicaid |
$112.35
|
| Rate for Payer: Mclaren Medicaid |
$112.35
|
| Rate for Payer: Mclaren Medicare |
$214.81
|
| Rate for Payer: Mclaren Medicare |
$214.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.55
|
| Rate for Payer: Meridian Medicaid |
$225.55
|
| Rate for Payer: Meridian Medicaid |
$225.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.87
|
| Rate for Payer: Nomi Health Commercial |
$644.43
|
| Rate for Payer: Nomi Health Commercial |
$644.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,272.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$908.33
|
| Rate for Payer: PACE Medicare |
$204.07
|
| Rate for Payer: PACE Medicare |
$204.07
|
| Rate for Payer: PACE SWMI |
$214.81
|
| Rate for Payer: PACE SWMI |
$214.81
|
| Rate for Payer: PHP Commercial |
$1,029.44
|
| Rate for Payer: PHP Commercial |
$1,441.87
|
| Rate for Payer: PHP Medicare Advantage |
$214.81
|
| Rate for Payer: PHP Medicare Advantage |
$214.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$929.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$929.46
|
| Rate for Payer: Priority Health Medicare |
$214.81
|
| Rate for Payer: Priority Health Medicare |
$214.81
|
| Rate for Payer: Priority Health SBD |
$1,068.68
|
| Rate for Payer: Priority Health SBD |
$763.00
|
| Rate for Payer: Priority Health Tiered Network |
$743.57
|
| Rate for Payer: Priority Health Tiered Network |
$743.57
|
| Rate for Payer: Railroad Medicare Medicare |
$214.81
|
| Rate for Payer: Railroad Medicare Medicare |
$214.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.47
|
| Rate for Payer: UHC Core |
$568.47
|
| Rate for Payer: UHC Core |
$568.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$214.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$214.81
|
| Rate for Payer: UHC Exchange |
$568.47
|
| Rate for Payer: UHC Exchange |
$568.47
|
| Rate for Payer: UHC Medicaid |
$112.35
|
| Rate for Payer: UHC Medicaid |
$112.35
|
| Rate for Payer: UHCCP Medicaid |
$112.35
|
| Rate for Payer: UHCCP Medicaid |
$112.35
|
| Rate for Payer: VA VA |
$214.81
|
| Rate for Payer: VA VA |
$214.81
|
|
|
PR OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 58615
|
| Min. Negotiated Rate |
$143.99 |
| Max. Negotiated Rate |
$451.91 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Medicare |
$231.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.88
|
| Rate for Payer: BCBS Complete |
$151.19
|
| Rate for Payer: BCBS MAPPO |
$222.14
|
| Rate for Payer: BCN Commercial |
$379.46
|
| Rate for Payer: BCN Medicare Advantage |
$222.14
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$319.88
|
| Rate for Payer: Cofinity Commercial |
$297.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.14
|
| Rate for Payer: Healthscope Commercial |
$410.96
|
| Rate for Payer: Healthscope Commercial |
$355.42
|
| Rate for Payer: Mclaren Medicaid |
$143.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.25
|
| Rate for Payer: Meridian Medicaid |
$151.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$244.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.91
|
| Rate for Payer: Nomi Health Commercial |
$266.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.50
|
| Rate for Payer: PACE SWMI |
$222.14
|
| Rate for Payer: PHP Medicare Advantage |
$222.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$384.31
|
| Rate for Payer: Priority Health Medicare |
$222.14
|
| Rate for Payer: Priority Health SBD |
$384.31
|
| Rate for Payer: Priority Health Tiered Network |
$384.31
|
| Rate for Payer: Railroad Medicare Medicare |
$222.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.31
|
| Rate for Payer: UHC Core |
$440.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$222.14
|
| Rate for Payer: UHC Exchange |
$440.31
|
| Rate for Payer: UHC Medicaid |
$143.99
|
| Rate for Payer: UHCCP Medicaid |
$143.99
|
|
|
PR OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 97165
|
| Min. Negotiated Rate |
$80.13 |
| Max. Negotiated Rate |
$178.23 |
| Rate for Payer: Aetna Commercial |
$129.10
|
| Rate for Payer: Aetna Medicare |
$100.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.10
|
| Rate for Payer: BCBS MAPPO |
$96.34
|
| Rate for Payer: BCN Commercial |
$93.18
|
| Rate for Payer: BCN Medicare Advantage |
$96.34
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$138.73
|
| Rate for Payer: Cofinity Commercial |
$129.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.34
|
| Rate for Payer: Healthscope Commercial |
$178.23
|
| Rate for Payer: Healthscope Commercial |
$154.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.22
|
| Rate for Payer: Nomi Health Commercial |
$115.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: PACE SWMI |
$96.34
|
| Rate for Payer: PHP Medicare Advantage |
$96.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.97
|
| Rate for Payer: Priority Health Medicare |
$96.34
|
| Rate for Payer: Priority Health SBD |
$101.97
|
| Rate for Payer: Priority Health Tiered Network |
$101.97
|
| Rate for Payer: Railroad Medicare Medicare |
$96.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.13
|
| Rate for Payer: UHC Core |
$80.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.34
|
| Rate for Payer: UHC Exchange |
$80.13
|
|
|
PR OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97166
|
| Min. Negotiated Rate |
$79.83 |
| Max. Negotiated Rate |
$178.23 |
| Rate for Payer: Aetna Commercial |
$129.10
|
| Rate for Payer: Aetna Medicare |
$100.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.73
|
| Rate for Payer: BCBS MAPPO |
$96.34
|
| Rate for Payer: BCN Commercial |
$92.83
|
| Rate for Payer: BCN Medicare Advantage |
$96.34
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$138.73
|
| Rate for Payer: Cofinity Commercial |
$129.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.34
|
| Rate for Payer: Healthscope Commercial |
$178.23
|
| Rate for Payer: Healthscope Commercial |
$154.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.22
|
| Rate for Payer: Nomi Health Commercial |
$115.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: PACE SWMI |
$96.34
|
| Rate for Payer: PHP Medicare Advantage |
$96.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.97
|
| Rate for Payer: Priority Health Medicare |
$96.34
|
| Rate for Payer: Priority Health SBD |
$101.97
|
| Rate for Payer: Priority Health Tiered Network |
$101.97
|
| Rate for Payer: Railroad Medicare Medicare |
$96.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.83
|
| Rate for Payer: UHC Core |
$79.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.34
|
| Rate for Payer: UHC Exchange |
$79.83
|
|
|
PR OCCUPATIONAL THERAPY EVALUATION
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 97003
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
|
|
PR OCCUPATIONAL THERAPY RE-EVALUATION
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 97004
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
|
|
PR OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 97168
|
| Min. Negotiated Rate |
$50.99 |
| Max. Negotiated Rate |
$120.95 |
| Rate for Payer: Aetna Commercial |
$87.61
|
| Rate for Payer: Aetna Medicare |
$68.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$65.38
|
| Rate for Payer: BCN Commercial |
$64.28
|
| Rate for Payer: BCN Medicare Advantage |
$65.38
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$87.61
|
| Rate for Payer: Cofinity Commercial |
$94.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.38
|
| Rate for Payer: Healthscope Commercial |
$104.61
|
| Rate for Payer: Healthscope Commercial |
$120.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.53
|
| Rate for Payer: Nomi Health Commercial |
$78.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$65.38
|
| Rate for Payer: PHP Medicare Advantage |
$65.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.99
|
| Rate for Payer: Priority Health Medicare |
$65.38
|
| Rate for Payer: Priority Health SBD |
$50.99
|
| Rate for Payer: Priority Health Tiered Network |
$50.99
|
| Rate for Payer: Railroad Medicare Medicare |
$65.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.05
|
| Rate for Payer: UHC Core |
$55.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.38
|
| Rate for Payer: UHC Exchange |
$55.05
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$13,644.54
|
|
|
Service Code
|
APR-DRG 4033
|
| Min. Negotiated Rate |
$12,994.80 |
| Max. Negotiated Rate |
$13,644.54 |
| Rate for Payer: BCBS Complete |
$13,644.54
|
| Rate for Payer: Mclaren Medicaid |
$12,994.80
|
| Rate for Payer: Meridian Medicaid |
$13,644.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,994.80
|
| Rate for Payer: UHC Medicaid |
$12,994.80
|
| Rate for Payer: UHCCP Medicaid |
$12,994.80
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$7,814.08
|
|
|
Service Code
|
APR-DRG 4032
|
| Min. Negotiated Rate |
$7,441.98 |
| Max. Negotiated Rate |
$7,814.08 |
| Rate for Payer: BCBS Complete |
$7,814.08
|
| Rate for Payer: Mclaren Medicaid |
$7,441.98
|
| Rate for Payer: Meridian Medicaid |
$7,814.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,441.98
|
| Rate for Payer: UHC Medicaid |
$7,441.98
|
| Rate for Payer: UHCCP Medicaid |
$7,441.98
|
|
