|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Hospital Charge Code |
0232T
|
| Min. Negotiated Rate |
$91.43 |
| Max. Negotiated Rate |
$41,594.00 |
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Medicare |
$459.00
|
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: BCBS Complete |
$367.20
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,594.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,594.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 50431
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$11,432.00 |
| Rate for Payer: Aetna Commercial |
$83.90
|
| Rate for Payer: Aetna Medicare |
$65.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.16
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$62.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,577.05
|
| Rate for Payer: BCN Commercial |
$476.46
|
| Rate for Payer: BCN Medicare Advantage |
$62.61
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$90.16
|
| Rate for Payer: Cofinity Commercial |
$83.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.61
|
| Rate for Payer: Healthscope Commercial |
$100.18
|
| Rate for Payer: Healthscope Commercial |
$115.83
|
| Rate for Payer: Mclaren Medicaid |
$42.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.74
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,432.00
|
| Rate for Payer: Nomi Health Commercial |
$75.13
|
| Rate for Payer: PACE SWMI |
$62.61
|
| Rate for Payer: PHP Medicare Advantage |
$62.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.86
|
| Rate for Payer: Priority Health Medicare |
$62.61
|
| Rate for Payer: Priority Health Narrow Network |
$103.86
|
| Rate for Payer: Priority Health SBD |
$103.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.61
|
| Rate for Payer: UHC Medicare Advantage |
$62.61
|
| Rate for Payer: UHCCP Medicaid |
$42.17
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 50430
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$26,827.00 |
| Rate for Payer: Aetna Commercial |
$193.86
|
| Rate for Payer: Aetna Medicare |
$150.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.32
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$144.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,447.09
|
| Rate for Payer: BCN Commercial |
$931.42
|
| Rate for Payer: BCN Medicare Advantage |
$144.67
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$193.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.67
|
| Rate for Payer: Healthscope Commercial |
$231.47
|
| Rate for Payer: Healthscope Commercial |
$267.64
|
| Rate for Payer: Mclaren Medicaid |
$96.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.90
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,827.00
|
| Rate for Payer: Nomi Health Commercial |
$173.60
|
| Rate for Payer: PACE SWMI |
$144.67
|
| Rate for Payer: PHP Medicare Advantage |
$144.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.66
|
| Rate for Payer: Priority Health Medicare |
$144.67
|
| Rate for Payer: Priority Health Narrow Network |
$239.66
|
| Rate for Payer: Priority Health SBD |
$239.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.67
|
| Rate for Payer: UHC Medicare Advantage |
$144.67
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
|
|
PR NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 36005
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$8,521.00 |
| Rate for Payer: Aetna Commercial |
$60.77
|
| Rate for Payer: Aetna Medicare |
$47.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.30
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$45.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.88
|
| Rate for Payer: BCN Commercial |
$414.85
|
| Rate for Payer: BCN Medicare Advantage |
$45.35
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Cofinity Commercial |
$60.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.35
|
| Rate for Payer: Healthscope Commercial |
$83.90
|
| Rate for Payer: Healthscope Commercial |
$72.56
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.62
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,521.00
|
| Rate for Payer: Nomi Health Commercial |
$54.42
|
| Rate for Payer: PACE SWMI |
$45.35
|
| Rate for Payer: PHP Medicare Advantage |
$45.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.92
|
| Rate for Payer: Priority Health Medicare |
$45.35
|
| Rate for Payer: Priority Health Narrow Network |
$73.92
|
| Rate for Payer: Priority Health SBD |
$73.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.35
|
| Rate for Payer: UHC Exchange |
$374.81
|
| Rate for Payer: UHC Medicare Advantage |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
PR NJX RETROGRADE URETHROCSTOGRAPY
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 51610
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$11,192.00 |
| Rate for Payer: Aetna Commercial |
$82.53
|
| Rate for Payer: Aetna Medicare |
$64.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$61.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.09
|
| Rate for Payer: BCN Commercial |
$189.12
|
| Rate for Payer: BCN Medicare Advantage |
$61.59
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Cofinity Commercial |
$82.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$98.54
|
| Rate for Payer: Healthscope Commercial |
$113.94
|
| Rate for Payer: Mclaren Medicaid |
$41.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.67
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,192.00
|
| Rate for Payer: Nomi Health Commercial |
$73.91
|
| Rate for Payer: PACE SWMI |
$61.59
|
| Rate for Payer: PHP Medicare Advantage |
$61.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.73
|
| Rate for Payer: Priority Health Medicare |
$61.59
|
| Rate for Payer: Priority Health Narrow Network |
$101.73
|
| Rate for Payer: Priority Health SBD |
$101.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.59
|
| Rate for Payer: UHC Exchange |
$232.45
|
| Rate for Payer: UHC Medicare Advantage |
$61.59
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 50690
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$12,197.00 |
| Rate for Payer: Aetna Commercial |
$89.27
|
| Rate for Payer: Aetna Medicare |
$69.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$66.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,404.37
|
| Rate for Payer: BCN Commercial |
$174.46
|
| Rate for Payer: BCN Medicare Advantage |
$66.62
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$95.93
|
| Rate for Payer: Cofinity Commercial |
$89.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.62
|
| Rate for Payer: Healthscope Commercial |
$123.25
|
| Rate for Payer: Healthscope Commercial |
$106.59
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.95
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,197.00
|
| Rate for Payer: Nomi Health Commercial |
$79.94
|
| Rate for Payer: PACE SWMI |
$66.62
|
| Rate for Payer: PHP Medicare Advantage |
$66.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.26
|
| Rate for Payer: Priority Health Medicare |
$66.62
|
| Rate for Payer: Priority Health Narrow Network |
$110.26
|
| Rate for Payer: Priority Health SBD |
$110.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.62
|
| Rate for Payer: UHC Exchange |
$675.59
|
| Rate for Payer: UHC Medicare Advantage |
$66.62
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 54250
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$21,467.00 |
| Rate for Payer: Aetna Commercial |
$154.45
|
| Rate for Payer: Aetna Medicare |
$119.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.97
|
| Rate for Payer: BCBS Complete |
$94.00
|
| Rate for Payer: BCBS MAPPO |
$115.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.35
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$115.26
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$165.97
|
| Rate for Payer: Cofinity Commercial |
$154.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.26
|
| Rate for Payer: Healthscope Commercial |
$184.42
|
| Rate for Payer: Healthscope Commercial |
$213.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,467.00
|
| Rate for Payer: Nomi Health Commercial |
$138.31
|
| Rate for Payer: PACE SWMI |
$115.26
|
| Rate for Payer: PHP Medicare Advantage |
$115.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.33
|
| Rate for Payer: Priority Health Medicare |
$115.26
|
| Rate for Payer: Priority Health Narrow Network |
$193.33
|
| Rate for Payer: Priority Health SBD |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.26
|
| Rate for Payer: UHC Exchange |
$211.68
|
| Rate for Payer: UHC Medicare Advantage |
$115.26
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 94761
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$518.00 |
| Rate for Payer: Aetna Commercial |
$4.85
|
| Rate for Payer: Aetna Medicare |
$3.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.21
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$3.62
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$5.37
|
| Rate for Payer: BCN Medicare Advantage |
$3.62
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$5.21
|
| Rate for Payer: Cofinity Commercial |
$4.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.62
|
| Rate for Payer: Healthscope Commercial |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$6.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$518.00
|
| Rate for Payer: Nomi Health Commercial |
$4.34
|
| Rate for Payer: PACE SWMI |
$3.62
|
| Rate for Payer: PHP Medicare Advantage |
$3.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.42
|
| Rate for Payer: Priority Health Medicare |
$3.62
|
| Rate for Payer: Priority Health Narrow Network |
$5.42
|
| Rate for Payer: Priority Health SBD |
$5.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.62
|
| Rate for Payer: UHC Exchange |
$10.67
|
| Rate for Payer: UHC Medicare Advantage |
$3.62
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 94762
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$3,528.00 |
| Rate for Payer: Aetna Commercial |
$29.33
|
| Rate for Payer: Aetna Medicare |
$22.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.52
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$21.89
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: BCN Medicare Advantage |
$21.89
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$31.52
|
| Rate for Payer: Cofinity Commercial |
$29.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.89
|
| Rate for Payer: Healthscope Commercial |
$35.02
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,528.00
|
| Rate for Payer: Nomi Health Commercial |
$26.27
|
| Rate for Payer: PACE SWMI |
$21.89
|
| Rate for Payer: PHP Medicare Advantage |
$21.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.38
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow Network |
$34.38
|
| Rate for Payer: Priority Health SBD |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.89
|
| Rate for Payer: UHC Exchange |
$41.07
|
| Rate for Payer: UHC Medicare Advantage |
$21.89
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 94760
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$407.32 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$3.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.80
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$3.33
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$3.42
|
| Rate for Payer: BCN Medicare Advantage |
$3.33
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$4.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$5.33
|
| Rate for Payer: Healthscope Commercial |
$6.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.00
|
| Rate for Payer: Nomi Health Commercial |
$4.00
|
| Rate for Payer: PACE SWMI |
$3.33
|
| Rate for Payer: PHP Medicare Advantage |
$3.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.61
|
| Rate for Payer: Priority Health Medicare |
$3.33
|
| Rate for Payer: Priority Health Narrow Network |
$3.61
|
| Rate for Payer: Priority Health SBD |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.33
|
| Rate for Payer: UHC Exchange |
$4.93
|
| Rate for Payer: UHC Medicare Advantage |
$3.33
|
|
|
PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 93923
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$18,053.00 |
| Rate for Payer: Aetna Commercial |
$156.24
|
| Rate for Payer: Aetna Commercial |
$156.24
|
| Rate for Payer: Aetna Medicare |
$121.26
|
| Rate for Payer: Aetna Medicare |
$121.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.24
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$116.60
|
| Rate for Payer: BCBS MAPPO |
$116.60
|
| Rate for Payer: BCBS Trust/PPO |
$415.24
|
| Rate for Payer: BCBS Trust/PPO |
$415.24
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Medicare Advantage |
$116.60
|
| Rate for Payer: BCN Medicare Advantage |
$116.60
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.60
|
| Rate for Payer: Healthscope Commercial |
$186.56
|
| Rate for Payer: Healthscope Commercial |
$215.71
|
| Rate for Payer: Healthscope Commercial |
$186.56
|
| Rate for Payer: Healthscope Commercial |
$215.71
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.43
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,053.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,053.00
|
| Rate for Payer: Nomi Health Commercial |
$139.92
|
| Rate for Payer: Nomi Health Commercial |
$139.92
|
| Rate for Payer: PACE SWMI |
$116.60
|
| Rate for Payer: PACE SWMI |
$116.60
|
| Rate for Payer: PHP Medicare Advantage |
$116.60
|
| Rate for Payer: PHP Medicare Advantage |
$116.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.85
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Narrow Network |
$176.85
|
| Rate for Payer: Priority Health Narrow Network |
$176.85
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.60
|
| Rate for Payer: UHC Exchange |
$147.23
|
| Rate for Payer: UHC Exchange |
$147.23
|
| Rate for Payer: UHC Medicare Advantage |
$116.60
|
| Rate for Payer: UHC Medicare Advantage |
$116.60
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
|
|
PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 93922
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$11,555.00 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Medicare |
$76.27
|
| Rate for Payer: Aetna Medicare |
$76.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.61
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$73.34
|
| Rate for Payer: BCBS MAPPO |
$73.34
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Medicare Advantage |
$73.34
|
| Rate for Payer: BCN Medicare Advantage |
$73.34
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$98.28
|
| Rate for Payer: Cofinity Commercial |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$98.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.34
|
| Rate for Payer: Healthscope Commercial |
$117.34
|
| Rate for Payer: Healthscope Commercial |
$135.68
|
| Rate for Payer: Healthscope Commercial |
$117.34
|
| Rate for Payer: Healthscope Commercial |
$135.68
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.01
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,555.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,555.00
|
| Rate for Payer: Nomi Health Commercial |
$88.01
|
| Rate for Payer: Nomi Health Commercial |
$88.01
|
| Rate for Payer: PACE SWMI |
$73.34
|
| Rate for Payer: PACE SWMI |
$73.34
|
| Rate for Payer: PHP Medicare Advantage |
$73.34
|
| Rate for Payer: PHP Medicare Advantage |
$73.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.72
|
| Rate for Payer: Priority Health Medicare |
$73.34
|
| Rate for Payer: Priority Health Medicare |
$73.34
|
| Rate for Payer: Priority Health Narrow Network |
$111.72
|
| Rate for Payer: Priority Health Narrow Network |
$111.72
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.34
|
| Rate for Payer: UHC Exchange |
$101.88
|
| Rate for Payer: UHC Exchange |
$101.88
|
| Rate for Payer: UHC Medicare Advantage |
$73.34
|
| Rate for Payer: UHC Medicare Advantage |
$73.34
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
|
|
PR NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 36221
|
| Min. Negotiated Rate |
$125.03 |
| Max. Negotiated Rate |
$35,314.00 |
| Rate for Payer: Aetna Commercial |
$256.78
|
| Rate for Payer: Aetna Medicare |
$199.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.95
|
| Rate for Payer: BCBS Complete |
$131.28
|
| Rate for Payer: BCBS MAPPO |
$191.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.46
|
| Rate for Payer: BCN Commercial |
$1,452.84
|
| Rate for Payer: BCN Medicare Advantage |
$191.63
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$275.95
|
| Rate for Payer: Cofinity Commercial |
$256.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.63
|
| Rate for Payer: Healthscope Commercial |
$306.61
|
| Rate for Payer: Healthscope Commercial |
$354.52
|
| Rate for Payer: Mclaren Medicaid |
$125.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.21
|
| Rate for Payer: Meridian Medicaid |
$131.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,314.00
|
| Rate for Payer: Nomi Health Commercial |
$229.96
|
| Rate for Payer: PACE SWMI |
$191.63
|
| Rate for Payer: PHP Medicare Advantage |
$191.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.11
|
| Rate for Payer: Priority Health Medicare |
$191.63
|
| Rate for Payer: Priority Health Narrow Network |
$311.11
|
| Rate for Payer: Priority Health SBD |
$311.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.63
|
| Rate for Payer: UHC Medicare Advantage |
$191.63
|
| Rate for Payer: UHCCP Medicaid |
$125.03
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J7050
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$0.95
|
| Rate for Payer: Aetna Medicare |
$0.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.02
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$0.71
|
| Rate for Payer: BCBS Trust/PPO |
$0.39
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.71
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.95
|
| Rate for Payer: Cofinity Commercial |
$1.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.71
|
| Rate for Payer: Healthscope Commercial |
$1.32
|
| Rate for Payer: Healthscope Commercial |
$1.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.00
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: PACE SWMI |
$0.71
|
| Rate for Payer: PHP Medicare Advantage |
$0.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$0.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.67
|
| Rate for Payer: UHC Medicare Advantage |
$0.71
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J7040
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.98
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$1.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.39
|
| Rate for Payer: BCN Medicare Advantage |
$1.38
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.38
|
| Rate for Payer: Healthscope Commercial |
$2.20
|
| Rate for Payer: Healthscope Commercial |
$2.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.00
|
| Rate for Payer: Nomi Health Commercial |
$1.65
|
| Rate for Payer: PACE SWMI |
$1.38
|
| Rate for Payer: PHP Medicare Advantage |
$1.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: Priority Health Medicare |
$1.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.38
|
| Rate for Payer: UHC Exchange |
$1.33
|
| Rate for Payer: UHC Medicare Advantage |
$1.38
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J7030
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$258.00 |
| Rate for Payer: Aetna Commercial |
$3.05
|
| Rate for Payer: Aetna Medicare |
$2.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.28
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$2.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.52
|
| Rate for Payer: BCN Medicare Advantage |
$2.28
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$3.05
|
| Rate for Payer: Cofinity Commercial |
$3.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.28
|
| Rate for Payer: Healthscope Commercial |
$4.22
|
| Rate for Payer: Healthscope Commercial |
$3.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.00
|
| Rate for Payer: Nomi Health Commercial |
$2.73
|
| Rate for Payer: PACE SWMI |
$2.28
|
| Rate for Payer: PHP Medicare Advantage |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$2.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.28
|
| Rate for Payer: UHC Exchange |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.28
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 98971
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$2,940.00 |
| Rate for Payer: Aetna Commercial |
$28.10
|
| Rate for Payer: Aetna Medicare |
$21.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.20
|
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: BCBS MAPPO |
$20.97
|
| Rate for Payer: BCBS Trust/PPO |
$529.88
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: BCN Medicare Advantage |
$20.97
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$30.20
|
| Rate for Payer: Cofinity Commercial |
$28.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.97
|
| Rate for Payer: Healthscope Commercial |
$33.55
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,940.00
|
| Rate for Payer: Nomi Health Commercial |
$25.16
|
| Rate for Payer: PACE SWMI |
$20.97
|
| Rate for Payer: PHP Medicare Advantage |
$20.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.05
|
| Rate for Payer: Priority Health Medicare |
$20.97
|
| Rate for Payer: Priority Health Narrow Network |
$28.05
|
| Rate for Payer: Priority Health SBD |
$28.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.97
|
| Rate for Payer: UHC Medicare Advantage |
$20.97
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 98972
|
| Min. Negotiated Rate |
$31.41 |
| Max. Negotiated Rate |
$4,544.00 |
| Rate for Payer: Aetna Commercial |
$42.09
|
| Rate for Payer: Aetna Medicare |
$32.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.23
|
| Rate for Payer: BCBS Complete |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$31.41
|
| Rate for Payer: BCBS Trust/PPO |
$800.90
|
| Rate for Payer: BCN Commercial |
$44.96
|
| Rate for Payer: BCN Medicare Advantage |
$31.41
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$45.23
|
| Rate for Payer: Cofinity Commercial |
$42.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$58.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,544.00
|
| Rate for Payer: Nomi Health Commercial |
$37.69
|
| Rate for Payer: PACE SWMI |
$31.41
|
| Rate for Payer: PHP Medicare Advantage |
$31.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$31.41
|
| Rate for Payer: Priority Health Narrow Network |
$41.16
|
| Rate for Payer: Priority Health SBD |
$41.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.41
|
| Rate for Payer: UHC Medicare Advantage |
$31.41
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 98970
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$1,697.00 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.01
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$11.12
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.12
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.12
|
| Rate for Payer: Healthscope Commercial |
$17.79
|
| Rate for Payer: Healthscope Commercial |
$20.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.00
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE SWMI |
$11.12
|
| Rate for Payer: PHP Medicare Advantage |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.83
|
| Rate for Payer: Priority Health Medicare |
$11.12
|
| Rate for Payer: Priority Health Narrow Network |
$15.83
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.12
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
|
|
PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31267
|
| Min. Negotiated Rate |
$168.91 |
| Max. Negotiated Rate |
$47,048.00 |
| Rate for Payer: Aetna Commercial |
$338.79
|
| Rate for Payer: Aetna Medicare |
$262.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.08
|
| Rate for Payer: BCBS Complete |
$177.36
|
| Rate for Payer: BCBS MAPPO |
$252.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,047.62
|
| Rate for Payer: BCN Commercial |
$385.57
|
| Rate for Payer: BCN Medicare Advantage |
$252.83
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$364.08
|
| Rate for Payer: Cofinity Commercial |
$338.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.83
|
| Rate for Payer: Healthscope Commercial |
$467.74
|
| Rate for Payer: Healthscope Commercial |
$404.53
|
| Rate for Payer: Mclaren Medicaid |
$168.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.47
|
| Rate for Payer: Meridian Medicaid |
$177.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,048.00
|
| Rate for Payer: Nomi Health Commercial |
$303.40
|
| Rate for Payer: PACE SWMI |
$252.83
|
| Rate for Payer: PHP Medicare Advantage |
$252.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$367.07
|
| Rate for Payer: Priority Health Medicare |
$252.83
|
| Rate for Payer: Priority Health Narrow Network |
$367.07
|
| Rate for Payer: Priority Health SBD |
$367.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.83
|
| Rate for Payer: UHC Exchange |
$529.98
|
| Rate for Payer: UHC Medicare Advantage |
$252.83
|
| Rate for Payer: UHCCP Medicaid |
$168.91
|
|
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 31288
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$41,551.00 |
| Rate for Payer: Aetna Commercial |
$299.44
|
| Rate for Payer: Aetna Medicare |
$232.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.78
|
| Rate for Payer: BCBS Complete |
$156.78
|
| Rate for Payer: BCBS MAPPO |
$223.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.16
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$223.46
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$321.78
|
| Rate for Payer: Cofinity Commercial |
$299.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.46
|
| Rate for Payer: Healthscope Commercial |
$413.40
|
| Rate for Payer: Healthscope Commercial |
$357.54
|
| Rate for Payer: Mclaren Medicaid |
$149.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.63
|
| Rate for Payer: Meridian Medicaid |
$156.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,551.00
|
| Rate for Payer: Nomi Health Commercial |
$268.15
|
| Rate for Payer: PACE SWMI |
$223.46
|
| Rate for Payer: PHP Medicare Advantage |
$223.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.50
|
| Rate for Payer: Priority Health Medicare |
$223.46
|
| Rate for Payer: Priority Health Narrow Network |
$323.50
|
| Rate for Payer: Priority Health SBD |
$323.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.46
|
| Rate for Payer: UHC Exchange |
$417.89
|
| Rate for Payer: UHC Medicare Advantage |
$223.46
|
| Rate for Payer: UHCCP Medicaid |
$149.31
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 99447
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$5,229.00 |
| Rate for Payer: Aetna Commercial |
$45.63
|
| Rate for Payer: Aetna Medicare |
$35.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.03
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$34.05
|
| Rate for Payer: BCBS Trust/PPO |
$873.81
|
| Rate for Payer: BCN Commercial |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$34.05
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$49.03
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.05
|
| Rate for Payer: Healthscope Commercial |
$54.48
|
| Rate for Payer: Healthscope Commercial |
$62.99
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.75
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,229.00
|
| Rate for Payer: Nomi Health Commercial |
$40.86
|
| Rate for Payer: PACE SWMI |
$34.05
|
| Rate for Payer: PHP Medicare Advantage |
$34.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.39
|
| Rate for Payer: Priority Health Medicare |
$34.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.39
|
| Rate for Payer: Priority Health SBD |
$40.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.05
|
| Rate for Payer: UHC Medicare Advantage |
$34.05
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 99448
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$7,968.00 |
| Rate for Payer: Aetna Commercial |
$67.74
|
| Rate for Payer: Aetna Medicare |
$52.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.79
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$50.55
|
| Rate for Payer: BCBS Trust/PPO |
$899.17
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Medicare Advantage |
$50.55
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$72.79
|
| Rate for Payer: Cofinity Commercial |
$67.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.55
|
| Rate for Payer: Healthscope Commercial |
$80.88
|
| Rate for Payer: Healthscope Commercial |
$93.52
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.08
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,968.00
|
| Rate for Payer: Nomi Health Commercial |
$60.66
|
| Rate for Payer: PACE SWMI |
$50.55
|
| Rate for Payer: PHP Medicare Advantage |
$50.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.84
|
| Rate for Payer: Priority Health Medicare |
$50.55
|
| Rate for Payer: Priority Health Narrow Network |
$59.84
|
| Rate for Payer: Priority Health SBD |
$59.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.55
|
| Rate for Payer: UHC Medicare Advantage |
$50.55
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 99449
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$10,542.00 |
| Rate for Payer: Aetna Commercial |
$91.66
|
| Rate for Payer: Aetna Medicare |
$71.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.50
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$68.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.41
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: BCN Medicare Advantage |
$68.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$98.50
|
| Rate for Payer: Cofinity Commercial |
$91.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.40
|
| Rate for Payer: Healthscope Commercial |
$109.44
|
| Rate for Payer: Healthscope Commercial |
$126.54
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.82
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,542.00
|
| Rate for Payer: Nomi Health Commercial |
$82.08
|
| Rate for Payer: PACE SWMI |
$68.40
|
| Rate for Payer: PHP Medicare Advantage |
$68.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.65
|
| Rate for Payer: Priority Health Medicare |
$68.40
|
| Rate for Payer: Priority Health Narrow Network |
$79.65
|
| Rate for Payer: Priority Health SBD |
$79.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.40
|
| Rate for Payer: UHC Medicare Advantage |
$68.40
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 99446
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$2,646.00 |
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna Medicare |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.31
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$16.88
|
| Rate for Payer: BCBS Trust/PPO |
$776.07
|
| Rate for Payer: BCN Commercial |
$25.90
|
| Rate for Payer: BCN Medicare Advantage |
$16.88
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$24.31
|
| Rate for Payer: Cofinity Commercial |
$22.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$27.01
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Mclaren Medicaid |
$11.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.72
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.00
|
| Rate for Payer: Nomi Health Commercial |
$20.26
|
| Rate for Payer: PACE SWMI |
$16.88
|
| Rate for Payer: PHP Medicare Advantage |
$16.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.81
|
| Rate for Payer: Priority Health Medicare |
$16.88
|
| Rate for Payer: Priority Health Narrow Network |
$19.81
|
| Rate for Payer: Priority Health SBD |
$19.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.88
|
| Rate for Payer: UHC Medicare Advantage |
$16.88
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
|
