|
PR PNCRTECT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$8,303.00
|
|
|
Service Code
|
HCPCS 48153
|
| Min. Negotiated Rate |
$747.02 |
| Max. Negotiated Rate |
$5,536.98 |
| Rate for Payer: Aetna Commercial |
$4,026.36
|
| Rate for Payer: Aetna Medicare |
$3,124.94
|
| Rate for Payer: BCBS Complete |
$2,080.40
|
| Rate for Payer: BCBS MAPPO |
$3,004.75
|
| Rate for Payer: BCBS Trust/PPO |
$747.02
|
| Rate for Payer: BCN Commercial |
$4,519.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,004.75
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cofinity Commercial |
$4,326.84
|
| Rate for Payer: Cofinity Commercial |
$4,026.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,004.75
|
| Rate for Payer: Mclaren Medicaid |
$1,981.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,154.99
|
| Rate for Payer: Meridian Medicaid |
$2,080.40
|
| Rate for Payer: Nomi Health Commercial |
$3,605.70
|
| Rate for Payer: PACE SWMI |
$3,004.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,004.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,981.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,396.95
|
| Rate for Payer: Priority Health HMO/PPO |
$5,536.98
|
| Rate for Payer: Priority Health Medicare |
$3,034.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,536.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,004.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,004.75
|
| Rate for Payer: UHC Exchange |
$3,004.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,004.75
|
| Rate for Payer: UHCCP Medicaid |
$1,981.33
|
|
|
PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 90669
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
|
|
PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 32940
|
| Min. Negotiated Rate |
$780.86 |
| Max. Negotiated Rate |
$1,774.88 |
| Rate for Payer: Aetna Commercial |
$1,589.19
|
| Rate for Payer: Aetna Medicare |
$1,233.40
|
| Rate for Payer: BCBS Complete |
$819.90
|
| Rate for Payer: BCBS MAPPO |
$1,185.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,185.96
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,707.78
|
| Rate for Payer: Cofinity Commercial |
$1,589.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,185.96
|
| Rate for Payer: Mclaren Medicaid |
$780.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,245.26
|
| Rate for Payer: Meridian Medicaid |
$819.90
|
| Rate for Payer: Nomi Health Commercial |
$1,423.15
|
| Rate for Payer: PACE SWMI |
$1,185.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,185.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,691.65
|
| Rate for Payer: Priority Health Medicare |
$1,197.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,691.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,185.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,185.96
|
| Rate for Payer: UHC Exchange |
$1,185.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,185.96
|
| Rate for Payer: UHCCP Medicaid |
$780.86
|
|
|
PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST
|
Professional
|
Both
|
$2,729.00
|
|
|
Service Code
|
HCPCS 32200
|
| Min. Negotiated Rate |
$725.48 |
| Max. Negotiated Rate |
$1,773.85 |
| Rate for Payer: Aetna Commercial |
$1,468.76
|
| Rate for Payer: Aetna Medicare |
$1,139.93
|
| Rate for Payer: BCBS Complete |
$761.75
|
| Rate for Payer: BCBS MAPPO |
$1,096.09
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.09
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,578.37
|
| Rate for Payer: Cofinity Commercial |
$1,468.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.09
|
| Rate for Payer: Mclaren Medicaid |
$725.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.89
|
| Rate for Payer: Meridian Medicaid |
$761.75
|
| Rate for Payer: Nomi Health Commercial |
$1,315.31
|
| Rate for Payer: PACE SWMI |
$1,096.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,570.68
|
| Rate for Payer: Priority Health Medicare |
$1,107.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,570.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.09
|
| Rate for Payer: UHC Exchange |
$1,096.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.09
|
| Rate for Payer: UHCCP Medicaid |
$725.48
|
|
|
PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 32960
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$1,588.07 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Medicare |
$89.36
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$85.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.07
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$85.92
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$123.72
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.92
|
| Rate for Payer: Mclaren Medicaid |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.22
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Nomi Health Commercial |
$103.10
|
| Rate for Payer: PACE SWMI |
$85.92
|
| Rate for Payer: PHP Medicare Advantage |
$85.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health HMO/PPO |
$123.75
|
| Rate for Payer: Priority Health Medicare |
$86.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.92
|
| Rate for Payer: UHC Exchange |
$85.92
|
| Rate for Payer: UHC Medicare Advantage |
$85.92
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
|
|
PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 55000
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$175.44
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Mclaren Medicaid |
$54.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO |
$134.75
|
| Rate for Payer: Priority Health Medicare |
$81.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.41
|
| Rate for Payer: UHC Exchange |
$80.41
|
| Rate for Payer: UHC Medicare Advantage |
$80.41
|
| Rate for Payer: UHCCP Medicaid |
$54.10
|
|
|
PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90713
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$43.27 |
| Rate for Payer: Aetna Commercial |
$43.27
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
|
|
PR POLLICIZATION DIGIT
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 26550
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$2,534.63 |
| Rate for Payer: Aetna Commercial |
$2,100.16
|
| Rate for Payer: Aetna Medicare |
$1,629.97
|
| Rate for Payer: BCBS Complete |
$1,113.78
|
| Rate for Payer: BCBS MAPPO |
$1,567.28
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$2,434.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.28
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$2,256.88
|
| Rate for Payer: Cofinity Commercial |
$2,100.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.28
|
| Rate for Payer: Mclaren Medicaid |
$1,060.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.64
|
| Rate for Payer: Meridian Medicaid |
$1,113.78
|
| Rate for Payer: Nomi Health Commercial |
$1,880.74
|
| Rate for Payer: PACE SWMI |
$1,567.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,060.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,534.63
|
| Rate for Payer: Priority Health Medicare |
$1,582.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,534.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,567.28
|
| Rate for Payer: UHC Exchange |
$1,567.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,567.28
|
| Rate for Payer: UHCCP Medicaid |
$1,060.74
|
|
|
PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$997.00
|
|
|
Service Code
|
HCPCS 95810
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$811.47 |
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Mclaren Medicaid |
$73.91
|
| Rate for Payer: Mclaren Medicaid |
$73.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO |
$156.96
|
| Rate for Payer: Priority Health HMO/PPO |
$156.96
|
| Rate for Payer: Priority Health Medicare |
$569.16
|
| Rate for Payer: Priority Health Medicare |
$569.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Exchange |
$563.52
|
| Rate for Payer: UHC Exchange |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
|
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 95782
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$1,387.84 |
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Mclaren Medicaid |
$76.89
|
| Rate for Payer: Mclaren Medicaid |
$76.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO |
$164.18
|
| Rate for Payer: Priority Health HMO/PPO |
$164.18
|
| Rate for Payer: Priority Health Medicare |
$878.12
|
| Rate for Payer: Priority Health Medicare |
$878.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Exchange |
$869.43
|
| Rate for Payer: UHC Exchange |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
|
|
PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 95811
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$1,013.28 |
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health HMO/PPO |
$163.29
|
| Rate for Payer: Priority Health HMO/PPO |
$163.29
|
| Rate for Payer: Priority Health Medicare |
$596.10
|
| Rate for Payer: Priority Health Medicare |
$596.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Exchange |
$590.20
|
| Rate for Payer: UHC Exchange |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95783
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$1,470.43 |
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Commercial |
$1,234.86
|
| Rate for Payer: Aetna Medicare |
$958.40
|
| Rate for Payer: Aetna Medicare |
$958.40
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCBS MAPPO |
$921.54
|
| Rate for Payer: BCBS Trust/PPO |
$686.79
|
| Rate for Payer: BCBS Trust/PPO |
$686.79
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: BCN Medicare Advantage |
$921.54
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Cofinity Commercial |
$1,234.86
|
| Rate for Payer: Cofinity Commercial |
$1,327.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.54
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.62
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$1,105.85
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PACE SWMI |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: PHP Medicare Advantage |
$921.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health HMO/PPO |
$179.12
|
| Rate for Payer: Priority Health HMO/PPO |
$179.12
|
| Rate for Payer: Priority Health Medicare |
$930.76
|
| Rate for Payer: Priority Health Medicare |
$930.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$921.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$921.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$921.54
|
| Rate for Payer: UHC Exchange |
$921.54
|
| Rate for Payer: UHC Exchange |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHC Medicare Advantage |
$921.54
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 95808
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$769.73 |
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Commercial |
$590.34
|
| Rate for Payer: Aetna Medicare |
$458.17
|
| Rate for Payer: Aetna Medicare |
$458.17
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCBS MAPPO |
$440.55
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCN Commercial |
$644.36
|
| Rate for Payer: BCN Commercial |
$644.36
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: BCN Medicare Advantage |
$440.55
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Cofinity Commercial |
$590.34
|
| Rate for Payer: Cofinity Commercial |
$634.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.55
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.58
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: Nomi Health Commercial |
$528.66
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PACE SWMI |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: PHP Medicare Advantage |
$440.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health HMO/PPO |
$110.36
|
| Rate for Payer: Priority Health HMO/PPO |
$110.36
|
| Rate for Payer: Priority Health Medicare |
$444.96
|
| Rate for Payer: Priority Health Medicare |
$444.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.55
|
| Rate for Payer: UHC Exchange |
$440.55
|
| Rate for Payer: UHC Exchange |
$440.55
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHC Medicare Advantage |
$440.55
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
|
|
PR PORTOENETEROSTOMY
|
Professional
|
Both
|
$4,815.00
|
|
|
Service Code
|
HCPCS 47701
|
| Min. Negotiated Rate |
$362.41 |
| Max. Negotiated Rate |
$3,129.75 |
| Rate for Payer: Aetna Commercial |
$2,255.96
|
| Rate for Payer: Aetna Medicare |
$1,750.89
|
| Rate for Payer: BCBS Complete |
$1,167.90
|
| Rate for Payer: BCBS MAPPO |
$1,683.55
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$2,534.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,683.55
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cofinity Commercial |
$2,424.31
|
| Rate for Payer: Cofinity Commercial |
$2,255.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,683.55
|
| Rate for Payer: Mclaren Medicaid |
$1,112.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,767.73
|
| Rate for Payer: Meridian Medicaid |
$1,167.90
|
| Rate for Payer: Nomi Health Commercial |
$2,020.26
|
| Rate for Payer: PACE SWMI |
$1,683.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,683.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,112.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,129.75
|
| Rate for Payer: Priority Health HMO/PPO |
$3,104.67
|
| Rate for Payer: Priority Health Medicare |
$1,700.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,104.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,683.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,683.55
|
| Rate for Payer: UHC Exchange |
$1,683.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,683.55
|
| Rate for Payer: UHCCP Medicaid |
$1,112.29
|
|
|
PR POSITIONAL NYSTAGMUS TEST
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 92542
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$1,840.07 |
| Rate for Payer: Aetna Commercial |
$36.03
|
| Rate for Payer: Aetna Medicare |
$27.97
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$26.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$26.89
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$38.72
|
| Rate for Payer: Cofinity Commercial |
$36.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.89
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.23
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Nomi Health Commercial |
$32.27
|
| Rate for Payer: PACE SWMI |
$26.89
|
| Rate for Payer: PHP Medicare Advantage |
$26.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO |
$33.02
|
| Rate for Payer: Priority Health Medicare |
$27.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.89
|
| Rate for Payer: UHC Exchange |
$26.89
|
| Rate for Payer: UHC Medicare Advantage |
$26.89
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
|
|
PR POST-CATARACT LASER SURGERY
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 66821
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$543.38 |
| Rate for Payer: Aetna Commercial |
$380.90
|
| Rate for Payer: Aetna Medicare |
$295.62
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$284.25
|
| Rate for Payer: BCBS Trust/PPO |
$417.89
|
| Rate for Payer: BCN Commercial |
$483.30
|
| Rate for Payer: BCN Medicare Advantage |
$284.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$409.32
|
| Rate for Payer: Cofinity Commercial |
$380.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.25
|
| Rate for Payer: Mclaren Medicaid |
$196.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.46
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Nomi Health Commercial |
$341.10
|
| Rate for Payer: PACE SWMI |
$284.25
|
| Rate for Payer: PHP Medicare Advantage |
$284.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO |
$543.38
|
| Rate for Payer: Priority Health Medicare |
$287.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.25
|
| Rate for Payer: UHC Exchange |
$284.25
|
| Rate for Payer: UHC Medicare Advantage |
$284.25
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 57250
|
| Min. Negotiated Rate |
$395.33 |
| Max. Negotiated Rate |
$1,809.43 |
| Rate for Payer: Aetna Commercial |
$790.04
|
| Rate for Payer: Aetna Medicare |
$613.16
|
| Rate for Payer: BCBS Complete |
$415.10
|
| Rate for Payer: BCBS MAPPO |
$589.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.43
|
| Rate for Payer: BCN Commercial |
$904.06
|
| Rate for Payer: BCN Medicare Advantage |
$589.58
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$849.00
|
| Rate for Payer: Cofinity Commercial |
$790.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.58
|
| Rate for Payer: Mclaren Medicaid |
$395.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.06
|
| Rate for Payer: Meridian Medicaid |
$415.10
|
| Rate for Payer: Nomi Health Commercial |
$707.50
|
| Rate for Payer: PACE SWMI |
$589.58
|
| Rate for Payer: PHP Medicare Advantage |
$589.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$914.55
|
| Rate for Payer: Priority Health HMO/PPO |
$922.14
|
| Rate for Payer: Priority Health Medicare |
$595.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$589.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.58
|
| Rate for Payer: UHC Exchange |
$589.58
|
| Rate for Payer: UHC Medicare Advantage |
$589.58
|
| Rate for Payer: UHCCP Medicaid |
$395.33
|
|
|
PR POSTERIOR NON-SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$3,333.00
|
|
|
Service Code
|
HCPCS 22840
|
| Min. Negotiated Rate |
$482.23 |
| Max. Negotiated Rate |
$21,897.63 |
| Rate for Payer: Aetna Commercial |
$984.98
|
| Rate for Payer: Aetna Medicare |
$764.46
|
| Rate for Payer: BCBS Complete |
$506.34
|
| Rate for Payer: BCBS MAPPO |
$735.06
|
| Rate for Payer: BCBS Trust/PPO |
$21,897.63
|
| Rate for Payer: BCN Commercial |
$1,213.35
|
| Rate for Payer: BCN Medicare Advantage |
$735.06
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cash Price |
$2,666.40
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Cofinity Commercial |
$1,058.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.06
|
| Rate for Payer: Mclaren Medicaid |
$482.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$771.81
|
| Rate for Payer: Meridian Medicaid |
$506.34
|
| Rate for Payer: Nomi Health Commercial |
$882.07
|
| Rate for Payer: PACE SWMI |
$735.06
|
| Rate for Payer: PHP Medicare Advantage |
$735.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,166.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,150.03
|
| Rate for Payer: Priority Health Medicare |
$742.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.06
|
| Rate for Payer: UHC Exchange |
$735.06
|
| Rate for Payer: UHC Medicare Advantage |
$735.06
|
| Rate for Payer: UHCCP Medicaid |
$482.23
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE
|
Professional
|
Both
|
$3,929.00
|
|
|
Service Code
|
HCPCS 22844
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$2,553.85 |
| Rate for Payer: Aetna Commercial |
$1,286.20
|
| Rate for Payer: Aetna Medicare |
$998.24
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: BCBS MAPPO |
$959.85
|
| Rate for Payer: BCBS Trust/PPO |
$53.49
|
| Rate for Payer: BCN Commercial |
$1,576.55
|
| Rate for Payer: BCN Medicare Advantage |
$959.85
|
| Rate for Payer: Cash Price |
$3,143.20
|
| Rate for Payer: Cash Price |
$3,143.20
|
| Rate for Payer: Cofinity Commercial |
$1,382.18
|
| Rate for Payer: Cofinity Commercial |
$1,286.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.85
|
| Rate for Payer: Mclaren Medicaid |
$630.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.84
|
| Rate for Payer: Meridian Medicaid |
$662.00
|
| Rate for Payer: Nomi Health Commercial |
$1,151.82
|
| Rate for Payer: PACE SWMI |
$959.85
|
| Rate for Payer: PHP Medicare Advantage |
$959.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,553.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.51
|
| Rate for Payer: Priority Health Medicare |
$969.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,493.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.85
|
| Rate for Payer: UHC Exchange |
$959.85
|
| Rate for Payer: UHC Medicare Advantage |
$959.85
|
| Rate for Payer: UHCCP Medicaid |
$630.48
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG
|
Professional
|
Both
|
$3,720.00
|
|
|
Service Code
|
HCPCS 22842
|
| Min. Negotiated Rate |
$483.43 |
| Max. Negotiated Rate |
$2,418.00 |
| Rate for Payer: Aetna Commercial |
$998.69
|
| Rate for Payer: Aetna Medicare |
$775.10
|
| Rate for Payer: BCBS Complete |
$512.61
|
| Rate for Payer: BCBS MAPPO |
$745.29
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: BCN Commercial |
$1,222.50
|
| Rate for Payer: BCN Medicare Advantage |
$745.29
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cash Price |
$2,976.00
|
| Rate for Payer: Cofinity Commercial |
$998.69
|
| Rate for Payer: Cofinity Commercial |
$1,073.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.29
|
| Rate for Payer: Mclaren Medicaid |
$488.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$782.55
|
| Rate for Payer: Meridian Medicaid |
$512.61
|
| Rate for Payer: Nomi Health Commercial |
$894.35
|
| Rate for Payer: PACE SWMI |
$745.29
|
| Rate for Payer: PHP Medicare Advantage |
$745.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,418.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,160.71
|
| Rate for Payer: Priority Health Medicare |
$752.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.29
|
| Rate for Payer: UHC Exchange |
$745.29
|
| Rate for Payer: UHC Medicare Advantage |
$745.29
|
| Rate for Payer: UHCCP Medicaid |
$488.20
|
|
|
PR POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG
|
Professional
|
Both
|
$4,091.00
|
|
|
Service Code
|
HCPCS 22843
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$2,659.15 |
| Rate for Payer: Aetna Commercial |
$1,070.35
|
| Rate for Payer: Aetna Medicare |
$830.72
|
| Rate for Payer: BCBS Complete |
$549.29
|
| Rate for Payer: BCBS MAPPO |
$798.77
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$1,308.59
|
| Rate for Payer: BCN Medicare Advantage |
$798.77
|
| Rate for Payer: Cash Price |
$3,272.80
|
| Rate for Payer: Cash Price |
$3,272.80
|
| Rate for Payer: Cofinity Commercial |
$1,150.23
|
| Rate for Payer: Cofinity Commercial |
$1,070.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.77
|
| Rate for Payer: Mclaren Medicaid |
$523.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$838.71
|
| Rate for Payer: Meridian Medicaid |
$549.29
|
| Rate for Payer: Nomi Health Commercial |
$958.52
|
| Rate for Payer: PACE SWMI |
$798.77
|
| Rate for Payer: PHP Medicare Advantage |
$798.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,659.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,243.14
|
| Rate for Payer: Priority Health Medicare |
$806.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,243.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.77
|
| Rate for Payer: UHC Exchange |
$798.77
|
| Rate for Payer: UHC Medicare Advantage |
$798.77
|
| Rate for Payer: UHCCP Medicaid |
$523.13
|
|
|
PR POSTPARTUM CARE ONLY SEPARATE PROCEDURE
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 59430
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$309.12 |
| Rate for Payer: Aetna Commercial |
$233.83
|
| Rate for Payer: Aetna Medicare |
$181.48
|
| Rate for Payer: BCBS Complete |
$174.07
|
| Rate for Payer: BCBS MAPPO |
$174.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$309.12
|
| Rate for Payer: BCN Medicare Advantage |
$174.50
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$251.28
|
| Rate for Payer: Cofinity Commercial |
$233.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.50
|
| Rate for Payer: Mclaren Medicaid |
$165.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.22
|
| Rate for Payer: Meridian Medicaid |
$174.07
|
| Rate for Payer: Nomi Health Commercial |
$209.40
|
| Rate for Payer: PACE SWMI |
$174.50
|
| Rate for Payer: PHP Medicare Advantage |
$174.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO |
$251.05
|
| Rate for Payer: Priority Health Medicare |
$176.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.50
|
| Rate for Payer: UHC Exchange |
$174.50
|
| Rate for Payer: UHC Medicare Advantage |
$174.50
|
| Rate for Payer: UHCCP Medicaid |
$165.78
|
|
|
PR POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 64566
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$861.13 |
| Rate for Payer: Aetna Commercial |
$38.26
|
| Rate for Payer: Aetna Medicare |
$29.69
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$28.55
|
| Rate for Payer: BCBS Trust/PPO |
$861.13
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$28.55
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$41.11
|
| Rate for Payer: Cofinity Commercial |
$38.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.55
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.98
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Nomi Health Commercial |
$34.26
|
| Rate for Payer: PACE SWMI |
$28.55
|
| Rate for Payer: PHP Medicare Advantage |
$28.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health HMO/PPO |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$28.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.55
|
| Rate for Payer: UHC Exchange |
$28.55
|
| Rate for Payer: UHC Medicare Advantage |
$28.55
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR POTASSIUM HYDROXIDE PREPS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS Q0112
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$334.41 |
| Rate for Payer: Aetna Commercial |
$7.81
|
| Rate for Payer: Aetna Medicare |
$6.06
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$5.83
|
| Rate for Payer: BCBS Trust/PPO |
$334.41
|
| Rate for Payer: BCN Commercial |
$4.37
|
| Rate for Payer: BCN Medicare Advantage |
$5.83
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Cofinity Commercial |
$7.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.12
|
| Rate for Payer: Nomi Health Commercial |
$7.00
|
| Rate for Payer: PACE SWMI |
$5.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Medicare |
$5.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.83
|
| Rate for Payer: UHC Exchange |
$5.83
|
| Rate for Payer: UHC Medicare Advantage |
$5.83
|
|
|
PR PPPS, INITIAL VISIT
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS G0438
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$387.24 |
| Rate for Payer: Aetna Commercial |
$207.70
|
| Rate for Payer: Aetna Medicare |
$161.20
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS MAPPO |
$155.00
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$239.95
|
| Rate for Payer: BCN Medicare Advantage |
$155.00
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$207.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.75
|
| Rate for Payer: Nomi Health Commercial |
$186.00
|
| Rate for Payer: PACE SWMI |
$155.00
|
| Rate for Payer: PHP Medicare Advantage |
$155.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO |
$217.97
|
| Rate for Payer: Priority Health Medicare |
$156.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.00
|
| Rate for Payer: UHC Exchange |
$155.00
|
| Rate for Payer: UHC Medicare Advantage |
$155.00
|
|
