|
PR PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 34713
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$1,464.98 |
| Rate for Payer: Aetna Commercial |
$158.62
|
| Rate for Payer: Aetna Medicare |
$123.10
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$118.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.98
|
| Rate for Payer: BCN Commercial |
$175.44
|
| Rate for Payer: BCN Medicare Advantage |
$118.37
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$170.45
|
| Rate for Payer: Cofinity Commercial |
$158.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.37
|
| Rate for Payer: Mclaren Medicaid |
$76.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.29
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Nomi Health Commercial |
$142.04
|
| Rate for Payer: PACE SWMI |
$118.37
|
| Rate for Payer: PHP Medicare Advantage |
$118.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: Priority Health HMO/PPO |
$190.92
|
| Rate for Payer: Priority Health Medicare |
$119.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.37
|
| Rate for Payer: UHC Exchange |
$118.37
|
| Rate for Payer: UHC Medicare Advantage |
$118.37
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL
|
Professional
|
Both
|
$1,615.00
|
|
|
Service Code
|
HCPCS 61645
|
| Min. Negotiated Rate |
$117.81 |
| Max. Negotiated Rate |
$1,431.46 |
| Rate for Payer: Aetna Commercial |
$1,108.97
|
| Rate for Payer: Aetna Medicare |
$860.69
|
| Rate for Payer: BCBS Complete |
$568.07
|
| Rate for Payer: BCBS MAPPO |
$827.59
|
| Rate for Payer: BCBS Trust/PPO |
$117.81
|
| Rate for Payer: BCN Commercial |
$1,222.18
|
| Rate for Payer: BCN Medicare Advantage |
$827.59
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.73
|
| Rate for Payer: Cofinity Commercial |
$1,108.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.59
|
| Rate for Payer: Mclaren Medicaid |
$541.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.97
|
| Rate for Payer: Meridian Medicaid |
$568.07
|
| Rate for Payer: Nomi Health Commercial |
$993.11
|
| Rate for Payer: PACE SWMI |
$827.59
|
| Rate for Payer: PHP Medicare Advantage |
$827.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,431.46
|
| Rate for Payer: Priority Health Medicare |
$835.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,431.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$827.59
|
| Rate for Payer: UHC Exchange |
$827.59
|
| Rate for Payer: UHC Medicare Advantage |
$827.59
|
| Rate for Payer: UHCCP Medicaid |
$541.02
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 61642
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$559.62 |
| Rate for Payer: Aetna Commercial |
$445.23
|
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: BCBS Complete |
$277.20
|
| Rate for Payer: BCBS Trust/PPO |
$109.36
|
| Rate for Payer: BCN Commercial |
$480.86
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO |
$559.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$559.62
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL SM VASC TER
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 61641
|
| Min. Negotiated Rate |
$105.66 |
| Max. Negotiated Rate |
$279.80 |
| Rate for Payer: Aetna Commercial |
$222.61
|
| Rate for Payer: Aetna Medicare |
$173.50
|
| Rate for Payer: BCBS Complete |
$138.80
|
| Rate for Payer: BCBS Trust/PPO |
$105.66
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.55
|
| Rate for Payer: Priority Health HMO/PPO |
$279.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.80
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 19285
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$106.30
|
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$79.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$79.33
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$114.24
|
| Rate for Payer: Cofinity Commercial |
$106.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.33
|
| Rate for Payer: Mclaren Medicaid |
$52.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.30
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: PACE SWMI |
$79.33
|
| Rate for Payer: PHP Medicare Advantage |
$79.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$111.52
|
| Rate for Payer: Priority Health Medicare |
$80.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.33
|
| Rate for Payer: UHC Exchange |
$79.33
|
| Rate for Payer: UHC Medicare Advantage |
$79.33
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 19286
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$53.14
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$450.56
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$57.11
|
| Rate for Payer: Cofinity Commercial |
$53.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.64
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Nomi Health Commercial |
$47.59
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
| Rate for Payer: Priority Health HMO/PPO |
$55.99
|
| Rate for Payer: Priority Health Medicare |
$40.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Exchange |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$39.66
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 33340
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$1,214.69 |
| Rate for Payer: Aetna Commercial |
$992.73
|
| Rate for Payer: Aetna Medicare |
$770.47
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$740.84
|
| Rate for Payer: BCBS Trust/PPO |
$775.02
|
| Rate for Payer: BCN Commercial |
$1,122.01
|
| Rate for Payer: BCN Medicare Advantage |
$740.84
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cofinity Commercial |
$992.73
|
| Rate for Payer: Cofinity Commercial |
$1,066.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.84
|
| Rate for Payer: Mclaren Medicaid |
$487.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.88
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Nomi Health Commercial |
$889.01
|
| Rate for Payer: PACE SWMI |
$740.84
|
| Rate for Payer: PHP Medicare Advantage |
$740.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,214.69
|
| Rate for Payer: Priority Health Medicare |
$748.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,214.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.84
|
| Rate for Payer: UHC Exchange |
$740.84
|
| Rate for Payer: UHC Medicare Advantage |
$740.84
|
| Rate for Payer: UHCCP Medicaid |
$487.13
|
|
|
PR PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 19281
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$354.78 |
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Medicare |
$96.36
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$92.65
|
| Rate for Payer: BCBS Trust/PPO |
$100.60
|
| Rate for Payer: BCN Commercial |
$354.78
|
| Rate for Payer: BCN Medicare Advantage |
$92.65
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$124.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.65
|
| Rate for Payer: Mclaren Medicaid |
$61.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.28
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Nomi Health Commercial |
$111.18
|
| Rate for Payer: PACE SWMI |
$92.65
|
| Rate for Payer: PHP Medicare Advantage |
$92.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.90
|
| Rate for Payer: Priority Health HMO/PPO |
$130.49
|
| Rate for Payer: Priority Health Medicare |
$93.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.65
|
| Rate for Payer: UHC Exchange |
$92.65
|
| Rate for Payer: UHC Medicare Advantage |
$92.65
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 19282
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$2,700.00 |
| Rate for Payer: Aetna Commercial |
$62.02
|
| Rate for Payer: Aetna Medicare |
$48.13
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$46.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,700.00
|
| Rate for Payer: BCN Commercial |
$252.16
|
| Rate for Payer: BCN Medicare Advantage |
$46.28
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Cofinity Commercial |
$62.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.28
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.59
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$55.54
|
| Rate for Payer: PACE SWMI |
$46.28
|
| Rate for Payer: PHP Medicare Advantage |
$46.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$65.47
|
| Rate for Payer: Priority Health Medicare |
$46.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.28
|
| Rate for Payer: UHC Exchange |
$46.28
|
| Rate for Payer: UHC Medicare Advantage |
$46.28
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 50436
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$1,729.65 |
| Rate for Payer: Aetna Commercial |
$191.31
|
| Rate for Payer: Aetna Medicare |
$148.48
|
| Rate for Payer: BCBS Complete |
$100.42
|
| Rate for Payer: BCBS MAPPO |
$142.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.65
|
| Rate for Payer: BCN Commercial |
$213.06
|
| Rate for Payer: BCN Medicare Advantage |
$142.77
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$191.31
|
| Rate for Payer: Cofinity Commercial |
$205.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.77
|
| Rate for Payer: Mclaren Medicaid |
$95.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.91
|
| Rate for Payer: Meridian Medicaid |
$100.42
|
| Rate for Payer: Nomi Health Commercial |
$171.32
|
| Rate for Payer: PACE SWMI |
$142.77
|
| Rate for Payer: PHP Medicare Advantage |
$142.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO |
$233.28
|
| Rate for Payer: Priority Health Medicare |
$144.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.77
|
| Rate for Payer: UHC Exchange |
$142.77
|
| Rate for Payer: UHC Medicare Advantage |
$142.77
|
| Rate for Payer: UHCCP Medicaid |
$95.64
|
|
|
PR PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 50437
|
| Min. Negotiated Rate |
$158.90 |
| Max. Negotiated Rate |
$553.15 |
| Rate for Payer: Aetna Commercial |
$319.19
|
| Rate for Payer: Aetna Medicare |
$247.73
|
| Rate for Payer: BCBS Complete |
$166.84
|
| Rate for Payer: BCBS MAPPO |
$238.20
|
| Rate for Payer: BCN Commercial |
$355.26
|
| Rate for Payer: BCN Medicare Advantage |
$238.20
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$319.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.20
|
| Rate for Payer: Mclaren Medicaid |
$158.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.11
|
| Rate for Payer: Meridian Medicaid |
$166.84
|
| Rate for Payer: Nomi Health Commercial |
$285.84
|
| Rate for Payer: PACE SWMI |
$238.20
|
| Rate for Payer: PHP Medicare Advantage |
$238.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health HMO/PPO |
$386.13
|
| Rate for Payer: Priority Health Medicare |
$240.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.20
|
| Rate for Payer: UHC Exchange |
$238.20
|
| Rate for Payer: UHC Medicare Advantage |
$238.20
|
| Rate for Payer: UHCCP Medicaid |
$158.90
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING
|
Professional
|
Both
|
$984.00
|
|
|
Service Code
|
HCPCS 32557
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$980.78 |
| Rate for Payer: Aetna Commercial |
$188.28
|
| Rate for Payer: Aetna Medicare |
$146.13
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$140.51
|
| Rate for Payer: BCBS Trust/PPO |
$656.15
|
| Rate for Payer: BCN Commercial |
$980.78
|
| Rate for Payer: BCN Medicare Advantage |
$140.51
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cofinity Commercial |
$202.33
|
| Rate for Payer: Cofinity Commercial |
$188.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.51
|
| Rate for Payer: Mclaren Medicaid |
$93.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.54
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Nomi Health Commercial |
$168.61
|
| Rate for Payer: PACE SWMI |
$140.51
|
| Rate for Payer: PHP Medicare Advantage |
$140.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.60
|
| Rate for Payer: Priority Health HMO/PPO |
$202.54
|
| Rate for Payer: Priority Health Medicare |
$141.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.51
|
| Rate for Payer: UHC Exchange |
$140.51
|
| Rate for Payer: UHC Medicare Advantage |
$140.51
|
| Rate for Payer: UHCCP Medicaid |
$93.29
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 32556
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$1,091.21 |
| Rate for Payer: Aetna Commercial |
$159.66
|
| Rate for Payer: Aetna Medicare |
$123.92
|
| Rate for Payer: BCBS Complete |
$82.53
|
| Rate for Payer: BCBS MAPPO |
$119.15
|
| Rate for Payer: BCBS Trust/PPO |
$507.70
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$119.15
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$171.58
|
| Rate for Payer: Cofinity Commercial |
$159.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.15
|
| Rate for Payer: Mclaren Medicaid |
$78.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$82.53
|
| Rate for Payer: Nomi Health Commercial |
$142.98
|
| Rate for Payer: PACE SWMI |
$119.15
|
| Rate for Payer: PHP Medicare Advantage |
$119.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO |
$169.63
|
| Rate for Payer: Priority Health Medicare |
$120.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.15
|
| Rate for Payer: UHC Exchange |
$119.15
|
| Rate for Payer: UHC Medicare Advantage |
$119.15
|
| Rate for Payer: UHCCP Medicaid |
$78.60
|
|
|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$716.11 |
| Max. Negotiated Rate |
$2,246.86 |
| Rate for Payer: Aetna Commercial |
$1,436.71
|
| Rate for Payer: Aetna Medicare |
$1,115.06
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,072.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.86
|
| Rate for Payer: BCN Commercial |
$1,618.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.17
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,543.92
|
| Rate for Payer: Cofinity Commercial |
$1,436.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.17
|
| Rate for Payer: Mclaren Medicaid |
$716.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.78
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Nomi Health Commercial |
$1,286.60
|
| Rate for Payer: PACE SWMI |
$1,072.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,781.01
|
| Rate for Payer: Priority Health Medicare |
$1,082.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,781.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,072.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.17
|
| Rate for Payer: UHC Exchange |
$1,072.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.17
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,107.28 |
| Rate for Payer: Aetna Commercial |
$891.48
|
| Rate for Payer: Aetna Medicare |
$691.89
|
| Rate for Payer: BCBS Complete |
$468.10
|
| Rate for Payer: BCBS MAPPO |
$665.28
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$1,004.24
|
| Rate for Payer: BCN Medicare Advantage |
$665.28
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$958.00
|
| Rate for Payer: Cofinity Commercial |
$891.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.28
|
| Rate for Payer: Mclaren Medicaid |
$445.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$698.54
|
| Rate for Payer: Meridian Medicaid |
$468.10
|
| Rate for Payer: Nomi Health Commercial |
$798.34
|
| Rate for Payer: PACE SWMI |
$665.28
|
| Rate for Payer: PHP Medicare Advantage |
$665.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,107.28
|
| Rate for Payer: Priority Health Medicare |
$671.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,107.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.28
|
| Rate for Payer: UHC Exchange |
$665.28
|
| Rate for Payer: UHC Medicare Advantage |
$665.28
|
| Rate for Payer: UHCCP Medicaid |
$445.81
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$750.19 |
| Rate for Payer: Aetna Commercial |
$315.69
|
| Rate for Payer: Aetna Medicare |
$245.01
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$235.59
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$235.59
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cofinity Commercial |
$339.25
|
| Rate for Payer: Cofinity Commercial |
$315.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.59
|
| Rate for Payer: Mclaren Medicaid |
$154.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.37
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Nomi Health Commercial |
$282.71
|
| Rate for Payer: PACE SWMI |
$235.59
|
| Rate for Payer: PHP Medicare Advantage |
$235.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.20
|
| Rate for Payer: Priority Health HMO/PPO |
$385.57
|
| Rate for Payer: Priority Health Medicare |
$237.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.59
|
| Rate for Payer: UHC Exchange |
$235.59
|
| Rate for Payer: UHC Medicare Advantage |
$235.59
|
| Rate for Payer: UHCCP Medicaid |
$154.43
|
|
|
PR PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 43762
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$334.75 |
| Rate for Payer: Aetna Commercial |
$48.82
|
| Rate for Payer: Aetna Medicare |
$37.89
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$36.43
|
| Rate for Payer: BCBS Trust/PPO |
$210.26
|
| Rate for Payer: BCN Commercial |
$334.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.43
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Cofinity Commercial |
$48.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.43
|
| Rate for Payer: Mclaren Medicaid |
$23.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.25
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Nomi Health Commercial |
$43.72
|
| Rate for Payer: PACE SWMI |
$36.43
|
| Rate for Payer: PHP Medicare Advantage |
$36.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO |
$66.22
|
| Rate for Payer: Priority Health Medicare |
$36.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.43
|
| Rate for Payer: UHC Exchange |
$36.43
|
| Rate for Payer: UHC Medicare Advantage |
$36.43
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 43763
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$750.19 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$87.29
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$83.93
|
| Rate for Payer: BCBS Trust/PPO |
$750.19
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$83.93
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$120.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.93
|
| Rate for Payer: Mclaren Medicaid |
$56.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.13
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Nomi Health Commercial |
$100.72
|
| Rate for Payer: PACE SWMI |
$83.93
|
| Rate for Payer: PHP Medicare Advantage |
$83.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health HMO/PPO |
$155.71
|
| Rate for Payer: Priority Health Medicare |
$84.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.93
|
| Rate for Payer: UHC Exchange |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$83.93
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
|
|
PR PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS
|
Professional
|
Both
|
$2,444.00
|
|
|
Service Code
|
HCPCS 0201T
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$6,118.53 |
| Rate for Payer: Aetna Commercial |
$2,396.07
|
| Rate for Payer: Aetna Medicare |
$1,222.00
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,600.00
|
| Rate for Payer: BCN Commercial |
$6,118.53
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Cash Price |
$1,955.20
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,588.60
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL
|
Professional
|
Both
|
$2,317.00
|
|
|
Service Code
|
HCPCS 0200T
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$6,118.53 |
| Rate for Payer: Aetna Commercial |
$2,325.11
|
| Rate for Payer: Aetna Medicare |
$1,158.50
|
| Rate for Payer: BCBS Complete |
$249.62
|
| Rate for Payer: BCBS Trust/PPO |
$64.33
|
| Rate for Payer: BCN Commercial |
$6,118.53
|
| Rate for Payer: Cash Price |
$1,853.60
|
| Rate for Payer: Cash Price |
$1,853.60
|
| Rate for Payer: Mclaren Medicaid |
$237.73
|
| Rate for Payer: Meridian Medicaid |
$249.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,506.05
|
| Rate for Payer: UHCCP Medicaid |
$237.73
|
|
|
PR PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS
|
Professional
|
Both
|
$3,172.00
|
|
|
Service Code
|
HCPCS 27216
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$2,061.80 |
| Rate for Payer: Aetna Commercial |
$1,191.27
|
| Rate for Payer: Aetna Medicare |
$1,586.00
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,616.07
|
| Rate for Payer: BCN Commercial |
$1,302.33
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,365.79
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 25651
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,380.45 |
| Rate for Payer: Aetna Commercial |
$636.66
|
| Rate for Payer: Aetna Medicare |
$494.12
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS MAPPO |
$475.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.45
|
| Rate for Payer: BCN Commercial |
$727.64
|
| Rate for Payer: BCN Medicare Advantage |
$475.12
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$636.66
|
| Rate for Payer: Cofinity Commercial |
$684.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.12
|
| Rate for Payer: Mclaren Medicaid |
$324.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.88
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Nomi Health Commercial |
$570.14
|
| Rate for Payer: PACE SWMI |
$475.12
|
| Rate for Payer: PHP Medicare Advantage |
$475.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$479.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$768.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.12
|
| Rate for Payer: UHC Exchange |
$475.12
|
| Rate for Payer: UHC Medicare Advantage |
$475.12
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
|
|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$354.01 |
| Max. Negotiated Rate |
$1,651.47 |
| Rate for Payer: Aetna Commercial |
$696.06
|
| Rate for Payer: Aetna Medicare |
$540.23
|
| Rate for Payer: BCBS Complete |
$371.71
|
| Rate for Payer: BCBS MAPPO |
$519.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.47
|
| Rate for Payer: BCN Commercial |
$788.24
|
| Rate for Payer: BCN Medicare Advantage |
$519.45
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cash Price |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$748.01
|
| Rate for Payer: Cofinity Commercial |
$696.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.45
|
| Rate for Payer: Mclaren Medicaid |
$354.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.42
|
| Rate for Payer: Meridian Medicaid |
$371.71
|
| Rate for Payer: Nomi Health Commercial |
$623.34
|
| Rate for Payer: PACE SWMI |
$519.45
|
| Rate for Payer: PHP Medicare Advantage |
$519.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.20
|
| Rate for Payer: Priority Health HMO/PPO |
$837.58
|
| Rate for Payer: Priority Health Medicare |
$524.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$837.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.45
|
| Rate for Payer: UHC Exchange |
$519.45
|
| Rate for Payer: UHC Medicare Advantage |
$519.45
|
| Rate for Payer: UHCCP Medicaid |
$354.01
|
|
|
PR PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP
|
Professional
|
Both
|
$1,944.00
|
|
|
Service Code
|
HCPCS 25606
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$1,263.60 |
| Rate for Payer: Aetna Commercial |
$867.77
|
| Rate for Payer: Aetna Medicare |
$673.49
|
| Rate for Payer: BCBS Complete |
$462.74
|
| Rate for Payer: BCBS MAPPO |
$647.59
|
| Rate for Payer: BCBS Trust/PPO |
$72.38
|
| Rate for Payer: BCN Commercial |
$988.59
|
| Rate for Payer: BCN Medicare Advantage |
$647.59
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,555.20
|
| Rate for Payer: Cofinity Commercial |
$932.53
|
| Rate for Payer: Cofinity Commercial |
$867.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.59
|
| Rate for Payer: Mclaren Medicaid |
$440.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.97
|
| Rate for Payer: Meridian Medicaid |
$462.74
|
| Rate for Payer: Nomi Health Commercial |
$777.11
|
| Rate for Payer: PACE SWMI |
$647.59
|
| Rate for Payer: PHP Medicare Advantage |
$647.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,263.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,042.15
|
| Rate for Payer: Priority Health Medicare |
$654.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.59
|
| Rate for Payer: UHC Exchange |
$647.59
|
| Rate for Payer: UHC Medicare Advantage |
$647.59
|
| Rate for Payer: UHCCP Medicaid |
$440.70
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 36906
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$7,992.80 |
| Rate for Payer: Aetna Commercial |
$645.97
|
| Rate for Payer: Aetna Medicare |
$501.35
|
| Rate for Payer: BCBS Complete |
$333.46
|
| Rate for Payer: BCBS MAPPO |
$482.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,420.60
|
| Rate for Payer: BCN Commercial |
$7,992.80
|
| Rate for Payer: BCN Medicare Advantage |
$482.07
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$694.18
|
| Rate for Payer: Cofinity Commercial |
$645.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.07
|
| Rate for Payer: Mclaren Medicaid |
$317.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.17
|
| Rate for Payer: Meridian Medicaid |
$333.46
|
| Rate for Payer: Nomi Health Commercial |
$578.48
|
| Rate for Payer: PACE SWMI |
$482.07
|
| Rate for Payer: PHP Medicare Advantage |
$482.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.30
|
| Rate for Payer: Priority Health HMO/PPO |
$790.29
|
| Rate for Payer: Priority Health Medicare |
$486.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.07
|
| Rate for Payer: UHC Exchange |
$482.07
|
| Rate for Payer: UHC Medicare Advantage |
$482.07
|
| Rate for Payer: UHCCP Medicaid |
$317.58
|
|
