|
PR OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 99245
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Aetna Commercial |
$196.80
|
| Rate for Payer: Aetna Medicare |
$191.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.80
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCN Commercial |
$266.42
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Mclaren Medicaid |
$113.96
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$239.64
|
| Rate for Payer: Priority Health SBD |
$239.64
|
| Rate for Payer: Priority Health Tiered Network |
$239.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.26
|
| Rate for Payer: UHC Core |
$273.26
|
| Rate for Payer: UHC Exchange |
$273.26
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 99243
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$98.89
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.89
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$117.81
|
| Rate for Payer: Priority Health SBD |
$117.81
|
| Rate for Payer: Priority Health Tiered Network |
$117.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.31
|
| Rate for Payer: UHC Core |
$137.31
|
| Rate for Payer: UHC Exchange |
$137.31
|
| Rate for Payer: UHC Medicaid |
$55.81
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 99244
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$159.16
|
| Rate for Payer: Aetna Medicare |
$154.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.16
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCN Commercial |
$198.70
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Mclaren Medicaid |
$85.20
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.72
|
| Rate for Payer: Priority Health SBD |
$178.72
|
| Rate for Payer: Priority Health Tiered Network |
$178.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.02
|
| Rate for Payer: UHC Core |
$221.02
|
| Rate for Payer: UHC Exchange |
$221.02
|
| Rate for Payer: UHC Medicaid |
$85.20
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 99242
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.73
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Mclaren Medicaid |
$35.36
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.91
|
| Rate for Payer: Priority Health SBD |
$73.91
|
| Rate for Payer: Priority Health Tiered Network |
$73.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.22
|
| Rate for Payer: UHC Core |
$98.22
|
| Rate for Payer: UHC Exchange |
$98.22
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 99215
|
| Min. Negotiated Rate |
$110.52 |
| Max. Negotiated Rate |
$229.97 |
| Rate for Payer: Aetna Commercial |
$166.58
|
| Rate for Payer: Aetna Medicare |
$129.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.58
|
| Rate for Payer: BCBS Complete |
$116.05
|
| Rate for Payer: BCBS MAPPO |
$124.31
|
| Rate for Payer: BCN Commercial |
$157.73
|
| Rate for Payer: BCN Medicare Advantage |
$124.31
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$179.01
|
| Rate for Payer: Cofinity Commercial |
$166.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.31
|
| Rate for Payer: Healthscope Commercial |
$229.97
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Mclaren Medicaid |
$110.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.53
|
| Rate for Payer: Meridian Medicaid |
$116.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.23
|
| Rate for Payer: Nomi Health Commercial |
$149.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$124.31
|
| Rate for Payer: PHP Medicare Advantage |
$124.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$162.63
|
| Rate for Payer: Priority Health Medicare |
$124.31
|
| Rate for Payer: Priority Health SBD |
$162.63
|
| Rate for Payer: Priority Health Tiered Network |
$162.63
|
| Rate for Payer: Railroad Medicare Medicare |
$124.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.55
|
| Rate for Payer: UHC Core |
$157.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.31
|
| Rate for Payer: UHC Exchange |
$157.55
|
| Rate for Payer: UHC Medicaid |
$110.52
|
| Rate for Payer: UHCCP Medicaid |
$110.52
|
|
|
PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 99213
|
| Min. Negotiated Rate |
$50.56 |
| Max. Negotiated Rate |
$105.23 |
| Rate for Payer: Aetna Commercial |
$76.22
|
| Rate for Payer: Aetna Medicare |
$59.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.91
|
| Rate for Payer: BCBS Complete |
$53.09
|
| Rate for Payer: BCBS MAPPO |
$56.88
|
| Rate for Payer: BCN Commercial |
$80.24
|
| Rate for Payer: BCN Medicare Advantage |
$56.88
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$81.91
|
| Rate for Payer: Cofinity Commercial |
$76.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$91.01
|
| Rate for Payer: Healthscope Commercial |
$105.23
|
| Rate for Payer: Mclaren Medicaid |
$50.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.72
|
| Rate for Payer: Meridian Medicaid |
$53.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.02
|
| Rate for Payer: Nomi Health Commercial |
$68.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$56.88
|
| Rate for Payer: PHP Medicare Advantage |
$56.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74.68
|
| Rate for Payer: Priority Health Medicare |
$56.88
|
| Rate for Payer: Priority Health SBD |
$74.68
|
| Rate for Payer: Priority Health Tiered Network |
$74.68
|
| Rate for Payer: Railroad Medicare Medicare |
$56.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.56
|
| Rate for Payer: UHC Core |
$72.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.88
|
| Rate for Payer: UHC Exchange |
$72.56
|
| Rate for Payer: UHC Medicaid |
$50.56
|
| Rate for Payer: UHCCP Medicaid |
$50.56
|
|
|
PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 99214
|
| Min. Negotiated Rate |
$74.36 |
| Max. Negotiated Rate |
$154.92 |
| Rate for Payer: Aetna Commercial |
$112.21
|
| Rate for Payer: Aetna Medicare |
$87.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.59
|
| Rate for Payer: BCBS Complete |
$78.08
|
| Rate for Payer: BCBS MAPPO |
$83.74
|
| Rate for Payer: BCN Commercial |
$116.36
|
| Rate for Payer: BCN Medicare Advantage |
$83.74
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$120.59
|
| Rate for Payer: Cofinity Commercial |
$112.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.74
|
| Rate for Payer: Healthscope Commercial |
$154.92
|
| Rate for Payer: Healthscope Commercial |
$133.98
|
| Rate for Payer: Mclaren Medicaid |
$74.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.93
|
| Rate for Payer: Meridian Medicaid |
$78.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.22
|
| Rate for Payer: Nomi Health Commercial |
$100.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: PACE SWMI |
$83.74
|
| Rate for Payer: PHP Medicare Advantage |
$83.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$109.94
|
| Rate for Payer: Priority Health Medicare |
$83.74
|
| Rate for Payer: Priority Health SBD |
$109.94
|
| Rate for Payer: Priority Health Tiered Network |
$109.94
|
| Rate for Payer: Railroad Medicare Medicare |
$83.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.57
|
| Rate for Payer: UHC Core |
$111.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.74
|
| Rate for Payer: UHC Exchange |
$111.57
|
| Rate for Payer: UHC Medicaid |
$74.36
|
| Rate for Payer: UHCCP Medicaid |
$74.36
|
|
|
PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 99212
|
| Min. Negotiated Rate |
$27.33 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$32.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.40
|
| Rate for Payer: BCBS Complete |
$28.70
|
| Rate for Payer: BCBS MAPPO |
$30.83
|
| Rate for Payer: BCN Commercial |
$51.06
|
| Rate for Payer: BCN Medicare Advantage |
$30.83
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$44.40
|
| Rate for Payer: Cofinity Commercial |
$41.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.83
|
| Rate for Payer: Healthscope Commercial |
$57.04
|
| Rate for Payer: Healthscope Commercial |
$49.33
|
| Rate for Payer: Mclaren Medicaid |
$27.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.37
|
| Rate for Payer: Meridian Medicaid |
$28.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.29
|
| Rate for Payer: Nomi Health Commercial |
$37.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.75
|
| Rate for Payer: PACE SWMI |
$30.83
|
| Rate for Payer: PHP Medicare Advantage |
$30.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.81
|
| Rate for Payer: Priority Health Medicare |
$30.83
|
| Rate for Payer: Priority Health SBD |
$39.81
|
| Rate for Payer: Priority Health Tiered Network |
$39.81
|
| Rate for Payer: Railroad Medicare Medicare |
$30.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.54
|
| Rate for Payer: UHC Core |
$36.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.83
|
| Rate for Payer: UHC Exchange |
$36.54
|
| Rate for Payer: UHC Medicaid |
$27.33
|
| Rate for Payer: UHCCP Medicaid |
$27.33
|
|
|
PR OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 99211
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Priority Health SBD |
$9.86
|
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.96
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$23.53
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Healthscope Commercial |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$12.18
|
| Rate for Payer: Mclaren Medicaid |
$6.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Medicaid |
$7.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.95
|
| Rate for Payer: Nomi Health Commercial |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.86
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: Priority Health Tiered Network |
$9.86
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.02
|
| Rate for Payer: UHC Core |
$13.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.61
|
| Rate for Payer: UHC Exchange |
$13.02
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
|
|
PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 99205
|
| Min. Negotiated Rate |
$141.08 |
| Max. Negotiated Rate |
$294.41 |
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: Aetna Medicare |
$165.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.16
|
| Rate for Payer: BCBS Complete |
$148.13
|
| Rate for Payer: BCBS MAPPO |
$159.14
|
| Rate for Payer: BCN Commercial |
$211.86
|
| Rate for Payer: BCN Medicare Advantage |
$159.14
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$229.16
|
| Rate for Payer: Cofinity Commercial |
$213.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.14
|
| Rate for Payer: Healthscope Commercial |
$294.41
|
| Rate for Payer: Healthscope Commercial |
$254.62
|
| Rate for Payer: Mclaren Medicaid |
$141.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.10
|
| Rate for Payer: Meridian Medicaid |
$148.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.18
|
| Rate for Payer: Nomi Health Commercial |
$190.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$159.14
|
| Rate for Payer: PHP Medicare Advantage |
$159.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$205.84
|
| Rate for Payer: Priority Health Medicare |
$159.14
|
| Rate for Payer: Priority Health SBD |
$205.84
|
| Rate for Payer: Priority Health Tiered Network |
$205.84
|
| Rate for Payer: Railroad Medicare Medicare |
$159.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.16
|
| Rate for Payer: UHC Core |
$239.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.14
|
| Rate for Payer: UHC Exchange |
$239.16
|
| Rate for Payer: UHC Medicaid |
$141.08
|
| Rate for Payer: UHCCP Medicaid |
$141.08
|
|
|
PR OFFICE OUTPATIENT NEW LEVL I
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 99201
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$54.75 |
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
|
|
PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 99203
|
| Min. Negotiated Rate |
$62.90 |
| Max. Negotiated Rate |
$131.46 |
| Rate for Payer: Aetna Commercial |
$95.22
|
| Rate for Payer: Aetna Medicare |
$73.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.22
|
| Rate for Payer: BCBS Complete |
$66.05
|
| Rate for Payer: BCBS MAPPO |
$71.06
|
| Rate for Payer: BCN Commercial |
$109.72
|
| Rate for Payer: BCN Medicare Advantage |
$71.06
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$95.22
|
| Rate for Payer: Cofinity Commercial |
$102.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.06
|
| Rate for Payer: Healthscope Commercial |
$113.70
|
| Rate for Payer: Healthscope Commercial |
$131.46
|
| Rate for Payer: Mclaren Medicaid |
$62.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.61
|
| Rate for Payer: Meridian Medicaid |
$66.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.12
|
| Rate for Payer: Nomi Health Commercial |
$85.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: PACE SWMI |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$71.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92.88
|
| Rate for Payer: Priority Health Medicare |
$71.06
|
| Rate for Payer: Priority Health SBD |
$92.88
|
| Rate for Payer: Priority Health Tiered Network |
$92.88
|
| Rate for Payer: Railroad Medicare Medicare |
$71.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.10
|
| Rate for Payer: UHC Core |
$107.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.06
|
| Rate for Payer: UHC Exchange |
$107.10
|
| Rate for Payer: UHC Medicaid |
$62.90
|
| Rate for Payer: UHCCP Medicaid |
$62.90
|
|
|
PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 99204
|
| Min. Negotiated Rate |
$102.87 |
| Max. Negotiated Rate |
$214.64 |
| Rate for Payer: Aetna Commercial |
$155.47
|
| Rate for Payer: Aetna Medicare |
$120.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.07
|
| Rate for Payer: BCBS Complete |
$108.01
|
| Rate for Payer: BCBS MAPPO |
$116.02
|
| Rate for Payer: BCN Commercial |
$167.67
|
| Rate for Payer: BCN Medicare Advantage |
$116.02
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$167.07
|
| Rate for Payer: Cofinity Commercial |
$155.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.02
|
| Rate for Payer: Healthscope Commercial |
$214.64
|
| Rate for Payer: Healthscope Commercial |
$185.63
|
| Rate for Payer: Mclaren Medicaid |
$102.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.82
|
| Rate for Payer: Meridian Medicaid |
$108.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.14
|
| Rate for Payer: Nomi Health Commercial |
$139.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: PACE SWMI |
$116.02
|
| Rate for Payer: PHP Medicare Advantage |
$116.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$151.25
|
| Rate for Payer: Priority Health Medicare |
$116.02
|
| Rate for Payer: Priority Health SBD |
$151.25
|
| Rate for Payer: Priority Health Tiered Network |
$151.25
|
| Rate for Payer: Railroad Medicare Medicare |
$116.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.15
|
| Rate for Payer: UHC Core |
$183.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$116.02
|
| Rate for Payer: UHC Exchange |
$183.15
|
| Rate for Payer: UHC Medicaid |
$102.87
|
| Rate for Payer: UHCCP Medicaid |
$102.87
|
|
|
PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 99202
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Aetna Commercial |
$54.56
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.64
|
| Rate for Payer: BCBS Complete |
$37.96
|
| Rate for Payer: BCBS MAPPO |
$40.72
|
| Rate for Payer: BCN Commercial |
$77.49
|
| Rate for Payer: BCN Medicare Advantage |
$40.72
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$58.64
|
| Rate for Payer: Cofinity Commercial |
$54.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.72
|
| Rate for Payer: Healthscope Commercial |
$75.33
|
| Rate for Payer: Healthscope Commercial |
$65.15
|
| Rate for Payer: Mclaren Medicaid |
$36.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.76
|
| Rate for Payer: Meridian Medicaid |
$37.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.64
|
| Rate for Payer: Nomi Health Commercial |
$48.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$40.72
|
| Rate for Payer: PHP Medicare Advantage |
$40.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$40.72
|
| Rate for Payer: Priority Health SBD |
$53.08
|
| Rate for Payer: Priority Health Tiered Network |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$40.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.50
|
| Rate for Payer: UHC Core |
$71.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.72
|
| Rate for Payer: UHC Exchange |
$71.50
|
| Rate for Payer: UHC Medicaid |
$36.15
|
| Rate for Payer: UHCCP Medicaid |
$36.15
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
OP
|
$487.68
|
|
|
Service Code
|
NDC 43598034901
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.66 |
| Max. Negotiated Rate |
$438.91 |
| Rate for Payer: Aetna Commercial |
$414.53
|
| Rate for Payer: Aetna Medicare |
$243.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.99
|
| Rate for Payer: BCBS Complete |
$195.07
|
| Rate for Payer: Cash Price |
$390.14
|
| Rate for Payer: Cofinity Advantage |
$341.38
|
| Rate for Payer: Cofinity Commercial |
$419.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.14
|
| Rate for Payer: Healthscope Commercial |
$438.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$390.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.76
|
| Rate for Payer: PHP Commercial |
$414.53
|
| Rate for Payer: Priority Health SBD |
$307.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.99
|
| Rate for Payer: UHC Core |
$254.08
|
| Rate for Payer: UHC Exchange |
$191.66
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
IP
|
$353.40
|
|
|
Service Code
|
NDC 65162080710
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$222.64 |
| Max. Negotiated Rate |
$318.06 |
| Rate for Payer: Aetna Commercial |
$300.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.71
|
| Rate for Payer: Cash Price |
$282.72
|
| Rate for Payer: Cofinity Advantage |
$247.38
|
| Rate for Payer: Cofinity Commercial |
$303.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.72
|
| Rate for Payer: Healthscope Commercial |
$318.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.05
|
| Rate for Payer: PHP Commercial |
$300.39
|
| Rate for Payer: Priority Health SBD |
$222.64
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
IP
|
$256.80
|
|
|
Service Code
|
NDC 17478076610
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.78 |
| Max. Negotiated Rate |
$231.12 |
| Rate for Payer: Aetna Commercial |
$218.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.92
|
| Rate for Payer: Cash Price |
$205.44
|
| Rate for Payer: Cofinity Advantage |
$179.76
|
| Rate for Payer: Cofinity Commercial |
$220.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.44
|
| Rate for Payer: Healthscope Commercial |
$231.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.60
|
| Rate for Payer: PHP Commercial |
$218.28
|
| Rate for Payer: Priority Health SBD |
$161.78
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
OP
|
$437.10
|
|
|
Service Code
|
NDC 59651015201
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$171.78 |
| Max. Negotiated Rate |
$393.39 |
| Rate for Payer: Aetna Commercial |
$371.54
|
| Rate for Payer: Aetna Medicare |
$218.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.12
|
| Rate for Payer: BCBS Complete |
$174.84
|
| Rate for Payer: Cash Price |
$349.68
|
| Rate for Payer: Cofinity Advantage |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$375.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.68
|
| Rate for Payer: Healthscope Commercial |
$393.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.82
|
| Rate for Payer: PHP Commercial |
$371.54
|
| Rate for Payer: Priority Health SBD |
$275.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.12
|
| Rate for Payer: UHC Core |
$227.73
|
| Rate for Payer: UHC Exchange |
$171.78
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
OP
|
$256.80
|
|
|
Service Code
|
NDC 17478076610
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.92 |
| Max. Negotiated Rate |
$231.12 |
| Rate for Payer: Aetna Commercial |
$218.28
|
| Rate for Payer: Aetna Medicare |
$128.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.92
|
| Rate for Payer: BCBS Complete |
$102.72
|
| Rate for Payer: Cash Price |
$205.44
|
| Rate for Payer: Cofinity Advantage |
$179.76
|
| Rate for Payer: Cofinity Commercial |
$220.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.44
|
| Rate for Payer: Healthscope Commercial |
$231.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.60
|
| Rate for Payer: PHP Commercial |
$218.28
|
| Rate for Payer: Priority Health SBD |
$161.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.92
|
| Rate for Payer: UHC Core |
$133.79
|
| Rate for Payer: UHC Exchange |
$100.92
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
IP
|
$487.68
|
|
|
Service Code
|
NDC 43598034901
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$307.24 |
| Max. Negotiated Rate |
$438.91 |
| Rate for Payer: Aetna Commercial |
$414.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.99
|
| Rate for Payer: Cash Price |
$390.14
|
| Rate for Payer: Cofinity Advantage |
$341.38
|
| Rate for Payer: Cofinity Commercial |
$419.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.14
|
| Rate for Payer: Healthscope Commercial |
$438.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.76
|
| Rate for Payer: PHP Commercial |
$414.53
|
| Rate for Payer: Priority Health SBD |
$307.24
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
IP
|
$437.10
|
|
|
Service Code
|
NDC 59651015201
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$275.37 |
| Max. Negotiated Rate |
$393.39 |
| Rate for Payer: Aetna Commercial |
$371.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.12
|
| Rate for Payer: Cash Price |
$349.68
|
| Rate for Payer: Cofinity Advantage |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$375.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.68
|
| Rate for Payer: Healthscope Commercial |
$393.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.82
|
| Rate for Payer: PHP Commercial |
$371.54
|
| Rate for Payer: Priority Health SBD |
$275.37
|
|
|
PROGESTERONE MICRONIZED 100 MG CAPSULE
|
Facility
|
OP
|
$353.40
|
|
|
Service Code
|
NDC 65162080710
|
| Hospital Charge Code |
23122
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$138.89 |
| Max. Negotiated Rate |
$318.06 |
| Rate for Payer: Aetna Commercial |
$300.39
|
| Rate for Payer: Aetna Medicare |
$176.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.71
|
| Rate for Payer: BCBS Complete |
$141.36
|
| Rate for Payer: Cash Price |
$282.72
|
| Rate for Payer: Cofinity Advantage |
$247.38
|
| Rate for Payer: Cofinity Commercial |
$303.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.72
|
| Rate for Payer: Healthscope Commercial |
$318.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.05
|
| Rate for Payer: PHP Commercial |
$300.39
|
| Rate for Payer: Priority Health SBD |
$222.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.71
|
| Rate for Payer: UHC Core |
$184.12
|
| Rate for Payer: UHC Exchange |
$138.89
|
|
|
PR OMALIZUMAB INJECTION
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS J2357
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$77.37 |
| Rate for Payer: Aetna Commercial |
$56.04
|
| Rate for Payer: Aetna Medicare |
$43.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.22
|
| Rate for Payer: BCBS MAPPO |
$41.82
|
| Rate for Payer: BCBS Trust/PPO |
$46.35
|
| Rate for Payer: BCN Commercial |
$40.87
|
| Rate for Payer: BCN Medicare Advantage |
$41.82
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$60.22
|
| Rate for Payer: Cofinity Commercial |
$56.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.82
|
| Rate for Payer: Healthscope Commercial |
$77.37
|
| Rate for Payer: Healthscope Commercial |
$66.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.09
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$41.82
|
| Rate for Payer: PHP Medicare Advantage |
$41.82
|
| Rate for Payer: Priority Health Medicare |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.50
|
| Rate for Payer: UHC Core |
$45.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.82
|
| Rate for Payer: UHC Exchange |
$45.50
|
|
|
PR OMENTAL FLAP INTRA-ABDOMINAL
|
Professional
|
Both
|
$661.00
|
|
|
Service Code
|
HCPCS 49905
|
| Min. Negotiated Rate |
$200.86 |
| Max. Negotiated Rate |
$636.48 |
| Rate for Payer: Aetna Commercial |
$424.50
|
| Rate for Payer: Aetna Medicare |
$329.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.18
|
| Rate for Payer: BCBS Complete |
$210.90
|
| Rate for Payer: BCBS MAPPO |
$316.79
|
| Rate for Payer: BCN Commercial |
$522.38
|
| Rate for Payer: BCN Medicare Advantage |
$316.79
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cofinity Commercial |
$456.18
|
| Rate for Payer: Cofinity Commercial |
$424.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.79
|
| Rate for Payer: Healthscope Commercial |
$586.06
|
| Rate for Payer: Healthscope Commercial |
$506.86
|
| Rate for Payer: Mclaren Medicaid |
$200.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.63
|
| Rate for Payer: Meridian Medicaid |
$210.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$348.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$631.08
|
| Rate for Payer: Nomi Health Commercial |
$380.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$495.75
|
| Rate for Payer: PACE SWMI |
$316.79
|
| Rate for Payer: PHP Medicare Advantage |
$316.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$636.48
|
| Rate for Payer: Priority Health Medicare |
$316.79
|
| Rate for Payer: Priority Health SBD |
$636.48
|
| Rate for Payer: Priority Health Tiered Network |
$636.48
|
| Rate for Payer: Railroad Medicare Medicare |
$316.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.16
|
| Rate for Payer: UHC Core |
$634.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$316.79
|
| Rate for Payer: UHC Exchange |
$634.16
|
| Rate for Payer: UHC Medicaid |
$200.86
|
| Rate for Payer: UHCCP Medicaid |
$200.86
|
|
|
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$185.15
|
|
|
Service Code
|
NDC 00713053612
|
| Hospital Charge Code |
11143
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$116.64 |
| Max. Negotiated Rate |
$166.63 |
| Rate for Payer: Aetna Commercial |
$157.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.35
|
| Rate for Payer: Cash Price |
$148.12
|
| Rate for Payer: Cofinity Advantage |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$159.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.12
|
| Rate for Payer: Healthscope Commercial |
$166.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.86
|
| Rate for Payer: PHP Commercial |
$157.38
|
| Rate for Payer: Priority Health SBD |
$116.64
|
|
