|
PR NDSC URETEROTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 50980
|
| Min. Negotiated Rate |
$224.50 |
| Max. Negotiated Rate |
$2,962.71 |
| Rate for Payer: Aetna Commercial |
$451.89
|
| Rate for Payer: Aetna Medicare |
$350.72
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS MAPPO |
$337.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,962.71
|
| Rate for Payer: BCN Commercial |
$507.73
|
| Rate for Payer: BCN Medicare Advantage |
$337.23
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$485.61
|
| Rate for Payer: Cofinity Commercial |
$451.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.23
|
| Rate for Payer: Mclaren Medicaid |
$224.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.09
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Nomi Health Commercial |
$404.68
|
| Rate for Payer: PACE SWMI |
$337.23
|
| Rate for Payer: PHP Medicare Advantage |
$337.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO |
$558.16
|
| Rate for Payer: Priority Health Medicare |
$340.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$558.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.23
|
| Rate for Payer: UHC Exchange |
$337.23
|
| Rate for Payer: UHC Medicare Advantage |
$337.23
|
| Rate for Payer: UHCCP Medicaid |
$224.50
|
|
|
PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 50972
|
| Min. Negotiated Rate |
$225.99 |
| Max. Negotiated Rate |
$2,720.22 |
| Rate for Payer: Aetna Commercial |
$454.92
|
| Rate for Payer: Aetna Medicare |
$353.07
|
| Rate for Payer: BCBS Complete |
$237.29
|
| Rate for Payer: BCBS MAPPO |
$339.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,720.22
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$339.49
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$488.87
|
| Rate for Payer: Cofinity Commercial |
$454.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.49
|
| Rate for Payer: Mclaren Medicaid |
$225.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.46
|
| Rate for Payer: Meridian Medicaid |
$237.29
|
| Rate for Payer: Nomi Health Commercial |
$407.39
|
| Rate for Payer: PACE SWMI |
$339.49
|
| Rate for Payer: PHP Medicare Advantage |
$339.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO |
$560.83
|
| Rate for Payer: Priority Health Medicare |
$342.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.49
|
| Rate for Payer: UHC Exchange |
$339.49
|
| Rate for Payer: UHC Medicare Advantage |
$339.49
|
| Rate for Payer: UHCCP Medicaid |
$225.99
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$337.61 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$664.25
|
| Rate for Payer: Aetna Medicare |
$515.54
|
| Rate for Payer: BCBS Complete |
$354.49
|
| Rate for Payer: BCBS MAPPO |
$495.71
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$756.47
|
| Rate for Payer: BCN Medicare Advantage |
$495.71
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$713.82
|
| Rate for Payer: Cofinity Commercial |
$664.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.71
|
| Rate for Payer: Mclaren Medicaid |
$337.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$520.50
|
| Rate for Payer: Meridian Medicaid |
$354.49
|
| Rate for Payer: Nomi Health Commercial |
$594.85
|
| Rate for Payer: PACE SWMI |
$495.71
|
| Rate for Payer: PHP Medicare Advantage |
$495.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO |
$797.90
|
| Rate for Payer: Priority Health Medicare |
$500.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$495.71
|
| Rate for Payer: UHC Exchange |
$495.71
|
| Rate for Payer: UHC Medicare Advantage |
$495.71
|
| Rate for Payer: UHCCP Medicaid |
$337.61
|
|
|
PR NECK LIFT
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 00541
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Medicare |
$1,020.00
|
| Rate for Payer: BCBS Complete |
$816.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: Aetna Commercial |
$153.19
|
| Rate for Payer: Aetna Medicare |
$118.89
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$114.32
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.32
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$164.62
|
| Rate for Payer: Cofinity Commercial |
$153.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.32
|
| Rate for Payer: Mclaren Medicaid |
$38.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.04
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$137.18
|
| Rate for Payer: PACE SWMI |
$114.32
|
| Rate for Payer: PHP Medicare Advantage |
$114.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO |
$82.78
|
| Rate for Payer: Priority Health Medicare |
$115.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.32
|
| Rate for Payer: UHC Exchange |
$114.32
|
| Rate for Payer: UHC Medicare Advantage |
$114.32
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$620.75 |
| Rate for Payer: Aetna Commercial |
$126.42
|
| Rate for Payer: Aetna Medicare |
$98.11
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$94.34
|
| Rate for Payer: BCBS Trust/PPO |
$620.75
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: BCN Medicare Advantage |
$94.34
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$135.85
|
| Rate for Payer: Cofinity Commercial |
$126.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.34
|
| Rate for Payer: Mclaren Medicaid |
$26.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.06
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Nomi Health Commercial |
$113.21
|
| Rate for Payer: PACE SWMI |
$94.34
|
| Rate for Payer: PHP Medicare Advantage |
$94.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.75
|
| Rate for Payer: Priority Health HMO/PPO |
$55.18
|
| Rate for Payer: Priority Health Medicare |
$95.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.34
|
| Rate for Payer: UHC Exchange |
$94.34
|
| Rate for Payer: UHC Medicare Advantage |
$94.34
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$665.13 |
| Rate for Payer: Aetna Commercial |
$158.99
|
| Rate for Payer: Aetna Medicare |
$123.40
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$118.65
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: BCN Medicare Advantage |
$118.65
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$170.86
|
| Rate for Payer: Cofinity Commercial |
$158.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.65
|
| Rate for Payer: Mclaren Medicaid |
$41.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.58
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Nomi Health Commercial |
$142.38
|
| Rate for Payer: PACE SWMI |
$118.65
|
| Rate for Payer: PHP Medicare Advantage |
$118.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO |
$84.12
|
| Rate for Payer: Priority Health Medicare |
$119.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.65
|
| Rate for Payer: UHC Exchange |
$118.65
|
| Rate for Payer: UHC Medicare Advantage |
$118.65
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$990.03 |
| Rate for Payer: Aetna Commercial |
$178.90
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$133.51
|
| Rate for Payer: BCBS Trust/PPO |
$990.03
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$133.51
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$192.25
|
| Rate for Payer: Cofinity Commercial |
$178.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.51
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.19
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Nomi Health Commercial |
$160.21
|
| Rate for Payer: PACE SWMI |
$133.51
|
| Rate for Payer: PHP Medicare Advantage |
$133.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health HMO/PPO |
$109.47
|
| Rate for Payer: Priority Health Medicare |
$134.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.51
|
| Rate for Payer: UHC Exchange |
$133.51
|
| Rate for Payer: UHC Medicare Advantage |
$133.51
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$1,360.37 |
| Rate for Payer: Aetna Commercial |
$72.15
|
| Rate for Payer: Aetna Commercial |
$72.15
|
| Rate for Payer: Aetna Medicare |
$55.99
|
| Rate for Payer: Aetna Medicare |
$55.99
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Medicare Advantage |
$53.84
|
| Rate for Payer: BCN Medicare Advantage |
$53.84
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$11.50
|
| Rate for Payer: Mclaren Medicaid |
$11.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.53
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Nomi Health Commercial |
$64.61
|
| Rate for Payer: Nomi Health Commercial |
$64.61
|
| Rate for Payer: PACE SWMI |
$53.84
|
| Rate for Payer: PACE SWMI |
$53.84
|
| Rate for Payer: PHP Medicare Advantage |
$53.84
|
| Rate for Payer: PHP Medicare Advantage |
$53.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO |
$24.43
|
| Rate for Payer: Priority Health HMO/PPO |
$24.43
|
| Rate for Payer: Priority Health Medicare |
$54.38
|
| Rate for Payer: Priority Health Medicare |
$54.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.84
|
| Rate for Payer: UHC Exchange |
$53.84
|
| Rate for Payer: UHC Exchange |
$53.84
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,755.54 |
| Rate for Payer: Aetna Commercial |
$114.22
|
| Rate for Payer: Aetna Commercial |
$114.22
|
| Rate for Payer: Aetna Medicare |
$88.65
|
| Rate for Payer: Aetna Medicare |
$88.65
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Medicare Advantage |
$85.24
|
| Rate for Payer: BCN Medicare Advantage |
$85.24
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.24
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.50
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Nomi Health Commercial |
$102.29
|
| Rate for Payer: Nomi Health Commercial |
$102.29
|
| Rate for Payer: PACE SWMI |
$85.24
|
| Rate for Payer: PACE SWMI |
$85.24
|
| Rate for Payer: PHP Medicare Advantage |
$85.24
|
| Rate for Payer: PHP Medicare Advantage |
$85.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health HMO/PPO |
$67.22
|
| Rate for Payer: Priority Health HMO/PPO |
$67.22
|
| Rate for Payer: Priority Health Medicare |
$86.09
|
| Rate for Payer: Priority Health Medicare |
$86.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.24
|
| Rate for Payer: UHC Exchange |
$85.24
|
| Rate for Payer: UHC Exchange |
$85.24
|
| Rate for Payer: UHC Medicare Advantage |
$85.24
|
| Rate for Payer: UHC Medicare Advantage |
$85.24
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$88.41
|
| Rate for Payer: Aetna Medicare |
$68.62
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$65.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$65.98
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$95.01
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.98
|
| Rate for Payer: Mclaren Medicaid |
$12.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.28
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Nomi Health Commercial |
$79.18
|
| Rate for Payer: PACE SWMI |
$65.98
|
| Rate for Payer: PHP Medicare Advantage |
$65.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO |
$25.78
|
| Rate for Payer: Priority Health Medicare |
$66.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.98
|
| Rate for Payer: UHC Exchange |
$65.98
|
| Rate for Payer: UHC Medicare Advantage |
$65.98
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$121.68
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Mclaren Medicaid |
$12.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Meridian Medicaid |
$12.97
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$26.24
|
| Rate for Payer: Priority Health Medicare |
$72.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Exchange |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$1,456.52 |
| Rate for Payer: Aetna Commercial |
$99.43
|
| Rate for Payer: Aetna Commercial |
$99.43
|
| Rate for Payer: Aetna Medicare |
$77.17
|
| Rate for Payer: Aetna Medicare |
$77.17
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Medicare Advantage |
$74.20
|
| Rate for Payer: BCN Medicare Advantage |
$74.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$106.85
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| Rate for Payer: Cofinity Commercial |
$106.85
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.20
|
| Rate for Payer: Mclaren Medicaid |
$23.22
|
| Rate for Payer: Mclaren Medicaid |
$23.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.91
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Nomi Health Commercial |
$89.04
|
| Rate for Payer: Nomi Health Commercial |
$89.04
|
| Rate for Payer: PACE SWMI |
$74.20
|
| Rate for Payer: PACE SWMI |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$74.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO |
$48.85
|
| Rate for Payer: Priority Health HMO/PPO |
$48.85
|
| Rate for Payer: Priority Health Medicare |
$74.94
|
| Rate for Payer: Priority Health Medicare |
$74.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.20
|
| Rate for Payer: UHC Exchange |
$74.20
|
| Rate for Payer: UHC Exchange |
$74.20
|
| Rate for Payer: UHC Medicare Advantage |
$74.20
|
| Rate for Payer: UHC Medicare Advantage |
$74.20
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$296.90 |
| Rate for Payer: Aetna Commercial |
$109.17
|
| Rate for Payer: Aetna Medicare |
$84.73
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS MAPPO |
$81.47
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$140.25
|
| Rate for Payer: BCN Medicare Advantage |
$81.47
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$117.32
|
| Rate for Payer: Cofinity Commercial |
$109.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.47
|
| Rate for Payer: Mclaren Medicaid |
$12.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.54
|
| Rate for Payer: Meridian Medicaid |
$12.97
|
| Rate for Payer: Nomi Health Commercial |
$97.76
|
| Rate for Payer: PACE SWMI |
$81.47
|
| Rate for Payer: PHP Medicare Advantage |
$81.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health HMO/PPO |
$26.24
|
| Rate for Payer: Priority Health Medicare |
$82.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.47
|
| Rate for Payer: UHC Exchange |
$81.47
|
| Rate for Payer: UHC Medicare Advantage |
$81.47
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 95872
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$411.55 |
| Rate for Payer: Aetna Commercial |
$229.42
|
| Rate for Payer: Aetna Medicare |
$178.06
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$171.21
|
| Rate for Payer: BCBS Trust/PPO |
$411.55
|
| Rate for Payer: BCN Commercial |
$287.34
|
| Rate for Payer: BCN Medicare Advantage |
$171.21
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$246.54
|
| Rate for Payer: Cofinity Commercial |
$229.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.21
|
| Rate for Payer: Mclaren Medicaid |
$92.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.77
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Nomi Health Commercial |
$205.45
|
| Rate for Payer: PACE SWMI |
$171.21
|
| Rate for Payer: PHP Medicare Advantage |
$171.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health HMO/PPO |
$197.20
|
| Rate for Payer: Priority Health Medicare |
$172.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.21
|
| Rate for Payer: UHC Exchange |
$171.21
|
| Rate for Payer: UHC Medicare Advantage |
$171.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
|
|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$37.63 |
| Rate for Payer: Aetna Commercial |
$19.23
|
| Rate for Payer: Aetna Medicare |
$14.92
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.35
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$20.66
|
| Rate for Payer: Cofinity Commercial |
$19.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.07
|
| Rate for Payer: Nomi Health Commercial |
$17.22
|
| Rate for Payer: PACE SWMI |
$14.35
|
| Rate for Payer: PHP Medicare Advantage |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health HMO/PPO |
$22.40
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.35
|
| Rate for Payer: UHC Exchange |
$14.35
|
| Rate for Payer: UHC Medicare Advantage |
$14.35
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$21.67 |
| Max. Negotiated Rate |
$54.73 |
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$21.67
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$54.73
|
| Rate for Payer: BCN Medicare Advantage |
$21.67
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.75
|
| Rate for Payer: Nomi Health Commercial |
$26.00
|
| Rate for Payer: PACE SWMI |
$21.67
|
| Rate for Payer: PHP Medicare Advantage |
$21.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO |
$33.59
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.67
|
| Rate for Payer: UHC Exchange |
$21.67
|
| Rate for Payer: UHC Medicare Advantage |
$21.67
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$31.06
|
| Rate for Payer: Aetna Medicare |
$24.11
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.18
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.18
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$33.38
|
| Rate for Payer: Cofinity Commercial |
$31.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.18
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.34
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Nomi Health Commercial |
$27.82
|
| Rate for Payer: PACE SWMI |
$23.18
|
| Rate for Payer: PHP Medicare Advantage |
$23.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.70
|
| Rate for Payer: Priority Health HMO/PPO |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$23.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.18
|
| Rate for Payer: UHC Exchange |
$23.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$33.62
|
| Rate for Payer: Aetna Medicare |
$26.09
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$25.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: BCN Commercial |
$74.28
|
| Rate for Payer: BCN Medicare Advantage |
$25.09
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| Rate for Payer: Cofinity Commercial |
$33.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.09
|
| Rate for Payer: Mclaren Medicaid |
$16.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.34
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: PACE SWMI |
$25.09
|
| Rate for Payer: PHP Medicare Advantage |
$25.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO |
$37.30
|
| Rate for Payer: Priority Health Medicare |
$25.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.09
|
| Rate for Payer: UHC Exchange |
$25.09
|
| Rate for Payer: UHC Medicare Advantage |
$25.09
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$768.68 |
| Rate for Payer: Aetna Commercial |
$27.03
|
| Rate for Payer: Aetna Medicare |
$20.98
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$20.17
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$20.17
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| Rate for Payer: Cofinity Commercial |
$27.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.17
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.18
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Nomi Health Commercial |
$24.20
|
| Rate for Payer: PACE SWMI |
$20.17
|
| Rate for Payer: PHP Medicare Advantage |
$20.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$35.82
|
| Rate for Payer: Priority Health Medicare |
$20.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.17
|
| Rate for Payer: UHC Exchange |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$20.17
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$1,073.51 |
| Rate for Payer: Aetna Commercial |
$31.50
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$33.85
|
| Rate for Payer: Cofinity Commercial |
$31.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Nomi Health Commercial |
$28.21
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$39.48
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.51
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$846.89 |
| Max. Negotiated Rate |
$3,703.38 |
| Rate for Payer: Aetna Commercial |
$1,698.02
|
| Rate for Payer: Aetna Medicare |
$1,317.87
|
| Rate for Payer: BCBS Complete |
$889.23
|
| Rate for Payer: BCBS MAPPO |
$1,267.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.38
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,267.18
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$1,824.74
|
| Rate for Payer: Cofinity Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,267.18
|
| Rate for Payer: Mclaren Medicaid |
$846.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.54
|
| Rate for Payer: Meridian Medicaid |
$889.23
|
| Rate for Payer: Nomi Health Commercial |
$1,520.62
|
| Rate for Payer: PACE SWMI |
$1,267.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,267.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,105.36
|
| Rate for Payer: Priority Health Medicare |
$1,279.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,105.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,267.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,267.18
|
| Rate for Payer: UHC Exchange |
$1,267.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,267.18
|
| Rate for Payer: UHCCP Medicaid |
$846.89
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,808.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$931.02 |
| Max. Negotiated Rate |
$5,250.25 |
| Rate for Payer: Aetna Commercial |
$1,866.69
|
| Rate for Payer: Aetna Medicare |
$1,448.77
|
| Rate for Payer: BCBS Complete |
$977.57
|
| Rate for Payer: BCBS MAPPO |
$1,393.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,250.25
|
| Rate for Payer: BCN Commercial |
$2,103.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,393.05
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cofinity Commercial |
$2,005.99
|
| Rate for Payer: Cofinity Commercial |
$1,866.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,393.05
|
| Rate for Payer: Mclaren Medicaid |
$931.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,462.70
|
| Rate for Payer: Meridian Medicaid |
$977.57
|
| Rate for Payer: Nomi Health Commercial |
$1,671.66
|
| Rate for Payer: PACE SWMI |
$1,393.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,393.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,825.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,315.22
|
| Rate for Payer: Priority Health Medicare |
$1,406.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,315.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,393.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,393.05
|
| Rate for Payer: UHC Exchange |
$1,393.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.05
|
| Rate for Payer: UHCCP Medicaid |
$931.02
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$676.28 |
| Max. Negotiated Rate |
$4,223.76 |
| Rate for Payer: Aetna Commercial |
$1,359.50
|
| Rate for Payer: Aetna Medicare |
$1,055.13
|
| Rate for Payer: BCBS Complete |
$710.09
|
| Rate for Payer: BCBS MAPPO |
$1,014.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,223.76
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.55
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$1,460.95
|
| Rate for Payer: Cofinity Commercial |
$1,359.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.55
|
| Rate for Payer: Mclaren Medicaid |
$676.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.28
|
| Rate for Payer: Meridian Medicaid |
$710.09
|
| Rate for Payer: Nomi Health Commercial |
$1,217.46
|
| Rate for Payer: PACE SWMI |
$1,014.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,672.90
|
| Rate for Payer: Priority Health Medicare |
$1,024.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,672.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.55
|
| Rate for Payer: UHC Exchange |
$1,014.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.55
|
| Rate for Payer: UHCCP Medicaid |
$676.28
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,384.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$814.51 |
| Max. Negotiated Rate |
$3,770.48 |
| Rate for Payer: Aetna Commercial |
$1,637.71
|
| Rate for Payer: Aetna Medicare |
$1,271.06
|
| Rate for Payer: BCBS Complete |
$855.24
|
| Rate for Payer: BCBS MAPPO |
$1,222.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,770.48
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.17
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cofinity Commercial |
$1,759.92
|
| Rate for Payer: Cofinity Commercial |
$1,637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.17
|
| Rate for Payer: Mclaren Medicaid |
$814.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.28
|
| Rate for Payer: Meridian Medicaid |
$855.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.60
|
| Rate for Payer: PACE SWMI |
$1,222.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$814.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,849.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,024.94
|
| Rate for Payer: Priority Health Medicare |
$1,234.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,024.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,222.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.17
|
| Rate for Payer: UHC Exchange |
$1,222.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.17
|
| Rate for Payer: UHCCP Medicaid |
$814.51
|
|
